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- How to Add ” Death and Dying to Your Care Management Services and Deliver End of Life Care”
The geriatric care manager takes many steps before a terminal diagnosis .The GCM client may begin see disturbing symptoms and realize they must see doctor. This pause before death is not spelled out not a single flash -more a period of time when the older person undergoes physical examinations, various tests, and ultimately ends when the individual is told they are suffering from a terminal illness
But before the judgment, what does the Geriatric care manager do for the elder.
Visit the older client on a regular basis to monitor their symptoms, care and support them in the quest to find answers.
Maintain up to date medication list and care plan
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.
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The recovery phase of death and dying occurs when people finally are able to cope with the mental, social, physical, religious and financial effects of their disease, a heavy load In the disease process and acceptance process, this is the period of time after a medical procedure such as chemotherapy, radiation or surgery. The client’s response to treatment is being monitored. Recovery does not always mean remission, but instead it is the ability to accept and deal with the struggles of their illness.
A Story About the recovery phase
William died at the home of his son after he had accepted that he was to die of liver failure. After his coming to terms with his death, he and his family, sons and grandchildren were able to say the goodbyes and offer the unconditional love that they had been fearful to express before his acceptance. A feeling of light joy permeated his room, a family room overlooking the garden, where his hospital bed was set up. Great grandchildren brought pictures, marveled at “grandpa grandpa “ high up in a hospital bed. His son put a g headphone with a mike on and William could hear and speak, as he had not in years. His 24-hour caregivers, were gifted loving careproviders from a GCM agency Livhome .
The 24 hour shifts included a nurse of 18 years from central America and a man finishing his PHD from the Congo. They cared for him with great warmth, so his family could just be his family, relaxing in their love and surrounding him ,as if in a circle, that swirled with 4 generations, going every which way while he watched, really loved and melted into his last stage. They ate meals, chitchatted and welcomed new family coming in to see William, as he remained in the center in his hospital bed, the fulcrum of the gathering..
The geriatric care manager, GCM Mary Brennan, from Livhome , a seasoned powerful and so kind LCSW, adjusted here and there, with care providers, family needs, Bill’s needs and followed the guidance of hospice, who were slowly increasing the pain meds, and supporting his heath and medical care needs in death. The geriatric care management agency worked as a partner supplying 24 care and support for the family.
Bill was able to have again, a magical care provider from Livhome, who had been with him for almost two years and was so at the end.
You are only as strong as your weakest link- those are the care providers. These people were the raft that floated bill up while the family, offered love and hospice provided medical and end of life support. Together they buoyed Bill into his last stage of dying , knowing that his family was the fabric of every step he took toward forward towards death.