Cathy Cress

Expert in Aging Life and Geriatric Care Management

Aging Family Tools,End of Life Issues

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End of Life Issues in the Whole Family Approach

– These issues can be complex and can be emotionally charged. They may be connected to cultural, religious, and moral beliefs. When important end of life decisions need to be made, the stress of the responsibility, and the seriousness of the situation can cause great discomfort. Care managers are often engaged to help facilitate the discussions, 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 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.

In the sitation I found myself in last week with a family members dealing with end of life issues  their issues were : relationship to money as he would need to have 24 hour care to return home to die, 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. Most important was should the elderly man withdraw dialysis and extereme measures that were not saving his life. He was competent and had chosen these.  All, these probelms were solved in the hospital by a family meeting with hospice, the care managed home care agency the son and his wife and myself  and many meetings with the physicians. I acted a care manager to facilitate the discussion, as I am am very extended family member who has been involved as an  unpaid  care manager for 2 years. The end result, as I said in my blog, was to move to  the son’s home, with 24 hour care and Hospice, where the entire family is gathered in and out all day and the elderly man is dying with such peace knowing that his family is surrounding  him.

Memorial Day- Look Into GRECC- Great Program of VA

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Here is a follow up to my blog yesterday from the front page of the Wall Street Journal today Memorial Day.

If you work with elders look into the GRECC program . I can’t say enough about the VA once you get there- (a mountain to climb). But at the top is heaven. My Dad and I got the best care in the world. He had a geriatrician who spent an hour with him each visit, all the supplies he needed, psychiatric services, kindness, gentleness, transportation almost door to door and respect for what he had suffered and who he was in the here and now.

I got a geriatric assessment. I teach it, think it, write it but no one ever had the kindness to offer it to me. I found in those few hours with the VA RN and Social Worker what an incomparable tool it really is. Their goal was to tell me my Dad was going to die and help me through it. I wasn’t a geriatric care manager then- I was just who I really am, a daughter, caregiver and human being in pain. They supported me, gave me tools, consoled me ,cradled me.

So I would like to honor the GRECC program on Memorial Day and say it is brilliant, human, kind, and a tool that the VA offers that is life changing to all who use it. It was all that to me and my father- Harry V. Cress pictured above.

 

How Do You Do A Quality Of Life Assessment?

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Care Plan for a Caregiver- The Difference Between Stress and Burden

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Sally Hemingway’s stress and burden and how he Geriatric Care Manager takes each away

 

Sally Hemingway is a family care provider for her live in male friend Tom Jefferson. They are both is their 80’s.Like all care providers, Sally has both a level of stress and of burden. What’s the difference?

Level of stress is defined as the strain felt by the caregiver. Sally feels strained because she has lost her sense of self and does not have access to her own family and grandchildren. Her strain also comes from her fear that if she faints, as she did a year ago or leaves, as she did a few years ago, what will happen to Tom, the man who she now considers the love of her life. She also feels strained because she feels that Mr. Jefferson’s adult children do not trust her.

 

Burden refers to the management of tasks, which depends partly on the coping skills and other supports available. This is the energy needed to provide for care giving needs of a senior relative compared to an individual’s own reserves. So burden must be examined by the geriatric care manager or aging professional. Additional responsibilities, stresses, and individual personality characteristics will help determine the burden of specific care giving situations.

Sally’s energy is low because ,after all .she is over 80. Sally now does everything for Tom Jefferson and being over 80 has her own medical problems. . That is a huge burden. She’s is doing ADL’s, IADL’s, bill paying driving, meals – – everything.

 

That is an overwhelming burden so you know as an aging professional or geriatric care manager, you must create a care plan to relieve this overwhelming stress and  burden by getting Sally respite and arranging  a private duty care provider agency , an adult day care center for Tom Jefferson , the love of her life.

 

So this is a way to look at stress and burden in a caregiver.

Watch new Interview With Cathy Cress MSW March 27,2013

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Interview March 27, 2013 with Cathy Cress MSW with Ramsey Bahrawy –Your Money Your Life- Psychosocial assessment of an elder to assess anxiety and depression

 

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