Cathy Cress

Expert in Aging Life and Geriatric Care Management

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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 to Assess the Caregiver and Avoid Hospital Readmission

September 6, 2019

 

Assessing the Family Caregiver is a new but crucial concept for geriatric care managers and professionals in aging.As geriatric care managers and aging professional, we are health and social services oriented. For almost 3 decades we have assessed the care receiver for problems with function, social connection, and psychological issues. If we suspect depression we have completed that screen. If our client plans to move, has cultural needs and preferences, exhibits signs of dementia, need ways to improve quality of life or a spiritual connection, we have assessed the care receiver for those problems.

All our assessments have left out the major fact – care is an exchange. To receive care, the patient/client usually needs a family caregiver to give or supervise it. That family caregiver is the glue that holds it all together and his or her inner bond begins to break with the strain of caring.

Other countries have seen what the US has yet to grasp. In the United Kingdom, a seminal law passed in 1995 called the Recognition and Services Act , which provided British caregivers a statutory right to request an assessment at the same time that a frail elder or adult with disabilities is assessed.

So developing a caregiver assessment is critical, especially in this era of penalties to hospitals for readmission. The caregiver is the key to keeping an older person in the community and not back in the hospital. If they are not trained, have physical problems that inhibit caring, find some tasks, like changing adult diapers uncomfortable, have no car to pick up meds or drive to the doctor’s follow up an appointment, you have a problem and probably a readmission.

Learn how to do a caregiver assessment along with a care receiver assessment .This will help you keep your aging client both out of the hospital and potentially out of inappropriate placement in a skilled nursing facility. Plus you will learn just not how to assess caregiver burnout but be able to create a care plan that will help your family caregiver have a better quality of life while they giver better care to their loved one. Read the chapter ” Assessing the Caregiver ” in my book Care Manager’s Working With the Aging Family, Jones and Bartlett. The price has just been cut in half to make it more affordable for the practitioner.

Filed Under: Aging, Aging Life Care, aging life care manager, Blog, care manager, caregiver, caregiver assessment, case manager, elder care manager, Families, GCM Start -Up, Geriatric Care Management Business, geriatric care manager, Geriatric Care Manager, geriatric social worker, home care, nurse advocate, nurse care manager, Private Duty Home Care, Quality of Life Tagged With: aging parent, aging parent care, caregiver assessment, caregiver burnout, caregiver family meeting, caregiver overload, caregiver overload with sisters, caregiving family members, caring for a yourself as a parent, case manager, elder care crisis, geraitric assessment, geriatric care management, geriatric care managers, geritaric care manager, National Association of Geriatric Care Managers, parent care, Psychosocial assessment, red flags for a family meeting, stress and burden

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

March 3, 2018

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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 GCM-pix-3.jpghome, 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.

Filed Under: Aging, Aging Family, Aging Life Care, aging life care manager, care manager, Families, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, nurse advocate, nurse care manager, Quality of Life, Quality of Life for elders Tagged With: aging family, aging parent, aging parent care, aging parent crisis, assessing for quality of life, Care Managers Working with the Aging Family, caregiver family meeting, case manager, Geriatric Assessment, geriatric care management, geriatric care managers, Handbook of Geraitric Care Management, isolation and quality of life, knitting groups for the elderly, LCSW, Marriage and Family Therapist, midlife sibling, parent care, quality of life assessment, quality of life in retirement, social isolation, Whole Family Approach, whole family assessment

Loneliness& 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 GCM-pix-3.jpghome, 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.

A Care Management Agency can even develop a Quality of Life programs. Sage Eldercare in Northern California has developed a unique activity kit called Joyful Moments that helps family members, care managers, and caregivers. Joyful Moments, unique activity cards that give “the tools to re-engage older adults in life—and turn every visit from mundane to memory making. Nina Herndon the director of  Sage Eldercare is also an expert in quality of life for seniors and authored a chapter on how care managers can develop that skills with seniors Handbook of Geriatric Care Management 

Choice is important with seniors When values and preferences differ between elders 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 by assisting in removing barriers to quality of life that family members may, out of care and worry, put in the elder’s way.

Filed Under: Aging, Aging Family, Aging Life Care, aging life care manager, care manager, case manager, elder care manager, Families, Geriatric Care Management Business, geriatric care manager, Geriatric Care Manager, geriatric social worker, Loneliness, nurse advocate, nurse care manager, Quality of Life, Quality of Life for elders Tagged With: aging family, aging parent, aging parent care, aging parent crisis, assessing for quality of life, Care Managers Working with the Aging Family, caregiver family meeting, case manager, Geriatric Assessment, geriatric care management, geriatric care managers, Handbook of Geraitric Care Management, isolation and quality of life, knitting groups for the elderly, LCSW, Marriage and Family Therapist, midlife sibling, parent care, quality of life assessment, quality of life in retirement, social isolation, Whole Family Approach, whole family assessment

How to Assess the Caregiver and Avoid Hospital Readmission

October 1, 2017

 

Assessing the Family Caregiver is a relatively new but crucial concept for geriatric care managers and professionals in aging.As geriatric care managers and aging professional, we are health and social services oriented. For almost 3 decades we have assessed the care receiver for problems with function, social connection, and psychological issues. If we suspect depression we have completed that screen. If our client plans to move, has cultural needs and preferences, exhibits signs of dementia, need ways to improve quality of life or a spiritual connection, we have assessed the care receiver for those problems.

All our assessments have left out the major fact – care is an exchange. To receive care, the patient/client usually needs a family caregiver to give or supervise it. That family caregiver is the glue that holds it all together and his or her inner bond begins to break with the strain of caring.

Other countries have seen what the US has yet to grasp. In the United Kingdom, a seminal law passed in 1995 called the Recognition and Services Act , which provided British caregivers a statutory right to request an assessment at the same time that a frail elder or adult with disabilities is assessed.

So developing a caregiver assessment is critical, especially in this era of penalties to hospitals for readmission. The caregiver is the key to keeping an older person in the community and not back in the hospital. If they are not trained, have physical problems that inhibit caring, find some tasks, like changing adult diapers uncomfortable, have no car to pick up meds or drive to the doctor’s follow-up an appointment, you have a problem and probably a readmission.

Learn how to do a caregiver assessment along with a care receiver assessment.This will help you keep your aging client both out of the hospital and potentially out of inappropriate placement in a skilled nursing facility. Plus you will learn just not how to assess caregiver burnout but be able to create a care plan that will help your family caregiver have a better quality of life while they giver better care to their loved one. Read the chapter ” Assessing the Caregiver ” in my book Care Manager’s Working With the Aging Family, Jones and Bartlett. The price has just been cut in half to make it more affordable for the practitioner.

 

Filed Under: Aging, Aging Life Care, aging life care manager, Blog, care manager, caregiver, caregiver assessment, case manager, elder care manager, Families, GCM Start -Up, Geriatric Care Management Business, Geriatric Care Manager, geriatric care manager, geriatric social worker, home care, nurse advocate, nurse care manager, Private Duty Home Care, Quality of Life Tagged With: aging parent, aging parent care, caregiver assessment, caregiver burnout, caregiver family meeting, caregiver overload, caregiver overload with sisters, caregiving family members, caring for a yourself as a parent, case manager, elder care crisis, geraitric assessment, geriatric care management, geriatric care managers, geritaric care manager, National Association of Geriatric Care Managers, parent care, Psychosocial assessment, red flags for a family meeting, stress and burden

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