end of life care manager Archives ⋆ Cathy Cress

What are the 9 Care Manager’s Jobs in the Chronic Phase of the Good Death

June 17, 2017

Create an end of life care management service that gives a GOOD DEATH. Every stage of dying can be part of a good death, including the difficult point called the chronic phase.

This is the time between the diagnosis and the result from the treatments. During the phase, the dying person tries to cope with the demands of daily life while also going through necessary medical treatment, “often having to struggle with the unpleasant side effects of their treatment”.Chronic illness may also involve repeated episodes of deterioration in which the patient confronts and adjusts to these losses. Examples of these losses include cognitive function, sexuality, toileting, the ability to ambulate, eat and dress. The focus of life for both the family and the patient needs to be redefined, shifting from hope for a cure to coping with the illness

Geriatric care manager tasks:

Assist family to determine type of long-term care which may be safest and healthiest for the loved one: institutional: hospital chronic care or nursing home care, in-home nursing care or family care and make arrangements
Co-ordinate help from community organizations through the continuum of care
Assist client and family connect with support groups in death and dying
Assist learning management of disease skills such from health care staff, videos, manuals or brochures.
Monitor anticipatory grief needs
Learn about disease in order to help the patient make good decisions about his/her care and to help family members monitor their expectations
Monitor caregiver burden: encourage family caregiver’stake time for selves, take breaks, get rest get to medical appointments, for grief needs
Assess client’s non-medical needs: transportation, physician’s appointments, household tasks, personal care if hospice involved- medical if not involved
Assess family caregiver for overload, burnout, educational supports, home care supplement or family replacement care

Add an End of Life service and other care management services, plus all the forms necessary, by going my website Cathy Cress.com and check out MY GCM Operations Manual

Gwendolyn LAZO Harris MA, CT, Seniors at Home, San Francisco and Diane LeVan MA both highly expert care managers, created a seminal chapter “Palliative Care and End of Life Care Manager ” in my book Care Manager’s Working With the Aging Family

Do You Know How to Use Whole Family Approach to End of Life Issues ?

June 16, 2017

End of Life issues can be complex and can be emotionally charged. They may be connected to cultural, religious, and moral beliefs. When the important end of life decisions need to be made, the stress of the responsibility and the seriousness of the situation can cause great discomfort. Care managers are often engaged to help facilitate the discussions, and help family members come together to work as a functional unit.

Understanding the differing viewpoints is critical. Knowing what a parent wants and does not want during the last days and hours of life help define and simplify the role of the family. It relieves the family of the burden of having the responsibility of making decisions which may not be what their parents want, and can also avoid family conflicts when adult children may have differing values.” Proactive discussions and legal planning can help to reduce some of the potential conflicts.

In the situation I found myself with family member dealing with end of life issues their issues were: relationship to money as he would need to have 24 hour care to return home to die, where he would return home, as although the son was unsure, everyone agreed that the son’s home where all the grandchildren and great-grandchildren gathered was the best place. Most important was should the elderly man withdraw dialysis and extreme measures that were not saving his life. He was competent and had chosen these. All, these problems were solved in the hospital by a family meeting with hospice, the care managed home care agency the son and his wife and myself and many meetings with the physicians. Hospice facilitated the discussion. The end result was to move to the son’s home, with 24-hour care and Hospice, where the entire family, were gathered in and out all day and the old man died with such peace knowing that his family was surrounding him.In the need he and his family

Most important was should the elderly man withdraw dialysis and extreme measures that were not saving his life. He was competent and had chosen these. All, these problems were solved in the hospital by a family meeting with hospice, the care managed home care agency care manager, the son and his wife and myself and many meetings with the physicians. Hospice facilitated the discussion. The end result was to move to the son’s home, with 24-hour care and Hospice, where the entire family, were gathered in and out all day and the old man died with such peace knowing that his family was surrounding him.In the need he and his family

He was discharged to the son’s home, with 24-hour care and Hospice, where the entire family gathered in and out all day and the elderly man is dying with such peace knowing that his family is surrounding him.In the end, he and his family surrounded him with a “good heart” joy and peace at the end of his life.

What is the Care Manager’s Role in 5 Stages of Death?

June 13, 2017

Geriatric care manager’s serve older adults before they find they are dying. GCM’s work with chronic care clients, some times for years, who eventually succumb to their illness. They also work with client’s who come to them facing end of life issues.

The process of acceptance and adjustment to terminal illness has five phases:

· before the diagnosis,

· the acute phase

· the chronic phase

· the recovery phase

· the terminal phase

A care manager is a GPS for both the client and family through the

5 stages, bringing in critical service like palliative care and hospice

caregiver respite and quality of life the whole continuum of care for supporting end of life- at the right phase at the right time –

Interventions vary according to the phase. The GCM may already have served the client and they are now facing a terminal diagnosis. But a geriatric care manager may be brought in when the family is negotiating through any one of these phases, their work begins with making a determination of what phase the client is in and what services are appropriate for that client at that stage. They are also the best professional to bring in quality of life to every phase so that the client can have not only a good death but a good life to the very end.

Find out more by watching my you tube playlist on Death and Dying on my channel Geriatric Care 1

Gwendolyn LAZO Harris MA, CT,Seniors at Home , San Francisco and Diane LeVan MA both highly expert care managers, created a seminal chapter on Palliative Care and End of Life Care Manager in my book Care Manager’s Working With the Aging Family

What Is a Care Manager’s Role in Death and Dying?

June 11, 2017

Care Manager’s don’t just meet dying patients and their bereft children in the emergency room.

Care Managers play a big role in end of life issues. They are their navigators through all five stages of dying, many times long before palliative care or hospice are called. Often GCM’s can help the family and client to bring in hospice or palliative care.

The final passage through life can emotionally charged.  If the family is following a long labyrinth to the end, the blind alleys may be blocked by cultural, religious, and moral beliefs. Care managers can find an opening through this maze.  Money, family dynamics and fear of dying can all explode a fraught crisis of care in dying. When important end of life decisions need to be made, the stress of the responsibility, and the seriousness of the situation can break a wave of distress fear and anxiety over the “ whole family system” the dying elder. The geriatric care manager specializes in this whole family system.

Care Managers are often help facilitate throbbing discussions, and facilitate family members coming together to work as a functional unit.  Understanding the differing viewpoints is critical.  Knowing what a parent wants and does not want during the last days and hours of life help define and simplify the role of family.  It relieves the family of the burden of having the responsibility of making decisions which may not be what their parents want. Turning this around can also avoid family conflicts when adult children may have differing values.

Proactive discussions and legal planning building a circle of care can help to reduce some of the potential conflicts. Good legal guidance can also help to pay for care when an adult child wants to finance in home care.  But geriatric care managers do much more with clients and families who are facing end of life

Gwendolyn LAZO Harris MA, CT,Seniors at Home , San Francisco and Diane LeVan MA both highly expert care managers, created a seminal chapter on Palliative Care and End of Life Care Manager in my book Care Manager’s Working With the Aging Family

Care Manager’s Need to Know About Cultural End of Life Rituals?

February 25, 2016

If You want to know more about Death and Dying and adding culturally appropriate service to it check out my GCM Operations Manual

Care Manager’s Need to Know About Cultural End of Life Rituals?

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