Cathy Cress

Expert in Aging Life and Geriatric Care Management

Care Manager’s Must Help Elders at Risk of Covid -19 Prepare End Of Life Docs Fast

Aretha Frankin died without will 18 months ago -before COVID-19. Now older people both famous and out of the spotlight are dying in a pandemic not seen since 1917. According to Aretha’s ‘lawyer, Ms. Frankin was aware she needed to take care of this but ” never got around to it”. This left her estate liable for potentially millions of dollars of taxes and attorney fees and a drawn-out timeline for her 4 sons to inherit the proceeds from her estate.

Franklin was, as many have said, ” a force of nature” and a woman who would be hard to sway. But care managers specialize in working with VIP clients and the rich and famous. These clients are often uber difficult to work with- entitled, narcissistic equally hard to sway. Aretha Franklin’s attorney might have convinced her that she needed to work with him to protect her family and her estate before she died.

You as a care manager may have to take a more urgent  approach by yourself or with the client’s attorney because the stakes are so much higher as

now elders are likely to die with this virus rampaging throughout the world, striking the people with comorbidity, like people over 65, the hardest

Most geriatric care managers work with the wealthy top 10% if they want to survive as a business as Medicare does not cover long term care. Only the top 10%, like Aretha Frankin, can afford it. But what comes from being a good care manager is knowledge of death. End of Life care is one of their jobs.  Making sure their client has all their legal documents ahead of time is critical at this minute. With COVID-19 that clock runs on speed.

Right now with 80% of all the people in the US dying of COVID-19 elders, these documents- one a living will- are ana important job of the geriatric manager, as death

may be shrouded and waiting around the corner for many of your clients 

Once the COVID-19 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. The problem with COVID-19 is that the onset of the disease can be rapid.  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, this 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 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 your older client has these documents before they have COVID-19:

 

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.

But During Covid-19 could rush an elderly client towards death like a mammoth mudslide sweeping them into a hospital where no one can enter, even the family.

Care Managers play a big role in the end of life issues. They are their navigators through all five stages of dying, which is the time before COVID-19 could be long before palliative care or hospice are called.  But in this plauge’s reign, there is little time to plan so the five stages of death are on steroids. So, talk to your clients now before they get into a screaming ambulance to the hospital where no one can follow the including you and may never return.

 

 Proactive discussions and legal planning now can help to reduce the risk of dying like Frankin leaving the legacy of her music, a soundtrack to her life but a family both shattered and at war with each other. The COVID-19 clients you see now could be in this position and their families will be left with no rituals no funeral no advanced directives and only hopefully a zoom family meeting to say their last words. Good legal guidance can also help clients make better decisions,  avoids all this other legal horror on top of the torturous death of coronavirus. Making a will or a trust now will save the family from adding to the burden of a lonely painful death.

Consider getting this product with my GCM Operations Manual 

Concierge Clients Who Can Afford Private Geriatric Care Management No Longer Taking Cruises

 

Tens of thousands are dying in the US and worldwide of coronavirus so a cruise ship of any cruise now wreaks of expiring slowly on the ocean with no real hospital and no place to disembark. This is not the product that the upper 10% or anyone would board now. But in better times concierge products like a Viking Cruise as it is understandable to a high-end customer. They buy it –because it has exceptional services and recognizes their entitled station in life. Coronavirus recognizes no status class and kills all equally.

Sell Products Clients Need During the Pandemic

Geriatric care managers, rather than tell inquiry clients they do assessment–should offer products they need in this pandemic  – like relocation (moving an older person). Elders who live in dangerous SNF facilities, so vulnerable to COVID-19 

In an article from the LA Times Charlene Harrington a Professor from UCFS states”Families with loved ones in nursing homes should consider pulling them out if it’s at all feasible to care for them at home, said Charlene Harrington, professor emeritus at UC San Francisco’s School of Nursing.

“The risk of exposure is so overwhelming,” said Harrington, who has studied nursing homes since the 1980s. “It’s a terrible concern.”

ALCA suggested that you call all the SNF’s in your area and explain that you specialize in moving elders and can be of help to their clients who are moving out of SNF’s due to family concerns.

GCM Products for the Isolated and Lonely Seniors During Stay at Home Orders

Quality of Life (increasing the joy in an older person’s life who is lonely) can be an important service to offer during the coronavirus pandemic. Seniors who live alone are already isolated, lonely, and depressed and the virus only causes this to explode in their lives.  Quality of Life programs like Sage Eldercare’s Humminbird Program has gone remote and can be purchased for a minimal amount for client’s by families or agencies, nationally. Nina Herndon GCM, Sage owner and innovator, started this program several years ago because she was tired of watching elders she served watching TV 40 hours a day. She has brought it into the digital world to serve coronavirus patients nationally. Nina also wrote the Chapter on how to set up a Quality of Life program in my book  Handbook of Geriatric care Management 4th edition 

Products For Seniors Discharged from Hospitals in Pandemic When SNF’s will NOt Take Them

Home from the Hospital is a GCM product the Safely helps the older client through discharge and the first 3 months to make sure they do not return to the hospital, which now is overrun with coronavirus patients and at capacity.

Home From the Hospital pinpoints exactly what the older person needs for discharge with the hospital and why the family is desperately calling for help. They are calling for help at a piercing decibel level because nursing homes will not take them for fear of COVID 19 infection of their residents 

To do this, offer these products to families third parties, hospitals, and nursing homes in this crucial time. Develop continuously integrated solutions through a product procedure placed in your 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 especially under the huge stress of the coronavirus with vulnerable parents -just purchased and demands.

If you do not have an operation manual, I have all these products in my GCM Operations Manual plus 11 more, with all the procedures in place so you can instantly offer them. I will offer a 20% discount for the GCM manual during the pandemic for Geriatric Care Management Agencies suffering during the coronavirus outbreak. Contact me here 

Medicare For All Includes Long Term Care – Perhaps Pay Attention Now With -Covid 19 Raging ?

Long Term Care Not Covered by Medicare

Geriatric Care management and home care, among other critical services tin aging are not covered Long term care services, is not covered by Medicare. In Bernie Sanders & Elizabeth Warren’s Plan, Medicare for all would cover long term care, a point that the Washington Post said that Sanders did not emphasize enough.

Medicare For ALL Would Cover Long Term Care 

Time Magazine, recently reported that Covid-19 ‘s effect right now is making Medicare for all seem like the present need nor an unaffordable dream . The “Department of Housing and Urban Development halted foreclosures and evictions during the emergency; the Department of Education slashed federal student loan interest rates to zero and will allow borrowers to completely suspend payments if needed; Congress is negotiating a plan to send direct cash payments to families, and a version of paid sick leave just became law.”

What If We Had Medicare For All During Covid 19 Pandemic?

If we had Medicare for all during the Covid 19 pandemic, we would be better able to disburse funds in emergency situations and to purchase necessary machinery, such as ventilators ( that only the president seems to be able to dispense through the Defence Production Act & does not, during a crisis and get them where they need, like the 30,000 needed and missing in New York) face masks that as so needed that the CVC recommended bandanas and a 10-year-old student in Boston is sewing herself the height of the pandemic right now.

Unlike our current health care system, Medicare for All would include specific funding for dealing with pandemics or other health emergencies that could be distributed quickly without requiring additional legislation of presidential planning, which seems not to have happened at all. The United States cannot be left unprepared for mass health risks like COVID-19. It is time to put in place Medicare for All and better protect the health of the American public.

 

Ethical Dilemma

This lack of Medicare covering Long term care leaves geriatric care managers in an ethical dilemma of being able to only be able to serve the upper 10% and leaving 90% of seniors and thus under 64 with chronic care needs like MS, unserved.

 

Elizabeth Warren’s plan for Medicare for all could cost 20 Trillion over 10 years. Existing Medicare over the 10-year period would cost 16 trillion. The bill we are just passing in Congress to fund is 2 Trillion. We will need another bill. Are all the mounting deaths from Covid 19, 55,000 people with Covid 19 and counting, disruption to business, our lives and the hospital really worth not paying attention to Medicare for All- which it looks like we just might be able to afford?

Find out about this ethical dilemma and what care managers must do to serve the upper 10%, and ignore lower 90%, who have no long-term care under Medicare .

Since geriatric care management must be privately paid for, in the absence of coverage under present Medicare, in spite of our moral dilemma

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