Care Managers Working with the Aging Family Archives ⋆ Cathy Cress

Calls From Aging Dysfunctional Families-Handling the Entitled Type

August 15, 2023

Calls From Aging Dysfunctional Families-Types of aging dysfunctional families who can call you over the summer vacation

Narcissistic-Entitled Families

Calls from aging dysfunctional families’ adult children or Narcissistic Entited Families’ adult kids will happen during the summer. These VIP Clinet’s adult children call you desperately for private care over the summer visit. Their problems usually develop from a specific kind of “not good enough parenting” where the parents themselves struggle with personality disorders, like narcissistic borderline personality. Families who can afford geriatric care management and home care long-term can do so because they are VIP clients. These narcissistic families, who can afford care-managed home care are often headed by a scion with a narcissistic borderline personality. Watch Succession, Yellowstone, or reruns of BIG Hair 89’s Dallas- award-winning shows you stream and you know who these Scions are. We love to hate them but binge on their evil ways. These VIP Clients have the financial resources, to pay 4-6K for home care and long-term geriatric care management which is usually over a million dollars in assets. When gathering with their adult children during the summer vacation at the family summer house or a family reunion they see the seams shredding in their parent’s minds or bodies and call you for help because they did not have those good enough parents and have no model to care for them as the parents usually did not care for the adult children as kids. They often have no interest in caring for the parents themselves, as they themselves are entitled. You need clinical skills to work with these families because of the diagnosis of narcissism, which can tear a country or family apart. Part of this is drawn from Claudia Fine and Nick Newcombe’s excellent chapter “Entitlement in the Aging Family”, Care Managers Working With the Aging Family, Jones and Bartlett)

Calls From Aging Dysfunctional families-Real & TV Narcissistic-Entitled Families:

Calls from aging dysfunctional families will come this summer- with adult children looking for help. They may see their parents faltering and face caring for them, which they have no plans to do. They will hire you like the private chef or the gardener, a service to carry out their wishes. Entitlement in their family causes the adult children to at times be as difficult and nasty as the parents. These VIP families usually develop 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 (for example Former President Trump)They struggled with a borderline personality that went undiagnosed or was formally diagnosed and untreated. We can also see this Narcissistic entitled family head in Brian Cox who in Secession plays the beloved Scion to Love and Hate Logan Roy based on real-life narcissist Rupert Murdock. The adult children will call over the summer when they notice their aging parents’ confusion often because they still fear their aging, more confused will be a perhaps more fierce parent, and the adult kids have no nerve to approach telling them they care. You need clinical skills to deal with them because they are not on TV but asking for your help in real life and narcissism and borderline personalities take the kind of clinical skills Claudia Fine and Nick Newcombe’s excellent chapter “Entitlement in the Aging Family”, Care Managers Working With the Aging Family, Jones and Bartlett) gives you if you read it. But if you watch HBO Succession you see them in a series that can be an instructive clinical accompaniment.

Calls from Aging Dysfunctional families-Sumner Redstone’s VIP Family Struggles

Calls from aging dysfunctional families like Sumner Redstone’s is another example of this type of narcissistic borderline personality in heading a VIP family. He was a Media Magnate who founded CBS Viacom with a net worth of 500 billion. His narcissistic borderline personality created a long-term struggle with his family over inheritance and control after he developed dementia. Mr Redstone was conserved by his daughter

These families call you often because they see you as a way to get control of their parents and their parent’s money. These are tricky situations where you must face conservatorship and real war with both parents and adult siblings fighting against each other for power and money, a replacement for the love they never received in the nest. So clinical skills are critical to handling them of all entitled families – they are Tyrannosaurus of dysfunctional families.

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Who Are the Entitled Concierge Clients Who Can Afford Long Term Care?

April 25, 2022

Are you aware of the entitlement of the family? Entitlement is present in five types of these rich and famous families aging families who can afford care management, home care, and long-term care because they have vast financial resources. Part of this is drawn from Claudia Fine and Nick Newcombe’s excellent chapter ” Entitlement in the Aging Family”, Care Managers Working With the Aging Family, Jones and Bartlett)

Rich and Famous-Entitled Families:

These types of aging families, who can afford care management and home care, 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, and abundant discretionary cash flow. Or they spring 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 of the Family That is Rich and Famous

In these rich and famous clans, the entitlement of the family arises from being accustomed to purchasing everything and anything. They look to pay 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 of serving their own needs, especially those that are difficult, stressful, and time-consuming. ( Fine and Newcombe- Entitlement in the Aging Family, Care Managers Working With the Aging Family)

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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.

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7 Tips to Make Labor Day Midlife- Sibling Stress Free

August 28, 2019

Happy Labor Day.

If you are working with midlife siblings to solve elder care issues and they are attending a Labor Day barbecue-

Here are

Suggestions to make the ritual of Labor Day – a holiday to be enjoyed by midlife siblings and their families – not dreaded like the annual Thanksgiving dinner where Mom burns the turkey and your uncle gets drunk and sings.

Here are 7 tips to help them keep the Labor Day heartburn free without a midlife sibling to build a midlife sibling team over aging Mom and Dad issues.

1) Don’t discuss politics. In this era of the Trump presidency with so many families at odds over President The Democratic Presidential Race ,Trump, the Russian hacking investigation, DOMA, the building of the ” Mexican Wall ” –politics can be lethal to families. Spare siblings, and guests. This is bloodier than the civil war with so many kin at opposite poles. So keep it positive and light or just plain pass the time of day. And whatever you do, don’t drink too much and forget the ban on politics.

2) Remember that it is a family gathering and it is not “all about you”.Suggest keeping a positive attitude for the sake of aging parents, if they are there, and kids, who will model bad sibling behavior when they face parent- care in the future

3) Call email or Facebook, Evite everyone ahead of time. Ask everyone to bring a dish to share. That is the beginning of building a sibling family team- sharing food. Call every midlife sibling and family member. Do not exclude. Again to build a team effort.

4) Attempt to get all midlife siblings to plan activities ahead and jointly work to make them happen-with a sibling team spirit. Think of softball games, horseshoes, and a treasure hunt, anything that everyone can have joint ideas about beforehand. Use Facebook to do this- hopefully, all your siblings are your Facebook friends.

5) Arrange to split the bill for beverages like alcohol and soft drinks, again sibling team effort. Remember to go light on alcohol because, like the recent Houston explosion caused by hurricane flooding, alcohol can detonate sibling warfare.

6) Share jobs- setting up tables, bringing in equipment for sports or games, lawn chairs- especially ‘manning” the barbecue. (Sisters can cook too) Share it and don’t let anyone be top dog –be the chosen chef, unless everyone is fine with that.This is again modeling a sibling team about helping an aging Mom and Dad.

6) It is a party, not a sibling family meeting. If you want to talk about personal issues, make a date in the future to get together with your angry sister/brother.

7) Don’t make this a family meeting where old sibling grudges get hashed out.It is a holiday.

IF you are an ALCA member or GCMCheck out the chapter ” Working With Adult Aging Siblings” by Cathy Cress and Kali C Peterson in Care Manager’s Working With the Aging Family – for a deeper dive into how to work with midlife siblings around aging parent care.

Also, you could apply this to any labor day gathering with siblings and just leave out the aging parent issue.

HAVE A HAPPY LABOR DAY

Loneliness/Prolonged Isolation in seniors =Health Risk of Smoking 15 Cigarettes a Day

March 3, 2018

The AARP Foundation’s Connect2Affect has called social isolation a “growing health epidemic” among older adults. It equates the health risks of prolonged isolation with smoking 15 cigarettes daily.Adding a Quality of Life Program to a geriatric care management practice can help serve independent seniors who do not need hands-on care but do need more community and a way to help themselves overcome loneliness and social isolation.

In a recent study loneliness in seniors between the ages of 65 and 86 led to a 64 percent increase in the risk of developing dementia, an extraordinary spike in odds highlighting the importance of fostering meaningful relationships at all stages of life. Helping seniors, through a quality of life services, find new human connections and community , can give an older person a greater sense of happiness and joy. But as this study shows critically- better health.

Quality of Life of the older client can be important to the older person’s family.If the family is involved, which it often is, even if the senior is living alone, the care manager can assist families by beginning the dialogue to open discussions on preferences and values of the older client and the family. What would give the older person joy in their life? Would it be art, going to baseball games, being in a knitting group, having a tea for friends at their home, volunteering with a group?

Quality of Life issues that the care manager should assess is the individual’s need for social interaction or privacy; the value of family; proximity to cultural stimulation; and adaptability to change. These are just some of the many quality of life considerations.

When values and preferences differ between individuals, in the family, it is important to identify how the differences may impact all involved in the process. What if the older person wants an electric scooter so she can shop at Safeway, the store she has used since she was a young mother and wife? At the same time what if the adult son or daughter will only shop at organic, health food markets and wants her mother to shop there. On top of that, the daughter feels the electric scooter is unsafe and the aging mother feels she is safe. How do you solve this quality of life dilemma?

Care Managers can be so valuable in not only helping a senior create a path out of loneliness and isolation but assisting in removing barriers to quality of life that family members may, out of care and worry, put in the elder’s way.

7 Tips to Make Labor Day Midlife- Sibling Stress Free

Happy Labor Day.

If you are working with midlife siblings to solve elder care issues and they are attending a Labor Day barbecue-

Here are

Here are 7 tips to help them keep the Labor Day heartburn free without a midlife sibling to build a midlife sibling team over aging Mom and Dad issues.

HAVE A HAPPY LABOR DAY

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