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

What is the GCM’s Role is the Recovery Phase of Death and Dying ?

March 7, 2021

photo.JPG

 

The recovery phase of death and dying 

This occurs when people finally are able to cope with the mental, social, physical, religious, and financial effects of their disease, a heavy load  In the disease process and acceptance process, this is the period of time after a medical procedure such as chemotherapy, radiation or surgery. The client’s response to treatment is being monitored. Recovery does not always mean remission, but instead, it is the ability to accept and deal with the struggles of their illness

A Story About the recovery phase

William died at the home of his son after he had accepted that he was to die of liver failure. He was hospitalized and had not signed a Do Not Resuscitate because he actually did want everything done to save him. He had new twin grandsons a grandaughter he adored and loved life. He was having dialysis to treat his symptoms. A care manager knew that the doctors suspected cancer but believed the procedure to find out would kill him. But they felt their hands were tied by the DNR and the hypocritic oath. The care manager, finally, after talking to a nun on the staff of the Catholic hospital who said she would help,  and talked to the lead physician and asked that he order palliative care. He did and all 4 physicians talked to Bill gently and about removing the dialysis and signing a DNR. He did and after a family meeting lead by palliative care and hospice, William came home with 24-hour care.

The Recovery Phase Begins

After his coming to terms with his death, he and his family, sons, and grandchildren were able to say the goodbyes and offer the unconditional love that they had been fearful to express before his acceptance. A feeling of light joy permeated his room. For almost a month he lived in the family room overlooking the garden, where his hospital bed was set up. Great-grandchildren brought pictures, marveled at “grandpa grandpa “ high up in a hospital bed. His son put a  headphone with a mike on and William could hear and speak, as he had not in years. His 24-hour caregivers were gifted loving care providers from a GCM agency  Livhome. 

Home Care and Care Management in End of Life

.

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 his 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. They ate meals, chitchatted, and welcomed new family coming in to see William, as he remained in the center in his hospital bed, the fulcrum of the gathering.

End of Life Geriatric Care Management Well Done

The geriatric care manager, GCM Mary Brennan, from Livhome, a seasoned powerful and so kind LCSW,  was an orchestra leader in Bill’s death. She adjusted here and there, with care providers, family needs, Bill’s needs, and 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 there at the end as were all his sons – a life fully lived and a good, good death.

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.

 

Deliver a Good End of Life- Add Death and Dying to Your Care Management Agency

 

Serve Your Client Until Death Do You Part

 

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 their care

4.Provide family center care to caregiver 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: Aging, Aging deaths, Aging Life Care, aging life care manager, Benefits of ALCA to Hospice, Benefits of Care Management to Hospice, Benefits of Geriatric Care Management, Death & Dying, death and dying care manager, elder care manager, End of Life, End of Life Care manager, End of life documents, FREE MARKETING WEBINAR, FREE WEBINAR, GCM Clinical Tools, Good Death, Home From the Hospital, Hospice, Hospice Care, Hospital care manager, nurse advocate, nurse care manager, Palliative Care, Palliative care manager, Private Duty Home Care, Quality of Life in Dying, Recovery phase of death Tagged With: end, end of life care, end of life family meeting, free webinar, geriatric assessment for end of life, geriatric care manager, Good Life to the Very end, Hospice, Hospice at end of life, Livhome, Navigation through END of LIfe, recovery, recovery phase of death, recovery stage of dying, webinar end of life

How Do You Detect COVID–19 Symptoms in Seniors While Living Long Distance?

July 1, 2020

COVID–19  Detecting Symptoms in your loved one from a Distance

We can not always be with our loved ones. Long-Distance Families make approximately 43.5 million caregivers who have provided unpaid care to an adult or child in the last 12 months.  How can you keep a watchful eye on long-distance older family members for symptoms of COVID-19?  First, you will need to know what symptoms to watch and listen to.

Did you know that COVID -19 is known to develop into a severe acute respiratory syndrome and may result in death? The elderly are more susceptible to this contagion simply due to their age. Your job is to become their health detective by paying acute attention to physical symptoms and asking questions when conversing with your loved one.

Symptoms to Listen & Signs to Look for

Signs and symptoms of COVID-19 may appear 2-14 days after exposure, commonly referred to as the incubation period. Common signs and symptoms can include:

  • Fever, cough or tiredness – If your loved one is suddenly not making sense or acting confused when you are talking with them, this could be an indication of having a fever and an infection.  Listen for coughing during your conversation and don’t be afraid to ask if they are napping more often or sleeping longer than usual or if they are weaker than usual.

Other symptoms can/may include:

  • Shortness of breath or difficulty breathing             Muscle Aches
  • Chills                                                                             Sore Throat
  • Loss of taste or smell                                                 Headache
  • Chest pain

EXTREMELY IMPORTANT TO BE KNOWLEDGEABLE OF MEDICAL HISTORY

If your loved one has existing medical conditions such as heart disease, lung disease, diabetes, severe obesity, chronic kidney or liver disease, or compromised immune systems they may be at greater risk for contracting COVID-19.  

CALL YOUR LOVED ONE’S PCP OR ARRANGE FOR THEM TO BE TAKEN TO THE HOSPITAL IMMEDIATELY IF MORE THAN ONE OF THESE SYMPTOMS APPEAR.

As your loved one’s health detective – Vigilantly Monitor their Physical Appearance

Call often.  Listen for symptoms such as coughing, shortness of breath, inability to complete sentences without having to take a breath. Are they suddenly confused or confused more than usual?

Use your technology.  Face time with your loved one. Look at them.  Are they having a hard time breathing?  Watch and count how many times their chest raises per minute. Normal breathes per minute in the elderly is 10-30. With COVID-19 the rate will be lower. Look for the appearance of lost sudden weight loss. The virus can decrease their appetite as it affects their sense of smell, making food less appetizing. Look at your loved one’s lips.  Are they discolored or have a light blue tint? This is a sign of oxygen deprivation and could potentially be very serious.

If you see any of these signs call your loved one’s PCP immediately and take/arrange for them to be taken to the hospital immediately.

JOIN ME FOR MY NEW FREE WEBINAR               

Create 5 Telehealth Products for COVID 19

WHEN. THURSDAY AUGUST 6

TIME- 2 PM Pacific Standard Time

Care Management businesses are struggling with pandemic close-downs.

Support your business bottom line, clients, and their families.

Create 5 COVID-19 products.

Products from sheltering in place through the hospital, recovery at home, discharge from an SNF, or hospital for local and long-distance elders. Increase your bottom

line as COVID spreads throughout the US and more shutdowns loom

Learn Step by Step How to Consult with Aging Families and Seniors to Choose the best Hipaa Compliant Telehealth Products to Remotely Consult with Client

  • Help a Local Family Assist a Loved One Safely Shelter in Place
  • Help a Long-Distance Family Guide a Local Loved One Shelter in Place
  • Help an Aging Family Help a Loved on Hospitalized for Covid-19
  • Help an Aging Family Care for  a Loved one Recover when Discharged from a

Nursing Home

  • Help an Aging Family Care for a loved one Recover when Discharged from a

Hospital

WHEN. THURSDAY AUGUST 6

TIME- 2 PM Pacific Standard Time

       REGISTER NOW

Filed Under: Aging Community & Covid-19, Aging Family, aging family crisis, Aging Life Care Assocaition, aging life care manager, ALCA COVID-19 Crisis, ALCA Products for COVID_19, Blog, coronavirus, coronavirus marketing, Coronavirus safety elders, coronavirus shut down, CORONAVIRUS Stay at Home Plan, Covid-19, COVID-19 & Care Management, Covid-19 Nursing Home, Covis-19 Services, FREE WEBINAR, GCM COACHING SKILLS, GCM COVID 19 Crisis, GCM products in COVID-19, GCM technology, GCM Webinar, geriatric care management emergency proceduress, geriatric care manager, geriatric social worker, Home From the Hospital, inquiry COVID-19, Long Distance Care, Long distance caregiver, Pandemic, Symptoms of covid -19 Tagged With: aging family, aging life care manager, aging parent care, aging parent crisis, care manager, Care Managers Working with the Aging Family, caregiver burden, COVID-19 -inquiry, COVID-19 & INFECTION CONTROL, Covid-19 Symptoms, COVID-19 Telehealth product, GCM Telehealth Product, long distance care provider, long-distance, nurse advocate, nurse care manager, social distancing covid-19

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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What Concierge Aging Life or GCM Products Work Best During Covid-19?

April 7, 2020

Concierge Clients Who Can Afford Private Geriatric Care Management No Longer Taking Cruises

Tens of thousands are dying in the US and worldwide of coronavirus so a cruise ship of any cruise now wreaks of dying slowly on the ocean with no real hospital and no place to disembark. This is not the product that the upper 10% or anyone would board now. But in better times concierge products like a Viking Cruise as it is understandable to a high-end customer. They buy it –because it has exceptional services and recognizes their entitled station in life. Coronavirus recognizes no status class and kills all equally.

Sell Products Clients Need During the Pandemic

Geriatric care managers, rather than tell inquiry clients they do assessment–should offer products they need in this pandemic  – like relocation (moving an older person). Elders who live in dangerous SNF facilities, so vulnerable to COVID-19 

In an article from the LA Times Charlene Harrington a Professor from UCFS states”Families with loved ones in nursing homes should consider pulling them out if it’s at all feasible to care for them at home, said Charlene Harrington, professor emeritus at UC San Francisco’s School of Nursing.

“The risk of exposure is so overwhelming,” said Harrington, who has studied nursing homes since the 1980s. “It’s a terrible concern.”

ALCA suggested that you call all the SNF’s in your area and expalin that you specialize in moving elders and can be of help to their clients who are moving out of SNF’s due to family concerns.

 

GCM Products for the Isolated and Lonely Seniors During Stay at Home Orders

Quality of Life (increasing the joy in an older person’s life who is lonely) can be an important service to offer during the coronavirus pandemic. Seniors who live alone are already isolated, lonely, and depressed and the virus only causes this to explode in their lives.  Quality of Life programs like Sage Eldercare’s Humminbird Program has gone remote and can be purchased for a minimal amount for client’s by families or agencies, nationally. Nina Herndon GCM, Sage owner and innovator, started this program several years ago because she was tired of watching elders she served watching TV 40 hours a day. She has brought it into the digital world to serve coronavirus patients nationally. Nina also wrote the Chapter on how to set up a Quality of Life program in my book  Handbook of Geriatric care Management 4th edition 

Products For Seniors Discharged from Hospitals in Pandemic When SNF’s will NOt Take Themphoto.JPG

Home from the Hospital is a GCM product the Safely helps the older client through discharge and the first 3 months to make sure they do not return to the hospital, which now is overrun with coronavirus patients and at capacity.

. Home From the Hospital pinpoints exactly what the older person needs for discharge with the hospital and why the family is desperately calling for help. They are calling for help at a piercing decibel level because nursing homes will not take them for fear of COVID 19 infection of their residents 

To do this, offer these products to families third parties, hospitals and nursing homes in this crucial time. develop continuously integrated solutions through a product procedure placed in your company operation manual, along with all of your products so you ensure your staff can deliver, step by a step-that high-end product that the Concierge client especially under the huge stress of the coronavirus with vulnerable parents -just purchased and demands. If you do not have an operation manual, I have all these products in my GCM Operations Manual plus 11 more, with all the procedures in place so you can instantly offer them. I will offer a 20% discount for the GCM manual during the pandemic for Geriatric Care Management Agencies suffering during the coronavirus outbreak. Contact me here 

 

 

 

 

 

 

 

 

 

 

Filed Under: Aging, aging life care manager, Blog, case manager, coronavirus, coronavirus marketing, coronavirus shut down, Covid 19, elder care manager, Families, Geriatric Care Management Business, Geriatric Care Manager, Home care disaster plan, Home Care Emergency Coronavirus Plan, Home From the Hospital, Long distance caregiver, Move Management, moving parent in your home, Pandemic Tagged With: aging life care start up, Aging Life Or GCM Products, care management products, case manager, Certified Senior Advisors, CMSA, coronavirus, Covid-19, eldercare manager, geriatric social worker, marketing during COVID-19, marketing geriatric care, marketing geriatric care management, nurse care manager, pandemic, products vs services

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