Cathy Cress

Expert in Aging Life and Geriatric Care Management

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What is the Care Manager’s Role in the Terminal Phase of Death?

March 1, 2016

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The terminal phase of any life-threatening illness is the time between diagnosis and the final decline when no cure or extension of life is in the offing. The individual confronts progressive decline and deterioration. Death is imminent. The care manager has a role.

The focus of doctors and patients now changes from attempting to cure the illness or prolong life to trying to provide relief from pain and to comfort the sufferer. Religious concerns such as what happens after someone passes away or how to handle the suffering at the end of life or how to give comfort to family members are the focus during this time as well as trying to tie up any loose ends.

 

Care manager tasks:

Make referral to hospice if family has not  already reached out

Parnter with hospice and work under them

 

Monitor anticipatory grief needs

 

Communicate that this is the end (and time to say goodbye)

 

Assess spiritual needs and contact the appropriate religious spiritual counselors to provide comfort and healing.

 

Encourage family members to say The Four Things That Matter Most   “Please forgive me”, “I forgive you”, “Thank you”, and “I love you”. 

Assess the need for paid caregivers to help the family or help family members share round the clock care among family and friends

 

Support the family members in their need to

grieve and have respite by continuing to assess for overload and burn out with a caregiver assessment tool  https://cathycress.com/my-blog/entry/what-does-evereyone-get-from-a-caregiver-assessment

Prepare family for active phase of dying which can be loud and disturbing to someone who is not aware of what will occur

 Watch my new webinar on care managers working with death and dying

 If you want to add an End of Life service and other services, plus all the forms necessary, go to my web site Cathy Cress. Com and check out  my GCM Operations Manual 

 

 

 

 

 

 

 

Filed Under: Aging Tagged With: Forgiveness, four things that matter, geriatric care manager, Hospice, terminal phase of death

How Do You Find Forgiveness Through The VA?

July 23, 2015

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Forgiveness for adult children  for alcoholic parents is fighting a lifetime of nightmares . As a result of my path is forgiving my alcoholic PTSD ridden Dad I wrote an entire chapter on Forgiveness in the Aging Family in my book, Care Manager Working with the Aging Family 

My inspiration was again living with my aging Dad and only seeing him in the here and now and not as the drunk Dad of my childhood. The VA helped by providing the wide range of services in the GRECC program  for him and I was helped my teaching filial maturity and realizing this was my own life challenge.

 

I also found my Dad saved me and my whole family. His entering our family in California moving from Atlantic City New Jersey made us a whole family with 4 generations and the great grandchildren, grandchildren and really me- adored him.

My daughter Jill said as we knelt before his dead body. “We thought we were saving him and he saved us.”

 

Filed Under: Aging Tagged With: aging life and geraitric care manager, Forgiveness, Getting VA Benefits, GRECC Program, Mom Loves You Best Forgiving and Forging Sibling Relationships

Memorial Day- Look Into GRECC- Great Program of VA

May 27, 2013

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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.

 

Filed Under: Aging Tagged With: aging parent, aging parent care, aging parent crisis, assessing the caregiver, care plan as saftey net, care plan interventions, caregiver, caregiver assessment, caregiver burnout, caregiver family meeting, case manager, elderly at end of life, Forgiveness, Geriatric Assessment, geriatric assessment for end of life, geriatric care management, geriatric care manager, geriatric care managers, geriatrician, GRECC Program, informal caregiver, National Assocaition of Geraitric Care Managers, parent care, parent care crisis, POW World War II, PTSD in family caregivers, PTSD in Vets World War II, Suicides among military, Tools of Geraitric Care Managment, VA Care, VA disability delayed, Veterans Day

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

Sibling Talk Scheduled Senior Source Salon Oct 3rd, 2012 New York

September 25, 2012

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I will be in New York on October 3rd to speak at Senior Source a geriatric care management component of Self Help , a renown 75 year old New York Based program dedicated to Holocaust survivors seeking refuge in America, with a distinguished 75 year history, dedicated to enabling the elderly and other at-risk populations to live in their own homes, independently and with dignity.

The Senior Source Salon will be held from 6 PM to 8 PM October 3rd .

 

I will speak about negotiating midlife sibling issues in both the “nearly normal ” and dysfunctional aging family. My presentation will cover the challenges of negotiating and mediating with estranged siblings regarding their parents or loved ones finances, assets, estates and guardianship.

The presentation  will address sibling family dynamics in midlife and the steps siblings take  to achieve forgiveness in a midlife family . These steps can create sibling family team to care for an elderly parent.

 

This talk will be  based on my book Mom Loves You Best Forging and Forging Sibling Relationships, New Horizon Press,

To find out more about the event or sign up to attend go to Senior Source

Filed Under: Aging Tagged With: aging family, dysfuntional family, elder law attorney, Forgiveness, geriatric care manager, geriatric care manager New York, guardianship, mediation, midlife siblings, nearly normal family, parent care crisis, Self- Help, Senior Source, sibling family dynamics

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