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

10 marketing messages for Adult Kids Who Call 911 GCM Before & After Holidays

November 7, 2022

10 Marketing messages care managers should share with long-distance adult children before and after the holidays

Geriatric Care Managers are wonder women before and after the holidays for long-distance care providers. Share 10 marketing messages when shocked long-distance family members call you, who just spent the holidays with aging parents and freaked out at the decline.

So be prepared with terrific marketing copy and messaging when they call you.

Your copy in an ad or website should include-

“It’s a preventative and prudent idea to have a geriatric care manager in the town where your older relative resides. If there is a crisis, it is cheaper to have a GCM solve it. In an urgent situation, a care manager can go to the hospital or emergency room. This is saner and more cost-effective than you getting on last-minute, expensive flights. You can still go but they can immediately be there to deal with the crisis. They are good insurance.

Even when making marketing visits to 3rd parties like elder law attornies or wealth managers, you can pitch “Before any crisis, the GCM does an initial assessment and visit your long-distance older relative periodically (once a month, once every two months). This is preventative. That way they are there for you when you need them and have all the information to solve the problem.”

10 Marketing messages for long-distance adult children:

“Think of care managers the way you do one of those “blow-up beds.” You can pump them up when you need them in a crisis—actually avoid that crisis, and you yourself can sleep more soundly and with more peace of mind in your own bed.

Some of the things a geriatric care manager can do for long-distance care providers are:

1. Save money by helping keep your parent out of the hospital and you off emergency long-distance flights.

2. Facilitate a family discussion of needs, resources, and division of labor among friends family

3. Recommend ways to proactively prepare and plan for a parent’s possible healthcare crisis.

4. Work on family cooperation to formulate a realistic parent-care plan.

5. Assess the strengths and weaknesses of all of the potential caregivers

6. Help adult siblings resolve conflicts about care decisions.

7. Help siblings act together in the best interest of the parent

8. Decrease the tension between hometown and long-distance siblings

9. Help the long-distance care provider deal with guilt and frustration that may result from their inability to provide more of the day-to-day care.

10. Locate aging resources in your elder parents’ area quickly and without you having to do it.

Learn more about gaining new long-distance care provider clients –this coming holiday season.

FREE Webinar

SIGN UP FOR MY HOLIDAY WEBINAR –

Get Ready for the Holiday Rush

WEDNESDAY, November 16th, 2022, FROM 2 PM – 3:30 PM PST

Learn how to create!

Pre-Holiday Social media campaigns to reach worried caregivers
Pre- Holiday-Materials about the warning signs that a parent needs help
Pre-Holiday Marketing to help you sign up families who might face a serious decline in aging parents

How to sell services to desperate post-holiday callers from Normal dysfunctional & long-distance family
How to use tools to contain holiday chaos & arrange care in festive family fright
How to move the family to New Year’s stability

Position Your Agency ahead of Care Managers who do not have great pre-holiday marketing campaigns and lack the clinical skills how to work with Adult Children and families during the chaotic aging family holiday visit when adult kids find their aging parents need care
Featuring

Cathy Cress MSW author of the Handbook of Geriatric Care

Management

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 LOW 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 of 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

Can a Caregiver Assessment Avoid UnnecessaryPlacement ?

April 9, 2021

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

How Do Long Distance Families Cope with Elders Threatened by COVID-19

July 19, 2020

Caring for COVID-19 Risk From a Distance

Long-Distance Family caregivers are trying to get a handle of the new reality COVID 19 has on their lives. as caregivers, at a distance. For many families, the number one concern is the seniors in their family. As a Long-Distance Care provider, finding the balance between safety and well -being for seniors during the COVID 19 pandemic can be a new challenge added to the many overwhelming challenges that long-distance families face daily. Care managers can now overcome the distance with telehealth and Hipaa certified telehealth platforms.

Long-Distance Care Providers Already offer the Most Expensive Care and Now COVID-Care $

They already live far away from their loved one, a national average of 450 miles, and travel an average of 4-7 hours to give care. Long-distance caregivers have the highest annual expenses (about $8,728) compared to co-resident caregivers (about $5,885) or those who care for a loved one nearby.

The experience of a long-distance caregiver is much different from and more complicated than that of a caregiver who lives in the same town. It’s important to know the local resources and services. Long-distance care providers are either not familiar or have vague memories of stores and resources that have changed since they moved away.

Long-Distance Caregivers Suffer Depression, Anxiety and Now Fear of COVID

The crunch of caregiver demands frequently leads to depression, anxiety, and a feeling of helplessness. Caregiver overload is especially common among the long-distance sandwich generation, or those caring for their distant aging parents along with their own children and many times grandchildren. Long-distance caregivers are more likely to report emotional distress (47%) than caregivers either residing with their care recipient (43%) or residing less than one hour away (28%).

Neglecting Everyone in the family

When the long-distance caregiver tends to ailing parents, they feel they are neglecting their own family and work responsibilities. Yet when they tend to their family, spouse, or job, they feel they are neglecting their parents. They live in a double bind.

Keeping seniors safe yet socially connected

For most families, keeping senior loved ones safe coronavirus infection is their number one priority as it is with families that live locally. But Long Distance Families must do this remotely which means forgoing in-person visits and finding other ways to create a connection. These families their number one concern is the safety of the seniors among their families or friends. It is important to find a balance between safety to avoid contracting coronavirus and being able to maintain happiness through social interactions with family and friends.

Seniors and their concerned families want to avoid isolation, depressions, and hospitalization with COVID while sheltering in place.

Like any disaster but especially with this pandemic- you may not be prepared and are desperately seeking a plan.

JOIN ME FOR MY NEW FREE WEBINAR

Create 5 Telehealth Products for COVID 19

WHEN. THURSDAY AUGUST 6

TIME- 2 PM Pacific Standard Time

Care Management businesses are struggling with pandemic close-downs.

Support your business bottom line, clients, and their families.

Create 5 COVID-19 products.

Products from sheltering in place through the hospital, recovery at home, discharge from an SNF, or hospital for local and long-distance elders. Increase your bottom

line as COVID spreads throughout the US and more shutdowns loom

Learn Step by Step How to Consult with Aging Families and Seniors to:

Choose the best Hipaa Compliant Telehealth Products to Remotely Consult with Client

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

Help a Long-Distance Family Help a Local Loved One Shelter in Place

Help an Aging Family Help a Loved on Hospitalized for Covid-19

Help an Aging Family Help a Loved one Recover when Discharged from a

Nursing Home

Help an Aging Family Help a loved one Recover when Discharged from a

Hospital

WHEN. THURSDAY AUGUST 6

TIME- 2 PM Pacific Standard Time

REGISTER NOW

Can a Caregiver Assessment Avoid UnnecessaryPlacement ?

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

Avoid Elder Physical Abuse Though a Caregiver Assessment

Mrs. Handy has Two Dads in Her Head

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

Contact

Connect with Cathy

Get Cathy’s “10 Critical Success Steps to a Profitable Aging Life or GCM Business”