Cathy Cress

Expert in Aging Life and Geriatric Care Management

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What is the Care Manager’s Role with Hospice?

February 25, 2021

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What is a Geriatric Care Manager’s Role in Hospice?

The geriatric care manager serves older adults before they find they are dying. GCM’s work with chronic care clients, some times for years, who eventually succumb to their illness. They also work with clients who come to them facing the end of life issues.

 The process of acceptance and adjustment to terminal illness has five phases:

 

·      before the diagnosis,

 

·      the acute phase ­

 

·      the chronic phase

 

·      the recovery phase

 

·       the terminal phase 

 A care manager is a GPS for both the client and family through the

5 stages, bringing in critical services like palliative care and hospice

caregiver respite and quality of life the whole continuum of care for supporting the end of life- at the right phase at the right time –

Benefits You (as a GCM) will Bring to Hospice

  • You (as a geriatric care manager) will bring the client to Hospice much earlier in the 5 stages of death and dying than one month before death

 

  • You will do a Quality of Death assessment to find out the patient’s wishes for a good death

 

  • You will make sure all the critical paperwork is needed is gathered and organized, including:
  • Insurance
  • Legal
  • Financial
  • Healthcare
  • End of life

Interventions vary according to the phase. The GCM may already have served the client and they are now facing a terminal diagnosis. But a geriatric care manager may be brought in when the family is negotiating through any one of these phases, their work begins with making a determination of what phase the client is in and what services are appropriate for that client at that stage. They are also the best professionals to bring in the quality of life to every phase so that the client can have not only a good death but a good life to the very end.

Benefits You Bring To the Family Friends and Hospice

  • You will monitor the client/care receiver’s and family caregiver’s health and psychosocial status and the paid caregiver’s care plan, to improve the quality of care and life for the client and caregiver So That Hospice can direct all it’s attention to the client and assured family
  • caregivers needs are being met
Shot of a wife consoling her husband during a counseling session with a therapist
  • You will accompany the client to all medical appointments and make sure that the 10 minutes cover all questions, that the physician’s orders are recorded and followed, and that all meds are picked up and set up properly So What –Hospice does not provide this  and ensures the client gets to all appointment relieves the family of another task and everyone is getting all the correct information from the physician

 

  • You will make sure that the family has an online personal health record or a notebook if they wish So What -The family has a way to keep track of information from many professional involved and passes on the correct information to everyone in the family and they can feel more in control in an emotionally chaotic time

 

  • You will do a caregiver assessment and suggest interventions from the local continuum of care, including support groups, counseling, respite care, and private duty home care So What –You are insuring a whole family approach and  the family caregivers are getting the support and respite they need in this frightening time for their loved one

 

  • You will coordinate family meetings to facilitate issues like shock, grief, and shutting down So What- You are a container, allowing the family caregiver to deposit their tremulous at timesdesperate feelings in a safe place so they can get help from you and be calmer for the dying loved one
  • You will coordinate health literacy information and training of disease skills for family So What- You will create a forum for the family caregivers to express their grief, fear  and even hopes and demystifying all the unknown medical terminology to make the family feel more literate and self-assured in approaching the medical staff to get the information they need

 

  • You will monitor anticipatory grief in family and friends and bring in resources

    So What- You will create a forum for the family caregivers to express their grief fear even hope and find the help they need to so on with the journey to death

 

  • You will review all new medication with family caregivers and care staff- So What-you will unravel the confusing litany of pharmaceutical terminology  and make sure the family and friends both understand  what med does what, how to set up meds  and remind the meds when hospice is not present

Join me in my new FREE Webinar
Learn to Sell Benefits not Features to Third Parties  to Grow Your Care Management Bottom Line

When: February,20th 2020
2PM-3:30 PM PST
Learn
 

What is a benefit vs features and how to find benefits for each 3rd party you market to?

What specific problems you solve for hospice, wealth managers, elder law attorneys, and concierge physicians  

What specific problems to solve for upscale Assisted Living, accountants, financial planners, MD’s  

Step by Step how to set up meetings with 3rd parties to make the sale

SIGN UP


Find out more by watching my youtube playlist on Death and Dying on my channel Geriatric Care 1

Follow Cathy @ cathycress.com

Filed Under: Aging, Aging Life Care, aging life care manager, Benefits, Benefits of ALCA to Hospice, Benefits of Care Management, Benefits of Care Management to Hospice, Benefits of Geriatric Care Management, Benefits vs Features, Benifits & Assisted Living, Blog, care manager, case manager, Death and Dying Care Management, death and dying care manager, elder care manager, Families, Geriatric Care Manager, geriatric care manager, geriatric social worker, nurse advocate, nurse care manager, Palliative care manager Tagged With: aging family, aging life care manager, aging parent crisis, Benefits, benefits of ALCA, Benefits of Care Managers To Hospice, Benefits Of Geriatric Care Managers, care manager, case manager, end of life, end of life care manager, Features and Benefits, Features and Benefits of geriatric care management, five phases of death, free webinar, Free webinar marketing, geriatric care manager, Hospice, nurse advocate, nurse care manager, palliative care manager. Hospice

End of Life-When Do You Need Mediation?

February 23, 2021

Why do some families need mediation at the end of life? Mediation is a voluntary process in which the parties, with the help of an impartial third party mediator, work together to resolve their differences or solve a problem they were unable to address satisfactorily without help. These family differences especially happen to dysfunctional families but can beset any family at the end of life. They are faced with overwhelming emotions and decisions that demand that the family work together as a team. What happens to dysfunctional and even nearly normal families during this trying time? They don’t gather as a team. They fight. They fret and they feud. What are the results of this fighting, fretting, and feuding in families at the end of life?                                        family-charis1-226x300.jpg

Unresolved family conflicts emerge

            Dysfunctional families become more dysfunctional

Family members’ grief, pain, and anxiety are often masked as anger and presents as conflict (past and present)                                                 

Older person dies without resolving important family issues

Older person dies in conflict, not in peace

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 

 In this 1 ½ -hour webinar you will learn how to 

  • Transition the patient/family through the five stages of death     
  • Help clients be active participants in their care
  • Give the family/caregiver tools to manage care
  • Provide family center care to caregiver and family
  • Choose the right support services through all stages of death
  • Introduce Hospice and Palliative care and work with their team
  • Use ALCA End of Life Benefits During COVID
  • 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

 

Filed Under: Aging, aging life care manager, Death & Dying, Death and Dying Care Management, death and dying care manager, DNR, End of Life, End of Life Care manager, GCM role Death and Dying, geriatric social worker, Good Death, Hospice, Hospice Care, mediation, Mediation End of Life, Mediator, nurse care manager Tagged With: Advanced Directives, aging parent, aging parent care, aging parent crisis, ALCA care Manager, ALCA in End Of Life, disputes at end of life, dysfunctional aging family, dysfuntional family, elder mediation, end of life, end of life family meeting, facilitator, families fretting at end of life, family meeting, Fighting and Feuding at end of life, GCM mediator, geraitric care manager, Geriatric Assessment, geriatric care manager, geriatric care managers, Handbook of Geriatric Care Management third edition, mediation, mediation end of life, mediiator, My Geraitric Care Management Operations Manual, nurse advocate, nurse care manager, power of attorney for health care, siblings feuding, siblings fighting, step sibling family meeting

How Does Atul Gawande View Quality of Life in Dying ?

February 21, 2021

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   A good life to the very end 

Atul Gawande’s acclaimed book, “Being Mortal“ opened our eyes to the medical way of death. He showed millions of readers how the quality of life and human interaction while dying trump the number of years gained through questionable painful procedures and dying in an institution.

He tells us that “our ultimate, goal, after, is not a good death but a good life to the very end

 

Quality of Life Can Be There to the End of Life

GCM Nina Herndon brings you that same quality of life message- about dying –where an elder can still live the end of life with joy. Her new chapter “Supporting Clients’ Quality of Life: Drawing on Community, Informal Networks, and Care Manager Creativity” in the Handbook of Geriatric Care Management 4th edition is a geriatric care management Nina has devoted her career to giving elders a care plan for a happy life and a happy life to the very end.

 Bringing Joy in the here and now of Dying

 Bringing joy in the here and now of dying can be done through using quality of life tools- Spiritual, emotional, intellectual, creative, and physical quality of life. Increasing the spiritual quality of life can mean for a person is dying and wishes to return to a spiritual group she knew before, connecting them to the faith they are familiar with. Even homebound clients can have visits from members of a religious community or a prelate. They can have hymns sung, prayers said or whatever religious ritual their spiritual group follows, like communion, at home. Care providers can be trained to engage them by reading religious texts or playing hymns.

The Power Reminiscence at End of Life

Spirituality can be the environment. I once had a client who was in a nursing home dying of cancer and wanted to go home to die with hospice and 24-hour care. Hisgrandma_holding_rosary_shutterstock_40017103-255x255.jpg spirituality was the environment and he had been a lead volunteer to build a trail in Santa Clara California from Los Gatos up the steep winding highway 17 over the Santa Cruz mountains to the Lexington Reservoir. He had no family so the care manager asked the volunteers he had worked with if they would visit him at his home. They happily agreed and 300 volunteers took shifts, 24 hours a day to sit with him reminisce, tell stories and sing while he died over several weeks. This is what joy that bringing a spiritual quality of life can offer in dying.

Tools for Reminicance at End of Life

Friends emailing short personal videos with good wishes and memories, that a family member can show on a phone or computer- can bring emotional joy at end of life. Sending notes, not of condolences but great memories can be a salve to dying. Volunteering to give respite to family members, if visiting is allowed during COVID or post the pandemic, can give an opportunity to share old memories or look at old photos and give family respite. You may have thought those old photo albums should be dumped but they can bring the joy of reminiscence if shared at end of life or with seniors at any time.

 

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  

 

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

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

Filed Under: Aging, Aging Family, Aging Life Care, aging life care manager, care manager, case manager, Death & Dying, Death and Dying, Death and Dying Care Management, death and dying care manager, End of Life, End of Life Care manager, Families, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, Good Death, Hospice, Hospice Care, Hospital care manager, nurse advocate, nurse care manager, Photo Albums& Reminicance, Quality of Life, Quality of Life and Reminicance, Quality of Life for elders, Quality of Life in Death, Quality of Life in Dying Tagged With: aging family, aging life care manager, aging parent crisis, assessing for quality of life, Atul Gawande, Being Mortal, care manager, case manager, death and dying, geriatric care manager, Handbook of Geriatric Care Management, nurse care manager, Quality of Life at end of life, quality of life in dying, Reminicence Therapy, Reminiscence at End of Life

What Joy Can a Care Manager Give in the Terminal of End of Life?

February 16, 2021

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Bringing Joy to The End of Life

A care manager can bring joy in the terminal phase of dying and give a good life to the very end. Here is a wonderful example 

 Bill died at the home of his son after he had accepted that he was to die of liver failure. After his coming to terms with his death, he and his family, sons, and grandchildren were able to say the goodbyes and offer the unconditional love that they had been fearful to express before his acceptance. A feeling of light joy permeated his room, a family room overlooking the garden, where his hospital bed was set up. Great-grandchildren brought pictures, marveled at “grandpa grandpa “ high up in a hospital bed.

The Joy of Hearing and Care Providers to Let Family Just be Family

His son put a  headphone with a mike on and William could hear and speak, as he had not in years.  It was like the wonderful film and concept  Alive Inside.  Hearing was a gift that gave him such joy. in his last weeks of life.

His 24-hour caregivers were gifted loving care providers from a GCM agency  Livhome. The 24-hour shifts included a nurse of 18 years from Central America and a man finishing his Ph.D. from the Congo. They cared for him with great warmth, so his family could just be his family, relaxing in their love and surrounding him, as if in a circle, that swirled with 4 generations, going every which way while he watched, really loved, and melted into his last stage. They ate meals, chitchatted, and welcomed new family coming in to see William, as he remained in the center in his hospital bed, the fulcrum of the gathering.

The Joy of a Great Care Manager620-amy-goyer-juggles-work-and-caregiving-mobile-technology.imgcache.rev1382542973676.web.jpg

The geriatric care manager, GCM Mary Brennan, from Livhome, a seasoned powerful and so kind LCSW, adjusted here and there, with care providers, family needs. Bill’s needs and followed the guidance of hospice, who were slowly increasing the pain meds, and supporting his health and medical care needs in death. The geriatric care management agency worked as a partner supplying 24 care and support for the family.

Bill was able to have again, a magical care provider from Livhome, who had been with him for almost two years and was so at the end.

You are only as strong as your weakest link- those are the care providers. These people were the raft that floated Bill up while the family, offered love and hospice provided medical and end-of-life support. Together they buoyed Bill into his last stage of dying, knowing that his family was the fabric of every step he took toward forward towards death. They gave him that good life till the very end.

If you want to add an End of Life service and other services, plus all the forms necessary, go to my website,  and check out GCM Manual 

Free Webinar

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 

 

 In this 1 ½ -hour free 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.    26patient_600-1.jpg

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

Filed Under: Aging, Death & Dying, Death and Dying Care Management, death and dying care manager, Dementia & Holidays, End of Life, Good Death, Hospice, nurse advocate, nurse care manager, Palliative Care, Private Duty Home Care Tagged With: aging family, aging life care manager, ALCA in End Of Life, Alive Inside, Being Mortal, care manager, case manager, Dying at Home, end of life care manager, GCM in Death and Dying, geriatric care manager, Good Life to the Very end, Hospice, Hospice at Home, Joy in End of Life, nurse advocate, nurse care manager, terminal phase of death, Terminal Stage of Death

Do You Do Cultural Assessment With an End Of Life Client?

February 13, 2021

 

 

 Each Culture Has Different Customs and Beliefs in End of LifeiStock_000063346301_Medium-1.jpg

There may be cultural differences in end-of-life decision making as a result of underlying cultural values with disclosure of a terminal illness and very critically -use of life-sustaining medical treatment. With the widespread availability of advanced medical technology in the United States, people are encouraged to do everything possible to seek a cure for a life-threatening medical condition or sustain life. However, there are many other cultures for whom quality of life is more important than the length of life.

Other Cultures Do Not Follow US Medical Model ChiCheng_hmpgHdr.jpg

There are some societies, such as Japan, where a terminal illness may not be disclosed to a patient and it is culturally inappropriate to discuss impending or imminent death. For instance, among some Chinese, it is considered bad luck to discuss death because such talk may cause death to occur. Sometimes the ethnic elder is not expected to make healthcare decisions and the responsibility may be based on a traditional family hierarchy. For instance, in many Filipino families, there may be a designated decision-maker who is not the patient (e.g., the oldest son or a daughter or son who is a health professional) and who articulates the wishes of the elder or family.

Some Cultures Follow Religious  Customs and Beliefs in Death & Dying

Other end-of-life decisions are based on religious tenets. In many Catholic immigrant communities, there may be strong resistance to an advance directive because the document would signify a “loss of hope” or be interpreted as suicide, which is against church doctrine. These beliefs may also influence the use of hospice services.

 

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

 

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

 

 

 

 

 

 

 

 

 

Filed Under: Advanced Directives, advanced directives& COVID-19, Aging, Aging Life Care, aging life care manager, ALCA Role Death and Dying, Benefits of ALCA to Hospice, Cultural Assessment, Cultural Assessment Death, Cultural Beliefs in Death, Death & Dying, Death and Dying, Death and Dying Care Management, death and dying care manager, End of Life, End of Life Care manager, End of Life Cultural Assessment, End of life documents, Families, FREE WEBINAR, GCM role Death and Dying, Geriatric Care Management Business, Geriatric Care Manager, Geriatric Care Manager Cultural Assessment, geriatric social worker, Good Death, Hospice, Hospice Care, nurse advocate, nurse care manager, Palliative Care, Palliative care manager, SNF death COVID-19, US Medicalization of Death Tagged With: 5 stages of death, Acceptance Phase of Death, adding end of life services, Aging Life Care Association, care manager cultural assessment, chronic phase of death, COVID-19 Deaths, cultural assessment, Cultural Beliefs in Death, Cultural Customs in Death, cultural diversity, death and dying in COVID-19, geriatric care manager, Hospice at end of life, Palliative Care at end of life, US medicaization of Death

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