Who Are the Entitled Concierge Clients Who Can Afford Long Term Care?

April 25, 2022

Are you aware of the entitlement of the family? Entitlement is present in five types of these rich and famous families aging families who can afford care management, home care, and long-term care because they have vast financial resources. Part of this is drawn from Claudia Fine and Nick Newcombe’s excellent chapter ” Entitlement in the Aging Family”, Care Managers Working With the Aging Family, Jones and Bartlett)

Rich and Famous-Entitled Families:

These types of aging families, who can afford care management and home care, are identified by the aging parents’ socioeconomic, financial, and political prominence. ( example President Reagan)They are families in which all basic needs, services, resources, and creature comforts are obtained via income, assets, and abundant discretionary cash flow. Or they spring from the political position, station, or power. The entitlement of the family is passed from the parent to the child, like a virus, who in turn brings these behaviors and actions to the caregiving milieu and care management relationship.

Entitlement of the Family That is Rich and Famous

In these rich and famous clans, the entitlement of the family arises from being accustomed to purchasing everything and anything. They look to pay others to meet their needs (as opposed to families who must themselves find and orchestrate ways to meet basic and complex needs themselves or with the help of the extra-familial system). Often these families have household staff, i.e., nannies, butlers, drivers, private pilots, cooks, and maids. They may have available to the business and family lawyers and accountants, as well as, teams of medical professionals and concierge physicians. Consequently, in almost all situations they are uninvolved in processes of serving their own needs, especially those that are difficult, stressful, and time-consuming. ( Fine and Newcombe- Entitlement in the Aging Family, Care Managers Working With the Aging Family)

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What is President Biden’s New Infrastructre Caregiver Plan?

April 14, 2021

President Biden announced the American Jobs Plan, a $2 trillion investment in infrastructure, jobs, and home care. It includes a $400 billion investment to expand access to Medicaid home and community-based services (HCBS)

Why This Plan for Home-Based Care?

Only 15% of U.S. seniors 80 or older receive care at home. In Switzerland, Denmark, Mexico, and Sweden, that figure is above 30%, with numbers even higher in Israel and Lithuania.

Medicaid has slowly evolved over the years, placing a greater emphasis on home- and community-based services. But the ground gained has been relatively minor compared to investments in other settings like nursing homes.

In 1995, Medicaid spent about 18 cents out of every long-term care dollar on HCBS services. Today, that number has reached 57 cents per dollar.

The Scale of the Problem is Mamouth

The number of seniors is projected to grow by more than 40 million, approximately

doubling, by 2050, while the population older than 85 will nearly triple. Unlike most other industrialized nations, the United States does not provide a public long-term-care benefit for all older adults.

Only10-15% of Americans can Afford Private Duty Homecare

Because Medicare does not pay for home care, only the top 10-15 % can afford private duty home care, while in many other nations it is a right and free to all through the government. What Biden’s new plan does is take a giant step in making home care possible a greater number of Americans.

The plan calls for expanding access to and quality of HCBS to help more older adults and people with disabilities live in the community and extending the Money Follows the Person program to help individuals who are in nursing facilities and other institutions return to the community.

What The Pandemic Has taught us about Aging and Dying

at Home

What the continuing pandemic has painfully taught us is when we are ill- we want to be home in the arms of our family. When we are threatened with or facing death, we do not want want to be in a sterile hospital with only anonymous caring nurses and zoom to comfort us in our last minutes in this world. We want to be at home- in the arms of our family and loving caregivers.

Long before the COVID-19 emergency, health care policy experts have increasingly recognized the value of home-based health care. A recent AARP survey found that three in four adults 50 years and older would prefer to age in their homes and communities. And a growing body of evidence suggests it is less expensive to deliver care in the home.

Indeed, for years we’ve seen hospitalized patients more quickly returning to their homes and communities to heal and recover safely, reducing costs for themselves and the health care system.

The Plague of Isolation on top of the Plague of COVID -in Locked Down Nursing Homes

Home-based care addresses negative health effects of social isolation and loneliness, which drive poorer health outcomes that annually cost billions of excess health care dollars.

Isolation is also equal to 15 cigarettes each day. Elders in a nursing home during the pandemic were isolated from the families and their fellow residents so much so that despair may have led to the 174000 deaths as of March 2021.

So Biden has launched a bill the builds the infrastructure of home care for the lower 30% on Medicaid until in America’s future, Medicare and home care for all is reached.

Be Wonder Woman- A Geriatric Care Manager- After The Holidays

January 2, 2020

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Make a New Years resolution to be Wonder Woman

for long-distance families in 2020. If you are a geriatric care manager or Aging Life Care Manager, use this in your marketing copy.

Some of the things a geriatric care manager can do for you are:

1. Save you money by helping keep your parent out of the hospital and you off emergency long-distance flights.

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

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

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

5.Assess the strengths and weaknesses of all of the potential caregivers

6. Help adult siblings resolve conflicts about care decisions.

7. Help siblings act together in the best interest of the parent

8.Decrease the tension between hometown and long distance siblings

9. 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.

10.Locate aging resources ( both no -cost through the older Americans Act) in your aging parent’s area quickly and without you having to do it

Offer long-distance caregivers a complimentary consultation.

Tell them it’s a preventative and prudent idea to have a geriatric care manager in the town where your older relative resides. If there is a crisis, it is cheaper to have them solve it. In an urgent situation, the GCM can go to the hospital or emergency room. Explain this is saner and more cost-effective than you getting on last-minute, expensive flights. They can still fly in but the ALCA or geriatric Care manager can immediately be there to deal with the crisis. You are good insurance.

Before any crisis, you do an initial assessment and visit your older relative periodically (once a month, once every two months).This is preventative. That way you are there for the long-distance care providers when they need you as have all the information to solve the problem. Tell them to Think of you as one of those blow-up beds. You can pump them up in a crisis—perhaps avoid that crisis, and the long-distance adult child can sleep more soundly and with more peace of mind in your own bed.

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Red Flags for Long Distance Siblings Inquiring About Services Before the Summer Visit.

July 9, 2019

Checklist Midlife Siblings Holiday Visit to Aging Parents

Do you have adult children inquiring about your services before the they make a summer visit to grandparents ? Here is a Check List of 10 red flags for danger to share with long distance midlife siblings for their mid- summer visit to aging parents? A midlife sibling summer or visit to elderly parents to can be bitter or sweet or it can be just plain scary. Ask them to call you when they return and you can set up a meeting with all the siblings to discuss care.

The frightening part often happens when you haven’t seen an aging Mom or Dad for a while. If midlife siblings live long distance, making an occasional visit can set off alarms, especially if they find aging Mom or Dad has gone downhill . Then a geriatric or aging life care manager is just the perfect answer. Let them figure this out with your geriatric care manager Sherlock Holmes guidance and clues to find your value.

Curb Appeal – Does your Dad’s home look more like an unmaintained rental? Is there disrepair, a weedy yard, uncleaned carpets or furniture?
Housekeeping – Are there dirty dishes, unwashed sheets, a mess where things used to be tidy? Does the house look like it needs a scrubbing, or at least someone to help with cleaning?
Medication – Can you find a stash of outdated medication in the bathroom, bedroom or anywhere? ➢ Driving – Is driving with your older Dad frightening? Ask him to drive you somewhere. How is his reaction time, or judgment? Can he drive at night? Does he have traffic tickets? Assess the car. Is it worse for wear, dented or are there telltale signs of accidents?
Trash- Are there bags of trash in the basement or out back? Look in closets.

Collections- Are there growing collections that appear to be out of control, of newspapers, magazines, old sports memorabilia, ashtrays – any accumulation that appears to be taking over space and looks excessive. This is a sign of hoarding
Shopping- Take him out shopping or out to a meal to celebrate the day. When he does shopping or pays for a meal, does he have problems with checks, credit cards, figuring tips, or calculating discounts? Does he forget his wallet or other important personal items he should have with him?
Change in Behavior- Is Dad quiet when he used to be loud? Is he paranoid, having mood swings, unsocial when he used to be the belle of the ball or life of the party?
Odors- Did you smell urine? Must? Mildew? Dirty clothes or dishes?
Refrigerator- Are there science experiments, aka moldy food in the refrigerator?
Unpaid Bills- are there piles of unpaid bills in drawers or in your loved one’s desk. Are their notices or gas or electric turn offs? Search their desk and perhaps, in you have access, look at their bill pay account.

If any of these clues turn up trouble, you should set up meeting vis phone or in person to talk your midlife siblings about the problems discovered and set up a family meeting via Skype, in person or a family conference call.

For More professionals can Read Care Manager’s Working With Nearly Normal Families- Working With Long Distance Care Providers in

Handbook of Geriatric Care Management 4^th edition

Watching Harvey’s Devistation-Do You Have a 2017 Emergency Plan for Your Elder Care Agency ?

August 31, 2017

Do you have procedures for an emergency at your Aging Life, Geriatric Care Management or private duty home care agency?

The ability of an agency to function despite an emergency is critical. The 2017 hurricane season has brought us the horror of Harvey with a category 4 storm that has wreaked never before seen flooding. So far crews in Texas have found the bodies of 31 victims of Harvey’s wrath and warned on Wednesday that the number of dead would almost certainly soar as water levels across much of the Houston area start to recede.

In the US.Katrina’s devastation in New Orleans led to new Federal Rules that forced a wide range of health care providers to create emergency plans which created better emergency plans in nursing homes. This brought plans and safety drills but plans had never included the almost biblical flooding that is happening in Houston right now.Ben Taub hospital even with an emergency plan was so flooded it had a difficult time getting patients out, although, in the end, every patient was moved to safety

So in light of Harvey- Does your agency have an emergency plan?

Informal procedures work in a start up care management business but what if the solo practitioner is ill and out?

If illness, accident, some other unforeseen event overtakes an owner or manager, no emergency procedures can be suicide in an emergency, not to mention liability to your elderly clients.

Katrina left New Orleans GCM’s, desperately scrambling to care for their clients in hotels as the floodwater rose. They were and left to re-build their business again, which took years.

Every geriatric care professional needs a formal, written backup plan that dictates action, should a disaster or emergency arise.

It ‘s necessary to assess your company’s risk of temporary or permanent service disruption if a disaster or emergency is experienced. This may seem an overwhelming task at first, but when you break it down into pieces, it becomes workable.

Learn about preparing for emergencies how you can prepare you, your clients and staff for disasters and absences of key personnel. Preparing for these ever growing emergencies, work wide is now in Liz Barlowe’s chapter Preparing for Emergencies in the Handbook of Geriatric Care Management.

Get the new Handbook of Geriatric Care Management 4th edition now out on Kindle

Be Wonder Woman- A Geriatric Care Manager- After The Holidays

Make a New Years resolution to be Wonder Woman

Some of the things a geriatric care manager can do for you are:

9. 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.

Offer long-distance caregivers a complimentary consultation.

Learn care management marketing so you can:

Contact

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