Cathy Cress

Expert in Aging Life and Geriatric Care Management

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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

GCM Agency Lifespan Wins Top Awards

April 11, 2021

Geriatric Care Management Home Care Agency Wins National Award

Lifespan a 35-year-old geriatric care agency in Santa Cruz, California won prestigious awards from both national and local groups this month. Home Care Pulse awarded the care management home care agency ” Provider of Choice Award” for being best in class for rendering quality care to their clients, being trustworthy, and providing outstanding home care services the award was based on customer and staff surveys. Locally they also won the Santa Cruz Good Times Award for “Best of Homecare “award while competing with all home care agencies in their county.

Lifespan helped build trust during the “annus horibillus ” year of COVID  through their own website.Clients could see their extreme COVID safety precautions prominently provided on the navigation bar of their website. 

Outstanding Home Care in the year of COVID

The award recognized their outstanding home care services providing quality care through impeccably trained COVID safety-equipped and monitored home care staffing during the pandemic, building community trust. Clients in Santa Cruz, California needing care management services during COVID and ongoing were provided geriatric care management services developed over the agencies 35-year history and fine-tuned for clients’ needs during the epidemic

Quality of Life as Well as Quality of Care

The agency continued to offer Well Being – a service for lonely and isolated seniors who dramatically suffered during the pandemic from sheltering in place. Lifespan not only served the quality of care needs of clients but also the Quality of Life Needs  answering isolation and loneliness in a pandemic

Videos Showing Home Care Safety Build Trust

Finally, they showed the community their excellence and safety through videos in their email newsletters for 6 months, done with a phone by a talented staff member. The agency provides Quality of Life activities and adds videos about  Lifespan‘s Well Being Program. They upload them to their YouTube channel another great way they build trust with their agency. Market safety from Covid-19.

During the continuing but diminishing pandemic, as clients begin to use services like care managers and home care again, it is critical that you build that trust by showing customers you are safe. In Lifespan’s case, you can also win awards for this.

Filed Under: Aging, Aging Life Care, aging life care manager, Blog, Covid Safety Video, COVID-19 Safety, Families, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, home care, Home Care Award, Home Care Covid Safety, Home Care Pulse, Home Care Trust, nurse advocate, nurse care manager, PPE, PPE Nursing Homes, Private Duty Home Care, Provider of Choice Award, Quality of Life, Videos Tagged With: aging family, aging life and geraitric care manager, aging life care management, aging life care manager, aging parent care, care manager, case manager, Community Award, COVID Safety Precautionss, geriatric care manager, geriatric care manager private duty home care, Home Care Pulse, Home Care Pulse Awards, Home Care Trust, Lifespan, nurse advocate, nurse care manager, Outstanding Home Care, private duty home care

What Types Concierge Clients Can Afford Paid Care Besides Donald Trump On the Holidays?

November 1, 2020

 Types of aging families who can afford care management

Families who can afford geriatric care management and home care  long term can do so because they have the financial resources, which are usually over a million dollars in assets.. Part of this is drawn from Claudia Fine 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 develops from a specific kind of “not good enough parenting” in which the parents themselves have struggled with personality disorders, most typically, in this type of family, narcissistic borderline personality  ( example President Trump)They struggled with 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.  ( Fine and Newcombe- Entitlement in the Aging Family, Care Managers Working With the Aging Family)

 

 Rich and Famous-Entitled Families:

These families are identified by the parents’ socioeconomic, financial and political prominence.  ( example President Reagan)They are families in which all basic needs, services, resources and creature comforts are obtained via income, assets, abundant discretionary cash flow and/or come from the political position, station or power.  Once again, the entitlement of the family is passed from the parent to the child who in turn brings these behaviors and actions to the caregiving milieu and care management relationship.  In this category, the entitlement arises out of a family that is accustomed to purchasing everything.  They look to paid others to meet their needs (as opposed to families who must themselves find and orchestrate ways to meet basic and complex needs themselves or with the help of the extra-familial system).  Often these families have household staff, i.e., nannies, butlers, drivers, private pilots, cooks, and maids.  They may have available to the business and family lawyers and accountants, as well as, teams of medical professionals and concierge physicians.  Consequently, in almost all situations they are uninvolved in processes, especially those that are difficult, stressful and time-consuming.  ( Fine and Newcombe- Entitlement in the Aging Family, Care Managers Working With the Aging Family)

 

Well-heeled seniors,affluentseniors.jpg

According to the New York Times, may be middle-class retirees who buy shoes from Payless but have a defined pension can afford care at home when they need it and private care management. They rode the post-war economy, held jobs long term and through that defined pension (no 401K) face a very healthy financial picture in aging.  They worked for city, county, state government are teachers, truck drivers, social workers or were union members in all trades. They had a career at Xerox, IBM, Campbell Soup and big Fortune 500 companies.

 

Professionals- Physician, Attorneys, CPAs

This group made a very healthy living during the late 20th Century, probably had a defined pension and have very lucrative investments that allow them to afford home care and care management. They usually come from nearly iStock_000063346301_Medium-1.jpgnormal families and have been well parented although you will find a mixture of dysfunctional aging families. Their adult children tend to be supportive of their parents, although again you will find a mixture of dysfunctional families in this category.

If you are in any of these families, how will you spend the coming holidays with them- and will you spend the future COVID-ridden Holidays with them. If you are a geriatric care manager or geriatric therapist, what will you advise your clients do during this star crossed holiday on ice.?

SIGN UP FOR MY NEW FREE WEBINAR

 

8 Ways to Tame the Turmoil of the Holidays & Twindemic in the Aging Family

 Learn how!

  • How to sell services to the desperate Aging Family during the holiday surge
  • How to give hope to frantic children who call when their aging parent struggling with Loneliness and isolation on the holidays
  • How to help the Aging Family make holiday visits remotely or safely in person
  • How to counsel the Aging Family to track aging decline &Twindemic risk in loved ones
  • How to work with both dysfunctional and long-distance families who call during the holidays
  • How to use GCM tools to contain Holiday chaos
  • How to use financial forecasting to prepare for business growth during the holidays

Sidestep the Many Care Managers Who Do not know how to work with Dysfunctional family or do COVID Coaching of Aging Families so the client chooses you

THIS FREE WEBINAR IS Thursday, December 3, 2020, FROM 2 PM – 3:30 PM PST

Sign Up Now

 

 

 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

 

  

 

 

 

 

 

 

Filed Under: Aging, Aging Life Care, Aging Life Care Assocaition, aging life care manager, Aging therapist, ALCA & Skilled Nursing Facility, Blog, Concierge aging clients, Concierge Client, concierge clients, Concierge Senior, COVID & HOLIDAY SEASON, Covid 19 Webinar, Covid Holiday Remote Visit, COVID Webinar, Covid-19 and GCM SERVICES, COVID-19 Webinar, elder care manager, Families, Geriatric Assessment, Geriatric Care Management Business, Geriatric Care Manager, geriatric care manager, geriatric social worker, high end clients, Holiday Meltdown in Aging Family, Holiday Rituals in Aging Family, Holiday season, Holiday Sibling Rivalry, Holidays, HolidaySeason and COVID, home care, Long Distance Care, Long distance caregiver, Narcissistic Personality, nurse advocate, nurse care manager, Remote Thanksgiving Family Visit, Webinar Tagged With: Aging Concierge client, aging family, aging life care manager, aging parent care, aging parent crisis, care manager, case manager, Certified Senior Advisors, Concierge Care Manager, Covid, COVID & Holiday Season, COVID VIRTUAL CHRISTMAS VISIT, COVID VIRTUAL HANN, COVID VIRTUAL THANKSGIVING VISIT, Covid-19 Telehealth, COVIF VIRTUAL THANKSGIVING VISIT, Entitled, Entitled Family, geriatric care manager, Holiday COVID Celebration, Narcissistic Personality, nurse advocates, nurse care manager, Rich and Famous, Virtual COVID Holiday Celebration, well heeled seniors

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.

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Are Rich and Famous Among the Concierge Clients Who Can Afford Long Term Care?

March 11, 2020

Four types of aging families can afford geriatric care management, home care, and long term care because they have financial resources, usually over a million dollars in assets. Part of this is drawn from Claudia Fine and Nick Newcombe excellent chapter ” Entitlement in the Aging Family”, Care Managers Working With the Aging Family, Jones and Bartlett)

 

 Rich and Famous-Entitled Families:

These families are identified by the aging parents’ socioeconomic, financial and political prominence.  ( example President Reagan)They are families in which all basic needs, services, resources, and creature comforts are obtained via income, assets, abundant discretionary cash flow and/or come from the political position, station or power.  The entitlement of the family is passed from the parent to the child, like a virus, who in turn brings these behaviors and actions to the caregiving milieu and care management relationship. 

Entitlement That Abuses Family With Riches

In this category, the entitlement arises out of a family that is accustomed to purchasing everything.  They look to paid others to meet their needs (as opposed to families who must themselves find and orchestrate ways to meet basic and complex needs themselves or with the help of the extra-familial system).  Often these families have household staff, i.e., nannies, butlers, drivers, private pilots, cooks, and maids.  They may have available to the business and family lawyers and accountants, as well as, teams of medical professionals and concierge physicians.  Consequently, in almost all situations they are uninvolved in processes, especially those that are difficult, stressful and time-consuming.  ( Fine and Newcombe- Entitlement in the Aging Family, Care Managers Working with the Aging Family)

Free Webinar-Sales and Marketing to Find the VIP Concierge Client

March 31, 2020 -2PM -3:30 PM PST

Concierge clients are the only way a GCM or ALCA care manager can make a profit and have their business thrive. Find out who are they, how you find them, design GCM Products they will purchase, and create a marketing plan and gold standard services to have them sign your contract and use your services long term

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Who They Are- 4 Types

  • How to Locate them in your service area
  • How to create a strategic marketing plan to sell to them
  • How to Develop Gold Standard GCM Products and Services
  • How to transform your GCM entrepreneurial dream into a profitable reality with 10 key marketing steps to learn more 
  • How to overcome the double bind of your caring model and learn how to care and make money
  • How to create a marketing strategy and messages that attract concierge clients 
  • How to reach this target audience
  • How to design products that exactly meet Concierge Clients needs
  • How to obtain adult children’s buy-in           
  • How to use words that will make them choose you
  • How to get care staff they will like and not fire
  • How to get the contract signed with ease

 

 

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Filed Under: Aging, Blog, elder care manager, Families, Geriatric Assessment, Geriatric Care Management Business, geriatric care manager, geriatric social worker, home care, Narcissistic Personality, nurse advocate, nurse care manager, Webinar Tagged With: aging family, aging life care manager, aging parent care, aging parent crisis, care manager, case manager, Certified Senior Advisors, geriatric care manager, nurse advocates, nurse care manager, well heeled seniors

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