Cathy Cress

Expert in Aging Life and Geriatric Care Management

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Is Biden’s Caregiver Bill Really Infrastructure?

May 11, 2021

House Republicans Denounce Biden Caregiver Infrastructure Plan -Say It Is Not Infrastructure.

House Democrats defended President Joe Biden’s inclusion in his “American Jobs Plan” of $400 billion in support for caregiving, after Republicans criticized the package as stretching the definition of infrastructure and called on the White House to scale it back.

WHY CALL It INFRASTRUCTURE

The word “infrastructure” means something solid, essential, distributed and in the public interest. But as we have all learned in the pandemic year, care infrastructure is just that: UNPAID OR LOWGunnDadJacket.jpg PAID Caregivers are “rocks” and the solid foundation upon which the economy works. Without it, our families, our paychecks, our labor force participation, our workplaces all decline and we all suffer and collectively fall behind.

Like sagging bridges , unpaid women caregivers hold up the care infractstruce. In 2017, AARP found that about 41 million family caregivers in America perform roughly $470 billion worth of unpaid labor a year. Since then, the number of caregivers has increased to 53 million, meaning that more than one out of five Americans are unpaid  caregivers, according to AARP’s latest report.

 

The Care Infrastructure Collapsing

From February 2020 to January 2021  more than 2.3 million left their jobs, and that puts women’s labor force participation rate at 57%, the lowest it’s been since 1988. This was due to a lack ofchannel_caregiver_burnout.jpg childcare and closing of schools due to COVID  when 39% of   women family caregivers leave their job to have more time to care for a loved one.

Caregiving  for an elder reduces paid work hours for middle aged women by about 41 percent. In total, the cost impact of caregiving on the individual female caregiver in terms of lost wages and Social Security benefits equals $324,044. 34% leave because their work does not provide flexible hours. 

 

 

HOW MUCH WOULD IT COST GOVERNMENT IF FREE CAREGIVERS QUIT

Let’s put that free caregiving  into context.At $470 billion in 2013, the value of unpaid caregiving exceeded the value of paid home care and total Medicaid spending in the same year, and nearly matched the value of the sales of the world’s largest company, Wall-Mart ($477 billion). [AARP Public Policy Institute. (2015). Valuing the Invaluable: 2015 Update.]

So in 2013 the US Government would have to come up with $477 billion to replace free caregiving.

Let’s put that  free caregiving  into 2017 context.  AARP notes unpaid caregivers’ economic impact was more than  all out-of-pocket spending on U.S. health care in 2017($470 billion)and the total combined value added to the U.S. economy by the agriculture/forestry and mining sectors ($438 billion) that year.

So caregiving was not free, the US would have to come up with $477 billion in 2017 to replace it.

 

WHAT IF UNPAID CAREGIVERS  Totally COLLAPSED

If all these unpaid family caregivers stopped caring the national caregiving system would collapse, like dangerous American bridges .Then the US government would have to come up with $470 Billion to replace free caregivers or put all  elderly in nursing homes , which are havens for disease spread , which we know from the pandemic making them a holocaust of death. Congregate nursing homes and have become a broken national system since COVID.

So Biden has brilliantly found a way to avoid the $470,00 billion bill and instead create jobs that will keep elders at home cared for  through home health care paid through Medicare.

What Will Biden’s Investment  Create- in Jobs and the Economy

Sixty-five percent of the jobs — approximately 1.5 million jobs —resulting from Biden’s investment would be in child care, residential care, and home health care. An additional 225,000 jobs can be created or supported in sectors that support care work, and over 500,000 jobs would be supported in other sectors as direct care workers spend their wages on goods and services. 

Biden’s Plan of investing $77.5 billion per year would support over two million new jobs, at an average cost of $34,496 per supported job. Over 10 years, this translates to 22.5 million new jobs. Annually, a $77.5 billion investment in new jobs translates into $220 billion in new economic activity. 

So find your local representative and tell them to support Biden’s bill if you care about aging or caregivers or women or  shoring up the frayed- fraught care infrastructure.I have done a series of blogs on the bill . Check them out now 

Filed Under: Aging, Aging Life Care, aging life care manager, Biden's Caregiver Infastucure Paln, Blog, care economy, caregiver, caregiver infrastructure, Caregiver Infrastructure bill, Caregiver living wage, Caregiver low salary, caregiver mental health, CAREGIVER RESOUCES, Caregivers collapsing, Covid 19, Covid 19 Webinar, COVID Webinar, Families, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, nurse advocate, nurse care manager, Unpaid caregivers, unpaid family caregivers Tagged With: aging family, aging life care manager, aging parent care, aging parent crisis, Biden's infrastructure- Caregiver Bill, Care Economy, Care infrastructure, care manager, caregiver burden, caregiver burnout, caregiver low wage salary, caregiver stress, case manager, creating caregiver jobs, geriatric care manager, infrastructure Medicare jobs, Medicare non coverage LTC, nurse advocate, nurse care manager, Unpaid caregivers, unpaid family caregivers

Can a Caregiver Assessment Avoid UnnecessaryPlacement ?

April 9, 2021

GunnDadJacket.jpg

 

When a Caregiver is so Overwhelmed that A SNF is a Choice but a Very Bad Choice

If the family is so overwhelmed by the care that they are considering placement, this threat should trigger the GCM to do a caregiver assessment immediately, found in the Handbook of Geriatric Care Management If the GCM is called to relocate an older person and the underlying cause seems to be caregiver burnout, this can be another trigger to use this valuable GCM tool. By using a caregiver assessment the geriatric care manager may find that building respite for the caregiver, through other relative or paid caregivers, a caregiver support group, or coaching the caregiver to make changes that make her/ his tasks more bearable and doable and avoid inappropriate placement of the older person

Avoid Elder Physical Abuse Though a Caregiver Assessment

 

If caregiver abuse is suspected, a caregiver assessment is a critical immediate tool. This is a situation where the GCM must contact Adult Protective Services, following their own state’s laws. Elder abuse can be triggered by caregiver stress in some situations. Depression that reaches a clinical level in a caregiver can be predictive of elder abuse of an elderly client can prompt a GCM to do a caregiver assessment.  You should also do a geriatric depression scale at the same time. Use the GDS and the caregiver assessment to help both the caregiver and the care receiver and avoid the risk of physical abuse and prevent involvement of APS making the caregiver and care receiver’s lives even more painful and chaotic and risking placement in a nursing home.

Mrs. Handy has Two Dads in Her Head

Let’s take the example of Mrs. Handy, a caregiver daughter caregiver She calls a GCM as she is about to place her Dad. Besieged by so many other stressors,  her own health is deteriorating because she cannot get any sleep, due to her Dad going to bed so late and her inability to rise above her old self when her Dad was 40 and she was 19 and what he said she did. Now he is 70, very impaired with vascular dementia, incontinent and she needs to be who she is in the here and now a woman of 40, caring for an impaired Dad in her 70’s. The care manager coached her to set a new boundary for him to go to bed early. She needs help in getting rid of the old parent in her head and putting the 70-year-old demented incontinent parent before her. In addition, she sees her doctor for depression, joins an online caregiver support group, and asks siblings in other towns to take her Dad once a month for a week. Her Dad is not moved to skilled nursing. This is what a geriatric care manager can do for her to help avoid unnecessary placement.

Find out more on my playlist “Caregiver Assessment” on My Youtube channel Geriatric Care 

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Filed Under: Aging, aging family crisis, aging life business, Aging Life Care, Aging Life Care Assocaition, aging life care manager, Alzheimers, care manager, caregiver, Caregiver Burn Out, caregiver burnout, caregiver coaching, caregiver mental health, CAREGIVER RESOUCES, coaching caregivers Tagged With: aging family, aging life care manager, aging life geriatric care, aging parent care, aging parent crisis, barrier to caregiver assessment, care manager, caregiver assessment, caregiver burden, caregiver burn out, caregiver burnout, caregiver coaching, caregiver overwhelm, case manager, elderabuse, geraitric assessment, geriatric care manager, innappropriate placement, nurse advocate, nurse care manager, secondary stressors, unnecessary placement

Do You Know How to Use Whole Family Approach to End of Life Issues ?

February 10, 2021

Family Working Together as a Unit

The whole family approach is critical with death and dying. Care managers are often engaged to help facilitate the discussions at end of life, and help family members come together to work as a functional unit.

Understanding the differing viewpoints is critical

Knowing what a parent wants and does not want during the last days and hours of life help define and simplify the role of the family. It relieves the family of the burden of having the responsibility of making decisions which may not be what their parents want, and can also avoid family conflicts when adult children may have differing values.” Proactive discussions and legal planning can help to reduce some of the potential conflicts.

Major Family Issues at End of Life

 I found myself with a family member dealing with end of life issues. The

issues were:  money as the elderly man would need to have 24-hour care to return home to die and where he would return home, as although the son was unsure, everyone agreed that the son’s home where all the grandchildren and great-grandchildren gathered was the best place.

The most important was should the elderly man withdraw dialysis and extreme measures that were not saving his life. He was competent and had chosen this. 

Issues  Solved by A FamilyMeeting

All, these problems were solved by two things. The man’s physicians helped him understand the dialysis would not save him from dying.  Then a family meeting with hospice and his care managed home care agency LivHome the son and his wife, and myself was set up using the whole family approach.

Hospice facilitated the discussion. The end result was to move to the son’s home, with 24-hour care and Hospice, where the entire family, were gathered in and out all day and the old man died a ” Good Death” knowing that his family surrounded him. 

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

 

 Gwendolyn LAZO Harris MA, CT, Seniors at Home, San Francisco and Diane LeVan MA both highly expert care managers, created a seminal chapter “Palliative Care and End of Life Care Manager ” in my book Care Manager’s Working With the Aging Family 

Filed Under: Aging, aging life care manager, Blog, care manager, case manager, Death and Dying Care Management, death and dying care manager, elder care manager, End of Life Care manager, Families, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, nurse advocate, nurse care manager, Palliative care manager Tagged With: aging family, aging life care manager, aging parent, aging parent care, aging parent crisis, care manager, care plan interventions, caregiver, caregiver burden, caregiver family meeting, case manager, end of life, end of life care manager, end of life family meeting, family meeting, Geriatric Assessment, geriatric assessment for end of life, geriatric care manager, Hospice, National Assocaition of Geraitric Care Managers, nurse advocate, nurse care manager, Palliative Care, parent care, parent care crisis

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               

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TIME- 2 PM Pacific Standard Time

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  • Help a Local Family Assist a Loved One Safely Shelter in Place
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  • 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

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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

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

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