Cathy Cress

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Push for Elder to Move

November 15, 2014

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There is a “push-pull” effect in play when older people and their families are considering the possibility of a move . The “push” is usually a crisis or triggering moving, forcing the elder or the family to consider relocating the elder to a more supportive living environment. Examples of push effects are loss of social support, declining health, deferred home maintenance, decreasing finances, and dangerous home safety. All of these factors contribute to a lessening ability to maintain an elder’s existing level of function or independence in the current environment. .

 It’s important to note that by 2040, 21.4% of the US population 65 years of age and older is projected to have limitations in their activities of daily living (ADLs)

 

 

Filed Under: Aging Tagged With: decision to move, elders and fall risks, geriatric care manager, senior mover, widower

What Is the Next Step in Creating a Care Plan?

March 5, 2013

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How do you find the remaining problems in the care plan? After addressing the first problem, the problem reason the referral source hired you in the first place, (say father has Parkinson’s and is falling and son would like a geriatric assessment)

The next step would be by listing the client’s functional problems. What are the deficits you discovered in your functional assessment? A few examples might be the following: unable to prepare meals, unable to walk without a cane, unable to bathe, in pain, poor diet, difficulty swallowing. Start with the most serious functional problem. Perhaps even though your client has Parkinson’s, he or she refuses to wear a helmet, and has had falls. Begin there.

Next of course a care plan is a prescription to a problem so you offer a solution on the interventions side of your care plan. So if your client has a care provider the intervention for falls would be adult child to purchase helmet. Then care provider to remind client to wear helmet when he or she gets up to walk. If the client is not steady on her or his feet you might add do standby assistance each time the clients gets up to walk. You have only used one assessment tool next we will look at adding the care plan from a second assessment tool, psychosocial assessment.

Filed Under: Aging Tagged With: aging family, aging parent, aging parent care, aging parent crisis, care plan, care plan as saftey net, case manager, checklist for aging parent problems, elders and fall risks, Functional Assessment, geraitric assessment, geraitric care manager, geriatric care management, merging care plans, My Geraitric Care Management Operations Manual, National Association of Geriatric Care Managers, Parkinsons, Psychosocial assessment, red flags when visiting an aging parent, residential monitoring devices, steps to create a care plan

Home Modification- Convincing the Family or Older Adult

February 8, 2013

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The Geriatric Care Manager’s or aging professionals job after a home safety assessment is next to see if changes can be made. How do you do this?

The first step would be to present findings of the home safety assessment to the older person and their family or legally responsible party and show them plans to make changes. If dementia is involved or an older adult is conserved or has a guardian, this also may be presenting only to the family or legally responsible third party like a trust officer or power of attorney for finances. The GCM or aging professional also may be suggesting the expenses for the home modification. If home modifications for safety are simple, then the geriatric care manager or aging professional can come up with a budget. If complicated like ramps, renovating bathrooms or bathroom safety alterations suggest a bonded and licensed contractor or home handyman. All this information should be in the GCM or aging professional ‘s continuum of care database.

If the older adult is resistant, then the GCM or senior professional will have to help older person through resistance. This may take time and a little repair at a time.

If there is resistance among the family or with the older person, consider holding a family meeting in person or in a conference call. The agenda can be to discuss the need for home improvements, mediate with family members and how the older client could both accept them and stay safe at the same time. In a family meeting you can form a family team to work on home modification together, convincing the older parent this is necessary, figuring out a schedule, getting bids from contractors, eliminating immediate safety risks that are easy like throw rugs, hoses on the sidewalk, clutter.

Having family meetings throughout the process can heal old wounds, share the tasks that need to be done, because it takes a village to jointly support your aging family. This also takes the on – going support and guidance of a geriatric care manager or aging professional.

Be sure to tell his or her social supports if older person refuses and there are dangerous home safety issues. Finally. Refer to APS http://www.napsa-now.org/ if safety is a real danger and safety improvements that put the older person at risk are not going to be made.

Filed Under: Aging Tagged With: activities of daily living- mobility, adult protective services, aging parent crisis, bonded contractor for home modification, bonded handyman, Care Managers Working with the Aging Family, caregiver overload, case manager, checklist for aging parent problems, elders and fall risks, extended family, falls and seniors, falls and the elderly, family meeting, Functional Assessment, geraitric care manager, geriatric care management, Geriatric care management operations manual, home modification, home saftey assessment, mediator, NAPGCM, National Assocaition of Geraitric Care Managers, power of attorney for finances, reporting falls tp Dr.

What Do You do Once Home Safety Assessment Done?

February 7, 2013

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If you are a geriatric care manager or an aging professional and you have completed a home safety assessment, what is the next step?

Check if a bonded handyman services available in your client’s community. Find out if Home improvement weatherization is available Weatherization Assistance Program (WAP) of US Dept energy.

Investigate if utility bill payments plans available . Look into Automatic payment plans and third party alert system if bills not paid by seniors

Check if Home energy assistance programs are Available Finally, if ramps or repairs need to be done and your client or their family need assistance in hiring a contractor possible, help them locate one but make sure they are licensed and bonded and you check out references

Filed Under: Aging Tagged With: aging parent care, bathroom saftey for elders, caregiver burden, case manager, Center for Fall Prevention USC, checklist for aging parent problems, documenting falls, elders and fall risks, elders and mobility, Formal Supports of an older person, Functional Assessment, geraitric assessment, geraitric care manager, geriatric care management, Geriatric care management operations manual, geriatric care manager, home modification, home saftey assessment, IADL financial abuse, My Geriatric Care Management Operations Manual, National Assocaition of Geraitric Care Managers, Psychosocial assessment

Fall Prevention : How Do You Assess

February 6, 2013

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Falls happen to everyone. Did you know that Fidel Castro, Nancy Reagan – even Kelsey Grammer of “Frasier” – all had falls. A home safety assessment should be done by a geriatric care manager when doing geriatric assessment.

This assessment should include evaluation of safety features like smoke alarms, wiring etc., and how safe floor plan is .It should cover should the older person’s special needs and disabilities ,such rugs they might trip on because of ambulating problems ,stairs they might fall down ,stairs they cannot climb, upper bedroom they should not sleep in because of these ambulation issues.

The GCM or senior professional should observe the older person performing Activities of daily living like climbing stairs or cooking to see if they can perform ADLS safely.After doing a home safety assessment comes helping the family find way to modify the elders home for safety.

Modifying homes to make them safer and more accessible allows many elderly people to stay in their homes during their later years. This is good news, since the majority of older Americans prefer this stay-at-home home option (often called “aging in place”) to other situations like assisted living.

According to the nonprofit Rebuilding Together, 80% of those aged 50 and older own their own homes, and 92% of them want to age in place. For many seniors, living in their home is not only important to their emotional well-being, it’s often more cost-effective than other housing options. The Fall prevention Center for Excellence at USC offers this link for home safety assessments and a bevy of information for both assessment and home modifications.

Filed Under: Aging Tagged With: aging parent care, aging parent crisis, bathroom saftey for elders, caregiver stress, case manager, Center for Fall Prevention USC, documenting falls, elders and fall risks, elders and home repairs, elders and mobility, falls and the elderly, Funtional Assessment, geraitric assessment, geraitric care manager, Geriatric care management operations manual, grab bars, My Geraitric Care Management Operations Manual, National Association of Geriatric Care Managers, SPLAT

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Cathy Cress is the leading national expert in Aging Life and Geriatric Care Management. She is author of Handbook of Geriatric Care Management 4th edition, Jones and Bartlett, published 2015 and known as the bible of geriatric care management. Continue Reading >

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