Cathy Cress

Expert in Aging Life and Geriatric Care Management

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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.

Filed Under: Aging, Aging Family, aging family crisis, aging life business, Aging Life Care, Aging Life Care Assocaition, aging life care manager, care manager, caregiver, caregiver assessment, Caregiver Burn Out, CAREGIVER RESOUCES, case manager, CIRCLE OF CARE, estranged siblings, GCM COACHING SKILLS, Geriatric Care Management Business, geriatric care manager, Geriatric Care Manager, geriatric social worker, midlife siblings, nurse advocate, nurse care manager, Siblings Tagged With: caregiver assessment, CAREGIVER RESOURCES, caregiver strain, caregiver stress, Circle of Care, family caregivers, geriatric care manager

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

How To Create a Team in the Long Distance Family During Covid 19?

May 16, 2020

 

OFFERING A COVID care plan product with Long Distance Care Providers

The first step for the Long-distance family members (LDF) worried about elder exposure and hospitalization of Covid-19 can be to take a team approach. This can be a call with a geriatric care manager for a consultation that will help long-distance families work as a team to keep elder family member safe while you are at a distance This Care management consultation can be done with a HIPAA-compliant video conferencing services 

 

  • 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, the care manager will have a discussion with senior and the long-distance family regarding their wishes, explaining 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 with the older adult and suggest they 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 access AARP advanced directives documents for any state which can be executed quickly.

 

  • If documents are completed, locate in the 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 caring village.com  so the long-distance from always has the updated documents.

Other problems that geriatric care managers who offer consultation can solve for  long-distance family members

  • Create a Household plan of action for prevention and possible infection with COVID 19.
  • Identification of technology tools to keep client and LDF in contact
  • Evaluate the presence of required cleaning/safety products as recommended by CDC
  • Evaluate the area of home appropriate for quarantine in the event of suspected COVID infection of client or caregiver
  • GCM can also focus on the quality of life of seniors and provide a comprehensive plan to ensure the individual is living a quality of life while providing consistent communication with the Long Distance family-like Hummingbirdproject.net Thanksgiving-Travel-2_20151119-171457_1.jpg
  • Development of client-specific communication tool for possible hospitalization to individualize client needs, status and care planning post hospitalization

 

Join my new GCM on Line Classes Working on Covid- 19

This research was done by my geriatric care management student GCM Maryann Prudhomme. My students are working on Covid-19 products in both all of my two new online classes in blackboard right now. If you are interested in joining our class and

learning tools to be a geriatric care manager go to cathycress.com online classes

 

 

 

Join Me in My New Free Webinar

Conquer Care Management Sales- 5 Steps Close the Sale on COVID-19 Products

 

Sales have severely declined in COVID_19. Learn how to increase your, clients, through all your products but especially new Covid-19 and telehealth. Sell Successfully

this and any GCM product in a 2-part intake. Closing the sale means the client signing your contract and giving you a deposit. Most care managers are untrained and terrified of this process. They are more terrified of going out of business with COVID 19

Learn the 5 steps to make and close a care management sale to get that contract signed, get a deposit, grow your business, bolster cash flow, make payroll, and stop you from being one of the 50% of new US businesses that fail after five years.

When?

Date Tuesday, June 23

Time 2:00 PM -3:30 PM

 

You will Learn

 

What are Covid-19 GCM Services you can offer

How to make the sale in the inquiry call -with a complimentary consultation

How to ” Identify needs using client” challenge questions” to find the problem you need to solve to make the sale

How to present your offer by selling solutions to the problem with a mini care plan

How to manage objections if the caller has concerns about price or product

 How to close the sale with non-aggressive closing questions to have your contract signed, get a deposit, and grow your business with a new client

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Filed Under: Advanced Directives, Advanced Directives and Covid-19, Aging, Aging Family, aging family crisis, Aging Life Care, Aging Life Care Assocaition, Benefits of Care Management, Care Management Products, care manager, CAREGIVER RESOUCES, case manager, CIRCLE OF CARE, coronavirus, Coronavirus emergency plan, coronavirus marketing, coronavirus quality of life virtual program, coronavirus shut down, Covid 19, Long Distance Care, Long distance caregiver Tagged With: ADVANCED DIRECTIVES & COVID-19, aging family, aging life care manager, aging life geriatric care manager, aging parent crisis, care manager, case manager, COVID-19 PRODUCTS, geriatric care manager, long distance families, marketing during COVID-19, nurse advocate, nurse care manager

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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Trouble on The Tracks -11 New Year Resolutions For Aging Parent Worries

December 27, 2019

Here are some suggestions that you might consider as New Years resolutions-  as we approach January.

You may have already vowed this and not followed through because it is uncomfortable or scary or too much to take on— but this is one that will help avoid disaster.

It’s not “go on a diet,” but what you should do after the holiday with
your parents if you spot red flags that made you concerned about your aging mom or dad. Here is a list of resolutions you might make for your next visit to your parents after the holiday gave you a reason to worry about an aging family member:

11 New Years Resolutions 4 post-holiday parent worries  

  •  Accompany the elderly person to the doctor, and talk to the doctor in person
  •  Gather legal financial and insurance paperwork,scan all, put originals in a safety deposit box and leave easily found  copies for your parents
  • Have all bills except magazines forwarded to yourself or another relative who will manage them
  • Contact and meet with old and present friends and form a network of support
  • Investigate quality of life local programs like a senior center, bridge group anything that would bring your parent joy and engagement
  • If your older family members are in a facility, make contact with staff that cares for them, and the ombudsman.
    Meet with your elderly relative’s present support network or set up a circle of care 
  • Look into Lyft or Uber’s senior driving program  or GoGO- Grandparent if seniors should or no longer wish to drive
  • Arrange a family meeting to see how adult children and friends can share tasks using Lots of Helping Hands
  • Look into Forgiveness techniques for adult siblings  if you have old wounds that may stop you from sharing care with adult brothers and sisters
  • Meet with an aging life or geriatric care manager in the area who can do all these tasks for you

Filed Under: Aging, aging life care manager, Blog, CIRCLE OF CARE, Families, Geriatric Care Management Business, Geriatric Care Manager, Long Distance Care, New Year Resolutions, New Years, parent care, POST HOLIDAY SEASON, Quality of Life, Quality of Life for elders Tagged With: aging life care manager, aging parent crisis, care manager, elder care manager, geriatric care manager, Go-Go Grandparent, Lyft for seniors, New Years resolutions for adult children, nurse care manager

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