All the single ladies

The "curse" of Dementia and/or Alzheimer's

Witnessing the gradual decline of a loved one is heart-breaking. Taking care of a person or persons suffering from either Dementia or Alzheimer's is a challenge. Three publications that touched my soul, two I would recommend for gaining better understandiong include:

Keeper: One House, Three Generations, and a Journey into Alzheimer's by Andrea Gillies

Still Alice by Lisa Genova

Dealing with dementia by Homa Khaleeli [Download Dealing with Dementia] in the Mail & Guardian 18 to 24 November 2011, Health insert.

 

Women enabling women

Women working together - the Women's Charter & how to work together

Social Development - rights, justice, legal help, social welfare, health, HIV-AIDS, marriage & divorce, violence & women, homosexuality, death & dying, children & youth, education & training

Economic development & job creation - consumer issues, work & women, making own money, agriculture

Physical infrastructure - land & housing, water & sanitation (toilets), electricity, road & transport, telephones

Who makes the rules? - the Constitution, the Commission on Gender Equality, different parts of the government

Development and how it happens - what development is, how development happens

All this and more forms part of a UKZN Centre for Adult Education & Midlands Women's Group publication, first published 1999 - 2nd edition 2004.

 

Sexuality even better later in life

Sex gets better while getting older, but requires some adjustments, such as substituting the penetration model, says sex therapist and author Dr Marlene Wasserman (aka 'Dr Eve'). There is a new emerging paradigm about the female sexual response cycle:

People live longer and are often active well into their eighties. Why not also enjoy the rich rewards of a healthy and fulfilling sex life? Download Enjoy (even) better sex Psychologies Aug-Sept2010 pp72-3

is aimed at the ageing reader wanting to continue enjoying sex.

What to do if death do us part

Losing a loved one can be devastating—this post is intended to give basic guidance about what to do if someone dies.

Different circumstances:

Nature and place of death:		Deceased's body	Post mortem	Death Notice1.
In hospital	Natural causes	To arrange with funeral director for collection	No need	The doctor issues
	Unnatural	Must be transferred to a state mortuary	Compulsory autopsy	State mortuary issues
At home (or at a Home for the Elderly or Nursing)	Natural causes	Contact the doctor first—if seen deceased within 24 hours/reasonable time and is assured of cause of death & if doctor is willing to issue?
		May arrange collection with funeral director	No need, but2.	The doctor issues
		If the doctor is unwilling to sign the death notice:
		Funeral service arrange private autopsy	Ascertain the cause of death	Pathologist issues
		2. If the body is to be cremated, a second doctor must examine to confirm that there is no reason why the body cannot be cremated.
	Unnatural	SA Police Services must informed:
		SAPS will move to state mortuary	Compulsory autopsy	State mortuary issues
In a vehicle accident or by suicide or murder	Unnatural death	SA Police Services take custody	Compulsory autopsy	State mortuary issues

1. The Death Notice referred to here is the 'Notification of Death' (cause of death) form, also known in South Africa as a BI-1663 Medical Certificate, which is needed to obtain a death certificate. The Births and Deaths Registration Act of 1992 requires every death must be reported to the Department of Home Affairs. The death certificate is vital in order to administer a deceased estate— every instruction given and transaction done on behalf of the deceased, e.g. closing accounts, etc, will need to be accompanied by a original or certified copy of the death certificate. Several originally printed copies of the death certificate can be obtained from Home Affairs at a fee each, or several photo copies can be made of the death certificate and certified as true copies at any SA Police Services station.

In all the cases listed above the body of the deceased must be identified by a relative or friend— anyone who knew the deceased—before the death notice can be issued. The identifier must take both own and the deceased's identity books (or passports) to the mortuary when identifying. The mortuary/body number needs to be obtained from the mortuary staff.

What if the deceased had been an organ donor?

It should not delay funeral plans, as organs need to be removed as soon as possible after brain death to ensure a successful transplantation. Support systems are maintained until organs have been removed. The Organ Donor Foundation must be contacted as soon as possible: Toll Free on 0800 22 66 11

Funeral arrangements:

A funeral is customary, but not an obligation. Sometimes a public memorial service is held in addition to a personal funeral or in the event of a cremation. A cremation service is often less expensive than burial, primarily due to the cost of the burial site

The first step in organising a funeral is to choose an undertaker/funeral home that you feel comfortable with, one who is reliable and gives you confidence in their ability that would guide you with regard to all of the important decisions.

Most funeral parlours require payment upfront. If the deceased had a funeral policy, the policy is to be handed over to the funeral director for verification. Payment of funeral expenses can be claimed from the estate of the deceased.

The immediate financial needs of the dependants:

Advise the person/s with signing powers of the deceased bank account/s to withdraw sufficient cash prior to announcing the deceased's death and closure of the account—this is especially important in the event of a joint account, the remaining partner must open her/his own account and transfer sufficient funds.

Initiate the application processes for all life policies payable to beneficiaries, especially if it is people that were dependant on the deceased, because such finances are required to tide the individual/s over until the estate is wrapped up.

Do keep in mind that spouses or life partners can claim UIF benefits when a worker dies. Dependants must claim within 6 months of the worker’s death. Dependent children can claim only if there is no spouse or life partner; or if the spouse or life partner does not claim within 6 months of the worker’s death. Download Form UI2.5 - Application for dependant2019s benefits by surviving spouse or life partner

Report the individual's death and initiate the administration of the estate:

In my experience, this is the hardest and most challenging aspect of another's death. Winding up an estate comprise four stages, namely:

Stage 1—Establish who, preparation of all the relevant documentation and appointment of the Executor

• Deceased's Death Certificate
• Identity Document of deceased
• Marriage Certificate (if applicable) / Divorce Order
• Surviving spouse's Identity Document & Antenuptial Contract (if applicable)
• Names of deceased's parents
• Names and addresses of beneficiaries
• Name of predeceased spouse or divorced spouse - date and place of death and Master's reference number

 Assets

• Deed of Transfer / Mortgage Bond
• Registration papers for motor vehicle/s
• Firearm Licences
• Share & Investment Certificates
• Bank account details and the name of the branch
• Name of Brokers / Insurance policy documents Short term insurance policy document
• Employer's name
• Pension/Provident Fund
• Particulars of Business interests
• Inter Vivos Trusts / Loan Account / Letters of Authority
• Details of foreign assets
• Usufructuary or fiduciary interests

Liabilities

• Bond Account details
• Hire purchase agreements
• Funeral Expenses / Funeral Cover
• List of outstanding Accounts

General

• Pension details
• Medical Aid details / address
• SARS Income Tax/Vat reference number
• Name of Accountants
• Deeds / Security Box held with Banking Institution

Stage 2—Collection of assets and payments of debts

Stage 3—Liquidation and distribution account

Stage 4—Final distribution and closure

Procedures and information relevant to other countries:

United Kingdom

Australia—a handy booklet by Kristine A Rodgers

United States of America

Northern Ireland

Revised 25 May 2010

Decision-making incapacity

How will you protect yourself from abuse, neglect and exploitation when you cannot make decisions for yourself because of diminished capacity as a result of mental illness, intellectual disability, physical disability or an incapacity related to ageing in general?

A power of attorney is a document that authorises an appointed party to act on another person's behalf in business and legal matters. The person authorised to act (on your behalf) is commonly known as the agent or simply the attorney, while the authorising party (you) is commonly known as the principal or donor. Often a close friend, partner or member of the family is appointed as agent.

There are three kinds of powers of attorney:

• General power of attorney—authorises the agent in general.
• Limited power of attorney—limits the authority of the agent to specified matters/issues/circumstances.
• Health care power of attorney—applies specifically to appoint someone to make health care decisions for you (but should not be confused with a living will) when you are unable to do so.

It is important to keep in mind that a power of attorney terminates on the incapacity of the person who granted the power (the principal or donor).

Consideration is being given to the introduction into South African law of an enduring power of attorney and a conditional power of attorney. The first (enduring power of attorney) endures the subsequent incapacity of the person who granted it, while the second (conditional power of attorney) will come into effect only on incapacity.

At present, the South African law deals with decision-making incapacity by way of curatorship—a difficult, cumbersome and costly process involving medical and legal expertise presented in the high court.

Residence for elderly

Recently I was faced with the reality of organising accommodation of an elderly parent who could no longer live on her own—a task more challenging than anticipated.

I found Senior Service to be very useful, user friendly and a free search facility of Retirement Villages, Old Age Homes, Frail Care centres, Nursing Homes, Step-down facilities—the number one website if you are looking for retirement accommodation for a parent or maybe yourself. Another is Retirement Places.

There are many factors to consider with regard to retirement accommodation, issues such as:

• The person's financial means:
  • Many retirement villages entail sectional title or share block ownership and monthly levies payable. Often such units are to let and there are many new developments.
  • Others entail Tenancy Right (alternatively called life rights / occupation right), which is an upfront cash payment for the right to occupy a unit, for example Flower Foundation retirement villages, plus monthly levies/rental.
  • Yet other are purely rental, with an initial application fee. Some of these are aimed at financially needy.
  • There are also many local government owned elderly accommodation, such as the City of Johannesburg's homes for senior citizens.

The condition of the person's health is an important consideration:

• If the elderly person is still totally independent and able to look after themselves a retirement village cottage or flat is an option. However, it is important to keep in mind that health often deteriorates with age.
• When daily nursing is not yet required semi-independent apartments or bed-sitters with access to resident nursing clinics is an option.
• When an elderly person can no longer cope with daily chores such as cooking, shopping, laundry and so forth, mid care should be considered. Residents usually require some assistance with daily living activities such as bathing, dressing and administration of medications.
• When dependant on daily nursing, frail care is the answer.
• Some retirement facilities offer the full range, which is ideal—as health deteriorates the care is increased. Most retirement homes require a medical doctor's report and want to conduct an interview with the applicant, in order to make an assessment of the individual's dependency and care required.

 

The individual's mobility:

• Closely associated to health is the individual's mobility. The less mobile, the more care is required.
• Mobility restrictions and/or aided walking also restrict a person's access with regard to stairs, etc.

 

Applying for retirement accommodation is often a rather involved process. Be prepared for:

• Comprehensive application form
• Declaration of financial situation
• Medical doctor's report and script for all medication taken daily
• Testimonial or character report
• Debit order form for monthly levies
• Deposit or application fee payable
• Personal interview by the social worker and/or nursing manager
• A waiting list

Once a loved one is in care, it is prudent to take note of the nature of care provided and to be watchful with regard to potential elderly abuse, which is be defined as any form of contact that harms an elderly person in any way, or neglect.

Supplemented 14 December 2010.

Organising care

Being sole provider and taking care of a sick child or parent can be challenging.

Medical aid coverage is generally limited and you require:

• A doctor's script with the ICD10 code
• The nursing or caregiver agency practice number
• Prior approval

A24-Group Medical Staffing is a possibility with a practice number through which to organise nursing, a caregiver or home care.

Nursing Services of South Africa provides nursing care to patients within their own homes.

Sister 4 U provides frail care, child care and home care in the Cape Town area.

It is prudent to make a note of home care services in your area for when you quickly need to arrange care. help @ hand is such a resource in the Tshwane area.