Cathy Cress

Expert in Aging Life and Geriatric Care Management

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What Does a Care Manager Do Before End of Life Diagnosis?

February 28, 2021

End of Life has 5 Phases       

Before the end-of-life diagnosis, the ALCA or GCM care manager helps clients be an active participant in their care and gives the family caregiver the tools to manage the care.            

The geriatric care manager serves older adults before they find they are dying. GCM’s work with chronic care clients, sometimes for years, who eventually succumb to their illness. But 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 
  • Geriatric Care Managers Tasks Before the diagnosis

  • Schedule medical  appts
  • Help family ask questions  of medical professionals
  • Before visiting  the client maintain an updated medication list and a list of any drug allergies
  • Assist the family in organizing all  Advanced care planning documents documents

  • Go to medical appointments with the client or train family member make a list of questions have ready
  • Set up personal health records.       
  • Assist family members in setting up and use of a calendar to keep a log of important medication information, questions, and things out of the ordinary that happens to the ill person
  • https://youtu.be/vHfuzkTcpMs  
  •  
  • Join me Thursday, March 11, and learn why End of Life Services Are a perfect new service for care managers 

  • Deliver a Good End of Life- Add Death and Dying to Your Care Management Agency

     

    Serve Your Client Until Death Do You Part

     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: 5 Stages of Dying, 5 stages of End of Life, Advanced Directives, Advanced Directives and Covid-19, Aging, Aging Life Care, aging life care manager, Blog, Death and Dying, End of Life, End of life documents, Families, FREE WEBINAR, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, Hospice, nurse advocate, nurse care manager, Palliative Care, Quality of Life in Dying Tagged With: 5 stages of death, adding end of life services, aging family, aging life care manager, aging parent crisis, ALCA in End Of Life, care manager, case manager, end of life care manager, GCM Family Coaching end of life, GCM in Death and Dying, geriatric care manager, Hospice at end of life, Navigation through END of LIfe, nurse advocate, nurse care manager, Tools to manage end of life, webinar end of life

Dysfunctional Aging Families Can Wreak Havoc at End of Life

February 18, 2021

What do Feuding families do at the end of life?

 

When a family member is facing death and dying dysfunctional families have flawed conversations. Often they do not communicate at all or engage in destructive banter. They see one another as enemies. They demonize one another.

Feuding families are what I call dysfunctional families. They blame each other instead of locking arms in a crisis.

They sabotage resolution.

They actively compound already difficult decisions with intractable, interpersonal conflict. They create problems independent of the underlying issues.

Facing Fractured Communication

What are some of the struggles that these aging dysfunctional families with fractured communication can face?

Aging parents who lack the capacity to make decisions have no advance directives, DPOA and a

health-care proxy, and adult siblings, who must make end of life decisions, can’t agree

Withdrawal of life support with no designated health care agent and adult children and/or spouse disagree

Pain management adult children and/or and spouse disagree.

Answer to Fractured Family at End of Life – Mediation.

Mediation is a tool that can be a good resource for dysfunctional families at the end of life. It can help with these difficult families face the death of a parent without fracturing the entire family. It can allow an older person to die without pain inflicted by their own family.

 

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 and Covid-19, Aging, aging life care manager, Benefits of ALCA to Hospice, Death and Dying, Death and Dying Care Management, Dysfunctional aging family, Dysfunctional Family Mediation, End of Life, End of Life Care manager, End of life documents, estranged elder parents and adult kids, estranged siblings, Families, FREE WEBINAR, GCM COACHING SKILLS, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, Good Death, Hospice Care, mediation, Mediation End of Life, nurse advocate, nurse care manager Tagged With: adult sibling, aging family, aging parent care, aging parent crisis, care planning, caregiver burnout, conservator, death, dysfunctional aging family, dysfunctional family, dysfuntional family, elder care crisis, end of life, end of life family meeting, estranged siblings, families fretting at end of life, fretting at end of life, geraitric assessment, geriatric care management, geriatric care manager, geriatric care managers, mediation, mediator, My Geriatric Care Management Operations Manual, no advanced directive, no DPOA, no health care proxy, withdraw of life support

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

Adding End of Life to Care Management Agency- Advanced Directives

February 7, 2021

slide-worried-manjpg.jpg

When Does A Care Manager Begin if Terminal Diagnosis?

Once the terminal diagnosis 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. 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, advanced care planning 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

 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 the dying client has these documents:

• A durable power for attorney for healthcare 

• A living will 

• A do not resuscitate order DNR (efforts to restart the heart after it has stopped 

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.

Deliver a Good End of Life- Add Death and Dying to Your Care Management Agency

iStock_000063346301_Medium-1.jpg

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

Sign Up 

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

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& COVID-19, Aging, Aging Community & Covid-19, aging family crisis, Death and Dying, Death and Dying Care Management, End of Life, End of Life Care manager, End of life documents, Hospice, Hospice Care, Palliative care manager Tagged With: adding end of life services, Advanced Directives, aging life care manager, death and dying, death and dying in COVID-19, durable power of attorney, end of life, end of life care, geriatric care manager, Hospice at end of life, Navigation through END of LIfe

Avoid Aretha Franklin’s Fate- Help Elders at Risk of Covid & Prepare End Of Life Docs Fast

January 30, 2021

Preparations for Death a Hard Step for Some

Everyone must prepare for the end of life. When Aretha Frankin died a tribute to her was an armada of 100 pink Cadillacs at her funeral. But in spite of the glittery homage to her storied life and career, she died without a will.

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.

In the Year of the Plague Care Managers Preparing Clients For Death  More Urgent

You as a care manager must 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.

, these documents- one a living will- are an important job of the geriatric manager, as death

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

Advanced  Care Planning Discussions In Covid Critical

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:

  • A durable power for an attorney for healthcare 
  • A living will
  • A do not resuscitate order DNR (efforts to restart the heart after it has stopped

 If No Advanced Care Documents & COVID Strikes Elders Wishes Unfulfilled

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 at 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 plague 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.

GCM Care Planning Stope Elders From Dying Without a Will Like Aretha Franklin

 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.

SIGN UP FOR MY LATEST 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     

S

 

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

Recommendations

 Cathy is a great consultant who has helped me remain focused and balanced while developing my business and juggling other responsibilities.   I highly recommend using the operations manual as a guide for businesses, especially startups.   Also, tools such as Cathy’s competition survey, marketing survey, and Cathy’s book entitled Handbook of Geriatric Care Management are great resources to use now and future.  Cathy is the business coach/business consultant I needed.  I will always be grateful for the time and money she saved me during this process.  Thanks, so much Cathy for all that you do!  I appreciate you!

Patrice Harrison LMSW, IPR

 

 

 

 

Presented by:
CATHY CRESS, MSW

 

 

Filed Under: Aging, Aging Family, aging family crisis, aging life care manager, Aretha Franklin, case manager, Concierge Senior, coronavirus, Coronavirus emergency plan, coronavirus shut down, Covid-19, Death and Dying Care Management, death and dying care manager, DNR, elder care manager, Elderlaw Attorney, End of Life Care manager, End of life documents, Geriatric Care Management Business, Geriatric Care Manager, geriatric care manager, living will, nurse advocate, nurse care manager, Quality of Life in Dying, Wealth Management Departments Tagged With: Advanced Directives, aging life and geraitric care manager, aging parent crisis, coronavirus, coronavirus and seniors, COVID_19, COVID-19 Deaths, COVOD_10& Advanced directives, death and dying, death and dying in COVID-19, geriatric care manager, Hospice Care, hospice for elderly parent, nurse advocate, nurse care manager

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