geriatric social worker Archives ⋆ Cathy Cress

Aging Life or Care Management Intakes- Do You Know How to Make the Sale?

May 15, 2020

Do you know how to increase your slower inquiry calls during COVID-19?

It all starts

with having Covid-19 products, alongside your existing products and services. But the sale is made at the inquiry when the client calls you.

Especially during the pandemic do you know how to sell over the phone when you cannot yet go to all people’s homes? Even so, do you make this fatal and costly mistake with a client inquiry? When you get a request for information, over the phone, do you drive to the client’s home to do the intake- without first getting a deposit and contract first? How does this break your bank balance?

Aging Life care manager Sally Sanitze received an inquiry call and drove an hour to see the client. After spending two hours explaining her services, doing a geriatric assessment then asking for a deposit and signed contract the older gentleman said he could not afford her services and would not sign the contract at that time. The Aging Life care manager came up empty-handed.

How do you avoid traveling for two hours, spending 3 or more hours with a client, and not getting the case or making the sale?

You do the inquiry over the phone with a complimentary consultation, and then make the sale and ask for the contract and the deposit. You do not drive to the client’s home without first getting a signed contract deposit – first.

Here’s how You Do Two Call Intake

You do a two-call intake. The first inquiry call to your agency taken by a highly experienced staff in your office. That person must clearly understand the client problem, prompting the call to your agency and crucially finding out how it impacts both the client and the care providers.

They then offer an appointment to do a complimentary consultation for 30 minutes scheduled within 24 hours, made for the agency director.

What To Do in the Complementary Consultation

Do briefly outline how you are an expert at solving the problems (moving,keeping at home, COVID-19 safety in an elder’s home or home from the hospital with Covid-19)
Do a mini care plan showing exactly how you would solve the client ‘sand care providers problem outlined in the first inquiry call
Do make the sale by asking the client if they are ready to move forward with a contract and deposit
If they say yes send out a contract through Adobe and get a deposit through Pay Pal.

Join Me in My New Free Webinar

Conquer Care Management Sales- 5 Steps Close the Sale on COVID-19Products

Sales have severely declined in COVID_19. Learn how to increase your, clients,

through all your products but especially the new Covid-19 and telehealth. Sell Successfully this and any GCM product in a 2-part intake. Closing the sale means the client signing your contract and giving you a deposit. Most care managers are untrained and terrified of this process. They are more terrified of going out of business with COVID 19

Learn the 5 steps to make and close a care management sale to get that contract signed, get a deposit, grow your business, bolster cash flow, make payroll, and stop you from being one of the 50% of new US businesses that fail after five years.

When?

Date Tuesday, June 23

What are Covid-19 GCM Services you can offer
How to make the sale in the inquiry call -with a complimentary consultation
How to ” Identify needs using client” challenge questions” to find the problem you need to solve to make the sale
How to present your offer by selling solutions to the problem with a mini care plan
How to manage objections if the caller has concerns about price or product
How to close the sale with non-aggressive closing questions to have your contract signed, get a deposit, and grow your business with a new client
SIGN UP FOR FREE

10 Parts of Care Manager’s Role With Family Death and Dying of COVID-19?

May 13, 2020

GCM Role is Working With Family In COVID-19

Care managers cannot be in the hospital with a patient dying of COVID-19. They can support their bereft children, who cannot see their parents during the hospitalization, in those last moments of goodbye’s or after the death in this deadly pandemic.

In normal times care managers play a big role in end of life issues. They are their navigators through all five stages of dying, many times long before palliative care or hospice are called. Often GCM’s can help the family and client to bring in hospice or palliative care. But is COVID -19 they can offer guidance to the family through the sometimes weeks of hospitalization, intubation, their loved one is on a ventilator and ultimately often- death separated from loved ones.

Navigation Through a COVID-19 Death

The normal final passage through life can emotionally charged. If the family is following a long labyrinth to the end, in coronavirus, the blind alleys may be blocked by a rushed hospitalization, banned from seeing their loved one in the hospital and not understanding the disease that is killing their loved one. Care managers can find an opening through this maze. Family dynamics and fear of dying can all explode a fraught crisis of care in dying of coronavirus. When vital end of life decisions need to be made, the stress of the responsibility and the seriousness of the situation can break in a mammoth wave of distress fear and anxiety over the “ whole family system”. The geriatric care manager specializes in this whole family system even at the end of life.

Facilitate Family talks over hospitalized COVID-19 Elder

Care Managers can facilitate terrified discussions, and clear the way for family members to come together to work as a functional unit around an unknown killer disease that preys on their loved one. Understanding the differing viewpoints is critical. Knowing what a parent wants and does not want during the last days and hours of life help define and simplify the role of the family. It helps the family bear the burden of having the responsibility of making decisions that their parent wants. Turning this around can also help families have some solace that they carried out their parent’s wishes after their parent’s death.

Care managers can help family members handle the stress of an elder’s hospitalization and death by:

Encouraging routines, exercise and social connectedness with friends and family
Advocate for them with the hospital staff to get updates in this chaotic time in hospitals,
Help them maintain contact with hospital personal to get updated medical status
Create opportunities to communicate safely with the hospitalized family member via text, telephone, email, or video chat
Support and mediate if necessary proactive discussions and advanced directive preparation in a rush if not done
Build a circle of care can help to reduce some of the potential conflicts,
Support them in having essential conversations, prior needing intubation, on last wishes if health status deteriorates
Provide opportunities to say goodbye
guide them in setting up rituals that can celebrate the end of life and give solace to a family during a time when there are yet no rituals for a COVID-19 death.
Work with the hospital to set up Zoom with the family to say goodbye to a loved one.
Geriatric care managers do much more with clients and families but especially now with Covid-19 elder’s and their families facing a separated, fractious end of life
See more about Cathy and her book Care Manager’s Working With The Aging Family

Nursing Homes residents in Pandemic -Need Help Today, Mother’s Day& Future

May 10, 2020

MOTHER’S DAY 6 FEET APART AND LONLEY

Nursing home residents, like prisoners, are locked in space “less” than 6 feet apart in facilities with a growing death rate that has reached 20% of all Covid-19. Support them on Mother’s Day and every day in the future. Their situation is increasingly dire as in Florida, a state with the largest elderly population the cases have spiked radically since restrictions were lifted 60% of new cases are in nursing homes

If you are an aging professional- step up to the plate. Through the Hartford Foundation join Huddles.The network is designed to support nursing home leadership, staff, residents, and families impacted by the COVID-19 pandemic. For the week of May 11-15, the huddles will focus on testing. They have organized the Engage Initiative for COVID-19 in Nursing Home. So join and advocate for facilities with the highest death rate in the country- where the federal government does nothing as a holocaust is occurring

MAKE A SIGN AND VISIT A LOCAL NURSING HOME TODAY

Support older residents in nursing homes by making a SIGN and standing outside the facility. Gather some friends. People all over the country are doing this, showing the residents they are loved. In Holiday Florida, nursing home residents were treated to a mother’s day parade. In Chillicothe, Ohio. residents drove around the driveways of a nursing home in HONK for HUGS

Today or someday this week, just call a nursing home in your city and tell them what you are doing. Get their permission and ask if you can go from window to window with your sign of Happy Mother’s Day or ” whatever you wish for them “and wave. It is that simple. Today these elderly, sick and threatened mothers, cannot see anyone, often have family long distance who cannot see them, and are literally locked in a facility where beds are not 6 feet apart.

PLAY IT FORWARD – DO SOMETHING FOR NURSING HOME RESIDENTS IN THE NEXT FEW WEEKS

No matter what your state, town, or the facility is doing to protect them they are the number one target of coronaviruses doing to protects them. AARP has started a mutual Aide group to both give and receive emotional aide during a pandemic. Join a group or organize a group to make phone calls to residents of the local nursing homes. If you are a retired medical professional down to an aide or someone who can answer the phone- instead of virtually, you could really step up to the plate, and volunteer to help a nursing home that is understaffed in the pandemic .

In my home state, CALIFORNIA, you can join the Social Bridging Program. You can also join the Friendship line to call older people who are lonely and just need you to be there to listen.

ONE SMALL STEP FOR PEOPLE IN THE BULLSSEYE OF DEATH

The point is to do something one small thing whether it is on Mother’s Day Monday or this week. Take a step to help the bullseyes targets of COVID-19 the elderly who are terrified, lonely, and now on Mother’s Day alone.

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.

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

April 9, 2020

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.

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 suggest – 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.

https://www.forbes.com/sites/johnkoetsier/2020/04/02/elder-tech-how-to-keep-seniors-connected-safe-happy-in-the-coronavirus-era/#3443c2dc66cf

Care Manager tasks:

Make referral to hospice if 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 active phase of dying which can be loud and disturbing to someone who is not aware of what will occur

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

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