Cathy Cress

Expert in Aging Life and Geriatric Care Management

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Dysfunctional Aging Families Can Wreak Havoc at End of Life

December 6, 2022

What do Feuding families do at the end of life?

 

When a family member is facing death and dying dysfunctional families have flawed conversations. Often they do not communicate at all or engage in destructive banter. They see one another as enemies. They demonize one another.

Feuding families are what I call dysfunctional families. They blame each other instead of locking arms in a crisis.

They sabotage resolution.

They actively compound already difficult decisions with intractable, interpersonal conflict. They create problems independent of the underlying issues.

Facing Fractured Communication

What are some of the struggles that these aging dysfunctional families with fractured communication can face?

Aging parents who lack the capacity to make decisions have no advance directives, DPOA and a

health-care proxy, and adult siblings, who must make end of life decisions, can’t agree

Withdrawal of life support with no designated health care agent and adult children and/or spouse disagree

Pain management adult children and/or and spouse disagree.

Answer to Fractured Family at End of Life – Mediation.

Mediation is a tool that can be a good resource for dysfunctional families at the end of life. It can help with these difficult families face the death of a parent without fracturing the entire family. It can allow an older person to die without pain inflicted by their own family.

 

Deliver a Good End of Life- Add Death and Dying to Your Care Management Agency

 

Serve Your Client Until Death Do You Part

Upcoming Free Webinar

Deliver a Good End of Life 9 Steps to Death &Dying

Jan 24, 2023 02:00 PM Pacific Time (US and Canada)

SIGN-UP Description

Deliver a Good End of Life- 9 Steps to Add Death and Dying to Your Care Management Agency
Serve Your Client until Death Do You Part
Join me on January 24 2023 and learn why End of Life Services re a perfect new service for care managers
 Learn to guide the patient/family through the five stages of death. Understand how to help clients be active participants in their care. Give the family caregivers tools to manage care. Find out how to provide family-centered care to caregivers and family. Learn to choose the right support services for the client through all stages of death.
Introduce Hospice and Palliative care to the client earlier and work with their team.
Find out how Use COVID -19 family coaching for GCM. Discover the role of Death Doula at end of life.

Time

Jan 24, 2023 02:00 PM Pacific Time (US and Canada)

SIGN-UP 

Join me Thursday, March 11, and learn why End of Life Services Are a perfect new service for care managers

 In this 1 ½ -hour webinar you will learn how to

 1. Transition the patient/family through the five stages of death

2. Help clients be active participants in their care

3. Give the family/caregiver tools to manage care

4. Provide family center care to caregivers and family

5. Choose the right support services through all stages of death

6. Introduce Hospice and Palliative care and work with their team

7. Use ALCA End-of-Life Benefits During COVID

8.Use  COVID -19  Family Coaching for GCM

Sign Up 

If you really want to add End of Life to your care management business sign up for this webinar now

 

Filed Under: Advanced Directives, Advanced Directives and Covid-19, Aging, aging life care manager, Benefits of ALCA to Hospice, Death and Dying, Death and Dying Care Management, Dysfunctional aging family, Dysfunctional Family Mediation, End of Life, End of Life Care manager, End of life documents, estranged elder parents and adult kids, estranged siblings, Families, FREE WEBINAR, GCM COACHING SKILLS, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, Good Death, Hospice Care, mediation, Mediation End of Life, nurse advocate, nurse care manager Tagged With: adult sibling, aging family, aging parent care, aging parent crisis, care planning, caregiver burnout, conservator, death, dysfunctional aging family, dysfunctional family, dysfuntional family, elder care crisis, end of life, end of life family meeting, estranged siblings, families fretting at end of life, fretting at end of life, geraitric assessment, geriatric care management, geriatric care manager, geriatric care managers, mediation, mediator, My Geriatric Care Management Operations Manual, no advanced directive, no DPOA, no health care proxy, withdraw of life support

What Does a Care Manager Do Before End of Life Diagnosis?

November 29, 2022

End of Life has 5 Phases   

   

 

Before the end-of-life diagnosis, the ALCA or GCM care manager helps clients be active participants in their care and gives the family caregiver the tools to manage the care.            

The geriatric care manager serves older adults before they find they are dying. GCMs work with chronic care clients, sometimes for years, who eventually succumb to their illness. But they also work with clients who come to them facing the 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 
  • Geriatric Care Managers’ Tasks Before the diagnosis

  • Schedule medical  appts
  • Help family ask questions  of medical professionals
  • Before visiting  the client maintain an updated medication list and a list of any drug allergies
  • Assist the family in organizing all  Advanced care planning documents documents

  • Go to medical appointments with the client or train family members make a list of questions and have ready
  • Set up personal health records.       
  • Assist family members in setting up and use of a calendar to keep a log of important medication information, questions, and things out of the ordinary that happens to the ill person
  •  
  •  
  • Join me Tuesday, January 24, and learn why End of Life Services Are a perfect new service for care managers 

  • Deliver a Good End of Life- Add Death and Dying to Your Care Management Agency

  •  

     

     

    Serve Your Client Until Death Do You Part

     In this 1 ½ -hour webinar you will learn how to

     1. Transition the patient/family through the five stages of death

  •  2. Help clients be active participants in their care               

    3. Give the family/caregiver tools to manage care

    4. Provide family center care to caregivers and family

    5. Choose the right support services through all stages of death

    6. Introduce Hospice and Palliative care and work with their team

    7. Use ALCA End-of-Life Benefits During COVID

    8.Use  COVID -19  Family Coaching for GCM

  • Sign -Up 

  • Free Webinar

     

     

    If you really want to add End of Life to your care management business sign up for this webinar now

Filed Under: 5 stages of death, 5 Stages of Dying, 5 stages of End of Life, Advanced Directives, Advanced Directives and Covid-19, Aging, Aging Life Care, aging life care manager, Atul Gawande, black care manager, black concieirge nurse, black concierge care manager, black concierge RN, Black Entrepreneur, Black Entrepreneur RB, Black entrepreneurs, Black Geriatric Care Manager, Black geriatric care managers, Black RN, black RN care manager, black social worker, black travel nurse, Black Travel Nurses, Black Travel RN, Blog, care management business, Death & Dying, Death and Dying, Death and Dying Care Management, death and dying care manager, End of Life, End of life documents, Families, FREE WEBINAR, GCM working with end of life, GCM workinh with hospice, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, Good end of life, Good hospice, Hospice, nurse advocate, nurse care manager, Palliative Care, Quality of Life in Dying Tagged With: 5 stages of death, adding end of life services, aging family, aging life care manager, aging parent crisis, ALCA in End Of Life, care manager, case manager, Elizabeth kubla Ross, end of life care manager, End of Life Diagnosis, GCM Family Coaching end of life, GCM in Death and Dying, geriatric care manager, Hospice at end of life, Navigation through END of LIfe, nurse advocate, nurse care manager, Tools to manage end of life, webinar end of life

11 Parts of Care Manager’s Role With Family Death and Dying of COVID-19?

February 4, 2021

 

GCM Role is Working With Family In COVID-19

Care managers cannot be in the hospital with a  patient dying of COVID-19. They can support their bereft adult children, who cannot see their parents during the hospitalization, in those last moments of goodbye’s or after the death in this deadly pandemic.

In normal times 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. But is COVID -19 they can offer guidance to the family through the sometimes weeks of hospitalization, intubation, their loved one is on a ventilator and ultimately often- death separated from loved ones.

Navigation Through a COVID-19 Death

 The normal final passage through life can emotionally charged.  If the family is following a long labyrinth to the end, in coronavirus, the blind alleys may be blocked by a rushed hospitalization, banned from seeing their loved one in the hospital, and not understanding the disease that is killing their loved one.

Care managers can find an opening through this maze.  Family dynamics and fear of dying can all explode a fraught crisis of care in dying of coronavirus. When vital end-of-life decisions need to be made, the stress of the responsibility and the seriousness of the situation can break into a mammoth wave of distress fear, and anxiety over the “ whole family system”. The geriatric care manager specializes in solving these end of life decisions for whole family system even at the end of life.

Facilitate Family talks over hospitalized COVID-19 Elder

Care Managers can facilitate terrified discussions outside the hospital, and clear the way for family members to come together to work as a functional unit around an unknown killer disease that preys on their loved one. 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 helps the family bear the burden of having the responsibility of making decisions that their parent wants. Turning this around can also help families have some solace that they carried out their parent’s wishes after their parent’s death. 

 

Care managers can help family members handle the stress of an elder’s hospitalization and death by:

  • Encouraging routines, exercise, and social connectedness with friends and family
  • Advocate for them with the hospital staff to get updates in this chaotic time in hospitals
  • Help them maintain contact with the” hospital quarterback “ to get updated medical status and give input
  • Find technology for the family to communicate with the hospitalized family member  via text, telephone, email, or video chat
  • Support and mediate if necessary proactive discussions and advanced directive preparation in a rush if not done
  • Build a circle of care can help to reduce some of the potential conflicts,
  • Support them in having essential conversations, prior to needing  intubation, on last wishes if health status deteriorates  
  • Provide opportunities to say goodbye via technology
  • guide them in setting up rituals that can celebrate the end of life and give solace to a family during a time when there are yet no rituals for a COVID-19 death.
  • Work with the hospital to set up Zoom with the family to say goodbye to a loved one. 
  • Geriatric care managers do much more with clients and families but especially now with Covid-19 elder’s and their families facing a  separated, fractious end of life
  • Deliver a Good End of Life- Add Death and Dying to Your Care Management Agency

     

    Join me Thursday March 11 and learn why End of Life Services Are a perfect new service for care managers

     Sign Up   

    In this 1 ½ -hour webinar you will learn how to

     

    1.Transition the patient/family through the five stages of death

  • 2.Help clients be active participants in their care3.Give the family/caregiver tools to manage care

    4. Provide family center care to caregiver and family

    5 Choose the right support services through all stages of death

    6.Introduce Hospice and Palliative care and work with their team

    7. Use ALCA End of Life Benefits During COVID

    8.Use  COVID -19  Family Coaching for GCM

    Sign Up 

    If you really want to add End of Life to your care management business sign up for this webinar now

     

     See more about Cathy and her book Care Manager’s Working With The Aging Family

  • DyingGriefandBurial in the AgingFamily

Filed Under: Advanced Directives and Covid-19, Aging, Aging Community & Covid-19, Aging Life Care, aging life care manager, ALCA COVID-19 Crisis, ALCA Role Death and Dying, Blog, care manager, case manager, CIRCLE OF CARE, coronavirus, Coronavirus emergency plan, coronavirus shut down, Covid 19, COVID-19 & Care Management, Covid-19 Death, Death and Dying, Death and Dying Care Management, death and dying care manager, elder care manager, End of Life, Families, FREE WEBINAR, GCM role Death and Dying, GCM Working With Aging Family, Geriatric Care Management Business, Geriatric Care Manager, geriatric care manager, geriatric social worker, Good Death, nurse care manager, Therapist Specializing in Aging Tagged With: adding end of life services, aging life and geraitric care manager, death and dying, death and dying in COVID-19, Death and Dying in hospital, end of life care manager, geriatric care manager, Hospice at end of life, Hospice Care, hospice for elderly parent, Navigation through END of LIfe, Palliative Care at end of life, Technolog COVID-19 in Hospital, Tools to manage end of life

Emergency Go Binder -Family Caregivers Need One in Pandemic

August 13, 2020

   In An Emergency, I  Panicked

I live in Santa Cruz County, Ca. , where the disaster of COVID stalks us but we had a double disaster with one of the 30 fires begun by lightning strikes all over California. Our fire set the Santa Cruz mountains, with ancient 3000-year-old redwoods, ablaze, and caused 70,000 evacuations ,as the firefighters did not have enough fire personnel to fight the fire. There were so many fires statewide that all firefighters in the state were not enough to fight the blazes. In addition to the horror, the fast-spreading fire, our three assigned planes to drop water on the inferno, could not fly as smoke and fog prevented it. They went to other California fires.

I Had No Grab and GO, Binder

When all this was announced by emergency alerts we were told to prepare to evacuate too. In spite of just teaching how to put together a go binder for COVID- I had no go binder myself. I had no list of what I would take in an emergency from a 5 bedroom house with multiple family heirlooms, original art by children, grandchildren, and now famous friends, I had never scanned the multiple  photographs of our family in frames to GOOGLE PHOTOS  all over the house and those critical important documents like our trust, birth certificates, passports, insurance info in filing to add a go binder. I  never made a GO Binder. I am doing it now when the fire is 30% contained. 

Prepare for Double Disasters Now

In emergency situations, people sometimes do not think rationally like me. We never know how we are going to react in an emergency until it actually happens. In order to prepare for any situation, hurricanes & COVID, Fires &COVID- creating a grab-and-go binder should be an important part of your shelter in place plan for aging friends or relatives.

With COVID,the older person who is sheltering in place, as safe as the family and elder have been, can still contract COVID and be rushed to the hospital in an emergency. But on top of COVID other emergencies like storms wildfires, floods happen on the top of the pandemic. Think of this summer where hurricanes have already spun up the east coast, making it a double cataclysm of elders’ and family caregivers’ lives.

What to put in Go- Binder

You want and binder with all the emergency contacts, documents like advanced directives, DNR power of attorney and family contacts, You the family cannot physically go into the hospital or evacuate but this Go binder can take your place. With important information about your family member when they are admitted without you by their side. Your go- binder should contain your family members’ most important information and documents. This will include.

  • Medical information
  • Emergency Contact List
  • Advanced Directives 
  • Critical medical, insurance, social security, Trust/will docs                                                                                                             
  • Check out The new 5th edition of my GCM Operations Manual with  5 new COVID-19 Coaching products to use with Telehealth to Assist Family Caregivers to guide older Loved ones to:

  • Shelter in Place in Long Distance Family
  • Shelter in Place in Long Local Family
  • Recover at  Home If Do not enter the Hospital
  • Recover after discharge from the hospital in Long Distance Family
  • Recover after discharge from the hospital if Local Family
  • Find Out More Below

GCM Manual New 5th edition

Filed Under: Advanced Directives and Covid-19, advanced directives& COVID-19, Aging, aging family crisis, Aging Life Care, aging life care manager, ALCA COVID-19 Crisis, ALCA Disaster Plan, ALCA Products for COVID_19, Blog, Coronavirus Coaching, Coronavirus emergency plan, Coronavirus safety elders, coronavirus shut down, CORONAVIRUS Stay at Home Plan, COVID, COVID-19 & Care Management, COVID-19 & Wildfire, COVID-19 &Shelter in Place Plan, Covid-19 and GCM SERVICES, COVID-19 Emergency Go Binder, COVID-19 Emergency Plan, Covid-19 GCM Products, COVID-19 Hospital Discharge Plan, COVID-19 Plus Hurricane, COVID-19 Recover at Home Plan, elder care manager, Emergency Go Binder, Emergency Plan, Geriatric Care Manager, geriatric social worker, nurse advocate, nurse care manager Tagged With: 5th edition GCM OPERATIONS MANUAL, ADVANCED DIRECTIVES & COVID-19, aging parent crisis, care manager, case manager, COVID GCM Procedures, COVID- 19 GO Binder, COVID-19 PRODUCTS, Covid-19 Telehealth, COVID-19& LONG DISTANCE CARE, crisis with aging parents, geriatric care manager, nurse advocate, nurse care manager, parent care crisis

Offering a COVID care plan product for Long Distance Care Providers

July 27, 2020

 

 

 

Initial Intake

The first step for the Long-distance family members (LDF) worried about elder exposure and hospitalization is an initial consultation and intake with the client and LDF.  This consult will identify the current status of the senior in the home environment.  This care management consultation can be done with a HIPAA-compliant video conferencing service

 

  • Required Legal Documents Family Long Distance Family Needs

     

  • – The first thing that the geriatric care manager works on is to find out if the older person has the required legal documents – Advanced directives, POA/HCPOA & GCM HIPAA  release because of the risk of both hospitalization and death due to age-related COVID-19. If these documents are not present, have a discussion with senior/LDF regarding their wishes, explaining that older adults over 65 are at higher risk for severe illness. The care manager will discuss who is to be the health care decision-maker and consult a family attorney or elder law attorney to complete.  If they choose not to use an elder law attorney, as time is of the essence in the pandemic, they can suggest accessing AARP advanced directives documents for any state which can be executed quickly.
  • G0-Binder

  •  If documents are completed, locate in-home and provide explanations to the family that they must give a copy to emergency contacts and physicians as required and place in planning binder.  In the planning “Go binder” list all emergency contacts with phone numbers/e-mail addresses – family, friends, physicians, pharmacy, professionals providing in-home services.  Also, list all medications and prescribing physicians in “Go Binder”.  Upload documents into caregiving applications like caringvillage.com so the long-distance family always has the updated documents.

JOIN ME FOR MY NEW FREE WEBINAR 

Create 5 Telehealth Products for COVID 19

WHEN. THURSDAY AUGUST 6

TIME- 2 PM Pacific Standard Time

Care Management businesses are struggling with pandemic close-downs.

Support your business bottom line, clients, and their families.

Create 5 COVID products

Products from sheltering in place through the hospital, recovery at home, discharge from an SNF, or hospital for local and long-distance elders. Increase your bottom

line as COVID spreads throughout the US and more shutdowns loom

Learn Step by Step How to Consult with Aging Families and Seniors

Choose the best Hipaa Compliant Telehealth Products to Remotely Consult with Client

  • Help a Local Family Help a Loved One Safely Shelter in Place
  • Help a Long-Distance Family Help a Local Loved One Shelter in Place

  • Help an Aging Family Help a Loved on Hospitalized for Covid-19
  • Help an Aging Family Help a Loved one Recover when Discharged from a

Nursing Home

  • Help an Aging Family Help a loved one Recover when Discharged from a

Hospital

WHEN. THURSDAY AUGUST 6

 

TIME- 2 PM Pacific Standard Time

       REGISTER NOW 

Filed Under: Advanced Directives and Covid-19, Aging, Aging Community & Covid-19, Aging Life Care, aging life care manager, Aging therapist, ALCA & Skilled Nursing Facility, ALCA COVID-19 Crisis, ALCA Products for COVID_19, Blog, Covid 19 Webinar, COVID-19 & Care Management, COVID-19 Webinar, GCM COVID 19 Crisis, GCM products in COVID-19, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, Intake COVID-19, Long Distance Care & COVID-19, nurse advocate, nurse care manager, Telehealth COVID-19products Tagged With: ADVANCED DIRECTIVES & COVID-19, aging family, aging life and geraitric care manager, aging life care manager, aging parent crisis, care manager, case manager, coronavirus and seniors, Coronavirus disaster plan, COVID_19 inquiry, Covid-19, COVID-19 Webinar, COVID-19& LONG DISTANCE CARE, geriatric care manager, nurse advocate, nurse care manager, Webinar

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