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)

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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.

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Jan 24, 2023 02:00 PM Pacific Time (US and Canada)

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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

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If you really want to add End of Life to your care management business sign up for this webinar now

Can a Caregiver Assessment Avoid UnnecessaryPlacement ?

April 9, 2021

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

Wonder Woman Saves Proactive , Long Distance Aging Family on the Holidays

December 1, 2020

Geriatric care managers are wonder woman for long-distance care providers

More than a million people have died of COVID in the past 7 days , according to the CDC.

This is an important message for care managers to use before the upcoming holidays. Getting on a plane to travel is dangerous for the long-distance care provider in the

highest national spread of COVID. Plus they might carry the deadly infection to their aging parents, the most vulnerable group to die of COVID. This gives these distant caring family members every reason not to see their parents- but what will they then do to keep them safe- Hire a Geriatric Care Manager.

Add This to Your Ad Copy or Website

If You live Long Distance from an aging parent during the COVID spread, it’s a preventative and prudent idea to have a geriatric care manager in the town where your older relative resides. If your parents are sheltering in place, they can make sure they are safe and use tools to prevent the loneliness and isolation that can set in over the holidays. If there is a crisis, like a COVID diagnosis,

they are right there to professionally manage it. In an urgent situation, a care manager can go to the hospital or emergency room. This is saner, safer, and more cost-effective than you getting on last-minute, expensive flights without any social distancing protection for you or your aging parents when you see them. Geriatric Care Managers are good insurance.”

Use Telehealth to Market to 3rd Parties Over the Holiday

You can make marketing visits to 3rd parties through HIPAA-compliant video

conferencing services like elder law attornies or wealth managers. You can pitch “Before any crisis, the GCM do an initial assessment and visit your long-distance older client on a regular basis. This is preventative. That way a professional is there for your client 1-1, when you need them and has a health care background to solve the problem.”

Here is a better line for long-distance adult children:

“Think of care managers the way you do one of those blow-up beds. You can pump them

up when you need them in a crisis—perhaps avoid that crisis, and you yourself can sleep more soundly and with more peace of mind in your own bed.

Some of the things a geriatric care manager can do for long-distance care providers are:

1. Save your worry, fear of COVID, and money by helping keep your parent safe from COVID and out of the hospital and you off dangerous emergency long-distance flights.

2.Help your parents avoid loneliness and isolation by arranging virtual quality of life activities to keep them socially engaged while sheltering in place.

4.Facilitate a family discussion of needs, resources, and division of labor among friends family

5. Recommend ways to proactively prepare and plan for a parent’s possible health care crisis like COVID.

6. Work on family cooperation to formulate a realistic parent-care plan.

7.Assess the strengths and weaknesses of all of the potential caregivers if needed

7. Help adult siblings resolve conflicts, if any, about care decisions.

8. Help the long-distance care provider deal with guilt and frustration that may result from their inability to provide more of the day-to-day care.

9. Locate aging resources in your elder parents’ area quickly and without you having to do it.

Learn more about gaining new long-distance care provider clients -this coming holiday season.

SIGN UP FOR MY HOLIDAY WEBINAR

8 Ways to Tame the Turmoil of the Holidays & Twindemic in the Aging Family

ONLY 4 DAYS LEFT to SIGN UP

Learn how!

How to sell services to the desperate Aging Family during the holiday surge
How to give hope to frantic children who call when their aging parent struggling with Loneliness and isolation on the holidays
How to help the Aging Family make holiday visits remotely or safely in person
How to counsel the Aging Family to track aging decline &Twindemic risk in loved ones
How to work with both dysfunctional and long-distance families who call during the holidays
How to use GCM tools to contain Holiday chaos
How to use financial forecasting to prepare for business growth during the holidays

Sidestep the Many Care Managers Who Do not know how to work with Dysfunctional family or do COVID Coaching of Aging Families so the client chooses you

THIS FREE WEBINAR IS Thursday, December 3, 2020, FROM 2 PM – 3:30 PM PST

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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 to Assess the Caregiver and Avoid Hospital Readmission

September 6, 2019

Assessing the Family Caregiver is a new but crucial concept for geriatric care managers and professionals in aging.As geriatric care managers and aging professional, we are health and social services oriented. For almost 3 decades we have assessed the care receiver for problems with function, social connection, and psychological issues. If we suspect depression we have completed that screen. If our client plans to move, has cultural needs and preferences, exhibits signs of dementia, need ways to improve quality of life or a spiritual connection, we have assessed the care receiver for those problems.

All our assessments have left out the major fact – care is an exchange. To receive care, the patient/client usually needs a family caregiver to give or supervise it. That family caregiver is the glue that holds it all together and his or her inner bond begins to break with the strain of caring.

Other countries have seen what the US has yet to grasp. In the United Kingdom, a seminal law passed in 1995 called the Recognition and Services Act , which provided British caregivers a statutory right to request an assessment at the same time that a frail elder or adult with disabilities is assessed.

So developing a caregiver assessment is critical, especially in this era of penalties to hospitals for readmission. The caregiver is the key to keeping an older person in the community and not back in the hospital. If they are not trained, have physical problems that inhibit caring, find some tasks, like changing adult diapers uncomfortable, have no car to pick up meds or drive to the doctor’s follow up an appointment, you have a problem and probably a readmission.

Learn how to do a caregiver assessment along with a care receiver assessment .This will help you keep your aging client both out of the hospital and potentially out of inappropriate placement in a skilled nursing facility. Plus you will learn just not how to assess caregiver burnout but be able to create a care plan that will help your family caregiver have a better quality of life while they giver better care to their loved one. Read the chapter ” Assessing the Caregiver ” in my book Care Manager’s Working With the Aging Family, Jones and Bartlett. The price has just been cut in half to make it more affordable for the practitioner.

Can a Caregiver Assessment Avoid UnnecessaryPlacement ?

When a Caregiver is so Overwhelmed that A SNF is a Choice but a Very Bad Choice

Avoid Elder Physical Abuse Though a Caregiver Assessment

Mrs. Handy has Two Dads in Her Head

Find out more on my playlist “Caregiver Assessment” on My Youtube channel Geriatric Care

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