Can a Caregiver Assessment Avoid UnnecessaryPlacement ?

April 9, 2021

When a Caregiver is so Overwhelmed that A SNF is a Choice but a Very Bad Choice

If the family is so overwhelmed by the care that they are considering placement, this threat should trigger the GCM to do a caregiver assessment immediately, found in the Handbook of Geriatric Care Management If the GCM is called to relocate an older person and the underlying cause seems to be caregiver burnout, this can be another trigger to use this valuable GCM tool. By using a caregiver assessment the geriatric care manager may find that building respite for the caregiver, through other relative or paid caregivers, a caregiver support group, or coaching the caregiver to make changes that make her/ his tasks more bearable and doable and avoid inappropriate placement of the older person

Avoid Elder Physical Abuse Though a Caregiver Assessment

If caregiver abuse is suspected, a caregiver assessment is a critical immediate tool. This is a situation where the GCM must contact Adult Protective Services, following their own state’s laws. Elder abuse can be triggered by caregiver stress in some situations. Depression that reaches a clinical level in a caregiver can be predictive of elder abuse of an elderly client can prompt a GCM to do a caregiver assessment. You should also do a geriatric depression scale at the same time. Use the GDS and the caregiver assessment to help both the caregiver and the care receiver and avoid the risk of physical abuse and prevent involvement of APS making the caregiver and care receiver’s lives even more painful and chaotic and risking placement in a nursing home.

Mrs. Handy has Two Dads in Her Head

Let’s take the example of Mrs. Handy, a caregiver daughter caregiver She calls a GCM as she is about to place her Dad. Besieged by so many other stressors, her own health is deteriorating because she cannot get any sleep, due to her Dad going to bed so late and her inability to rise above her old self when her Dad was 40 and she was 19 and what he said she did. Now he is 70, very impaired with vascular dementia, incontinent and she needs to be who she is in the here and now a woman of 40, caring for an impaired Dad in her 70’s. The care manager coached her to set a new boundary for him to go to bed early. She needs help in getting rid of the old parent in her head and putting the 70-year-old demented incontinent parent before her. In addition, she sees her doctor for depression, joins an online caregiver support group, and asks siblings in other towns to take her Dad once a month for a week. Her Dad is not moved to skilled nursing. This is what a geriatric care manager can do for her to help avoid unnecessary placement.

Find out more on my playlist “Caregiver Assessment” on My Youtube channel Geriatric Care

Start-Up Geriatric Care Management Marketing and PR Checklist

April 7, 2021

To grow an ALCA or Geriatric Care management business, you must use- marketing and public relations (PR). ( usually social workers and nurses have never done )Here is a helpful start –

Start-Up Geriatric Care Management PR/ Marketing Checklist

1. Brand Identity- including logo design and collateral material design

Services needed to complete

Research competition, develop key differentiating features, develop a brand positioning statement, and develop business names, graphic design for the logo.

, colors for business communication. Consider consulting a branding firm.

2. Business Identity –

Get coordinated business card envelopes, note cards, and folders

Services needed to complete

Graphic design, printing, and delivery

3. Products sheets or Sell sheets, Brochures

Services needed to complete- Copywriting, graphic design, printing, and delivery

4. Identified and 3rd party targets – including a prospect profile

Services needed to complete-

Identify targets ( elder law attorneys, assisted living, concierge physicians, trust/wealth management departments) in your services area. Research develops prospect profiles, mailing lists, key factors in specific communication messages per target audience. Add to marketing excel sheets.

Want to know more?

Caregiver Assessment- What Does It Takes Professionally ?

March 30, 2021

Doing TWO Assessments

To meet the needs of the whole aging family, the care receiver, and the caregivers, GCMs need to begin assessing the caregiver as well as the care receiver. There is a synergy between the caregiver and client – they are interdependent. If the caregiver is stressed or weak the client does not receive good care. They both suffer without supports that a care manager can give them.

A caregiver assessment helps the GCM see this faltering interdependence by using a caregiver assessment. The National Center on Caregiving at the Family Caregiver Alliance calls this a process gathering information describing the caregiving situation and identifying the family caregivers’ particular problems, needs, resources, and strengths. This means that the care manager can see issues from a caregiver’s perspective and can focus on what supports they need to give them the best care. The GCM compares this to the client’s assessment of needs. The result of doing two assessments is discovering both the client/ care receiver needs and restore health and well-being, prevent poor care, client injury or illness, caregiver burnout, trauma or quiting, and unnecessary placement in a nursing home.

Create a Circle of Care

One resource that a GCM can bring to a caregiving family is what Gail Sheehy calls a circle of care. To create this supportive connection, the GCM needs to take her or his coaching skills and put together a support system around the formerly isolated, solitary family caregiver. The GCM can coach the family caregiver to ask for help so the GCM can assist in reorganizing the family so adult siblings can share in the care of the older client with the identified family caregiver. The GCM is what Sheehy calls a compassionate coach who can help the beleaguered caregiver attract and assemble a platform to keep on giving the care she or he wants to give the aging person.

Caregiver Resources

A circle of care includes emotional resources for the direct family caregiver. These emotional resources could and should include adult siblings. Reconnecting midlife brothers and sisters, through the circle of care, is an important GCM task, as siblings are the longest and deepest relationships in any person’s life. The GCM may have to depend on his or her clinical skills in helping siblings with forgiveness or reconnecting siblings who live long distances apart to add them to a circle of care. Midlife siblings have often spent the last 30 years tending to their own families, so the point of reconnection of midlife brothers and sisters often happens when they are in middle age in the midst of a crisis in parent care. This is where the GCM needs to employ clinical skills in midlife sibling work or to find the resources for the family to help with this healing sibling reconnection.

Can You Give a Good Death without” Rage, Rage Against the Dying of the Light”?

March 9, 2021

Dylan’s Thomas warns us in his poem

Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.

Give a good death – not a cold terrifying dying of the light.

But today a care manager or geriatric social worker can help an older client go gentle into that good night, they do not have to burn and rage at the close of their day because you will be giving them as Atul Gawande suggests – a good death – not a cold terrifying dying of the light.

The terminal phase of any life-threatening illness is the time between diagnosis and the final decline when no cure or extension of life is in the offing. The individual confronts progressive decline and deterioration. Death is imminent. The care manager has a role.

The focus of doctors and patients now changes from attempting to cure the illness or prolong life to trying to provide relief from pain and to comfort the sufferer. Religious concerns such as what happens after someone passes away or how to handle the suffering at the end of life or how to give comfort to family members are the focus during this time as well as trying to tie up any loose ends.

Death to Rage About- Alone in the Hospital

But in the time of the plague, when 95.5 % of souls still die in the hospital and not at

home the care manager has a critical role with the family. High tech introduced by the care manager and at times the hospital with the care manager coordinating the family outsides and unable to touch their dying loved one – can make this death full of rage more gentle as the person passes into the night.

Care Manager tasks:

Make a referral to hospice if the family has not already reached out

Partner with hospice and work under them

Monitor anticipatory grief needs

Communicate that this is the end (and time to say goodbye)

Assess spiritual needs and contact the appropriate religious-spiritual counselors to provide comfort and healing.

Encourage family members to say The Four Things That Matter Most “Please forgive me”, “I forgive you”, “Thank you”, and “I love you”.

Assess the need for paid caregivers to help the family or help family members share round the clock care among family and friends

Support the family members in their need to grieve and have respite by continuing to assess for overload and burn out with a caregiver assessment tool

Prepare family for the active phase of dying which can be loud and disturbing to someone who is not aware of what will occur

Bring in technology if death is alone in the hospital

Join me Thursday, March 11, 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 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

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

Adding End of Life to Care Management Agency- Advanced Directives

February 7, 2021

When Does A Care Manager Begin if Terminal Diagnosis?

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, advanced care planning 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

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 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:

• A durable power for attorney for healthcare

• A living will

• A do not resuscitate order DNR (efforts to restart the heart after it has stopped

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.

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

Serve Your Client Until Death Do You Part

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

Sign Up

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

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 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

Can a Caregiver Assessment Avoid UnnecessaryPlacement ?

When a Caregiver is so Overwhelmed that A SNF is a Choice but a Very Bad Choice

Avoid Elder Physical Abuse Though a Caregiver Assessment

Mrs. Handy has Two Dads in Her Head

Find out more on my playlist “Caregiver Assessment” on My Youtube channel Geriatric Care

Adding End of Life to Care Management Agency- Advanced Directives

When Does A Care Manager Begin if Terminal Diagnosis?

Advance Directives

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

Sign Up

Sign Up

Contact

Connect with Cathy

Get Cathy’s “10 Critical Success Steps to a Profitable Aging Life or GCM Business”