Ten Warning Signs You Are Working With a Dysfunctional Family

November 3, 2022

Ten Warning Signs you are Working with Dysfunctional Family represents critical information to share with long-distance caregivers before their holiday visit. Do you know them? They include contentiousness, anger, and cut off and all are listed below. These clinical issues give the visiting caregiver signs that they need to call a care manager and you the care manager the most challenging job of an aging professional. What you have to know is family system theory and be clinically skilled in entering this treacherous family system – to get care for an older person

1. Contentiousness – Old fights erupt; the siblings and parents get into arguments with one another about an old issue

2. Anger – Siblings and family members express physical anger, emotional abuse, financial abuse

3. Distancing & cut off – Some siblings or parents have nothing to do with family and may not speak to parents or siblings for long periods of time.

Ten Warning Signs You are Working with the Dysfunctional Family – Fusion, Denial, Triangulation, Entitlement

4. Fusion – Siblings and family members, such as the mother and eldest daughter, blend into one another, For example, the daughter sounds, acts, and has the same prejudices as the mother. . Think of the media’s portrayal of Lindsay Lohan and her mother.

5. Denial – Adult siblings do not see a decline in a parent, do not face reality, and do not take care of parent if he or she needs care.

6. Triangulation – Tension between two family members or siblings causes one to enlist a third family member or sibling to avoid change For example, two adult sibling object to the cost of care of an aging parent. They gang up on the third adult sibling who thinks the cost of care is reasonable and justified.

7. Sense of Entitlement – Siblings who are accustomed to purchasing services need not personally solve their own, children’s siblings or parents’ problems. This lack of engagement leaves them, unprepared and unwilling in getting involved in solving family tribulations.

Ten Warning Signs You Are Working with a Dysfunctional Family – Narcissism, Needy Adult Siblings, Substance Abuse, and Cut Off

8. Narcissism – One or more siblings has an “it’s all about me” attitude and

other siblings resent this. The self-absorbed sibling either does not participate

9. Needy Adult Siblings – These adult siblings feel starved for affection and often seek affection from professionals and other people in their lives for compensation for the care they didn’t receive as children.

10 . Substance and Other Abuse – The family and siblings have a history of drug, alcohol, and/or child abuse.

If this fits you you and your aging parent needs care may need to contact a geriatric care manager.

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WEDNESDAY, November 16th, 2022, FROM 2 PM – 3:30 PM PST

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Pre-Holiday Social media campaigns to reach worried caregivers
Pre- Holiday-Materials about the warning signs that a parent needs help
Pre-Holiday Marketing to help you sign up families who might face a serious decline in aging parents

How to sell services to desperate post-holiday callers from Normal dysfunctional & long-distance family
How to use tools to contain holiday chaos & arrange care in festive family fright
How to move the family to New Year’s stability

Know The Ten Warning Signs you are working with a dysfunctional family and position Your Agency ahead of Care Managers who do not have great pre-holiday marketing campaigns and lack the clinical skills how to work with Adult Children and families during the chaotic aging family holiday visit when adult kids find their aging parents need care
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Cathy Cress MSW author of the Handbook of Geriatric Care

Management

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Close the GCM or ALCA Sale to Assisted Living With Benefits not Features

February 11, 2022

Marketing Tactics – Use Benefits

ALCA members need to sell the benefits of Geriatric Care Management to assisted living. Care managers are perfect professionals to help assisted living residents if they have just moved in, are unhappy with the move, not participating in activities isolating or general when they are not thriving in the resident community.

Marketing care management to ALF’s takes some particular marketing tactics

Although it might seem counterintuitive, consumers rarely want to buy things for the sake of buying them – they want what they purchase to solve their problems.

To borrow from the example of an umbrella, features of this umbrella might be its unbreakable spokes or wind-resistant construction – but the benefit is staying dry even in strong winds that might break lesser umbrellas. The benefit of staying dry in strong winds that break other umbrellas – this make the sale.

Clients who purchase home care or care management want to buy benefits – what your product or service can do for them.

GCM Benefits To Assisted Living

Let’s take a third-party. Care Managers often market to Assisted Living. ALF Directors want to hear how your ALCA or GCM agency is going to help the Assisted Living site. Of course, you can describe your agency features, price, training of staff, gold standard service. However, benefits are what make the sale and keep the Assisted Living dry not flooded by the rain.

But here are some benefits you can offer to Assisted Living when you are seeking referrals and you have a service for residents that involves Quality Of Life

YOUR GCM ALCA AGENCIES BENEFITS

The problem: Assisted Living does not want residents to move out. Most facilities are strictly non-medical and do not have one to one companion and geriatric care management services. Your geriatric care management agency can solve that problem through the benefits of ALCA or geriatric care management.

The assisted living and retirement community population sometimes have clients with needs that cannot be met with their nonmedical, non-one-on-one support services, (usually just an activities director)

You will help facility with residents who are not adjusting to the facility or considering moving by engaging them in activities that will enhance the quality of their life, SO WHAT so they remain in the facility
You will help residents not engaging in activities to participate in the ALF’s activities program or outside activities and socialization program through a quality of life assessment & companion, SO WHAT so they do not want to move out of the facility
You will engage with new residents who are just adjusting both to the facility and their move, to engage in socialization and activity programs. You can help them make friends & engage in outside activities through a quality of life assessment and companion, SO WHAT so they do not consider moving out
You will make monthly monitoring visits to make sure Companion is meeting all the client’s needs, keep in touch with the family and facility with frequent e-mails, texts or telephone updates plus sending a monthly report SO WHAT so everyone is on the same page through your great communication skills.

So, selling the benefits to the third party, who will refer your agency to families of residents who are struggling, is a much more potent selling point that features your agency.

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A feature is a fact A benefit tells your customer the advantages of those facts

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The difference between selling features vs benefits

You will learn how to sell the benefits of your services for each 3rd party you serve

How Benefits make your sale to wealth managers, elder law attorneys, and concierge physicians to get referrals for new clients

The Benefits that make you5 sale to upscale Assisted Living, accountants, financial planners, Hospice

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

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Please Elvis – We had a Blue Christmas

December 26, 2020

A Blue Christmas or Hannakka is what the dysfunctional family always has. Elvis gets them. He sings it for this joyless broken-hearted –yet furious- family. They have a blue holiday filled with memories of ruined, -maybe drunken- giftless pain while most holiday songs warble their celebration should be white.

And when those blue snowflakes start falling
That’s when those blue memories start calling
You’ll be doin’ all right with your Christmas of white
But I’ll have a blue, blue, blue, blue Christmas

You can’t be Elvis but here are some more steps a geriatric care manager can transform these families after they call on the holiday.

Identify intergenerational roles and conflicts: The GCM must ” get” existing power dynamics within the family, redefine responsibilities to move to generational maturity, and realign roles and tasks for each family member.

The GCM should encourage a new two-way nurturing relationship between the adult child and the aging parent that never existed. At the same time, the GCM must enable the adult child as a caregiver to set limits that are appropriate to a mature relationship (a very hard redo) The GCM shapeshifts the adult child to identify and remove himself or herself from triangulated, fused, or other destructive family patterns that blue, blue Christmas

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5 Vital Clinical Tools to Help Aging Dysfunctional Families-Post Horrid Holidays-

Thursday, January 21, 2021

Give frantic adult children hope when they desperately call after the holiday

Join me and learn how to come to the rescue of concierge dysfunctional families who found coal in their stocking.

Learn how to!

Understand the Dysfunctional Aging Family System you must enter to get care for elders
Understand 11 Warning Signs You Are Working with Dysfunctional Family
Master Vital Clinical Tools, you to solve client problems
Take Six Steps Professional Must Take to Work with These Difficult Families
Get care for aging family members when the dysfunctional family members resist

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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.

What To Expect Narcissistic Entitled Families Who Call a Care Manager

March 10, 2020

Four types of aging families, who can afford geriatric care management and private duty home care as they have the financial resources, will call you to inquire about your services. You need to have excellent clinical skills to manage these families.

Two are dysfunctional aging families who take extensive psychodynamic skills. One is the narcissistic entitled family.

Part of this is drawn from Claudia Fine formerly of Senior Bridge and Nick Newcombe excellent chapter ” Entitlement in the Aging Family”, Care Managers Working With the Aging Family, Jones, and Bartlett)

Narcissistic-Entitled Families:

Entitlement in these families usually develop from a specific kind of “not good enough parenting” in which the parents themselves have struggled with personality disorders. Typically, in this type of family, narcissistic borderline personality .( example President Trump)the parent had a borderline personality that went undiagnosed or was formally diagnosed and untreated. The narcissistic or borderline parent essentially does not experience the child/children as separate and discreet from themselves and, moreover, uses the child/children to serve parental needs. This parent-child relationship is characterized by severe boundary issues in which seduction and abandonment are ever-present dynamics and where emotional unpredictability and instability are constant.

What Will Take Your Great Clinical Skills With These Families?

Fine and Newcombe point out the adult child finds him or herself in is either of two categories. They can be elevated to the” perfect” child in the mental health challenged mother or father’s eyes, so that the parent feels worthwhile.
These children grow up to be your client’s family and the person who usually calls the care manager. If they hire you they are demanding because they are afraid if they are not inflexible with you they will get nothing from your services.
Or the second category where the child is devalued by the parent so that the narcissistic entitled mother or father feels superior ” perfect” and all-powerful. They will present, according, to Claudia Fine and Nick Newcombe, as needy and insatiable, and easily ” injured” by the care manager who is attempting to help them.

Both types of adult children who interact with you are frequently angry to care for the parent who never cared for them, gave little to them as a child, thus demanding and needy themselves. All this repulsion comes from never having a mother or dad who was there for them so in response will be difficult family caregivers to work with.

( Fine and Newcombe- Entitlement in the Aging Family, Care Managers Working With the Aging Family)

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