Alcohol Abuse and Aging Archives ⋆ Cathy Cress

Do You Have Universal Health Precautions in Place with COVID-19

May 6, 2020

Assurances You Must Give Your Clients of Universal Precautions In COVID-19 to Trust You

In this pandemic, you will have to give your potential clients assurance that your care providers can render concierge caregiving, companionship, and personal care services and quality of life have completed the Corona Virus universal precautions training and have all necessary masks and gloves for each case. You should assure that caregivers should are required to take their own temperature prior to each shift and all shifts are available. In addition, you should tell clients or potential clients caregivers are able to pick up and deliver groceries, medications as well as do light housekeeping and cooking or you will arrange for meals to be delivered from the restaurant they choose.

EVEN IN A PANDEMIC, CONCIERGE CLIENTS CAN AFFORD PRIVATE GCM

Concierge Client’s Can Afford You Due to Income Disparity in the US and NO LONG TERM CARE COVERAGE Under Medicare.

Concierge customers are sadly the only customer who can afford you because Medicare does not cover long term care and, in an age of income disparity, 75% of all wealth is held in the hands of the upper 10%. They will choose you -the geriatric care manager over your competition if you have products and Four Seasons services to deliver those products- rivals do not have.

Products make sense to a high-end customer who is brand /product-oriented in purchasing anything that reflects who they are. Think Gucci purses, Rolex or Montblanc watches Dior dresses and now COVID-19 Home From the Hospital or END of LIfe Services.

4 Seasons Mentality for GCM Clients Key

All care management customers in upper 10% relate to products not peace of mind

The Four Seasons offers a template in identifying and responding to a client’s needs – availability of 24 -hour room service, one-hour dry cleaning.

From the moment, a guest sets foot into a Four Seasons establishment, the staff is trained to identify and respond to that client’s needs in an integrated fashion.

A Geriatric Care Manager must apply a Four Seasons Mentality to an older identify client’s needs. So, you must assess their quality of life needs, home care needs, types of referral sources they prefer, and preferred service delivery. Most important their health care needs and psychosocial needs must be identified and delivered under the same high-quality delivery by a professional care manager.

At the time care management services are started, the client may have a range of physical, emotional,

intellectual, and spiritual problems needs. The Concierge care manager’s role is to identify these needs and provide integrated, continuous solutions to meet the client’s needs.

COVID-19 PRODUCTS/SERVICES IN A PANDEMIC

Rather than tell clients you do assessment– offer products they are seeking – like relocation (moving an older person), VIP Care Management, Quality of Life (increasing the joy in an older person’s life who is lonely with Stay at Home Restrictions), Dementia Care, Home from the Hospital,( which many desperately need, especially during the COVID -19 epidemic), Medication Assessment,- End of Life Services, Products that pinpoint exactly what the older person needs are in a pandemic & ongoing and why the family is desperately calling for help. But these products need to be

Jaguar level, not a Hyundai buy. To do this, develop continuously integrated solutions through a product procedure placed in a company operation manual, along with all of your products so you ensure your staff can deliver, step by a step-that high-end product that the Concierge client just purchased and demands.

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COVID-19 Assurances You Must add to Your Products &Staff

Income Inequality and No Coverage For Long Term Care Controls On Your GCM Market

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Why VIP GCM Clients prefer GCM Products
How to Develop a 4 Season Menu of Products
How to deliver 4 Seasons Service With VIP Products

VIP Products to Add to your Menu of Services

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The 2 Deadliest US Sites of COVID-19 Nursing Homes & Prisons

May 2, 2020

PRISON INMATES AND NURSING HOME PATIENTS NOT 6FT APART – 6 FEET UNDER

70% of inmates in federal prisons have COVID-19. In Kansas, the Lansing Correctional Facility had a riot of inmates over COVID-19 lack of care or protection It took the rebellion to get the coronavirus testing PPE and care. The Bureau of Prisons in Kansas confirmed finally that 79 staff have coronavirus and 88 prisons and prisoners dead.

Older residents in nursing homes cannot rebel like prisoners. Many can’t even walk. The Atlantic Magazine just published an article, We are Killing Elders Now. The writer states “In at least six states, these fatalities account for half of all COVID-19 deaths, and according to the World Health Organization, half of all coronavirus fatalities in Europe have been traced to nursing homes too. Some of this mortality is linked to long-term-care facilities that are shoddily run or that violate health standards. But most of them are doing the best they can with what they have. And they don’t have much”.

KAISER FOUNDATION NURSING HOME STAFFING AND USE OF PPE NOT REQUIRED IN MOST STATES

Kaiser reports -Staff Screening. It is more common for states to recommend rather than require daily screening of staff for illness in NFs (24 states recommend, 16 states + DC require)

Use of PPE. More states recommend (23 states) than require (7 states + DC) staff to use PPE

Two States that require testing for coronavirus of ALL residents of nursing homes are Maryland where 556 have died as of the Washington Post article. and Tennessee

THE FEDS HAVE NO CMS FEDERAL GUIDELINES OR REPORTING

We have no federal guidelines for safety testing according to an article by the Kaiser Foundation

It is now estimated that 16,000 deaths have occurred in nursing homes and that is without the federal government revealing any numbers and not making available any testing. But the numbers are probably huge- if we could just do testing.

CMS announced it would have a meeting of a “panel” of experts “ sometime at the end of May”. After probably 20,000 older people died and the feds did nothing this shows their sense of urgency about this pandemic’s national “elder cleansing”.

WHAT CONNECTS PRISONS AND NURSING HOMES – CONCENTRATION CAMPS

So, what is the connection between the viral spread of COVID-19 in nursing homes and prisons- 6 feet ? Prisoners and residents, in nursing homes, and prisons cannot social distance. Jails and prisons have human beings crammed together with no choice. Nursing homes have 2 beds or if you are on Medicaid three to a room. Neither group has a choice to social distance. They are ” concentrated” as in concentration camps or death camps.

Do SOMETHING – HELP NURSING HOMES PREVENT MORE CARNAGE

So, as someone who has spent her career in aging, I am calling out to everyone, especially professional in aging – do something. Since the feds appear to be doing little- call your congressman, write a letter to the editor.

BE KIND LIKE RACHEL MADDOW REPORTS LA JEWISH HOME LA WAS

Rachel Maddow suggests calling your local nursing homes and see what they need. Be kind like the LA Jewish Home was to a smaller nursing home LA Brier Oaks. They wanted to test their residents and had no tests and the larger LA Jewish Home had tests and shared them with the smaller as a good neighbor. What they found was ravaging but it also showed caring and generosity. Care and be generous and show the helpless elders in nursing homes in your town you are opposed to -nursing home being prisons or concentration camps.

How Important are Nurse Care Managers?

February 28, 2020

My husband Pete and our family have our own RN case manager.

Pete had open heart surgery 3 days ago at Stanford Hospital. The utility and utter comfort of having a care manager hit me personally on this health care journey.

Our Stanford Cardiac Care Manager

Stanford’s cardiac unit is a wonder to behold. Your family touchpoint is, of course, the care manager. She is your navigator, comforter in chief, and patient-friendly-dispenser of information framed in a digestible synopsis.

In her warm yet filled with authority voice, our care manager Christine Harris RN BSN greeted us in pre-op and explained what would happen during the surgery. She soothed our fractured nerves. Facing open heart surgery was, as with all patients, like taking a long trip you researched well but never understand the whole journey nor the wrong turns you just might take.

It had taken Pete 7 years to get to this point as he was one of a category of 2% heart patients that had no symptoms. He had not wanted to do the surgery and they respected his wishes. In the last few months, they found his heart not getting enough oxygen, so he finally decided to do it. The day before surgery he was chopping down a plum tree, among the many, in our California yard.

12 Hours of Open Heart Surgery

As the open heart surgery was 12 hours long- most of it pre-op and then post-op, Christina our care manager became our navigator through the long hours of waiting She came to us at every stage, shared information that calmed us and made us feel health literate about what was happening to Pete.

Trouble on the Tracks

But in the late afternoon, when we were feeling so sure he was sailing through the procedure, we became alarmed. Stanford has a color-coded electronic screen of all patents in surgery showing you their operating stage. We were watching this large electronic surgery board, much like an airline flight board with scheduled take-offs and landings. Pete was about to land in post-op then before our eyes -reversed to the operating room. Pedro, the navigator of the board, had no idea what happened but told us Christine would be down to talk to us. My two daughters and I were then on red alert and our lovefest with the ease of all this dumped back into reality.

Tear in the Heart

As any case manager would, Christine arrived with calming information. As they were about to close up Pete’s chest after the new valve went in flawlessly, they noticed a small tear in the aorta. She explained that the aorta, like all of Pete’s body, was almost 8o- years old and thin enough to tear. Dr. Fichbine saw bleeding, along with the 30 residents who were watching, did a small patch, closed up the incision then sent him on his way to post-op. In reality, it was more serious, but she shared the steps taken and he was in truth patched up and on his way to recovery. She gave us the right information mellowing it out enough that we went from Post 9/11 color-coded red- terrorist attack imminent —to calming green – low threat. Pete arrived back in post-op and we got to see him at 7:30 that night 13 hours after his trip through the surgical theaters.

Christine is also our head discharge planner and goes to see Pete every day, along with Dr. Fishbine on rounds. She will be there at discharge when she, a Stanford pharmacist, and a cardiac nurse share discharge plans.

So thanks to all the care managers who like Christine, guide us over troubled waters, comfort us and hold our hands while they navigate us to a safer shore.

Is Senior Alcohol Abuse At A Crisis Level?

February 15, 2019

AARP says alcohol abuse among seniors in a national crisis

According to Paula’s Span ‘s New York Times blog New Old Age, about assisted living 70% of all older people in assisted living drink alcohol.

Does that surprise you? Increasingly geriatric care managers, need to and do worry about alcohol.

Substance abuse or dependence, including alcohol use, drug misuse, and nicotine use, can have severe negative physical, cognitive, and psychological consequences for the older adult. Geriatric Care manager screening for this is essential, not only to detect the problem, but to identify potentially harmful interactions with other physical and mental conditions that could lead to high blood pressure, falls, or memory loss. Improper substance use can increase comorbidities and interfere in the treatment process, and therefore increase medical complexity.

Having a clear definition of what constitutes problem drinking in the elderly is difficult.

With younger adults, clear criteria are defined in the Diagnostic and Statistical Manual of Mental Disorders, including disruption of role function, financial instability, and decreasing social networks. But these criteria can be present in the older adult population at large without a substance abuse problem. Additionally, substance abuse problems are masked by other problems associated with aging, including falls, injury, confusion, self-neglect, depression, emotional liability, memory loss, sleep disturbance, and adverse drug interactions. Furthermore, an elder’s tendency to use alcohol frequently or heavily is dismissed as “the only vice she has left” or “something to help him sleep.

Are there solutions? AARP recommended this book

The National Council on Aging has a good list of solutions at the end of this article.Recommendations are made in this article but there is not one answer and this topic is obviously one that needs much more exploring by Geriatric Care Managers, who encounter this problem frequently with their aging clients.