nurse care manager Archives ⋆ Cathy Cress

Did John Mc Cain, Susan Collins and Rand Paul Stop Seniors From Being Kicked Out of Nursing Homes?

September 26, 2017

Seniors all over the US , many of whom were middle class, worked all their lives but have spent down their retirement, will lose their federal safety net in Medicaid if the ACA is defeated by the Republican Senate, October 1.

For the second time Senator John McCain a war hero and now brain cancer patient, who wants to the Senate to follow the rules of order, and Susan Collins a compassionate Republican ,along with Dr. Rand Paul ,a Republican who thinks the bill is not severe enough, may save seniors from losing nursing home coverage with Medicaid once again.

The New York Times reported in a June attempt to gut the ACA New York Times that this includes middle and upper-class seniors who have used all their savings because they have no choice but to remain in a nursing home. The June New York Times story covers Alice Jacobs, 90, who once owned a factory and horses. She has raised four children and buried two husbands.

But years in an assisted living center drained her savings, and now she relies on Medicaid to pay for her care at Dogwood Village, a nonprofit, county-owned nursing home here.

“You think you’ve got enough money to last all your life, and here I am,” Ms. Jacobs said.

Medicaid pays for most of the 1.4 million people in skilled nursing homes, like Ms. Jacobs. It covers 20 percent of all Americans and 40 percent of poor adults.

But little has been said about what would happen to older Americans in nursing homes if the cuts took effect.

I am on the board of the Health Projects Center in Santa Cruz County California who oversees the care of these Medicaid seniors.If the ACA became Trumpcare what would happen in all states is if the ACA is gutted on October 1. The program would be block granted .In California, very progressive state most likely seniors would still be protected in skilled nursing. But in red states block granting would mean millions of seniors and younger people would lose Medicaid coverage

We will have to wait until the final vote in 4 days but if you feel strongly that that senior being dumped from nursing homes is a social catastrophe, contact your senator or congressman

With Irma’s Carnage- Do You Need a Midlife Family Meeting to do an Aging Parent Disaster Plan ?

September 18, 2017

Warning- close your family floodgates as New Orleans closed theirs after Hurricane Issac and Katrina.

September’s catastrophic disaster with Hurricanes Irma and Harvey hitting near the anniversary of Hurricane Katrina should conjure up a midlife sibling nightmare. It brings back the now recurring goblins of Katrina -the most gruesome weather cataclysm where 39 elderly residents died, trapped or abandoned in retirement centers and 1400 elder overall died in Katrina’s watery wrath.We just plunged into the horror again with Irma where, so far 8 elderly have died, with criminal charges pending and new regulations by the governor, after he was accused of not responding to calls from the facility. On Irma’s heels with now have Maria and Jose, which should terrify adult children enough to take emergency action to protect their parents.

This recent confluence of hurricane deaths and hurricanes looming right now, should be a deafening shout to you and your midlife siblings that you need to convene a midlife sibling disaster plan family meeting to protect any aging family members-, no matter where your elderly parents live or what level of care. You need that disaster plan because older people are more likely to die in catastrophes than any other population. As I pointed out in my last blog, just because they are in a facility – they are not safe– in fact, Katrina and Irma tell us perhaps they are more in peril.

So before Maria or another hurricane, tornado, earthquake, flood, or any disaster hits, you need to have a midlife sibling family meeting to come up with a disaster plan for aging family members. I posted this a week ago but after Irma ‘s carnage, I have revised my list

What would be the agenda of that midlife sibling disaster family meeting?

If your loved ones are in a FACILITY- do not trust the facility to handle the situation. Look at what just happened in Irma.

1)Get a copy of the facilities disaster and evacuation plan.Compare it to state regulations. If it does not include calling the family before the disaster, consider moving your loved one or make sure that is changed.

2)Appoint a sibling to be in charge of reading the disaster evacuation plan and be the contact person.

3)Call your state facility licensing body and find out the state regulations to see if they match the facilities- CCRC, Assisted Living or Nursing Home

4) Have a telephonic family meeting before the disaster if possible

5) make sure the state requires backup generators for heat and air conditioning- a flaw in Florida’s regulations in Irma

If the loved one is LIVING AT HOME alone or with an adult child.

1) Create a disaster plan for the older person. This would map out what each sibling and family member needs to do

2) Create a disaster team. This would include every adult siblings all over the country, family nearby, caregivers and neighbors.

4) Include someone on the team who can carry heavy objects like wheelchairs.

5) Name a substitute caregiver if the regular one can’t get there.

6) Make an evacuation plan for your aging family member’s house. Where is the nearest Red Cross shelter

7) What disaster supplies do you do you have on hand? Get list from your local Red Cross

8)Find out how many people do you need to make the move to safety or a shelter?

9) Put all of the above in writing.

10) Share a copy your disaster plan with everyone. E-mail copies to everyone on the family disaster team including all adult siblings, neighbors and friends.

11) Get everyone’s agreement especially midlife siblings and the older person. Be a unified disaster team.

12 ) Call a geriatric care manager to manage the plan or help you create it with your elderly parents, if you live long distance. They can do the heavy lifting, can help moderate a family meeting- can research state laws, be there in a disaster immediately, create and implement a disaster plan for your parent, that you approve and can be part of.

Professionals check out the chapter “ Preparing for Emergencies” in my Handbook of Geriatric Care Management fourth edition,

Professionals Check out my book Care Managers Working With the Aging Family, Jones and Bartlett, with its chapter on Family Meetings and the Aging Family by Rita Ghatak, director of Stanford’s Aging Program.

Why Did Eight Elders Die in a Nursing Home in Florida & What is the Moral of the Horror Story?

September 14, 2017

Eight older people just died in a Florida Nursing Home after Hurricane Irma ravaged Florida. Their deaths appear to be from extreme heat when their backup generator failed air conditioners after 1/2 of Florida’s power has not been restored. It is at present a criminal investigation.Now all Florida nursing homes are being inspected

This points to two disaster preparedness steps I suggest —-first to families of elders and second for professionals.

Alert to families, even if your loved one is in s skilled nursing home or assisted living, don’t assume they are safe. Know when you place them (and update each year), the facility disaster’ and evacuation plan. Make sure before you choose a facility this complies with state codes.Call The state Ombudsman.

As Irma approached, I suggested to a friend here in California, that she find out her parents Florida Assisted Living facility, disaster, and evacuation plan. They lived in an independent apartment in a CCRC. The Dad is 98 and the Mom 96.

Mom is mid-state Alzheimer’s and Dad is mentally clear but frail. My friend had never thought about a disaster plan even with a looming hurricane that would envelop the entire state.

As the Monster cat 5 hurricane approached, she thought her parents in safe hands in a what she termed a ” great” facility. When she called, her contact at the facility was in Rhode Island, which I thought strange in a disaster like a hurricane. Since her parents lived in an independent apartment, the contact told her they had to make their own arrangements. There had been a meeting telling residents how to prepare but, she had no idea if the Dad had was at the meeting.

I was floored. The family knew nothing about this disaster preparedness meeting. The Dad was 98. What was the evacuation plan, did they have safety supplies – like flashlights days of food, water? My friend was in California.

Here is the moral to the story.

My advice to any family with a loved one in a facility of any kind, do not just assume your elders are safe. Get a copy the facility emergency plan, evacuation plan, know that they will contact you and if not why (in the case of my friend they said folks in independent living were in charge of their own emergency plans. )Make this a check off in shopping for a facility for loved ones. Global warming has brought an increase in these mega disasters and no matter where your parent resides they are vulnerable to earthquake, flood tornado, hurricane, polar vortex or fire – it is not if but a big when you need to do this.

For professionals –have this information on file about any facility a client is placed. Make sure they adhere to state laws, update it each year and if it does not make sense to you, do not use them.

For more information, the University of Florida, Home of Disaster filled hurricanes has a great set of directions.

Call a geriatric care manager to manage the plan if you live long distance and make sure the facility is inspected and safe in a disaster.

Professionals check out the Preparing for Emergencies-chapter in Handbook of Geriatric Care Management fourth edition, by Liz Barlowe on Disaster planning

What’s a Filial Crisis in the Nearly Normal Family?

September 7, 2017

In the nearly normal aging family when the parent figure in family ages and begins to suffer the losses of getting old. Then the filial crisis occurs. What’s that-? The midlife adult children need to learn to learn to balance love and duty to their aging parents with independence. These midlife children must create a two-way relationship instead of the parent sending, love, money and be nurturing only one way. This throws adult children in a nearly normal family into a tailspin. It has always been a one-way street – ending with them. Were they selfish – no? That’s what good parents do- nurture their children through all the stages of life. However, this new stage takes a two-way streetaby

Baby boomer children, are shocked and baffled when their now aging parents are no longer that John Wayne father figure who can root out every bad guy depending only on his gun and horse. When their Dad or Mom need to ask for support following to loss of health in old age, their adult children are thrown into crisis. This crisis has been labeled a filial crisis by pioneering social worker Margaret Blenkner. Blenkner, a breaker of new ground in the social sciences was the first director of the Benjamin Rose Institute in Cleveland and introduced the concept of the filial crisis. This crisis, she theorized, happened when the adult child realized that their parents were not invulnerable. Like the Twin towers crumbling after America ‘s 911, these adult children saw their impregnable parents start to disintegrate and with it the supportive bulwarks f After a life time of seeing their parents as the indomitable during their often indulged, financial, economic and emotional support, even in their children mid-life.

This filial crisis is, in essence, a new developmental phase in life, the loss of your parent’s independence and their dependence on you.

The healthy family is also thrown off balance by this shock to the system. The person who took the lead role on the family stage has not shown up or forgets their lines.At this giant pause in family play, the family system, even in the normal family must face the loss of control in the system because the parents or parent figures usually have that control. When they can no longer manage on their own, or function as the main gear or guide that moves the family system forward even the normal family is thrown off balance.

Professionals Check out my book Care Managers Working With the Aging Family , with its chapter Loss Dependence, “Filial Maturity and Homeostasis in the Aging Family“, Leonie Nowitz and Cathy Cress, Jones and Bartlett, to learn more about a Filial Crisis in the Nearly Normal Aging Family

How Can You Improve Your Midlife Sibling Relationship Post Labor Day

September 5, 2017

Did you spend Labor Day with midlife and care of your aging parents came up. Did you wake with a horrible hangover- either from too much booze or just amplified emotional tension that turns you inside out next morning.

Perhaps it involved arguments over aging parent care? If dealing with your siblings gives you a royal headache, the tension may have been made worse by the conflagration of alcohol and /or age old rifts between you and your siblings that started in childhood.

It may be time to look into the roots of your family script before your parents do need care or if they need care now.

Did your step, half or blood sibling do something long ago that’s still a weeping wound in your mind? Does it keep you apart or in each other’s faces – – especially awkward- during a holiday gathering when families were flocking together consuming mounds of barbecue & pot luck food and sharing old stories or recent family news

If the main villain in the family tragedy is a sibling or step sibling or half sibling – here’s a post-Labor Day quiz to see if you need help from someone like a geriatric care manager

Find out if have a sibling “ I Hate You Story”. Maybe you did not think you needed this test few weeks ago. Post Labor Day – if you know you need the test now- here it is.

Take the test below.

1. Have you told your sibling story more than once to the same person?

2. Do you play the sibling events more than two times in a day in your mind?

3. Do you find yourself speaking to the sibling who hurt you even when the person is not there?

4. Have you made a commitment to yourself to tell the sibling story without being upset then found yourself agitated anyway?

5. Is the sibling who hurt you a central character in your story?

6. When you tell your sibling story does it remind you of other painful things that happened to you?

7. Does the sibling story focus primarily on your pain and what you lost?

8. In your sibling story is there a villain?

9. Have you made a commitment not to tell the sibling story again and then broken your vow?

10. Do you look for other people with similar sibling problems to tell your story to?

11. Has your sibling story stayed the same over time?

12. Have you checked the details of your sibling story for accuracy?

If you answer yes to five or more the questions, there is a good chance you have a sibling I Hate You “ story. To end brother or sister blood step or half sibling blood feud and make peace makes forgiveness as a gift to you.

Try a change of season resolution and welcome autumn by taking the – a step towards sibling forgiveness and parent care with the help of a geriatric care manager to hopefully make the next holiday, sometimes the dreaded Thanksgiving with siblings will be spent hangover free with the parent care issue resolved

Professionals Check out my book Care Manager’s Working With the Aging Family , with it’s chapter Working With Adult Aging Siblings Jones and Bartlett, to learn more about working with feuding midlife siblings.

Why Did Eight Elders Die in a Nursing Home in Florida & What is the Moral of the Horror Story?

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