My Geriatric Care Management Operations Manual is available now on my web site Cathy cress.com. http://www.cathycress.com/ Find why you need it and what it can do for geriatric care managers, profit or non-profits senior agencies, home health agencies or private duty home health agencies that want to enhance their services and add a new profit center through the addition of geriatric care management.
Setting an agenda for the siblings family meeting about end of life is critical and should be done before the meeting. It is your GPS to success.
Here is a case example. I once did geriatric care management for an aging woman who was dying. Her first husband had died a few years before and had immediately married her old high school boyfriend, who had dumped her, 50 years before..
She now had terminal cancer, had a gastric tube and had lapsed into a coma. She had given her new husband power of attorney for health care. He wanted to take her off life support but did not want her to come home nor did he want take care of her himself, with the support of Hospice. The old boyfriend wanted to have her cared for in a skilled nursing facility. A sibling family meeting took place at the hospital with all the step siblings, the new husband and the hospice social worker as mediator. Her blood children wanted her to go home, the place where they grew up, with 24-hour care, Hospice and life support removed. The new husband’s children, her stepchildren agreed with their Dad decision to take her off life support and move her to a nursing home to die, without 24 hour care. The hospice social worker, skilled in mediation, met with everyone, including her elder law attorney, pre the meeting and used those individual meetings to create an agenda.
An agenda allows all parties know ahead of time what you plan to discuss and is a vital part of the process. Research on care management of elders and midlife siblings a shows that any family meeting is not up to scratch when siblings go into it with an agenda
The elder family member, if present, adult siblings and power of attorney for health care, need to be clear on the meeting’s purpose or agenda
The facilitator or mediator must meet with the older adult and midlife siblings and power of attorney beforehand and individually discuss their point of view about the main problems to be solved, set goals for the meeting and use all information to create the agenda. For example if the meeting is whether to return home to die or go to a facility, then that subject should be discussed in each individual meeting and on the agenda.
The mediator or facilitator should also consul other professionals like physicians and hospice case managers or nurses, and elder law attorney’s, if involved, with a release of information, for results from medical tests, legal documents, or other the types of information that may be needed in the sibling family meeting to make decisions and discuss end of life. Any of this information that is pertinent to the goal of the meeting should be on the agenda. When the meeting begins, it is good for the mediator or facilitator to review the meeting goals and to clarify if specific decisions need to be made.
The end of the story is the dying elderly woman was moved to an excellent skilled nursing facility with 24-hour home care and Hospice. Life support was removed and she died three weeks later, her blood children at her side. The moral of the story is – do not marry that high school boyfriend who dumped you- and – use and agenda for a sibling family meeting about end of life. .
What is a geriatric care manager,what do they do for the aging family and midlife siblings- and exactly how do they do it?
I am beginning a new series of blogs on geriatric care management today. We will start with exactly what is a geriatric care manager.
What is geriatric care management? It is a series of steps taken by a professional geriatric care manager (GCM) to help solve older people’s problems. A GCM, who may be a social worker, a nurse, a gerontologist, or another human service professional, serves older people and their families. The GCM usually steps in when the older person or family is in crisis. Geriatric care management is also a preventative service rendered on demand, increasing the quality of an older person’s life, managing all the players rendering services to the older person, and offering assurance and peace of mind to the adult children of the older individual. How does the GCM solve these problems and render these services? The GCM uses classic social work and nursing tools, including client assessment, care planning, service coordination, and referral and monitoring.
What is the job of a professional GCM? Geriatric care manager’s jobs are similar to the role of all case managers, (neonatal, medical, adolescent) GCMs use all the classic tools of all case managers.
But unlike other case managers, GCMs specialize in serving adults aged 65 and older and offer very personalized services. GCMs historically have had much smaller caseloads than case managers have (especially those in public case management settings), giving GCMs great flexibility in delivering highly individualized services to their older clients. Unlike many case managers in public case management settings, GCMs are generally available 24 hours a day, 7 days a week, 365 days a year. They respond to client needs at the convenience of the client, which enables the GCM to cross the line from public sector human services into the for-profit service business. The GCM’s product is service, and that product must be available at all times to be useful to older people, their families, and third parties such as trust departments and conservators, who are willing to buy the product if it is offered in this manner.