Cathy Cress

Expert in Aging Life and Geriatric Care Management

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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

 

Filed Under: Advanced Directives, Advanced Directives and Covid-19, Aging, aging life care manager, Benefits of ALCA to Hospice, Death and Dying, Death and Dying Care Management, Dysfunctional aging family, Dysfunctional Family Mediation, End of Life, End of Life Care manager, End of life documents, estranged elder parents and adult kids, estranged siblings, Families, FREE WEBINAR, GCM COACHING SKILLS, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, Good Death, Hospice Care, mediation, Mediation End of Life, nurse advocate, nurse care manager Tagged With: adult sibling, aging family, aging parent care, aging parent crisis, care planning, caregiver burnout, conservator, death, dysfunctional aging family, dysfunctional family, dysfuntional family, elder care crisis, end of life, end of life family meeting, estranged siblings, families fretting at end of life, fretting at end of life, geraitric assessment, geriatric care management, geriatric care manager, geriatric care managers, mediation, mediator, My Geriatric Care Management Operations Manual, no advanced directive, no DPOA, no health care proxy, withdraw of life support

What is a Geriatric Care Management Care Plan? Finding Interventions in Your Business Plan

August 10, 2013

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How to find intervention for your care plan? Well you can just refer to your business plan (Hopefully you started your GCM business with one).

You can review your business plan and find all the sources you listed there as target markets such as the National Academy of Elder Law Attorneys web site for elder law attorneys. Most organizations serving seniors maintain a web site. Of course, you should only recommend services that you know to be competent and able to solve the particular problem you are seeking to ameliorate. For example, if you recommend a local conservator or guardian, there should be an organization in your state of conservators or guardians with a web site

You can expand your knowledge beyond your local continuum of care nationally the single point of entry  Eldercare Locator .

 

Filed Under: Aging Tagged With: Business Plan, care planning, conservator, elder locator, geriatric care manager

Financial Abuse as an IADL -Undue Infuence

January 27, 2013

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What is undue influence?

Undue influence is when an individual who is stronger or more powerful gets a weaker individual to do something that the weaker person would not have done otherwise.

What is undue influence? A stronger person uses various techniques or manipulations over time to gain power and compliance.

Undue influence can be wielded in one-time events. An example would be a discussion of transaction at an unusual or inappropriate time for example with a widow with recent bereavement someone says” let’s you sign your stock over to me”. There might be a consummation of a transaction in an unusual place like a funeral home. A person applying undue influence might insist or demand that business be finished at once. Multiple persuaders against a single vulnerable person might use undue influence. It might occur when there is an absence of third party advisors, Undue influence can occur when a perpetrator states that there is no time to consult financial advisor’s or attorneys

Undue influence can be used by totalitarian groups, both religious and non religious. An example of this is the mass death at Jonestown

It can be put forth by, especially, existing or cultivated, close and personal relationships. It can be used in fiduciary relationship like an executor, attorney, or accountant

It can be brought to bear in a non –fiduciary relationship like, clergy, housekeeper, gardener, and physician.

The number one villain in undue influence is family , the group most trusted by elders

There is a common denominator of financial exploitation of elders

Undue influence is most common on trusting relationships of long duration (nephew moves in the help elderly aunt and then takes over stock and changes will)

It many times is perpetrated by cultivated by people who are opportunistic

Undue influence can be exerted by someone Isolates the elder, promote dependency, or induce fear and distrust of others. This after happens with sweetheart scams – where a younger woman marries a much older man wealthier who she takes financial advantage of.

What should a GCM or aging professional do? First meet the client alone.

Few admit because afraid of caregiver abandonment or further abuse

If you work for an agency you should meet supervisor and report the abuse

Finally you should call as you are Call Adult Protective Services– In most states you are a Mandatory Reporter

Filed Under: Aging Tagged With: case manager, checklist for aging parent problems, conservator, crisis with aging parents, elder abuse, elder abuse by family members, elder abuse fiscal assessment, elder law attorney, financial abuse, Financial Planner, Forgiveness, Functional Assessment, GCM Operations Manual, geraitric assessment, Geriatric Assessment, guardianship, IADL financial abuse, IADLs, Instrumental Activities of Daily Living, Mickey Rooney, My Geraitric Care Management Operations Manual, National Assocaition of Geraitric Care Managers, Psychsocial Assessment

The 2nd Most Dangerous IADL- Financial Management

January 26, 2013

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IADL Handling Financial Affairs

Another IADL a geriatric care manager or aging professional assess ,is handling financial affairs

Can the older person plan, budget, manage investments, pay bills, balance a checkbook, and manage day-to-day purchases without assistance? Is the person at risk for scams, undue influence, credit problems, or other financial difficulties because of functional limitations? Does the person show good judgment in regard to finances? Has the person changed lifelong habits in how he or she manages money?

On first meeting a client, often it is difficult to gain enough trust to fully assess functioning in this area. As a first step, questions about who pays the bills and manages investments open up the topic. Based on responses to earlier less threatening questions, the geriatric care manager or aging professional may detect some clues that can shed light on functional capacity here.

For example, if someone has difficulty shopping because Alzheimer’s disease has affected his or her ability to make a shopping list and go through the market independently to shop, it is expected that this person will need assistance with bookkeeping and money matters. Because the Lawton IADL scale it is important to recall that the less demanding tasks are presented first and those requiring higher cognitive functioning are presented later. Thus, difficulties performing the easier tasks indicate the likelihood of difficulties performing the higher-order functions.

When the care manager tours the house, he or she can discreetly and with permission look for unpaid bills lying about or piles of mail that need attention. Stacks of solicitations for charities and/or contests should be noted. Enlisting information from key informants, such as adult children, is important to round out the evaluation of this area. Adult children may be able to review the older person’s checkbook to make sure things are in order. They may be aware of utilities or insurances that have threatened termination for nonpayment. They may know whether the older adult participates in “contests” or gives more money than ever before to charities. Financial advisors for the older person may also be a source of information for assistance in evaluating functional performance. Because finances are a very private topic in many families, this subject needs to be handled with delicacy and discretion.

 


 


 

Filed Under: Aging Tagged With: ADLs, aging parent crisis, caregiver burden, conservator, elder abuse by family members, elder abuse fiscal assessment, elderlaw attorney, Functional Assessment, geraitric care manager, geriatric care management, National Association of Geriatric Care Managers, parent care, Psychosocial assessment, red flags for a sibling I hate you story

New Years Resolutions To Help Aging Parents

December 26, 2012

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Here are some suggestions that you might consider as New Years resolutions. It’s not “go on a diet,” but what you should do after the holiday with your parents, when you spotted red flags that made you worry about your aging mom or dad. Here is the entire list of resolutions you might make for a in a January visit to your parents, after the holiday gave you reason to worry about an aging family member:
➢ Accompany the elderly person to the doctor, and talk to the doctor in person.
➢ Gather legal financial and insurance paperwork, and meet with professionals.
➢ Have all mail forwarded to yourself or another relative who will manage it
➢ Contact and meet with old and present friends.
➢ If your older family members are in a facility, make contact with staff that cares them, and the ombudsman.
➢ Meet with your elderly relative’s support network.

➢ Meet with a geriatric care manager http://www.caremanager.org/ in the area.

Filed Under: Aging Tagged With: Cognitive Assessment, conservator, elder abuse fiscal assessment, elder financial abuse, forwarding aging parents mail, Functional Assessment, Geriatric Assessment, geriatric care management, Handbook of Geraitric Care Management, holidays with aging parents, National Assocaition of Geraitric Care Managers, ombudsman, parent care crisis, Psychosocial assessment, red flags for a family meeting, Undue Influence, visit to doctor with elderly parents

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