The Stories of Dementia in the District

These are stories of clients receiving support through Iona’s Dementia Navigator program. You can view the Dementia Navigator Program Demographics Sheet to learn more about the clients served since the program launched in November 2017.

Dan’s Story

In late 2019, Dan, an 80-year-old Caucasian male and retired house cleaner residing in Ward 1, confided in a social worker at his local senior center about his inability to cover his gas bill. The social worker connected Dan with an Iona social worker to aid in restoring his financial stability. As the pandemic unfolded, Dan and his Iona social worker proactively sought assistance, applying for energy and rental aid, discounted phone service, and renter’s property tax credits. Enrolling Dan in these programs reduced his monthly expenses, freeing up resources to cover essential needs such as food, medication copays, and rent. 

As the partnership between Dan and his Iona social worker deepened, it became evident that additional needs required attention. Dan’s mobility issues and sporadic cognitive challenges emerged as areas of concern. In response, the Iona social worker helped Dan navigate the intricacies of the EPD Waiver (Medicaid) application process to qualify for an in-home aide to assist with shopping, transportation, and household tasks. Iona’s social worker also scheduled appointments with Dan’s physicians and utilized a phone-based translation service to ensure Dan understood correspondence and benefits-related applications in his first language. 

Addressing safety concerns within Dan’s living environment became another priority for the Iona social worker. Reports of pest infestations were promptly relayed to Dan’s property manager, with follow-up measures implemented to ensure a pest-free living space. When mold stains were discovered on apartment walls, the social worker orchestrated meetings with the property manager and coordinated the secure packing of Dan’s belongings, enabling timely mold remediation work to commence. 

When Dan refused in-home help and his self-neglect increased, Iona’s social worker continued to visit Dan weekly, ensuring he had food, help with mail-review and assistance calling family members. Dan’s case was closed when a guardian was appointed to oversee his care and affairs. 

Over four years, Iona social workers provided 522.5 hours of service to Dan. 

Brenda’s Story

Brenda, a 70-year-old African American woman residing in Ward 5, has been under the care of a Dementia Navigator since September 2022. Initially grappling with the news of her Alzheimer’s diagnosis, she faced uncertainties regarding her future. Her vision of continuing to work into her senior years, taking on consulting roles, was abruptly shattered by the onset of early dementia symptoms. This left her grappling with financial instability due to a lack of income and health insurance, alongside high out-of-pocket healthcare costs stemming from her lapsed insurance and her attempts to find out what was making her “feel crazy.” 

Throughout 2023, the Dementia Navigator worked tirelessly to assist Brenda in enrolling in Medicare and claiming her Social Security benefits, thereby establishing a stable income and assembling a solid healthcare team. Working together with her daughter, Brenda and the Dementia Navigator began to face the scary realities of a future with Alzheimer’s and develop a long-term care plan. The Dementia Navigator also addressed Brenda’s immediate needs by arranging home-delivered meals, connecting her to bill-paying support, locating a therapist, and enrolling her daughter in the DC Caregivers Institute. Additionally, the Dementia Navigator connected the family with Legal Counsel for the Elderly, resulting in the creation of power of attorney documents and a will aligned with Brenda’s wishes. 

Expressing a strong desire to remain in her childhood home for as long as possible, Brenda faced the challenge of its deteriorating condition, exacerbated by negligent renters and the progression of her illness. The home had a leaky roof, crumbling walls, broken exterior doors, a hole in the bathroom floor, and inadequate insulation, significantly driving up Brenda’s heating bill. 

Brenda’s limited income and savings made it impossible to afford necessary repairs. So, the Dementia Navigator assisted her in applying to Rebuilding Together, a program which promised the potential to complete such renovations— if Brenda ever made it to the top of their extensive waitlist. Together, Brenda and the Dementia Navigator crafted a letter explaining how meaningful the repairs would be for her and meticulously gathered the extensive documentation needed to be considered for acceptance. After enduring months of anxious waiting, with Brenda sometimes losing hope and the Dementia Navigator regularly calling to check on the status of the waitlist, Brenda received confirmation in September 2023 that her application had been accepted, with a program coordinator scheduled to assess the required repairs. 

By year’s end, she had been approved to have her entire list of repairs addressed, with work commencing in January. Overjoyed by the news, Brenda expressed a sense of regained control amid the challenges imposed by Alzheimer’s. 

Over two and a half years, Iona social workers provided 447 hours of service to Brenda. 

Theresa’s Story

Theresa, an 83-year-old Caucasian woman residing in Ward 2, was connected with a Dementia Navigator through Legal Counsel for the Elderly (LCE) to safeguard her against potential exploitation by her landlord due to her severe memory impairment. Suffering from significant short-term memory loss and other difficulties stemming from dementia, Theresa has a hard time retaining information, leaving her vulnerable to the deceptive practices of her landlord, who seeks to illegally evict her. With the collaborative efforts of LCE and the Dementia Navigator, Theresa has been provided with protection, enabling her to focus on securing alternative housing options that cater to her needs for affordability, accessibility, and safety, free from harassment. 

Unfortunately, suitable housing meeting Theresa’s requirements is hard to find in the District. Ideally, she would benefit from residing in an assisted living facility equipped to address the memory and cognitive impairments associated with dementia. However, her income falls short of covering the costs of such housing, and her financial status exceeds the threshold for qualifying for the limited number of Medicaid-subsidized options available. Even affordable independent senior housing options with none of the support built in that Theresa needs, have waiting lists of at least six months. 

In less than 1 year, Iona social workers provided 113 hours of service to Theresa. 

Sharon’s Story

Sharon, a 73-year-old African American woman residing in Ward 8, is a retired Airline employee who takes pride in never being married and being very independent. In June of 2022, she was referred to Iona’s Money Management Program (MMP) following severe financial exploitation, during which over $75,000 was stolen from her. Struggling to manage her bills independently, Sharon began working with a social worker who helped set up autopay for some bills, scheduled biweekly home visits to handle other bills over the phone or by check, and monitored her income by reviewing her bank statements monthly to ensure she was spending within her limits and not seeing any unfamiliar charges or withdrawals. Through the MMP social worker, Sharon successfully filed a financial fraud claim and recovered her stolen funds. 

In December 2022, due to her declining memory and increasing difficulty managing daily tasks and appointments, Sharon was referred to the Dementia Navigator Program. Having neglected medical care for over two years and experiencing confusion over insurance coverage changes, she required comprehensive assistance. With the Dementia Navigator’s support, Sharon was enrolled in appropriate healthcare coverage and accompanied to medical appointments to address both physical and cognitive health concerns. The Dementia Navigator team facilitated a memory evaluation, resulting in a formal diagnosis of dementia, and assisted Sharon in applying for benefits such as utility discounts, home-delivered meals, and Metro Access transportation services. Sharon’s situation was carefully monitored over the next year by phone calls and home visits to see Sharon. 

As Sharon’s condition deteriorated over the past four months, it became evident that she was having greater difficulty taking care of herself and navigating situations on her own. There were a couple instances where the Dementia Navigator had to call 911 for Sharon to help through an emergency. 

Sharon resisted in-home assistance and attendance at an Adult Day Center due to a lack of insight into her memory and care needs. Concerned for her safety, the Dementia Navigator engaged Sharon’s family and Adult Protective Services (APS). Collaborating with family members, including her nephew and cousin, the Dementia Navigator provided education on dementia care, highlighted the severity of the situation, and facilitated discussions to develop a care plan for Sharon. 

Currently, the Dementia Navigator makes weekly visits to see Sharon and continues to provide care coordination in conjunction with the APS social worker and Sharon’s family. The Dementia Navigator also provides check-ins, resources, and support to keep Sharon safe in her home, while also reducing her risk and enhancing her capacity to manage independently. 

In less than two years, Iona social workers provided 502 hours of service to Sharon.