Cathy Cress

Expert in Aging Life and Geriatric Care Management

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

June 17, 2017

 

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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:

  1. 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
  2. Co-ordinate help from community organizations through the continuum of care
  3. Assist client and family connect with support groups in death and dying
  4. Assist learning management of disease skills such from health care staff, videos, manuals or brochures.
  5. Monitor anticipatory grief needs
  6. Learn about disease in order to help the patient make good decisions about his/her care and to help family members monitor their expectations
  7. Monitor caregiver burden: encourage family caregiver’stake time for selves, take breaks, get rest get to medical appointments, for grief needs
  8. Assess client’s non-medical needs: transportation, physician’s appointments, household tasks, personal care  if hospice  involved- medical if not involved
  9. 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 1284078981.jpg

 

 

 

 

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  

 

 

 

 
 

Filed Under: Aging, Aging Life Care, Blog, care manager, case manager, Death and Dying Care Management, death and dying care manager, elder care manager, End of Life Care manager, Families, GCM Start -Up, Geriatric Care Management Business, Geriatric Care Manager, geriatric care manager, geriatric social worker, nurse advocate, nurse care manager, Palliative care manager Tagged With: adding end of life services, aging family crisis, aging life care manager, anticipatory grief, chronic phase of death, death and dying, eldercare manager, end of life care manager, geriatic care manager, geriatric care manager, hospice care manager hospice, nurse advocate, nurse care manager

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.

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  

 

Filed Under: Aging, aging life care manager, Blog, care manager, case manager, Death and Dying Care Management, death and dying care manager, elder care manager, End of Life Care manager, Families, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, nurse advocate, nurse care manager, Palliative care manager Tagged With: aging family, aging life care manager, aging parent, aging parent care, aging parent crisis, care manager, care plan interventions, caregiver, caregiver burden, caregiver family meeting, case manager, end of life, end of life care manager, end of life family meeting, family meeting, Geriatric Assessment, geriatric assessment for end of life, geriatric care manager, Hospice, National Assocaition of Geraitric Care Managers, nurse advocate, nurse care manager, Palliative Care, parent care, parent care crisis

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

June 13, 2017

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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  

Filed Under: Aging, Aging Life Care, aging life care manager, Blog, care manager, case manager, Death and Dying Care Management, death and dying care manager, elder care manager, Families, Geriatric Care Manager, geriatric care manager, geriatric social worker, nurse advocate, nurse care manager, Palliative care manager Tagged With: aging family, aging life care manager, aging parent crisis, care manager, case manager, end of life, end of life care manager, five phases of death, geriatric care manager, Hospice, nurse advocate, nurse care manager, palliative care manager. Hospice

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

June 11, 2017

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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  

Filed Under: Aging, Aging Life Care, aging life care manager, Blog, care manager, case manager, Death and Dying Care Management, death and dying care manager, elder care manager, Families, Geriatric Care Management Business, Geriatric Care Manager, geriatric care manager, geriatric social worker, ife care manager, nurse care manager Tagged With: aging life and geraitric care manager, death and dying, end of life care manager, geriatric care manager, Hospice Care, hospice for elderly parent

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

February 25, 2016

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

 

Filed Under: Aging Tagged With: cultural diversity, end of life care manager, geriatric care manager, hospice for elderly parent

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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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