Cathy Cress

Expert in Aging Life and Geriatric Care Management

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What Good Life to The Very End Can a Care Manager Bring ?

January 18, 2023

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Bringing Good Life to The Very  End

What Good Life to the very end can you bring -in the terminal phase of life -? 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 and stopped all lifesaving treatment, like dialysis at the hospital and entering hospice. The decision was made that he would die at his son’s home with 24 care from his Care Management agency Livhome and his ongoing care manager Mary Brennan.

After his coming to terms with his death, Bill and his family, sons,  grandchildren, and great grandkids were able to say their goodbyes and offer the unconditional love that they had been fearful to express before his acceptance of death. 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 and marveled at “grandpa grandpa “ high up in a hospital bed.

The  Good Life to The Very End -Joy of Hearing

His son put headphones 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.

The Good Life to the Very End- Let Family Just be Family

The family could just be family because they had care providers to care for bill. 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 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. His sons, grandchildren great grandchildren, and nephew ate meals, chitchatted, and welcomed each new family member coming in to see William, as he remained in the center in his hospital bed, the fulcrum of the gathering.

The Good Life to the End 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, and family needs. Bill’s needs 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 

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Deliver a Good End of Life 9 Steps to Death &Dying

Jan 24, 2023 02:00 PM Pacific Time (US and Canada)

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Good Life to The Very  End

 

Serve Your Client until Death Do You Part
Join me on January 24 2023 and learn why End of Life Services re a perfect new se

 

 

 

Learn to guide the patient/family through the five stages of death. Understand how to help clients be active participants in their care. Give the family caregivers tools to manage care. Find out how to provide family-centered care to caregivers and families. Learn to choose the right support services for the client through all stages of death.
Introduce Hospice and Palliative care to the client earlier and work with their team.
Find out how to Use COVID -19 family coaching for GCM. Discover the role of Death Doula at end of life.

Time

Jan 24, 2023, 02:00 PM Pacific Time (US and Canada)

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 death, 5 Stages of Dying, 5 stages of End of Life, Advanced Directives, Aging, Aging deaths, aging family crisis, aging life care manager, Benefits of ALCA to Hospice, Black Aging Family, black care manager, black concieirge nurse, black concierge care manager, black concierge RN, Black Entrepreneur, Black Entrepreneur RB, Black Entrepreneur RN, Black entrepreneurs, Black Geriatric Care Manager, Black geriatric care managers, Black RN, black RN care manager, black social worker, black travel nurse, Black Travel Nurses, Black Travel RN, care manager, care manager operations manual, Death & Dying, Death and Dying, Death and Dying Care Management, death and dying care manager, Dementia & Holidays, End of Life, End of life documents, entrepreneur business, entrepreneur care manager, entrepreneur RN, Geriatric care manager & Hospice, Good Death, Hospice, Hospice Care, 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

Dysfunctional Aging Families Can Wreak Havoc at End of Life

December 6, 2022

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

Upcoming Free Webinar

Deliver a Good End of Life 9 Steps to Death &Dying

Jan 24, 2023 02:00 PM Pacific Time (US and Canada)

SIGN-UP Description

Deliver a Good End of Life- 9 Steps to Add Death and Dying to Your Care Management Agency
Serve Your Client until Death Do You Part
Join me on January 24 2023 and learn why End of Life Services re a perfect new service for care managers
 Learn to guide the patient/family through the five stages of death. Understand how to help clients be active participants in their care. Give the family caregivers tools to manage care. Find out how to provide family-centered care to caregivers and family. Learn to choose the right support services for the client through all stages of death.
Introduce Hospice and Palliative care to the client earlier and work with their team.
Find out how Use COVID -19 family coaching for GCM. Discover the role of Death Doula at end of life.

Time

Jan 24, 2023 02:00 PM Pacific Time (US and Canada)

SIGN-UP 

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 caregivers 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

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

November 29, 2022

End of Life has 5 Phases   

   

 

Before the end-of-life diagnosis, the ALCA or GCM care manager helps clients be active participants 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. GCMs 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 members make a list of questions and 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
  •  
  •  
  • Join me Tuesday, January 24, 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 caregivers 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 

  • Free Webinar

     

     

    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 death, 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, Atul Gawande, black care manager, black concieirge nurse, black concierge care manager, black concierge RN, Black Entrepreneur, Black Entrepreneur RB, Black entrepreneurs, Black Geriatric Care Manager, Black geriatric care managers, Black RN, black RN care manager, black social worker, black travel nurse, Black Travel Nurses, Black Travel RN, Blog, care management business, Death & Dying, Death and Dying, Death and Dying Care Management, death and dying care manager, End of Life, End of life documents, Families, FREE WEBINAR, GCM working with end of life, GCM workinh with hospice, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, Good end of life, Good hospice, 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, Elizabeth kubla Ross, end of life care manager, End of Life Diagnosis, 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

Can You Give a Good Death without” Rage, Rage Against the Dying of the Light”?

March 9, 2021

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Dylan’s Thomas warns us in his poem

 

Do not go gentle into that good night,
Old age should burn and rave at  close of day;
Rage, rage against the dying of the light.

 Give a good death – not a cold terrifying dying of the light.

 

But today a care manager or geriatric social worker can help an older client go gentle into that good night, they do not have to burn and rage at the close of their day because you will be giving them as Atul Gawande suggests – a good death – not a cold terrifying dying of the light.

 

The terminal phase of any life-threatening illness is the time between diagnosis and the final decline when no cure or extension of life is in the offing. The individual confronts progressive decline and deterioration. Death is imminent. The care manager has a role.

The focus of doctors and patients now changes from attempting to cure the illness or prolong life to trying to provide relief from pain and to comfort the sufferer. Religious concerns such as what happens after someone passes away or how to handle the suffering at the end of life or how to give comfort to family members are the focus during this time as well as trying to tie up any loose ends.

Death to Rage About- Alone in the Hospital

But in the time of the plague, when  95.5 % of souls still die in the hospital and not at

home the care manager has a critical role with the family. High tech introduced by the care manager and at times the hospital with the care manager coordinating the family outsides and unable to touch their dying loved one – can make this death full of rage more gentle as the person passes into the night.

Care Manager tasks:

Make a referral to hospice if the family has not  already reached out

Partner with hospice and work under them

Monitor anticipatory grief needs

 Communicate that this is the end (and time to say goodbye)

 Assess spiritual needs and contact the appropriate religious-spiritual counselors to provide comfort and healing.

 Encourage family members to say The Four Things That Matter Most   “Please forgive me”, “I forgive you”, “Thank you”, and “I love you”.

Assess the need for paid caregivers to help the family or help family members share round the clock care among family and friends

 Support the family members in their need to grieve and have respite by continuing to assess for overload and burn out with a caregiver assessment tool 

Prepare family for the active phase of dying which can be loud and disturbing to someone who is not aware of what will occur

Bring in technology if death is alone in the hospital

 

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

 

Gwendolyn LAZO Harris MA, CT, Seniors at Home, San Francisco and Diane LeVan MA both highly expert care managers, created a seminal chapter “Palliative Care and End of Life Care Manager ” in my book Care Manager’s Working With the Aging Family  

 

 

Filed Under: 5 Stages of Dying, 5 stages of End of Life, Aging, Aging Family, aging family crisis, aging life business, Aging Life Care, Aging Life Care Assocaition, aging life care manager, ALCA Role Death and Dying, Blog, care manager, case manager, Death & Dying, Death and Dying Care Management, death and dying care manager, elder care manager, End of Life, End of Life Care manager, End of life documents, Families, Five Stages of Death, geriatric care manager, Geriatric Care Manager, geriatric social worker, Good Death, nurse advocate, nurse care manager, Palliative care manager, Webinar, Webinar ALCA GCM Tagged With: 5 stages of death, adding geriatric care management, aging life care manager, ALCA &end of life, ALCA Death and Dying, Atul Gawande nurse care manager eldercare manager, Benefits Care Managers, Benefits of Care Managers To Hospice, care manager, case manager, death and dying, eldercare manager, end of life care, free webinar, geriatric care manager, Hospice at end of life, Hospice Care, Palliative Care, terminal phase of dying, US medicaization of Death

What is the GCM’s Role is the Recovery Phase of Death and Dying ?

March 7, 2021

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The recovery phase of death and dying 

This occurs when people finally are able to cope with the mental, social, physical, religious, and financial effects of their disease, a heavy load  In the disease process and acceptance process, this is the period of time after a medical procedure such as chemotherapy, radiation or surgery. The client’s response to treatment is being monitored. Recovery does not always mean remission, but instead, it is the ability to accept and deal with the struggles of their illness

A Story About the recovery phase

William died at the home of his son after he had accepted that he was to die of liver failure. He was hospitalized and had not signed a Do Not Resuscitate because he actually did want everything done to save him. He had new twin grandsons a grandaughter he adored and loved life. He was having dialysis to treat his symptoms. A care manager knew that the doctors suspected cancer but believed the procedure to find out would kill him. But they felt their hands were tied by the DNR and the hypocritic oath. The care manager, finally, after talking to a nun on the staff of the Catholic hospital who said she would help,  and talked to the lead physician and asked that he order palliative care. He did and all 4 physicians talked to Bill gently and about removing the dialysis and signing a DNR. He did and after a family meeting lead by palliative care and hospice, William came home with 24-hour care.

The Recovery Phase Begins

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. For almost a month he lived in the 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. His son put a  headphone with a mike on and William could hear and speak, as he had not in years. His 24-hour caregivers were gifted loving care providers from a GCM agency  Livhome. 

Home Care and Care Management in End of Life

.

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.

End of Life Geriatric Care Management Well Done

The geriatric care manager, GCM Mary Brennan, from Livhome, a seasoned powerful and so kind LCSW,  was an orchestra leader in Bill’s death. She 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 there at the end as were all his sons – a life fully lived and a good, good death.

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.

 

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 their 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: Aging, Aging deaths, Aging Life Care, aging life care manager, Benefits of ALCA to Hospice, Benefits of Care Management to Hospice, Benefits of Geriatric Care Management, Death & Dying, death and dying care manager, elder care manager, End of Life, End of Life Care manager, End of life documents, FREE MARKETING WEBINAR, FREE WEBINAR, GCM Clinical Tools, Good Death, Home From the Hospital, Hospice, Hospice Care, Hospital care manager, nurse advocate, nurse care manager, Palliative Care, Palliative care manager, Private Duty Home Care, Quality of Life in Dying, Recovery phase of death Tagged With: end, end of life care, end of life family meeting, free webinar, geriatric assessment for end of life, geriatric care manager, Good Life to the Very end, Hospice, Hospice at end of life, Livhome, Navigation through END of LIfe, recovery, recovery phase of death, recovery stage of dying, webinar end of life

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