Happy Birthday to my Dad, Harry V. Cress.
Today he would have been 99. He was a father who had severe PTSD from being imprisoned in a WW2 prison camp in Germany. So, at times , he was a difficult Dad. He worked all his life as an advertising man. But, he suffered from all the PTSD symptoms from what he thought was the good war, so he never reached out for help. He moved in with me in 1989, after he lost his house on the New Jersey coast to ” The perfect storm”. But, once I got him into the VA in Menlo Park, California, he lived with me and my family for 20 years and was the perfect great grandfather, grandfather, and father.
However, as a cautionary tale, I was first surrounded by a very supportive loving family as a caregiver and second was a geriatric care manager. I also had the full help of the VA and all their incredible GRECC services that covered all the medical care, caregivers, geriatric social workers to support me as a caregiver, as my Dad, as a PTSD survivor was 100% disabled. He was a happy independent person for 14 years making our family a three-generation web of real happiness and constant family celebrations as a living ” whole” family. But as he gradually aged, developed vascular dementia then cancer, dying at our home in 20o8
So, moving a parent in your home is not for everyone
Moving an aging parent in your home encompasses not just the present but perhaps 20-30 years in the future. It means accepting the parent as they are in the moment, which may be ambulatory, cognitively intact and independent but seeing they will be gradually affected by the decrements of aging.
What challenges do you face?
Your parent may have perfect vision now and because of macular degeneration need a great deal of support in mobility, eating, and all the activities and daily living in the future. They may eventually be bedbound or is the later stages of dementia. The geriatric care manager needs to discuss the move in terms of what the future may bring for the adult child caregiver and discuss whether they feel they can accept this increasing level of care, if they could face caregiver burnout, if there are financial assets to hire caregivers to assist them or should there is a plan that may move the older person eventually to a higher level of care when care needs to increase.
What are the answers?
The GCM can do a GCM caregiver assessment if care needs to be rendered when the parent moves in. This will help the adult child see their strengths, skills, and abilities needed to provide care. This might include their own medical issues preventing caregiver tasks like lifting and tasks that they find and tasks they find repulsive, like changing adult diapers. This assessment can include a care plan that recommends family caregiver solutions, like aging technology, social supports, formal supports, respite, and training.
At my Dad’s funeral, my daughter said, ” we thought we were saving him but is so many ways he saved us. So Happy Birthday Dad you saved all the love for you I might have missed. Thanks for that grace.
Where Do You Do A Caregiver Assessment?
Caregiver assessment is best done in the care receiver’s home so you can actually observe the care. It is best completed out of earshot of the older person who is cared for so the caregiver can feel free to talk openly. As caregivers suffer high levels of stress, giving them a separate space to share their feelings is an important part of the caregiver assessment. However, the caregiver assessment should be done in a place that is convenient to the caregiver, which could be a donut shop, the home, or any comfortable venue. If to do the caregiver assessment the GCM must arrange respite, like bringing in another family member or paid caregiver, then that is another way to make this assessment go forward.
How Will A Genogram Help A Caregiver Assessment?
A genogram also helps the GCM assess whether any extended family and friends will make suitable and emotionally appropriate caregivers or not. For example, if a son has a historically strained relationship with his father, is he a good choice as a caregiver? The genogram helps to assess this old family tension and helps the GCM decide with the family as to who can really be good caregivers.
How Does a Psychosocial Assessment Bolster a Caregiver Assessment?
In addition, a psychosocial assessment, done at intake or updated as more care is needed, assesses key abilities and availability of the extended network of family caregivers. The psychosocial assessment illuminates the client’s financial status, including income, assets, benefits currently being received, health and long-term care insurance coverage, and eligibility or potential eligibility for entitlement programs. This information helps the GCM assess whether outside paid care providers can be afforded if needed to replace a family caregiver. The psychosocial assessment also tells about the family, formal and informal support networks, present and potential caregivers, and cultural variables.
Find out more in the YouTube from My Geriatric Care 1 Channel.
Why Do A Financial Projection To Start a GCM Business?
A financial projection may be mind-numbing to care managers who started this business with a great idea and a toolbox of care management skills. Beware– without tools to make money- your great idea of a private geriatric care management business may end up bankrupt.
Geriatric care managers need to understand revenue- how they make money to be financially to make a profit. Revenue does come from billing – but poor billing is very unprofitable billing. Money-losing billing is anything less than 85% of your client’s time. When you bill less than 85% you actually start losing money. Revenue is the high tide of money and is calculated by the number of client’s you serve, new client’s per month, number of clients canceling service. % of time billed (the goal is 85%) and what you charge for travel time.
You Need Financial Literacy to Start a GCM Business
Care managers can become more financially literate about making money by doing a financial projection over a three-year period. You can calculate the number of clients you need to make a profit when you will break even when you can hire new staff.
You can find out awesome facts before you open a care management business by doing this mind-numbing financial projection. Facts you can forecast are how much investment you will need for your business, what the cash flow consumed in the business will be, the number of client’s you need to make a profit and most of all when you will break even and rise above low tide– moving to the all-important high tide, through your excellent financial management and care management skills.
So use this financial decision tool of financial projection. Find it chapter 13 of the Handbook of Geriatric Care management 4th edition and watch youtube 5 Financial Projection below. Become a geriatric care manager with financial skills to make a Profit
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Find out more on my YouTube Channel My Geriatric Care 1 Channel.