What should be in your caregiver assessment toolbox?
A tool that you can tools use to solve the caregiver and care receiver’s problems you found in your care plan is a genogram.
A geriatric care managers assessment of the family caregiver is critical. Caregivers can and do fall apart. If you already did your caregiver assessment- great. But the extended family of the care receiver (client) should be assessed to find their strengths, weaknesses, dangers and real ability to help render caregiving services. This is where a genogram comes in.
A genogram allow you to see family patterns on a single page
Using a tool called a genogram can really show you the view of a family on a chart.Patterns in a family, especially the aging family that geriatric care managers and ALCA members serve, can be seen in a genogram showing you, for example, the generational cut off that happens over and over or alcoholism, or spousal abuse. You can see the weakness of family ties and where the care managers needed to focus to help the family get care for an older person.
A genogram allow you to see family support
A good genogram can be helpful in assessing the care receiver’s family support network and each relative’s relationship to the older client. Your genogram when paired with a psychosocial assessment, can help you assess whether the older client is living with a helpful spouse or partner, living with a difficult spouse, has relationship with an ex spouse, has cooperative and supportive children or grandchildren, has fighting or alienated children or grandchildren, has warring or alienated stepchildren or adoptive, has several children but only one child who “does it all,”.
In other words you pull up a traffic light, it is green, yellow or dangerous red. The genogram also can help tell the GCM whether you have ex spouses or partners who want to participate as caregivers and what their emotional relationship is the care receiver. In other words is there green-lighted support or red saying stop here-when the family caregiver desperately needs your GPS to find that that new road.
On Valentine’s Day it is not only grandchildren who should send valentines to Grandma but working mothers who should send heartfelt greetings to greeting. A recent study showed the majority of American households spend more than 10% of their household income on childcare — and a fifth of households more than a quarter of their income So if grandmothers offer free childcare, they are the financial safety net for young grandchildren.
They are often free caregivers for aging spouses, relieving the midlife daughters of that burden but inflicting mental and physical stress on themselves.
In fact AARP shows that approximately 43.5 million caregivers have provided unpaid care to an adult or child in 2013.In the same study, projected at $470 billion in 2013, the value of unpaid caregiving exceeded the value of paid home care and total Medicaid spending in the same year and nearly matched the value of the sales of the world’s largest company, Wal-Mart ($477 billion). [AARP Public Policy Institute. (2015). Valuing the Invaluable: 2015 Update.] Think of what is must be in 2019.
Grandmothers are not only that financial safety net but also an emotional safety net for spouses grandchildren. Younger siblings are happier and healthier when grandmother’s pitch in. Not only sibling get that boost from Grandma being there but Mom’s and Dads are less psychologically stressed if grandmother’s support their family taking over some of the multiple parental chores to raise young siblings.
And as Grandmother’s, AARP tells us what we know- it is sometimes the greatest joy of our lives and increases the quality of life of older people like nothing else can do
Even picking up after school, babysitting or helping in a garage sale make grandmothers a blessing. Making a missing baby book for the second third and fourth kid did who not get one, as parents were overwhelmed, is a huge support for parents and kids.
Grandmother’s help can be a key to making kids president. Both President Obama and President Clinton were raised in part by their grandmothers. Or take former Grandma in Chief, Michele Obama’s Mom, who watched over the Obama daughters as their parents raised healthy siblings while Mom and Dad and traveled the world.
So, working women with grandparent help send your Mom or Dad a card on Valentine’s Day and know we grandparents just adore those cards, handmade if possible, from those special Valentines who have our hearts- our grandchildren.
When they need your help as they age- remember what grandmother’s do for us. For now, send a valentine. Perhaps later look for a great aging life or geriatric care manager
Four types of aging families, who can afford geriatric care management and home care long as they have the financial resources, will call you over the holidays. Mom is unable to pull off the ritual of either Thanksgiving, Hannukah, Christmas or New Years or usually all four.You need to have excellent clinical skills to manage these families- get them through the holiday season and stabilized as the ongoing client after the first of the year.
The first two are dysfunctional aging families and take extensive psychodynamic skills. The last two are nearly normal aging families must have the crisis solved and shown tools and resources to arrange care in the future. Many times they can handle themselves after you have established care and a GPS to access the future care they need. But they may also want to remain as your clients for you to manage their care.
Part of this is drawn from Claudia Fine and Nick Newcombe excellent chapter ” Entitlement in the Aging Family”, Care Managers Working With the Aging Family, Jones and Bartlett)
Entitlement in these families usually develop from a specific kind of “not good enough parenting” in which the parents themselves have struggled with personality disorders, most typically, in this type of family, narcissistic borderline personality .( example President Trump)They struggled with borderline personality that went undiagnosed or was formally diagnosed and untreated. The narcissistic or borderline parent essentially does not experience the child/children as separate and discreet from themselves and, moreover, uses the child/children to serve parental needs. This parent-child relationship is characterized by severe boundary issues in which seduction and abandonment are ever-present dynamics and where emotional unpredictability and instability are constant. ( Fine and Newcombe- Entitlement in the Aging Family, Care Managers Working with the Aging Family)
Rich and Famous-Entitled Families:
These families are identified by the parents’ socioeconomic, financial and political prominence. ( example President Reagan)They are families in which all basic needs, services, resources and creature comforts are obtained via income, assets, abundant discretionary cash flow and/or come from the political position, station or power. Once again, the entitlement of the family is passed from the parent to the child who in turn brings these behaviors and actions to the caregiving milieu and care management relationship. In this category, the entitlement arises out of a family that is accustomed to purchasing everything. They look to paid others to meet their needs (as opposed to families who must themselves find and orchestrate ways to meet basic and complex needs themselves or with the help of the extra-familial system). Often these families have household staffs, i.e., nannies, butlers, drivers, private pilots, cooks, and maids. They may have available to the business and family lawyers and accountants, as well as, teams of medical professionals and concierge physicians. Consequently, in almost all situations they are uninvolved in processes, especially those that are difficult, stressful and time-consuming. ( Fine and Newcombe- Entitlement in the Aging Family, Care Managers Working with the Aging Family)
According to the New York Times, may be middle-class retirees who buy shoes from Payless but have a defined pension can afford care at home when they need it and private care management. They rode the post-war economy, held jobs long term and through that defined pension (no 401K) face a very healthy financial picture in aging. They worked for city, county, state government are teachers, truck drivers, social workers or were union members in all trades. They had a career at Xerox, IBM, Campbell Soup and big Fortune 500 companies.
Professionals- Physician, Attorneys, CPAs
This group made a very healthy living during the late 20th Century, probably had a defined pension and have very lucrative investments that allow them to afford home care and care management. They usually come from nearly normal families and have been well parented although you will find a mixture of dysfunctional aging families. Their adult children tend to be supportive of their parents, although again you will find a mixture of dysfunctional families in this category.
You need clinical skills to start and run an aging life or geriatric care management agency but you must have business skills as well.
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 to know how to do a competition survey to measure whether you have too much competition and what your competitors off so you can offer more and be chosen. You should also identify and survey other direct GCM competitors like the non-profit area agency on aging which may have a GCM arm or for-profit like accountants or elderlaw attorneys who include geriatric care management in their service mix .
You need to know branding. Aging life or geriatric care manager must use different branding and a marketing approach that messages hyper-attention to seamless care to attract these top 10% concierge clients who can afford your services long term.
Marketing your existing or new Aging Life or GCM business is vital to growth, but where you spend your marketing dollars? What marketing tactics make the most sense for you? Where will you reach your concierge client base best?
This is where your marketing strategy comes into play. Before the business can start generating large revenue, a concierge marketing strategy and sales techniques must be in place.
Your marketing message must be communicated to the concierge customer. You need to how to write a business plan, use social media to attract customers, how to do 1-1 marketing to third parties-
Find out more
- How do you attract Concierge upper 10 % of clients you need to keep your business afloat and really profitable?
- Want to know more about what you need to start or restart a Care Management Agency?
Join me Wednesday, October 17 Pacific Time for my latest webinar Pacific Time 2:00 PM
- Reach our target concierge audience
- Design products that exactly meet their needs
- Obtain adult children’s buy-in
- Use marketing that will make them choose you
- Get the contract signed with ease
- Create a brand that tells concierge clients they will get Four Seasons Service
- If you really want to run a GCM business that makes money by targeting concierge clients then you don’t want to miss this free training.
- In this FREE 1-hour webinar, you will learn how to:
- 5 Steps to Sign Up the Profitable GCM Concierge Client
- Want to know more about what you need to start or restart a Care Management Agency?