Cathy Cress

Expert in Aging Life and Geriatric Care Management

Care Manager’s Role In Death and Dying

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Care Manager’s don’t just meet dying patients and their bereft children in the emergency room.

 

Geriatric Care Managers play a big role in end of life issues. They are their navigators through all five stages of dying, many times long before palliative care or hospice are called. Often GCM’s can help the family and client to bring in hospice or palliative care.

 

The final passage through life can emotionally charged.  If the family is following a long labyrinth to the end, the blind alleys may be blocked by cultural, religious, and moral beliefs. GCM ‘s can find an opening through this maze.  Money, family dynamics and fear of dying can all explode a fraught crisis of care in dying. When important end of life decisions need to be made, the stress of the responsibility, and the seriousness of the situation can break a wave of distress fear and anxiety over the “ whole family system” the dying elder. The geriatric care manager specializes in this whole family system.

 

 

 

Geriatric Care managers are often help facilitate throbbing discussions, and facilitate family members coming 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. Turning this around can also avoid family conflicts when adult children may have differing values.

 

 

 

 Proactive discussions and legal planning building a circle of care can help to reduce some of the potential conflicts. Good legal guidance can also help to pay for care when an adult child wants to finance in home care.  But geriatric care managers do much more with clients and families who are facing end of life.

 

 

 

 

 

 

Areas to Cover in Whole Family Assessment- Sandwich Generation Issues

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Sandwich Generation Issues- Many family caregivers have multiple generations requiring their attention and care. In 1981, Dorothy Miller coined the term sandwich generation to refer to inequality in the exchange of resources and support between generations.

Specifically, Miller was referring to a segment of the middle-aged generation that provides support to both young and older family members yet does not receive reciprocal support in exchange. Miller emphasized the unique stressors of multigenerational caregiving and the lack of community resources available to assist the middle generation. Because multigenerational caregivers are most often women dealing with the complex role configurations of wife, mother, daughter, caregiver, and employee, some researchers use the phrase women in the middle interchangeably with the sandwich generation.

In 2013 this is more and more an issue with men – adult sons as well. I am now helping a family where the 93 old Dad is home dying at his son’s home with Hospice and an excellent geriatric care management agency Livhome supplying 24 hour care. The adult son has four grown sons and three grandchildren. In all we have 4 generations sandwiched together helped thankfully by an excellent Hospice and terrific geriatric care management agency. These agencies together and in unison help unlayer the sandwich and allow the whole family  to come together to bring joy to all their lives while they surround this great grandfather through his death . That’s the grace of the whole family approach to me .

Mediation at End of Life -Cathy Cress Speaking

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On April 19, 2013 I will be making a presentation-,at the 29th Annual National Association of Professional Geriatric Care Managers Conference in Philadelphia. I will be speaking along with attorney and mediator Dana Curtis .

 

The  topic is , GCM as the Accidental Mediator: Fretting and Fighting or Feuding: Intergenerational Conflict in the Adult Family at End of Life, Philadelphia, Penna.

Undue Influence- New York Times

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New York Times article -Undue influence – perhaps -committed on  a renowned painter Merton D. Simpson and major  collector of African art . Mr. Simpson is dead and housed in funeral home until someone pays for funeral. Aging professionals-  you just never have seen it all.

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