Cathy Cress

Expert in Aging Life and Geriatric Care Management

Care Manager’s Must Help Elders at Risk of Covid -19 Prepare End Of Life Docs Fast

Aretha Frankin died without will 18 months ago -before COVID-19. Now older people both famous and out of the spotlight are dying in a pandemic not seen since 1917. According to Aretha’s ‘lawyer, Ms. Frankin was aware she needed to take care of this but ” never got around to it”. This left her estate liable for potentially millions of dollars of taxes and attorney fees and a drawn-out timeline for her 4 sons to inherit the proceeds from her estate.

Franklin was, as many have said, ” a force of nature” and a woman who would be hard to sway. But care managers specialize in working with VIP clients and the rich and famous. These clients are often uber difficult to work with- entitled, narcissistic equally hard to sway. Aretha Franklin’s attorney might have convinced her that she needed to work with him to protect her family and her estate before she died.

You as a care manager may have to take a more urgent  approach by yourself or with the client’s attorney because the stakes are so much higher as

now elders are likely to die with this virus rampaging throughout the world, striking the people with comorbidity, like people over 65, the hardest

Most geriatric care managers work with the wealthy top 10% if they want to survive as a business as Medicare does not cover long term care. Only the top 10%, like Aretha Frankin, can afford it. But what comes from being a good care manager is knowledge of death. End of Life care is one of their jobs.  Making sure their client has all their legal documents ahead of time is critical at this minute. With COVID-19 that clock runs on speed.

Right now with 80% of all the people in the US dying of COVID-19 elders, these documents- one a living will- are ana important job of the geriatric manager, as death

may be shrouded and waiting around the corner for many of your clients 

Once the COVID-19 is known with an elderly client, the care manager who has added “end of life services” to their agency, is often the one who will initiate and guide advance care planning discussions. The problem with COVID-19 is that the onset of the disease can be rapid.  As difficult as these discussions may be, the burden on the family is significantly lessened if decisions about advance care planning are made before the client’s condition worsens.

Hopefully, this has already been done but many people put it off for fear of death. A recent study found that less than 50% of severely or terminally ill patients had an advance directive in their medical record.

Advance directives are legal documents that allow clients to make decisions about their health care and finances in advance of when they are not mentally or physically able to do so. These documents must be signed, dated, and witnessed naming another person to make decisions for you.

Your job as a care manager is the make sure your older client has these documents before they have COVID-19:

 

If the client does not have these legal documents and wishes to create them, the Geriatric Care Manager will suggest that the documents be put in place with the oversight and consultation of an elder law attorney.

But During Covid-19 could rush an elderly client towards death like a mammoth mudslide sweeping them into a hospital where no one can enter, even the family.

Care Managers play a big role in the end of life issues. They are their navigators through all five stages of dying, which is the time before COVID-19 could be long before palliative care or hospice are called.  But in this plauge’s reign, there is little time to plan so the five stages of death are on steroids. So, talk to your clients now before they get into a screaming ambulance to the hospital where no one can follow the including you and may never return.

 

 Proactive discussions and legal planning now can help to reduce the risk of dying like Frankin leaving the legacy of her music, a soundtrack to her life but a family both shattered and at war with each other. The COVID-19 clients you see now could be in this position and their families will be left with no rituals no funeral no advanced directives and only hopefully a zoom family meeting to say their last words. Good legal guidance can also help clients make better decisions,  avoids all this other legal horror on top of the torturous death of coronavirus. Making a will or a trust now will save the family from adding to the burden of a lonely painful death.

Consider getting this product with my GCM Operations Manual 

Celebrating the Resurrection in the season of COVID-19 deaths in Nursing Home

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

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