Cathy Cress

Expert in Aging Life and Geriatric Care Management

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Can a Caregiver Assessment Avoid UnnecessaryPlacement ?

April 9, 2021

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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

Before a Parent Moves in-Check if You Can Handle the Care

October 14, 2019

Happy Birthday to my Dad, Harry V. Cress.

Today he would have been 99. He was a father who had severe PTSD from being imprisoned in a WW2 prison camp in Germany. So, at times , he was a difficult Dad. He worked all his life as an advertising man. But, he suffered from all the PTSD symptoms from what he thought was the good war, so he never reached out for help. He moved in with me in 1989, after he lost his house on the New Jersey coast to ” The perfect storm”. But, once I got him into the VA in Menlo Park, California, he lived with me and my family for 20 years and was the perfect great grandfather, grandfather, and father.

However, as a cautionary tale, I was first surrounded by a very supportive loving family as a caregiver and second was a geriatric care manager. I also had the full help of the VA and all their incredible GRECC services that covered all the medical care, caregivers, geriatric social workers to support me as a caregiver, as my Dad, as a PTSD survivor was 100% disabled. He was a happy independent person for 14 years making our family a three-generation web of real happiness and constant family celebrations as a living ” whole” family. But as he gradually aged, developed vascular dementia then cancer, dying at our home in 20o8

So, moving a parent in your home is not for everyoneHVC-85th_20130525-233904_1.jpg

Moving an aging parent in your home encompasses not just the present but perhaps 20-30 years in the future. It means accepting the parent as they are in the moment, which may be ambulatory, cognitively intact and independent but seeing they will be gradually affected by the decrements of aging.

What challenges do you face?

Your parent may have perfect vision now and because of macular degeneration need a great deal of support in mobility, eating, and all the activities and daily living in the future. They may eventually be bedbound or is the later stages of dementia.  The geriatric care manager needs to discuss the move in terms of what the future may bring for the adult child caregiver and discuss whether they feel they can accept this increasing level of care, if they could face caregiver burnout, if there are financial assets to hire caregivers to assist them or should there is a plan that may move the older person eventually to a higher level of care when care needs to increase.

What are the answers?

The GCM can do a GCM caregiver assessment if care needs to be rendered when the parent moves in. This will help the adult child see their strengths, skills, and abilities needed to provide care. This might include their own medical issues preventing caregiver tasks like lifting and tasks that they find and tasks they find repulsive, like changing adult diapers.  This assessment can include a care plan that recommends family caregiver solutions, like aging technology, social supports, formal supports, respite, and training.

At my Dad’s funeral, my daughter said, ” we thought we were saving him but is so many ways he saved us. So Happy Birthday Dad you saved all the love for you I might have missed. Thanks for that grace.

 

 

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Filed Under: Adult children, Aging, Aging Family, aging family crisis, Aging Life Care, aging life care manager, caregiver, caregiver mental health, CAREGIVER RESOUCES, case manager, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, moving parent in your home, nurse advocate, nurse care manager, parent care Tagged With: assessing the caregiver, barrier to caregiver assessment, caregiver assessment, caregiver overwhelm, Functional Assessment, geriatric care manager, moving parent in, multigenerational family

What are the 3 Steps to Do a Caregiver Assessment?

October 12, 2019

 

Where Do You Do A Caregiver Assessment? 

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Caregiver assessment is best done in the care receiver’s home so you can actually observe the care. It is best completed out of earshot of the older person who is cared for so the caregiver can feel free to talk openly. As caregivers suffer high levels of stress, giving them a separate space to share their feelings is an important part of the caregiver assessment. However, the caregiver assessment should be done in a place that is convenient to the caregiver, which could be a donut shop, the home, or any comfortable venue. If to do the caregiver assessment the GCM must arrange respite, like bringing in another family member or paid caregiver, then that is another way to make this assessment go forward.

 

How Will A Genogram Help A Caregiver Assessment? ChiCheng_hmpgHdr.jpg

A genogram also helps the GCM assess whether any extended family and friends will make suitable and emotionally appropriate caregivers or not. For example, if a son has a historically strained relationship with his father, is he a good choice as a caregiver? The genogram helps to assess this old family tension and helps the GCM decide with the family as to who can really be good caregivers.

How Does a Psychosocial Assessment Bolster a Caregiver Assessment?

In addition, a psychosocial assessment, done at intake or updated as more care is needed, assesses key abilities and availability of the extended network of family caregivers. The psychosocial assessment illuminates the client’s financial status, including income, assets, benefits currently being received, health and long-term care insurance coverage, and eligibility or potential eligibility for entitlement programs. This information helps the GCM assess whether outside paid care providers can be afforded if needed to replace a family caregiver. The psychosocial assessment also tells about the family, formal and informal support networks, present and potential caregivers, and cultural variables.

Find out more in the YouTube from My Geriatric Care 1 Channel.

 

Filed Under: Adult children, Aging, Aging Family, aging family crisis, Aging Life Care, Aging Life Care Assocaition, aging life care manager, Blog, care manager, caregiver, caregiver assessment, Caregiver Burn Out, caregiver burnout, caregiver mental health, CAREGIVER RESOUCES, case manager, CIRCLE OF CARE, elder care manager, geriatric care manager, Geriatric Care Manager, geriatric social worker, nurse advocate, nurse care manager Tagged With: aging family, aging life care manager, care manager, caregiver assessment, caregiver burden, caregiver burnout, caregiver overload, caregiver overwhelm, caregiver stress, case manager, geriatric care manager, nurse advocate, nurse care manager

Caregiver Assessment- Can it Prevent Caregiver Burnout?

October 3, 2019

Caregiver Burnout is Big Federal Problem

Family caregivers are so many times in a complete state of caregiver burnout. From a policy perspective, the federal government and the long-term care system in the United State cannot afford to neglect the burnout and strain of millions of Americans caregivers any longer.

Despite the rewards caregivers get from giving care we know from years of research that being a family caregiver results in brutal losses. These degradations and deficits include role conflict and overload from the never-ending tasks demanded of a caregiver. Left in a permanent state of worry and anxiety much of the time, caregivers are working in a deteriorating and unpredictable situation.

Caregivers Feel Trappedchannel_caregiver_burnout.jpg

Caregivers can feel entrapped by there the restrictions on their own life. They are often beset by fiscal worries because they are not paid except in some states, like California under Medicaid. Yet the caregiving situation explodes in cost through medical bills, medical equipment and informal care that must be brought in, if the family can afford it.

Caregivers Are Not Attorneys

Family caregivers face a quagmire of legal problems including untangling wills, trusts, and inheritance issues which generally complicate care both emotionally and physically. Many times these family caregivers compound their fiscal woes by having to quit their job, running the risk of never being hired again, and that is if they can eventually return to work.

Caregivers Mental Health Ravaged

The caregivers own physical and mental health is often ravaged. They have to do medical tasks that years ago family caregivers never had to do. If they were paid by an agency, this would be a workman’s compensation nightmare for the company, yet these family caregivers are never even paid. So it is time that geriatric care managers and other professionals in aging started to respond to this family caregiver nightmare and use a caregiver assessment every time they assess an older client tended by a family caregiver.

Find out more in the YouTube below from My Geriatric Care 1 Channel.

 

 

Filed Under: Aging, Aging Family, aging family crisis, Aging Life Care, Aging Life Care Assocaition, aging life care manager, care manager, caregiver assessment, caregiver burnout, caregiver mental health, CAREGIVER RESOUCES, elder care manager, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, nurse advocate, nurse care manager, Webinar Tagged With: aging parent care, aging parent crisis, assessing the caregiver, caregiver, caregiver assessment, caregiver burnout, caregiver overload, caregiver overwhelm, caregiver stress, caregiving family members, case manager, elder care crisis, Functional Assessment, geraitric assessment, Geriatric Assessment, geriatric care management, geriatric care manager, informal caregiver, Marriage and Family Therapist, My Geriatric Care Management Operations Manual, stress and burden

Innappropriate Threat of Placement =Caregiver Assessment

September 30, 2019

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 for 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 at the same time.

Mrs. Handy has Two Dads in Her Head

Mrs. Handy our caregiver in many other blogs is about to place her Dad because she is 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. She needs to set the boundary of him going to be 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. This is what a geriatric care manager can do for her to help avoid unnecessary placement.

S

Filed Under: Aging, aging family crisis, aging life business, Aging Life Care, Aging Life Care Assocaition, aging life care manager Tagged With: aging life care manager, aging life geriatric care, aging life or geriatric care manager, aging parent care, aging parent crisis, care manager, caregiver assessment, caregiver burden, caregiver burn out, caregiver burnout, caregiver overwhelm, case manager, elderabuse, geriatric care manager, innappropriate placement, nurse advocate, nurse care manager, secondary stressors, unnecessary placement

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