Holiday Rituals in Aging Family Archives ⋆ Cathy Cress

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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Can’t See Aging Mom Christmas Hanukkah-7 Ways to Make Her Feel You Are There

December 15, 2019

Absent Long Distance Care Provider Holidays Answers

If you are a long-distance care provider, or a care manager that works with one, what’s the best way to keep in touch with the long-distance elder if you can’t visit on coming Christmas or Hanukkah.

Easy Low-Touch Non-Tech Ideas

Use low touch—the old-fashioned communication elders grew up – the Post Office and telephone. If you can’t see Mom or Christmas or Hanukkah, send a card. Older people came from a generation where cards and mail were really meaningful. It is easy and really touches elders who love opening the little personal mail they get, especially from family. These heritage links are a great way to support a far away elder. Non-tech, they cause no stress on their part. Even we boomers who walk haltingly through the tech world of 40 characters forget that connecting with a stamp or a call is so familiar to an older person. Plus you give that feeling of warmth they always got when they “ opened” “ or “ answered” something real (not virtual); Try having the whole family sending a card even kids. A flooded mailbox on Christmas or Hanukkah fills their hearts.

If and you can’t see Mom on Christmas or Hanukkah he or if Dad is not religious, mail holiday care packages —bake or buy cookies . Bake it with your children and send samples along with actual photos of everyone baking in the kitchen or buying treats. Even if they crumble a bit, elders will smell the affection.

Easy Option -Holiday in a Box

If you can’t see Mom on Hanukkah or Christmas, send a “ holiday in a box for Christmas and Hanukkah coming up. Send a basket of kids drawings, candy, nuts, home-baked or purchased holiday bread that reflects the holiday celebration plus a gift certificate for a Christmas dinner or dinner with a friend. Give Mom joy in a simple package. For an extra special surprise, arrange an invitation to a Hanukkah dinner with a friend or through your parents’ synagogue or church

A Little Help From Aging Parents Friends

Skip that holiday in a box, if you can’t see Mom on Hanukkah or Christmas you can create a circle of care. Get the app Lots of Helping Hands through neighbors, friends, people in your elder’s place of worship or a group they belong to. Then you can ask if they can arrange to include your older relative or friend in a Christmas dinner or Midnight Mass or Hanukkah meal, with Latkes or Shabbat service. You will then have an entire support team your elder with a whole circle of support in the future and not feel so alone.

Make Aging Tech for Holiday Gift

Send a high tech gift, if you can’t see Mom or Dad over Christmas or Hanukkah. Send a high tech device that your loved one can really use and figure out. I just ordered the Esky Wireless Locator because I keep misplacing my glasses.

How Care Managers Help Get for Long Distance Care Providers

Care Manager scan do lots of things for a family member who is long distance and can’t see Mom on Christmas or Hanukkah. Geriatric Care Manager Julie Menack in her chapter “Long Distance Care Providers” in my book Care Managers Working With the Aging Family lists tasks long-distance care providers can do to make their own lives and their long-distance loved ones saner, sounder and happier

Find a Care Manager Through Aging Life

If you want to investigate an Aging Life geriatric care manager in your parent’s own town find a professional who can help you do all this so you can remain a son or daughter and less stressed caregiver.

Best Tool for Dysfunctional Family on Holidays- Hope

December 8, 2019

Hope is the Best Tool on the Holidays

During Christmas and Hannaka family caregivers, especially in the dysfunctional family can be drinking or numbing themselves from the pain of caregiving. They will ruin the holiday celebration one way or another. Maybe they are drugging themselves with the telly or abusing prescription drugs. Depression and anxiety ( rife among caregivers) are predictors of increased alcohol use. Social isolation, which is experienced by some caregivers, is also predictive of increased alcohol use.

How do you as a geriatric care manager change the script for these aging dysfunctional families – family caregivers and older members who are supposed to care for but can’t. How does a professional GCM make the characters transform?

It’s actually simple –but loaded with skill- give them hope. You need to and use yourself to give them hope that things will change. It’s the best tool a geriatric care manager toolbox- especially on and after the dreaded holidays.

Use of Self

The use of Self is perhaps the most powerful tool for geriatric care managers. The use of Self provides families with guarded optimism. GCM’s have to offer a vision of the future that is based not only on a desire for hopeful outcomes. This has come from our own clinical knowledge and belief that change to their nasty crippled, family system is indeed possible.

By being direct, empathetic, and nonjudgmental, we become a holding bay for stressed caregivers, creating a place of safety, confidentiality, consistency, and support. Finally, GCM’s offer our clients a model of perseverance. By not giving up on the possibility of positive change and by exploring all options, the GCM enables families to feel that, regardless of the outcome, they have done all that they can to support the older adult.

Be like Judy Garland on the holiday offering hope

Have yourself a merry little Christmas.
Let your heart be light
From now on
our troubles will be out of sight

Give the” Merry Christmas – next year

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15 Alarm Bell for Holiday Visit With Aging Parents

December 6, 2019

ALARM BELLS FOR AGING FAMILY HOLIDAY VISITS

It’s almost Christmas and Hanukka and time for the family visit with older relatives. If you suspect festive cheer with an aging family could devolve into some scary scenes, here are some red flags to put in a checklist and share with your midlife siblings before the holiday celebration.

Perhaps your older parents have piles of junk mail, dirty clothes, unwrapped gifts when Mom used to shine through her color-coordinated presents. All are cause for the sibling 911 alarm- then action.

You can use this list to assess your parents or older family members during the holidays and compare notes on a post-holiday conference call. If all midlife siblings have the same criteria, it makes easier to agree on what to do and what to flag as family New Year’s resolutions.

Below is a list of red flags. If you saw any of these problems on Thanksgiving or Hanukkah or face them on Christmas- now is the time to do something about it. Use this is a checklist.

Alarm Bells List for Visiting Aging Long Distance Relatives During the Holidays

Unpaid bills
Missed appointments
Clutter in a home that was once always neat .
Refusing to go to medical providers
Not taking care of activities of daily living: cooking, bathing, dressing, housekeeping, etc.
Entering contests, credit card maxed out on shopping channels
Recent fall

POST-HOLIDAY EMERGENCY PLAN

When midlife adult children return from the holidays, the family can have a family meeting alone or with an aging professional and look at the problems on everyone’s list, agree on the top red flags and start helping the long-distance family.

Don’t wait till you and your midlife siblings are shocked out of sleep by late-night calls from brothers and sisters, frantically telling them of a crisis with aging Mom or Dad. Don’t force yourself and the other adult children to book last minute, high-cost flights, and gather in scary, sterile hospital rooms with brothers and sisters they have not really communicated in years.

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