Functional Assessment Archives ⋆ Cathy Cress

Can Blue Blue Christmas and Hanukkah Come From The Aging Brain Losing Power ?

December 3, 2019

As Elvis Predicted

Many families have a Blue Blue Christmas-or Hanukkah. Why does an aging crisis occur so often during the holidays? How can so many desperate adult children get care managers on the phone and howl about Mom or Dad in December? There are a million bad reasons, – too much alcohol, too many folks who do not get along and drink that alcohol. But the physical basis for all of this misery in an elder is often a loss of executive function and IADL’s and ADL’s

Why ADL’s and IADL’s.

It takes IADLs- (Instrumental Activities of Daily Living) shopping for gifts, cooking ritual meals and ADL’s walking to shop,decorate serve a ritual meal, climbing ( getting all those decorations out of the attic), grooming ( Mom can be found – in a “messy ensemble” at the feast) by the older person in charge of the holiday to pull it off. Then add depression to the aging stew – widowhood, loneliness and you have the challenges to an elder, usually the woman in the family, in managing this entire titanic ritual.

Crash of Executive Skills

The holidays in aging families can be a disaster for another neurological reason. Mom or Dad’s Executive Skills have crashed just like a computer.

Executive functioning involves the ability to organize, plan and carry out a set of tasks in an efficient manner. It also includes the ability to self-monitor and control our behaviors and multiple other cognitive functions and to perform the goal-directed behavior. It can be described as high-level thinking skills that control and direct lower levels of cognitive functioning.

Planning for the holidays takes those high level thinking skills -to execute and carrying out 25 different major tasks according to a study in the UK- Just think, planning a specific holiday ritual menu,( brisket and latkes or popovers and beef prime rib )- then shopping for it cooking it, planning the ritual items in the celebration – a menorah and

Hanukkah bush, Christmas tree, and creche buying them or getting them out of storage on and on.

Why we may end up with burned brisket or turkey.

This is a massive task event/ planning job taken on by one woman usually and as executive functioning power down in her brain- the computer-, which is our aging brain starts to crash- the result- the family freaks out because Mom forgot the ritual steps.

That’s why we need aging life or geriatric care managers to help divide the tasks when Mom cannot do this any longer

Subscribe to my YouTube Channel to learn More- Geriatric Care 1

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 everyone

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.

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 Trapped

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.

How Do You Create Emotional Quality of Life in Homebound Seniors?

August 14, 2019

Homebound seniors are miserably isolated and lonely with a devastating emotional quality of life.

AARP has estimated the there are 19.6 million in the US. This can be deadly to their quality of life. There are many answers new approaches throughout the US. One is called Virtual Senior Centers. These game-changing idea magically allow older people, who cannot get out, to use technology or the phone to enhance their emotional and physical quality of life. This is a brilliant idea

Senior Center Without Walls, another approach has been around since 2004. Each week, homebound seniors can access ,over 70 groups by phone or online, all from the comfort of home. Nancy Lynn Jarvis a mystery writer living in Santa Cruz reads each of her mysteries, as they are published live on the telephone to an entire group of homebound seniors in the San Francisco Bay area. Isolated seniors can access a wide breadth of fun and games the isolated seniors can find- just by joining

The Virtual Senior Center really opens up the world for homebound senior enhancing their emotional and intellectual quality of life. It also elevates the quality of life of the caregiver because it gives them a respite and the comfort that their loved one is experiencing a program that offers joy- the joy that comes from joining a community, making new friends and learning new things you choose to be part of, an amazing benefit for homebound seniors.

We’re Still Here an art exhibit is presently in Santa Cruz California and will travel to other museums in the state, addresses the plight of lonely and isolated seniors . Art and community organizing about the lives of lonely seniors are the thrust of this exhibit , for the the 70,000 visitors expected to attend this year in its run from April to September. They can to pick cards that offer one lonely senior a visit, a ride a chances to interact with a visitor. This exhibit will travel counties throughout California through other art museums, spreading the message that lonely isolated seniors need help- all through art. The exhibit was spearheaded by Nina Simon who is now world famous museum director and author who builds and teaches community driven museums.

Quality Of Life in Geriatric Care Agencies

Sage Eldercare Solutions a geriatric care management agency is Millbrae , California, developed a brilliant program , called Hummingbird designed by Nina Herndon a geriatric care manager with a passion for quality of life for seniors.The innovative idea engages clients through one-on-one activity sessions, carefully planned outings, and individualized Therapeutic Activity Kits that can be used by family members, care providers, and other care team members at any time to engage clients in a range of meaningful and stimulating activities. Sessions might include memory or sensory games, memoir writing, armchair travel, gardening, creating art or crafts, or special outings to a place connected with a client’s past or special interests.

Lifespan a 35 year old geriatric care agency in Santa Cruz, California recently opened their Well- Being program , another quality of life program that which encourages activities to enhance emotional, physical, intellectual and spiritual quality of life for seniors living in the community. Through a Well-Being Assessment of functional, psychosocial and general quality of life, a professional Lifespan Care Manager will identify areas that may promote the older person’s sense of well-being

If you are a geriatric care manager and think of adding a quality of life program that can enhance not just quality of care but the joy you give isolated seniors in your community, check out the quality of life Concierge Companion service included in my Geriatric Care Operations Manual

How Do You Create Emotional Quality of Life in Homebound Seniors?

March 7, 2018

Homebound seniors are miserably isolated. AARP has estimated the there are 19.6 million in the US This can be deadly to their quality of life. There is an answer called Virtual Senior Centers. These game-changing idea magically allows older people, who cannot get out, to use technology or the phone to enhance their emotional and physical quality of life. This is a brilliant idea.

Seniors Center Without Walls, has been around since 2004. Each week, seniors can access over 70 groups by phone or online, all from the comfort of home. Nancy Lynn Jarvis a mystery writer living in Santa Cruz reads each of her mysteries, as they are published live on the telephone to an entire group of homebound seniors in the San Francisco Bay area.Their winter catalog shows you the breadth of fun and games the isolated seniors can find- just by joining

The Virtual Senior Center really opens up the world for homebound senior enhances their emotional and intellectual quality of life for seniors . It also elevates the quality of life of the caregiver because it gives them a respite and the comfort that their loved one is experiencing a program that offers joy- the joy that comes from joining a community, making new friends and learning new things you choose to be part of, an amazing benefit for homebound seniors.

Self Help, a remarkable senior agency for Hollacast victims in New York City, put an extraordinary Virtual Senior Center together by partnering with Microsoft.. They have grown since their beginning to spread to many other cities.. Classes are led by a volunteer, like an opera class lead volunteers from a NYC opera company-.

One of the participants talks about the sense of community they feel, Marie says. “When we see each other, we say, ‘how are you?’ And if someone is missing you wonder if he or she is sick and you find out. We have a nurse who is knowledgeable and whom you can ask health questions when you see her in the class. She connects us with information she’s learned from the Mayo Clinic.”

The Virtual Senior Center really not only opens up the world for homebound senior but enhances their emotional and intellectual quality of life and downright joy in every day

SelfHelp has loaned many VCS participants all-in-one, simplified touchscreen computers with a senior-friendly interface, as well as providing free access to VSC programming and technical support, and internet access. new participants can join from all over the country and check up the website for further information.

If you are a geriatric care manager think of adding a personal assistant program that can enhance not just quality of care but the joy you give through quality of life care.

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