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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Learn About Death Doulas

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)

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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)

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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

How Does Atul Gawande View Quality of Life in Dying ?

September 15, 2021

 

   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 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.

 

 

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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, black aging family, black american geriatric care managers, Black Entrepreneurs, Black geriatric care managers, Black Nurse Entrepreneurs, Black start-up geriatric care management, Black travel nurses, 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 is President Biden’s New Infrastructre Caregiver Plan?

April 14, 2021

President Biden announced the American Jobs Plan, a $2 trillion investment in infrastructure, jobs, and home care. It includes a $400 billion investment to expand access to Medicaid home and community-based services (HCBS)

Why This Plan for Home-Based Care?

Only 15% of U.S. seniors 80 or older receive care at home. In Switzerland, Denmark, Mexico, and Sweden, that figure is above 30%, with numbers even higher in Israel and Lithuania.

Medicaid has slowly evolved over the years, placing a greater emphasis on home- and community-based services. But the ground gained has been relatively minor compared to investments in other settings like nursing homes.

In 1995, Medicaid spent about 18 cents out of every long-term care dollar on HCBS services. Today, that number has reached 57 cents per dollar.

The Scale of the Problem is Mamouth

The number of seniors is projected to grow by more than 40 million, approximately

doubling, by 2050, while the population older than 85 will nearly triple. Unlike most other industrialized nations, the United States does not provide a public long-term-care benefit for all older adults.

Only10-15% of Americans can Afford Private Duty Homecare

Because Medicare does not pay for home care, only the top 10-15 % can afford private duty home care, while in many other nations it is a right and free to all through the government. What Biden’s new plan does is take a giant step in making home care possible a greater number of Americans.

The plan calls for expanding access to and quality of HCBS to help more older adults and people with disabilities live in the community and extending the Money Follows the Person program to help individuals who are in nursing facilities and other institutions return to the community. 

What The Pandemic Has taught us about Aging and Dying

at Home

What the continuing pandemic has painfully taught us is when we are ill- we want to be home in the arms of our family. When we are threatened with or facing death, we do not want want to be in a sterile hospital with only anonymous caring nurses and zoom to comfort us in our last minutes in this world. We want to be at home- in the arms of our family and loving caregivers.

Long before the COVID-19 emergency, health care policy experts have increasingly recognized the value of home-based health care. A recent AARP survey found that three in four adults 50 years and older would prefer to age in their homes and communities. And a growing body of evidence suggests it is less expensive to deliver care in the home.

Indeed, for years we’ve seen hospitalized patients more quickly returning to their homes and communities to heal and recover safely, reducing costs for themselves and the health care system.

The Plague of Isolation on top of the Plague of COVID -in Locked Down Nursing Homes

Home-based care addresses negative health effects of social isolation and loneliness, which drive poorer health outcomes that annually cost billions of excess health care dollars. 

Isolation is also equal to 15 cigarettes each day. Elders in a nursing home during the pandemic were isolated from the families and their fellow residents so much so that despair may have led to the 174000 deaths as of March 2021. 

So Biden has launched a bill the builds the infrastructure of home care for the lower 30% on Medicaid until in America’s future, Medicare and home care for all is reached.

 

Filed Under: Age at home, AGING IN PLACE, American Jobs Plan, Blog, COVID-19 Recover at Home Plan, COVID-19 Safety, Expanding Medicare to Home Care, FOLLOW THE MONEY, geriatric care management emergency proceduress, geriatric care manager, Geriatric Care Managers value, geriatric social worker, Good Death, Home Based Care, home care, Home Care for All, Home From the Hospital, LOSING CLients TO COVID, Monet Follows the Person Program, Quality of Life, quality of life -COVID-19, Quality of Life for elders Tagged With: aging life and geriatric care manager, aging life care management, aging life care start up, aging life geriatric care manager, aging life or geriatric care manager, American Jobs Plan, Biden's Home Care Plan, Biden's Infastructure Bill, Deaths in Nursing Homes, Expanding Home Care, Home and Community Based Care, Home Based Care, home care, Isolation in Nursing Homes, Medicaid & Community Based Care, Medicaid funded Home Care, Medicare for All, Money Flows to the Person, nurse advocates, nurse entrepreneur

How Can Someone with Dementia Have a Better Quality of Life on a Holiday ?

April 2, 2021

 

Reminiscence and Story Telling

 

This Easter holiday is the perfect occasion to engage elders with dementia. The role of storytelling and reminiscence is very important for elders, as they look back on their life and holidays bring strong long-term memories. It gives them a chance to socialize as they tell their story. It also means someone usually listens or documents. That magically gives the elder social interaction and connectedness. So many Easter rituals can prompt stories for elders with some level of dementia. The ritual of dying easter eggs, finding easter baskets on Easter morning, dressing up for the local Easter Parade, eating ritual foods at Easter dinner or at Easter Brunch. Whether the older person is actually participating or watching, these rituals can prompt stories from their long-term memory.

 

Elders sharing stories means passing on history.

This gives the older person a chance to give the larger picture of their life and family history to children and grandchildren or extended family, who may have not heard all the details of their grandparents or parents’ life before- what they cooked, what they did on holidays like Easter. So the quality of the older person of both the older person and the aging family is increased through oral history and reminiscence

The aging professional can suggest family or friends just sitting down and prompting a story or oral history using  technology like your phone

Even elders with Alzheimer’s can find new joy with Reminiscence

When an elderly person develops Alzheimer’s or other forms of dementia, the short-term memory is frequently affected but long-term memories can remain as intact and vivid as they have always been during the course of the patient’s life. As a result, a family can use a practice called reminiscence therapy to help combat the frustration, confusion, and depression that can often accompany dementia and even bring joy to the older person

What is reminiscence therapy?

 Reminiscence therapy is like a therapy session where the elderly person will spend time recalling memories of his or her life, perhaps telling stories about things that happened and events the person can recall.

Sometimes senior experts or family members can use photos, familiar objects, or other such things to help jog the memory of the patient. Some therapists and family members can a scrapbook of a person’s life, including photos, letters, and other such personal memorabilia. This becomes a visual biography of the patient’s life and helps the older person remember who he or she is.

How does this quality of life therapy help? Almost all elderly men and women can start feeling discouraged and frustrated with their memory issues. Reminiscence can give peace and acceptance of the current situation by helping the person remember that he or she has had a good and full life. It also prompts communication skills of elderly people who otherwise may not feel very compelled to open up and share anything with anyone else.

Dementia and Reminiscence of Easter

So this Easter holiday try reminiscence. People with dementia can receive a richer quality of life when people actually listen to them. They feel as their thoughts and feelings actually matter. For anyone who has an elderly loved one suffering from dementia, this benefit alone can make reminiscence therapy a form of joy for a very confused elder. So when you dye Easter eggs, create easter baskets, do an Easter egg hunt, serve an Easter brunch or dinner, get them involved, let them watch, allow them to help if possible, serve them ritual food or to taste it and ask when how they experienced these rituals, when they were young. If you have old albums of pictures from their childhood of them at Easter, look and the photos with them. Then listen.

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YouTube channel:https://www.youtube.com/channel/UCaoHdozwS0RvKD

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YouTube channel:  Website: https://cathycress.com/

 

Blog: https://www.cathycress.com/blog/

Facebook page: https://www.facebook.com/pages/category/Gerontologist/Cathy-Cress-MSW-633836950007072/

Twitter: https://twitter.com/cathyjocress

Email: cressgcm@got.net

 

 

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Filed Under: Adult children, Aging, Aging Family, Aging Life Care, Aging Life Care Assocaition, aging life care manager, Dementia, Dementia & Holidays, Easter, Easter and Reminiscence, Easter Rituals, Emotional Quality of Life, Families, GCM Working With Aging Family, Geriatric Care Management Business, Geriatric Care Manager, geriatric care manager, Good Death, Holiday Rituals in Aging Family, nurse advocate, nurse care manager, Quality of Life on Easter Holiday, Quality of Life with Dementia, Reminiscence Therapy, Spiritual Quality of Life Tagged With: aging family, aging parent, aging parent care, aging technology, ancrestory.com, assessing for quality of life, care plan, care plan interventions, family caregivers, Family Caregivers using technology, flip video, genealogy, geriatric care management, geriatric care manager, geritaric care manager, grandfather, grandmothers, grandparents, increasing quality of life, LCSW, oral history, oral history and quality of life, oral history and You Tube, parent care, Quality of Life, quality of life assessment, reminicence and elder, Reminiscence and 4th of Jul;y, Reminiscence and Dementia, Reminiscence on the Holidays, storytelling and elders, technology for caregivers, You Tube, You Tube and storytelling

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