Cathy Cress

Expert in Aging Life and Geriatric Care Management

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Do You Do Cultural Assessment With an End Of Life Client?

February 13, 2021

 

 

 Each Culture Has Different Customs and Beliefs in End of LifeiStock_000063346301_Medium-1.jpg

There may be cultural differences in end-of-life decision making as a result of underlying cultural values with disclosure of a terminal illness and very critically -use of life-sustaining medical treatment. With the widespread availability of advanced medical technology in the United States, people are encouraged to do everything possible to seek a cure for a life-threatening medical condition or sustain life. However, there are many other cultures for whom quality of life is more important than the length of life.

Other Cultures Do Not Follow US Medical Model ChiCheng_hmpgHdr.jpg

There are some societies, such as Japan, where a terminal illness may not be disclosed to a patient and it is culturally inappropriate to discuss impending or imminent death. For instance, among some Chinese, it is considered bad luck to discuss death because such talk may cause death to occur. Sometimes the ethnic elder is not expected to make healthcare decisions and the responsibility may be based on a traditional family hierarchy. For instance, in many Filipino families, there may be a designated decision-maker who is not the patient (e.g., the oldest son or a daughter or son who is a health professional) and who articulates the wishes of the elder or family.

Some Cultures Follow Religious  Customs and Beliefs in Death & Dying

Other end-of-life decisions are based on religious tenets. In many Catholic immigrant communities, there may be strong resistance to an advance directive because the document would signify a “loss of hope” or be interpreted as suicide, which is against church doctrine. These beliefs may also influence the use of hospice services.

 

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 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: Advanced Directives, advanced directives& COVID-19, Aging, Aging Life Care, aging life care manager, ALCA Role Death and Dying, Benefits of ALCA to Hospice, Cultural Assessment, Cultural Assessment Death, Cultural Beliefs in Death, Death & Dying, Death and Dying, Death and Dying Care Management, death and dying care manager, End of Life, End of Life Care manager, End of Life Cultural Assessment, End of life documents, Families, FREE WEBINAR, GCM role Death and Dying, Geriatric Care Management Business, Geriatric Care Manager, Geriatric Care Manager Cultural Assessment, geriatric social worker, Good Death, Hospice, Hospice Care, nurse advocate, nurse care manager, Palliative Care, Palliative care manager, SNF death COVID-19, US Medicalization of Death Tagged With: 5 stages of death, Acceptance Phase of Death, adding end of life services, Aging Life Care Association, care manager cultural assessment, chronic phase of death, COVID-19 Deaths, cultural assessment, Cultural Beliefs in Death, Cultural Customs in Death, cultural diversity, death and dying in COVID-19, geriatric care manager, Hospice at end of life, Palliative Care at end of life, US medicaization of Death

Dear Governor Newsome – Don’t Sentence Frail Elders To Ca. Nursing Homes Wrenching Them from Free Loving Family Caregivers!

June 18, 2020

Dear Governor Newsome :

I am on the board of the Health Project Center in Santa Cruz, County that operates the MULTI-PURPOSE SENIOR SERVICES PROGRAM (MSSP program ). and CAREGIVER RESOURCES PROGRAM (CRC)  in both Monterey and Santa Cruz Counties.

KEEP THESE NURSING HOMES CERTIFIED SENIORS IN THE CHEAPER COMMUNITY

I am writing to support these programs and implore the governor not to cut their funding. These senior programs were created to keep people out of expensive nursing homes in the 1970s and keep them in the cheaper and nurturing community. By cutting MSSP and CRC the state will only accrue more debt by spending more money to fund now COVID -19 disease-ridden nursing homes. These nursing home certified beneficiaries who are the frailest and poorest of our elderly population. They are kept in the community by MSSP where they receive food services, socialization, and therapy. Their family caregivers receive respite.

Giving these caregivers respite can be the difference between caregiver burnout due to unpaid relentless 24-hour care of a loved one. Burnout ends in placement in nursing homes. But with COVID -19 still rampaging many cannot even get in.

 CAREGIVER RESOURCE CENTER  KEEPS FRAIL SENIORS IN FREE FAMILY CARE VS NURSING HOME PLACEMENT $80,000 a year 

Respite to caregivers to stop inappropriate placement in nursing homes is one of the main functions of the Caregiver Resources Centers in California,  which needs its funding kept intact by the governor. The Center provides support to families caring for loved ones with cognitive impairments such as Alzheimer’s Disease, making referrals to caregiver counseling, support groups, local caregiver service, and giving small respite grants. Without the caregiver falling apart, which the Caregiver Resource Center stops, once again, the older nursing home certified client will just end up being forced to trying to get into a nursing home at $80,000 a year, when the family caregiver was FREE.

 IF these programs are demolished by the governor and MSSP and CRC are axed out in a blood-spattered cut and these frail seniors will be dumped into California nursing homes where the state will spend needless money it does not have.

 

STATE WILL PAY $80,000 A YEAR PER PERSON FOR NURSING HOME PLACEMENT VS. $5000 FOR MSSP

These programs save the state money. Each of the MSSP clients is disabled enough to be eligible for nursing homes and poor enough to be eligible for MediCal. So instead of the

state paying $80,000 or $90,000 per person per year in a nursing home, the State pays only on average a little over $5,000 for the person to be in MSSP and nothing for the family caregiver. .This makes the cuts both fiscally wrong and mystifying.

 

 MSSP CUTS MAKE RECIPIENTS GO  TO NURSING HOMES WITH 0 TESTING, JUNK PPE THAT LOOKS LIKE  GARBAGE BAGS WITH HOLES

Seniors have borne the greatest share of death already from COVID-19, as over 50% of the dead in the US are now elders from coronavirus who lived in a nursing home rife with the virus. These MSSP participants, without the support of MSSP, will have to turn to nursing homes.  According to the House Select Committee on Nursing Homes a few days ago, these facilities do not have enough testing and personal protective equipment to stop the virus from spreading. They do not even have PPE and at CMS direction, FEMA has been sending out junk for PPE that looks like garbage bags with holes. This is what you would be sentencing these frail elders to with the scrawl of the governor’s seal.

 

 CRC CUTS SEND Frail ELDERS FROM FREE FAMILY CARE TO $80,000 YR NURSING HOMES

 You are sending these seniors from the loving care of their family to nursing homes with few beds, COVID-19 raging from one bed to the next bed, beds not 6 feet apart, and no

testing or PPE. All this while the state pays $80,000 or $90,000 per person per year in a nursing home when the State pays only on average a little over $5,000 for the person to be in MSSP.

CUTS TRAVESTY IN JUDGEMENT AND MORAL FISCAL BANKRUPT CHOICE 

 

I am a graduate of Berkeley with a master’s in SW in aging planning and community development and this is just planning for more state debt and more seniors dying in expensive, CMS FEMA and Federally caused, death traps called nursing homes.

Sincerely

Cathy Cress MSW

 

 Cathy  Cress
cressgcm@got.net
CressGCM Consult
https://cathycress.com/

Santa Cruz, Ca 95062

Filed Under: Adult children, Aging Family, aging family crisis, Aging Life Care Assocaition, aging life care manager, Aging therapist, Blog, caregiver, Caregiver Burn Out, caregiver burnout, CAREGIVER RESOUCES, CMS & Nursing Home Policy, Coronavirus safety elders, Covid-19 Death Nursing Homes, CUTS to California Caregiver Resource Centers, Cuts To California MSSP, Free Family Caregiver, Geriatric Care Management Business, Geriatric Care Manager, Infection Control Nursing Homes, MSSP cuts in California, nurse care manager, Nursing Home Deaths, Poor Nursing home staffing, PPE, PPE Nursing Homes, Skilled Nursing Facility, SNF death COVID-19 Tagged With: Aging advocate, aging life care manager, aging life or geriatric care manager, aging parent, California Senior Program Cuts, care manager, caregiver burden, caregiver burnout, case manager, CRC cuts IN CALIFORNIA, geriatric care manager, geriatric social worker, Governor Newsome-Ca, MSSP cuts in California, nurse advocate, nurse care manager, Stop Cuts to Frail Elder in California

California Cuts Pushing Frail Elders into the Cesspools of COViD-19

May 22, 2020

Here in California, the frailest, poorest and oldest in the state are being potentially knifed in the back by slashing budget cuts to the very services that keep them out of nursing homes.

 The Multipurpose Senior Services Program , one of the first geriatric care management programs in the nation, designed to keep fail elders out of nursing homes, is set to axed from the California State budget.

The Governor has also proposed elimination of $2.9 million of state funding and $3.9 million in federal matching funds for the 11 statewide Caregiver Resource Centers, 

providing critical respite care and counseling to caregivers of adults with chronic and disabling health conditions.images_20130906-154817_1.jpg

Both programs were designed 4 decades ago to keep elders at home and out of more expensive nursing homes and staunch family caregiver burnout. They offer huge safety nets, designed to keep frail seniors in the community.

MSSP is of a daycare program providing rich social and health services to frail elders and their families. The Care Resources Program caregiver respite and support to overwhelmed family caregivers.

These programs save the state a bundle of money. Each of the MSSP clients is disabled enough to be eligible for nursing homes and poor enough to be eligible for MediCal. So instead of the state paying $80,000 or $90,000 per person per year in a nursing home, the State pays only on average a little over $5,000 for the person to be in GunnDadJacket.jpgMSSP.This makes the cuts both fiscally stupid and mystifying.

What California government is doing is ripping giant holes in this web plummeting 45,000 seniors into the cesspool of COVID-19 skilled nursing facilities, where almost  half of California COVID-19 deaths occured.

 Without the services and supports available through MSSP, and the Caregiver Resource Center, many older Californians will have no other choice but to be admitted to nursing homes, where nearly half of all deaths related to COVID-19 have occurred. 

But the doors may be barred. Given the high risk of COVID-19 in nursing homes, owners are reluctant to take new patients. So, the elimination of the Caregiver Resources Center and  MSSP is really a death sentence to frail elders. It leaves no fire extinguisher for caregiver burnout of the family caregivers who care for elders with the toughest disease: brain impairment- Alzheimer’s, stroke, dementia, Huntington’s disease, Parkinson’s other conditions that may cause memory loss or confusion.

This may cause a cascade effect- placement of these horribly demented elders, into the plague-infested nursing home or also to death’s doorKali--Bill-Connies-book-.JPG

Governor Newsome has been a national hero as the first governor to issue a stay at home order to close counties down in California. He slowed the spread of coronavirus and kept California in a safe zone compared to most other states. But this was at the cost of taxpayer dollars as 4.7 Californians were put out of work. 

 He finds himself in a double bind now with a chasm of a budget hole, that he is trying up to fill with cuts like the ones proposed to the senior program. But the cuts will lead seniors to nursing homes  costing $80,000 a year instead of the $5000 for MSSP  into those caldrons of coronavirus

California is always the canary in the coal mine- the innovator that most states follow. So, these cuts can be expected across the nationwide. Who is the real villain in these cuts, the Trump Presidency. 875 billion was approved in the House of representatives in the HEROES Act. Cutting both programs saves $119 million. But these cuts would be eliminated if Congress OKs this aid for state and local governments — a prospect many state lawmakers believe is unlikely as President Trump is threatening to veto the money to the states . This has spurred a cacophony of outrage from local legislators and senior advocates. angered state lawmakers from both 

major political parties who say it’s irresponsible in light of the coronavirus pandemic that has spread through nursing homes across the state. It’s one of many conflicts emerging this week as lawmakers hold public hearings examining Newsom’s proposal before they must vote on a spending plan by June 15.

Want to help save these programs

 

PUBLIC COMMENTS – WRITTEN: Submit written public comments by email to: sbud.committee@sen.ca.gov

Filed Under: Adult children, Aging, Aging Family, aging family crisis, Aging Life Care Assocaition, Blog, Caregiver Burn Out, caregiver burnout, caregiver mental health, CAREGIVER RESOUCES, case manager, Coronavirus emergency plan, coronavirus shut down, Covid 19, Covid-19 Nursing Home, Dementia Activities, elder care manager, Families, geriatric care manager, MSSP cuts in California, nurse advocate, nurse care manager, quality of life in senior centers, SNF death COVID-19 Tagged With: aging family, aging life care manager, aging parent crisis, barrier to caregiver assessment, California Budget cuts for seniors, california caregiver resource center, caregiver burden, caregiver depression, case manager, Cuts to programs for frail elders, Family Caregiver Alliance, geriatric care manager, MSSP cuts in California, nurse advocate, nurse care manager, Trump veto

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.

Filed Under: 4th of july, 7 touches marketing, adult child physical abuse, Adult children, adult emotional abuse, ADULT SIBling, Aging, Aging Alcohol Abuse, Aging Community & Covid-19, Aging deaths, Aging Family, aging family crisis, aging life business, Aging Life Care, Aging Life Care Assocaition, aging life care manager, Aging therapist, ALCA & Skilled Nursing Facility, ALCA Beneifits, ALCA business Loans, ALCA Cobtract, ALCA COVID-19 Crisis, ALCA Disaster Plan, ALCA Ethical Dilemma, ALCA Financial literacy, ALCA Products for COVID_19, ALCA sales, Alcohol Abuse and Aging, Angela Jolie, Aretha Franklin, Assisted Living, Assisted Living & Geriatric Care Managers, Assisted Living Crisis, Assisted Living sales, bankruptcy, Barack Obama, Benefits, Benefits of ALCA to Hospice, Benefits of Care Management, Benefits of Care Management to Hospice, Benefits of Geriatric Care Management, Benefits vs Features, Benifits & Assisted Living, Bill Clinton, billing, Billing 85%, billing 85% of GCM 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Celebrating the Resurrection in the season of COVID-19 deaths in Nursing Home

April 12, 2020

Nearly 2000 residents of nursing homes or skilled nursing facilities are dead

from the coronavirus epidemic epidemic. According to The New York Times yesterday  “The virus has perhaps been cruelest at nursing homes and other facilities for older people, where a combination of factors — an aging or frail population, chronic understaffing, shortages of protective gear and constant physical contact between workers and residents — has hastened its spread.”

 Advocates blame the nursing homeowners who cut staff. “The residents are sitting ducks,” said Richard Mollot, the executive director of the Long Term Care Community Coalition.

World Wide Deaths

This is not just New York but it estimated that over 2100 nursing homes across the country  This holocaust of elders is not limited to the US. In France 3237 have died Madrid alone 4260 and Italy 8859 deaths prompting a parliamentary inquiry

We need an inquiry but more than that we need a federal response, which there is none and national coverage which is just starting to occur after the most vulnerable on the planet were locked up in buildings where no one  could visit, filled with the people with the highest risk, and staff going from facility to facility as they need three jobs to keep them afloat and spreading the virus then becoming ill themselves 

TRUMP CUT BACKS IN NURSING HOME STAFFING INFECTION CONTROL

This lack of staffing and cut back in infection control federally mandated by the Trump government. Trump cut back regulation upgrades mandated by the Obama administration

The Obama administration effort, finalized in 2016, requiring all long-term care facilities to develop infection control and prevention plans to detect, report and contain communicable diseases.  It also covered telemedicine, so needed now publishing infection control rates weekly in Nursing homes that manage from 1.6 million to 3.8 million infections each year, according to the Centers for Medicare and Medicaid Services. A 2017 analysis by Kaiser Health News found that 74 percent of nursing homes have been cited for lapses in infection control — the most frequent type of health violation.

ALCA GCM’S AND ALL AGING PROFESSIONALS PAY ATTENTION TO CARNAGE

Geriatric care managers who very often see patient in a nursing home have to sit up and pay stark attention to this, as do, adult children across the country who have placed their aging parents in what now is a cauldron of coronavirus with no one to track what is going on inside their parent’s last 

IN LA SUGGESTIONS TO TAKE RESIDENTS HOME

In LA where — death 8500 deaths  have been reported in a nursing home an LA County authority suggested family pull older residents out of the nursing homes past haste

Filed Under: Aging deaths, Aging Family, aging family crisis, aging life business, Aging Life Care Assocaition, aging life care manager, ALCA & Skilled Nursing Facility, Blog, coronavirus, Coronavirus emergency plan, coronavirus shut down, Covid 19, Death and Dying Care Management, Nursing Home Deaths, SNF death COVID-19, telemedicine, Universal Precaution Tagged With: aging, aging family, aging family crisis, aging life and geraitric care manager, aging life care manager, aging life care managers, aging parent care, care manager, Covid-19, COVID-19 Deaths, COVID-19 deaths SNF's, geraitric care manager, nursing home deaths, Obama Nursing Home regs, President Trump, roll back Nursing Home protections, roll back nursing home regs

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