Cathy Cress

Expert in Aging Life and Geriatric Care Management

How Can a Care Manager Help Elder Die Without a Will , as Aretha Franklin Just Did?

Aretha Frankin Died without a will last week. Most of us have heard this. According to her lawyer, she was aware she needed to take care of this but ” never got around to it”. This leaves her estate liable for potentially millions of dollars of taxes and attorneys fees and a drawn-out timeline for her 4 sons to inherit the proceeds from her estate.

Could a really good care manager have convinced Ms. Frankilin to ” get around to it” . She was, as many have said, ” a force of nature” and a woman who would be hard to sway. But care managers specialize in working with VIP clients and the rich and famous, who are often highly difficult to work with, so she might have convinced that she needed to work with her attorney to this to protect her family and her estate.

But we will never know.

However, care managers can specialize in End of Life care and one of their jobs is to make sure their client has all their legal documents

Once the terminal diagnosis is known with an elderly client, the care manager who has added “end of life services” to their agency, is often the one who will initiate and guide advance care planning discussions. As difficult as these discussions may be, the burden on the family is significantly lessened if decisions about advance care planning are made before the client’s condition worsens.

Hopefully, this has already been done but many people put it off for fear of death. A recent study found that less than 50% of severely or terminally ill patients had an advance directive in their medical record.

Advance directives are legal documents that allow clients to make decisions about their health care and finances in advance of when they are not mentally or physically able to do so. These documents which must be signed, dated and witnessed naming another person to make decisions for you.

Your job as a care manager is the make sure the dying client has these documents:

 

If the client does not have these legal documents and wishes to create them, the Geriatric Care Manager will suggest that the documents be put in place with the oversight and consultation of an elder law attorney

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 the important end of life decisions need to be made, like Ms. Franklin’s will, 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.

 Proactive discussions and legal planning can help to reduce some of the potential pitfalls. Good legal guidance can also help clients like Aretha Franklin make better decisions, like making a will or a trust, and saving her family from adding to the burden of her death.

Consider getting this product with my GCM Operations Manual 

What Does the Care Manager Do After Terminal Diagnosis?

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  • What does a care manager do after a terminal diagnosis has been given by a physician and the older person and their aging family have moved on to the ” Acute Phase” 


  •  The acute phase of death and dying begins at the time of diagnosis. The person has heard their terminal diagnosis from a doctor or other medical staff person and is then forced to try and understand their situation. Many people can’t absorb or understand their diagnosis the first time they hear it.

     

    Shock is often the first reaction. People are immobilized and temporarily shut down. This makes concentration and listening next to impossible. They may also want to avoid acknowledging the illness. People need time to process such news.

    The care manager can help clients cope by encouraging them to talk things out. Unless a decision needs to be made immediately, decision making should be postponed until there has been some time to talk things through.  If the family caregiver’s inability to perform family tasks interferes with timely medical treatment, then the care manager needs to intervene. They can organize other family to share care or help hire private duty home health care if this is affordable. The care manager can also do a mixture of both, order medical equipment, coordinate family meetings and attend doctor’s appointments.

     

    Ultimately decisions must be made regarding his or her medical care and available treatment options. Once treatment begins, the reality of the illness becomes a part of the family’s life, and adjustments and accommodations need to be made. At this point, the family is hopeful that a cure can be found.

  • Join me on my Free webinar February 25th 11 PST.
  • How to Add ” Death and Dying to Your Care Management Services and Deliver End of Life Care”   

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

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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

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