Cathy Cress

Expert in Aging Life and Geriatric Care Management

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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

Does The Dysfunctional Aging Family Need Mediation Post The Holidays ?

December 9, 2021

 

 

Does an Aging Family Need Mediation Post Holidays?

Do you need mediation for the dysfunctional family after the holidays? If your clients  ‘holiday visit from their family was miserable and you are care manager to the aging parents, a family meeting between the adult sisters and brothers and a mediatory might be needed this January. This will help you decide if you need a mediator or you can be a facilitator at the family meeting. Care Managers can do facilitation but you need very advanced training to be a mediator.

a. Compatible. Does their family generally present as a unit and lock arms together in a crisis? Do you usually work as a team?

b. Fragmented: Is their family unable to work together as a unit? Do their family members and siblings contact friends and outside professionals with their problems, while failing to confide in each other? Do family members ask other family and other

siblings, friends, and outside professionals to keep conversations secret from certain relatives? Is there a cache of family secrets that some family members do not tell others or share? Do kin pit one another against each other when trouble arises? Instead of locking arms in a crisis, does their family point fingers and blame each other? Does a dysfunctional family need mediation? 

c. Is their family productive or non-productive?

        1. Productive: Are the family members able to respond to the suggestions of friends or professionals and take necessary action to create change in the family?

         2. Nonproductive: Are any family members unable to mobilize when help is really needed? Do any siblings or other kin feel powerless to act? Is “victim” a term you would use for some family members and or siblings? Do family members ignore the ideas of friends or professionals who are trying to transform the sibling/ family dynamics? You need to assess -does the dysfunctional family need mediation?

d. Is their family stable or fragile?

         1.. Stable – When family members have disagreements, do they find a way to solve their problems? Does the family have long-standing relationships and respect the differences in each other?

         2. Fragile: Is there a history of emotional cut-offs or distancing on the part of one or more family members? Is there a pattern of generational divorce, remarriage? Do you need mediation for the dysfunctional family after the holidays?

Each family is different but if this family scores 2 out of three you should investigate bringing in a mediator ed6855aa32d877d7fc1ef9ee757e0f17-98.jpg

Sign Up for My Free January Webinar  

11 Vital Clinical Tools For Desperate Families Post-Holidays

             Thursday, Jan 6, 2022, 02:00 PM Pacific Time (the US and Canada)

 

 

  Give frantic adult children hope when they desperately call after the holiday  

 Join me Post-holiday and learn how to come to clinically rescue concierge dysfunctional families who found coal in their stocking.      

Learn how to!

  • Understand the Dysfunctional Aging Family System you must enter to get care for elders
  • Master 11Vital Clinical Tools you to solve client problems
  • Take Six Clinical Steps Professional Must Take to Work with These Difficult Families
  • Get care for aging family members when the dysfunctional family members resist

 SIGN UP NOW 

 

 

Find out more in the YouTube for My YouTube, Channel  Geriatric Care 1

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Find out more in the YouTube for My YouTube, Channel  Geriatric Care 1

 

 

 

 

Filed Under: aging family crisis, Aging Life Care, Aging Life Care Assocaition, aging life care manager, Blog, case manager, Dysfunctional aging family, Dysfunctional Family & Holidays, elder care manager, elder mediator, Geriatric Care Management Business, geriatric care manager, Geriatric Care Manager, geriatric social worker, mediation, nurse advocate, nurse care manager Tagged With: aging dysfunctional family, aging family, aging life care manager, aging parent care, aging parent crisis, care manager, case manager, dysfunctional family holidays, dysfunctional family roles, elder mediation, elder mediator, geriatric care manager, geriatric social worker, mediation, mediator, nurse advocate, nurse care manager, Psychosocial assessment

End of Life-When Do You Need Mediation?

February 23, 2021

Why do some families need mediation at the end of life? Mediation is a voluntary process in which the parties, with the help of an impartial third party mediator, work together to resolve their differences or solve a problem they were unable to address satisfactorily without help. These family differences especially happen to dysfunctional families but can beset any family at the end of life. They are faced with overwhelming emotions and decisions that demand that the family work together as a team. What happens to dysfunctional and even nearly normal families during this trying time? They don’t gather as a team. They fight. They fret and they feud. What are the results of this fighting, fretting, and feuding in families at the end of life?                                        family-charis1-226x300.jpg

Unresolved family conflicts emerge

            Dysfunctional families become more dysfunctional

Family members’ grief, pain, and anxiety are often masked as anger and presents as conflict (past and present)                                                 

Older person dies without resolving important family issues

Older person dies in conflict, not in peace

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 

  • Transition the patient/family through the five stages of death     
  • Help clients be active participants in their care
  • Give the family/caregiver tools to manage care
  • Provide family center care to caregiver and family
  • Choose the right support services through all stages of death
  • Introduce Hospice and Palliative care and work with their team
  • Use ALCA End of Life Benefits During COVID
  • 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 life care manager, Death & Dying, Death and Dying Care Management, death and dying care manager, DNR, End of Life, End of Life Care manager, GCM role Death and Dying, geriatric social worker, Good Death, Hospice, Hospice Care, mediation, Mediation End of Life, Mediator, nurse care manager Tagged With: Advanced Directives, aging parent, aging parent care, aging parent crisis, ALCA care Manager, ALCA in End Of Life, disputes at end of life, dysfunctional aging family, dysfuntional family, elder mediation, end of life, end of life family meeting, facilitator, families fretting at end of life, family meeting, Fighting and Feuding at end of life, GCM mediator, geraitric care manager, Geriatric Assessment, geriatric care manager, geriatric care managers, Handbook of Geriatric Care Management third edition, mediation, mediation end of life, mediiator, My Geraitric Care Management Operations Manual, nurse advocate, nurse care manager, power of attorney for health care, siblings feuding, siblings fighting, step sibling family meeting

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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Does The Dysfunctional Aging Family Need Mediation Post The Holidays ?

January 4, 2020

 

If your clients  ‘holiday visit from their family was miserable and you are care manager to the aging parents, a family meeting between the adult sisters and brothers might be needed this January. This will help you decide if you need a mediator or you can be a facilitator at the family meeting.

9 Warning Signs That Mediation May be Needed

  a.Compatible. Does their family generally present as a unit and lock arms together in a crisis? Do you usually work as a team?

b.Fragmented: Is their family unable to work together as a unit? Do their family members and siblings contact friends and outside professionals with their problems, while failing to confide in each other? Do family members ask other family and other siblings, friends and outside professionals to keep conversations secret from certain relatives? Is there a cache of family secrets that some family members do not tell others or share? Do kin pit one another against each other when trouble arises? Instead of locking arms in a crisis, does their family point fingers and blame each other?

c.Is their family productive or non-productive?

        1,.Productive: Are the family members able to respond to the suggestions of friends or professionals and take necessary action to create change in the family?

         2,.Nonproductive: Are any family members unable to mobilize when help is really needed? Do any siblings or other kin feel powerless to act? Is “victim” a term you would use for some family members and or siblings? Do family members ignore the ideas of friends or professionals who are           trying to transform the sibling/ family dynamics

d.Is their family stable or fragile?

         1.. Stable – When family members have disagreements, do they find a way to solve their problems?               Does the family have long-standing relationships and respect the differences in each other?

         2.Fragile: Is there a history of emotional cut-offs or distancing on the part of one or more family members? Is there a pattern of generational divorce, remarriage?

Each family is different but if this family scores 2 out of three you should investigate bringing in a mediator ed6855aa32d877d7fc1ef9ee757e0f17-98.jpg

Read Dana Curtis Esquire’s Mediation and Geriatric Care Management in Handbook of Geriatric Care Management 4th Edition 

Filed Under: aging family crisis, Aging Life Care, Aging Life Care Assocaition, aging life care manager, Blog, case manager, Dysfunctional aging family, Dysfunctional Family & Holidays, elder care manager, elder mediator, Geriatric Care Management Business, Geriatric Care Manager, geriatric care manager, geriatric social worker, mediation, nurse advocate, nurse care manager Tagged With: aging dysfunctional family, dysfunctional family holidays, dysfunctional family roles, elder mediation, elder mediator, mediation, mediator

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