Cathy Cress

Expert in Aging Life and Geriatric Care Management

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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.

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Why Phyllis Brostoff Says You Should Get a D on Your Written Geriatric Assessment

January 16, 2020

How To Score an A Writing a Geriatric Assessment

A written Geriatric assessment is the toughest skill a care manager can have in their toolbox. You want your A-game because they frequently go to elder law attorneys who submit them to court in conservatorship or guardianship lawsuits. As evidence, they must be perfect. You the care manager pull all your other skills of assessment, care planning, investigation of a case to find the right solution for the clients and objectivity. Plus what is not taught in gerontology classes – writing skills.

Phyllis Brostoff a legendary now retired geriatric care manager an ALCA board member taught this skill and published it in the Handbook of Geriatric Care Management in the Geriatric Assessment. Here is both how you might garden a D or even a flaming F and how to present that attorney your A-game.

WHAT ARE THE BIGGEST ERRORS GCM MAKE IN WRITING A GERIATRIC ASSESSMENT?

  • Sloppiness: not enough information is gathered, or used to evaluate problems
    • You are a detective and need to gather all the information (clues about the case in the beginning). This means talk to all family members, friends, formal supports,  to understand what are all the problems and how will you evaluate them. This includes using all assessment tools and gathering all records, medical, hospital, etc.

 

  • Errors: questionable information, information not checked–

 

  • One daughter says her father is confused and needs her care– not a paid caregiver. Another daughter says that the first daughter has taken financial advantage of the client by withdrawing money from Dad’s bank and should not be the care provider. You do not check the father’s bank account to see that the daughter has made withdrawals for her father’s accounts, which she has.

 

  • Poor spelling, grammar, sentence structure

 

  • Even though your geriatric assessment has every section included and fully filled out, with your care plan and logical conclusions well stated and correct, with perfect recommendations —if you used poor spelling and grammar, the family or attorney will discount it because of your poor writing presentation.
  • Poor organization of information.
    • For example, don’t put information about the client’s depression in the Home Management section of your geriatric assessment. Mrs. Typhoon feeling depressed does not go in the home safety section. Do not commingle sections. Write a tight outline, follow it, and make your written assessment cohesive.

 

 

  • Conclusions based on assumptions, not facts

 

  • Make sure your facts are presented clearly. In Mrs. Typhoon’s geriatric assessment, you would not say Problem: Mrs. Typhoon suffers from anxiety, based on your visit where you charted.” Ms.Typhoon looked full of anxiety.” You would state, “When visiting Mrs. Typhoon on November 1, 2026, Mrs. Typhoon stated to the GCM that she very anxious and wanted to take more of her Xanex.” GCM checked with Dr. Feelgood and he said she is taking 10mg of Xanax as needed.

 

  • Lack of coherence between problems, solutions offered in recommendations
  • Your geriatric assessment must lead to coherence between solutions and problems. At the beginning of Mrs. Typhoon’s geriatric assessment, her daughter Ms. Tornado wanted you to find out why her mother had multiple falls, and what level of care her mother belonged in. You state she has fallen five times and needs a walker but never state where she falls, which is going down the steps to the laundry room or offer a solution which could be a care provider do the laundry or moving to a single floor dwelling or both.

 

  • Recommendations incomplete: no or not enough choices offered, no argument put forth to guide decision-making
    • Recommendations in Ms. Typhoon’s geriatric assessment are incomplete. As stated above

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Filed Under: Aging, Blog, Care Plan, Families, Geriatric Assessment, Geriatric Care Management Business, Geriatric Care Manager, Webinar, Written Geriatric Assessment Tagged With: aging life care manager, care manager, eldercare manager, Geriatric Assessment, geriatric care manager, nurse care manager

Have You Done Disaster Planning for Aging Clients?

November 8, 2019

Do You Have a Disaster Plan?

The devastating fires up and down California this month should tell you that you need a family meeting to prepare any aging family members in any place you live, ( especially long-distance ). We are facing global warming and normal catastrophic weather events- tornados, hurricanes, polar vortex and floods like the last year’s floods in the midwest. You need a disaster plan because older people are more vulnerable than any age group.

What would be the agenda of that disaster family meeting?

1) Create a disaster plan for the older person. This map out what each sibling and family member needs to do

2) Create a disaster team. This would be all adult siblings all over the country, family nearby, caregivers and neighbors.

Share your disaster plan with everyone.

Include someone on the team who can carry heavy objects like wheelchairs

Name a substitute caregiver if the regular one can’t get there

3) Make an evacuation plan . Where is the nearest shelter, what supplies

Do you have on hand? Get list from your local Red Cross 

How many people do you need to make the move to safety? Look closely at picture on right. These SNF residents are in water up to their waists.

4) Put all of the above in writing. E-mail copies to everyone on the family disaster team including all adult siblings or create a closed facebook group hand share there.

5) Get everyone’s agreement especially midlife siblings and the older person.

For more information, the University of Florida,  Home of Disaster filled hurricanes has a great set of directions.

6) Call a geriatric care manager     to manage the plan if you live long distance

Professionals check out the  Preparing for Emergencies-chapter in  Handbook of Geriatric Care Management  fourth edition , by Liz Barlowe on Disaster planning

A GCM member Jim Boyd lost everything- his practice, home, last year in the Paradise Fire.

Professionals Check out my book Care Managers Working With the Aging Family, with it’s chapter on Family Meetings and the Aging Family by Dr. Rita Ghatak of Stanford

Filed Under: Aging, Aging Life Care, aging life care manager, Blog, care manager, Care Plan, caregiver, case manager, elder care manager, Elderly Disaster Plan, Emergency Plan, Families, geriatric care manager, geriatric social worker, Long Distance Care, nurse advocate, nurse care manager, Siblings Tagged With: aging family, aging life care manager, aging parent care, aging parent crisis, care manager, case manager, checklist for aging parent problems, geriatric care manager, Hurricane Harvey, long distance care provider, nurse advocate, nurse care manager, siblings

How Catchy Copy Can Sign Up New Long Distance GCM Clients

November 4, 2019

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GCM as Wonder Woman

Care managers need to create a gold-standard written copy to advertise their services to ling distance customers. However, you need a Wonder Woman spin that will make copy stand out from your competition.

Here is a sample you may use for long-distance care providers

1, “If you are a long-distance family care provider for an elder, give yourself Wonder Woman as a  powerful sister to help with the care of your aging family member.

2. Using a gold standard care manager is a preventative, prudent excellent choice for 3 reasons.

  • a. If you live long distance and there is an aging parent crisis,  your safest choice is to have a local GCM  to solve it. In an urgent situation, the care manager can go to the hospital or emergency room.
  • b. This is more cost-effective than you getting on last-minute, expensive flights. You can still go but, like Wonder Woman, they can immediately be there to deal with the crisis and solve it. She is good insurance.
  • c. Before any crisis, you can have the GCM aka Wonder Woman will do an initial assessment and visit your older relative periodically. This is preventative because Wonder Woman can see and solve the problem before it becomes a health crisis that might put your loved one in the hospital.
  • 3. Think of a care manager the way you do one of those blow-up beds. You can pump them up when you need in a crisis—perhaps avoid that crisis, and you yourself can sleep more soundly and with more peace of mind in your own bed.

5. What a geriatric care manager aka Wonder Woman and Superman can do for you are:

  • Save you money by helping keep your parent out of the hospital and you off emergency long-distance flights.
  • Facilitate a family discussion of needs, resources, and division of labor among friends family
  • Recommend ways to proactively prepare and plan for a parent’s possible health care crisis.
  • Work on family cooperation to formulate a realistic parent-care plan.

    .
  • Assess the strengths and weaknesses of all of the potential caregivers
  • Help adult siblings resolve conflicts about care decisions.
  • Help siblings act together in the best interest of the parent
  • Decrease the tension between hometown and long distance siblings
  • Help the long-distance care provider deal with guilt and frustration that may result from their inability to provide more of the day-to-day care.
  • Locate  the highest quality aging resources in your aging parents’ area quickly and without you having to do it

Join me in my latest free webinar when care managers busiest season starts after holiday visits can put long-distance families so over the edge and they call you

 

5 Ways to Tame the Turbulence of Holiday Meltdown in Aging Families

 Learn how!

  • How to work with both dysfunctional and long-distance families who call during the holidays
  • How to give hope to frantic children who call, after seeing their aging parent struggling with the rituals
  • How to sell services to desperate adult child callers   
  • How to use GCM tools to contain Holiday chaos
  • How to use financial forecasting to prepare for growth during the holidays
  • Sidestep the Many Care Managers Who Do not know how to work with Long Distance or Dysfunctional Aging Families so the  client chooses you

THIS FREE  WEBINAR IS NOVEMBER 21, 2019 FROM 2 PM – 3 PM PST

 

SIGN-UP NOW

10 Steps to Success in Selling Care Management to Assisted Living

FREE WEBINAR- 10 Steps to Success in Selling Care Management to Assisted Living

 

THIS WEBINAR BEGINS: Monday, June 24, 2019, 2 PM PST Ends 3:15 PM PST

 

Filed Under: Aging, aging family crisis, Aging Life Care, Aging Life Care Assocaition, aging life care manager, Blog, care manager, Care Plan, Families, Geriatric Care Management Business, Geriatric Care Manager, geriatric care manager, geriatric social worker, Holiday Rituals in Aging Family, Long Distance Care, Long distance caregiver, Marketing aging life care, marketing ALCA /GCM, marketing care management, Marketing copy, marketing geriatric care management, marketing to concierge clients, marketing to long distance adult children, marketing to the top 10$, nurse advocate, nurse care manager, Siblings Tagged With: aging family, aging life care manager, aging parent, aging parent crisis, care manager, case manager, elder care manager, family caregiver caregiver burnout, geriatric care manager, long distance families, long distance family on holiday, nurse advocate, nurse care manager

How is a Geriatric Care Manager a Care Connector With Mid Life Siblings ?

July 15, 2019

We are creeping towards to August which means often seeing our midlife siblings at more summer vacation events. At times  we are estranged from midlife sibling or we are polite at a family gathering but there is no real connection.siblings

Aging life or geriatric care managers are care connectors. They cannot do everything themselves for the family , like be the best geriatrician, accountant or home health aide nor do they have the skills to do that. What they have is the skill to connect to the right resource, like a geriatrician , elder-law attorney , support group or home health aide, especially for a family caregiver.

Emotional resources can link a circle of care for the direct family caregiver. These emotional supports could and should include adult siblings  .Siblings are the longest and deepest relationship in any person’s life. Reconnecting midlife or aging brother’s and sisters, through the circle of care, is a critical GCM task but to achieve this, the care manager may have to depend his clinical skills in helping siblings with forgiveness or reconnecting siblings who live long distance.

Midlife siblings have often spent the last 30 years tending to their own families .So the point of reconnection with middle aged brothers and sisters often happens when they are still working or  just retiring  — unexpectedly  thrown into a crisis in parent care.

This is where the GCM needs to have clinical skills to can help with healing this sibling disconnection-often short circuited by an old sibling wound  that helping the sister and brother work together as a circle of care . You replace the shorted fuse in the fuse box.

If the family is dysfunctional,  the care manager becomes a care connector and links the right resources  that might include an  mediator who specializes in aging families  or a Marriage and Family Therapist  who specializes in Aging  (hard to find)

If you are a geriatric care manager or therapist,you can find chapters on mediation, working with the nearly normal family and dysfunctional aging family, siblings, family meetings and care connection Handbook of Geriatric Care Management 4th ed. for help in all these areas.

It may be 4 months away till Thanksgiving but a an aging parent crisis could happen tomorrow. Reach Out now for help.

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Filed Under: ADULT SIBling, Aging, aging family crisis, Aging Life Care, Aging Life Care Assocaition, aging life care manager, Blog, care management start-up, care manager, Care Plan, caregiver assessment, Caregiver Burn Out, Dysfunctional Aging Familu, elder care manager, Families, Geriatric Care Management Business, geriatric care manager, geriatric social worker, Long Distance Care, SIBLING, sibling rivalry, sibling sharing care, Siblings Tagged With: adult sibling conflict, adult sibling estrangement, adult sibling meeting, aging life geriatric care manager, care manager, dysfunctional family, elder care manager, elder mediator, geriatric care manager, Marriage and Family Therapist, nurse care manager

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