Cathy Cress

Expert in Aging Life and Geriatric Care Management

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Do You Do Cultural Assessment With an End Of Life Client?

February 13, 2021

 

 

 Each Culture Has Different Customs and Beliefs in End of LifeiStock_000063346301_Medium-1.jpg

There may be cultural differences in end-of-life decision making as a result of underlying cultural values with disclosure of a terminal illness and very critically -use of life-sustaining medical treatment. With the widespread availability of advanced medical technology in the United States, people are encouraged to do everything possible to seek a cure for a life-threatening medical condition or sustain life. However, there are many other cultures for whom quality of life is more important than the length of life.

Other Cultures Do Not Follow US Medical Model ChiCheng_hmpgHdr.jpg

There are some societies, such as Japan, where a terminal illness may not be disclosed to a patient and it is culturally inappropriate to discuss impending or imminent death. For instance, among some Chinese, it is considered bad luck to discuss death because such talk may cause death to occur. Sometimes the ethnic elder is not expected to make healthcare decisions and the responsibility may be based on a traditional family hierarchy. For instance, in many Filipino families, there may be a designated decision-maker who is not the patient (e.g., the oldest son or a daughter or son who is a health professional) and who articulates the wishes of the elder or family.

Some Cultures Follow Religious  Customs and Beliefs in Death & Dying

Other end-of-life decisions are based on religious tenets. In many Catholic immigrant communities, there may be strong resistance to an advance directive because the document would signify a “loss of hope” or be interpreted as suicide, which is against church doctrine. These beliefs may also influence the use of hospice services.

 

Deliver a Good End of Life- Add Death and Dying to Your Care Management Agency

Serve Your Client until Death Do You Part

 

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 caregiver 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

Sign Up

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

 

 

 

 

 

 

 

 

 

Filed Under: Advanced Directives, advanced directives& COVID-19, Aging, Aging Life Care, aging life care manager, ALCA Role Death and Dying, Benefits of ALCA to Hospice, Cultural Assessment, Cultural Assessment Death, Cultural Beliefs in Death, Death & Dying, Death and Dying, Death and Dying Care Management, death and dying care manager, End of Life, End of Life Care manager, End of Life Cultural Assessment, End of life documents, Families, FREE WEBINAR, GCM role Death and Dying, Geriatric Care Management Business, Geriatric Care Manager, Geriatric Care Manager Cultural Assessment, geriatric social worker, Good Death, Hospice, Hospice Care, nurse advocate, nurse care manager, Palliative Care, Palliative care manager, SNF death COVID-19, US Medicalization of Death Tagged With: 5 stages of death, Acceptance Phase of Death, adding end of life services, Aging Life Care Association, care manager cultural assessment, chronic phase of death, COVID-19 Deaths, cultural assessment, Cultural Beliefs in Death, Cultural Customs in Death, cultural diversity, death and dying in COVID-19, geriatric care manager, Hospice at end of life, Palliative Care at end of life, US medicaization of Death

11 Parts of Care Manager’s Role With Family Death and Dying of COVID-19?

February 4, 2021

 

GCM Role is Working With Family In COVID-19

Care managers cannot be in the hospital with a  patient dying of COVID-19. They can support their bereft adult children, who cannot see their parents during the hospitalization, in those last moments of goodbye’s or after the death in this deadly pandemic.

In normal times 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. But is COVID -19 they can offer guidance to the family through the sometimes weeks of hospitalization, intubation, their loved one is on a ventilator and ultimately often- death separated from loved ones.

Navigation Through a COVID-19 Death

 The normal final passage through life can emotionally charged.  If the family is following a long labyrinth to the end, in coronavirus, the blind alleys may be blocked by a rushed hospitalization, banned from seeing their loved one in the hospital, and not understanding the disease that is killing their loved one.

Care managers can find an opening through this maze.  Family dynamics and fear of dying can all explode a fraught crisis of care in dying of coronavirus. When vital end-of-life decisions need to be made, the stress of the responsibility and the seriousness of the situation can break into a mammoth wave of distress fear, and anxiety over the “ whole family system”. The geriatric care manager specializes in solving these end of life decisions for whole family system even at the end of life.

Facilitate Family talks over hospitalized COVID-19 Elder

Care Managers can facilitate terrified discussions outside the hospital, and clear the way for family members to come together to work as a functional unit around an unknown killer disease that preys on their loved one. 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 the family.  It helps the family bear the burden of having the responsibility of making decisions that their parent wants. Turning this around can also help families have some solace that they carried out their parent’s wishes after their parent’s death. 

 

Care managers can help family members handle the stress of an elder’s hospitalization and death by:

  • Encouraging routines, exercise, and social connectedness with friends and family
  • Advocate for them with the hospital staff to get updates in this chaotic time in hospitals
  • Help them maintain contact with the” hospital quarterback “ to get updated medical status and give input
  • Find technology for the family to communicate with the hospitalized family member  via text, telephone, email, or video chat
  • Support and mediate if necessary proactive discussions and advanced directive preparation in a rush if not done
  • Build a circle of care can help to reduce some of the potential conflicts,
  • Support them in having essential conversations, prior to needing  intubation, on last wishes if health status deteriorates  
  • Provide opportunities to say goodbye via technology
  • guide them in setting up rituals that can celebrate the end of life and give solace to a family during a time when there are yet no rituals for a COVID-19 death.
  • Work with the hospital to set up Zoom with the family to say goodbye to a loved one. 
  • Geriatric care managers do much more with clients and families but especially now with Covid-19 elder’s and their families facing a  separated, fractious end of life
  • Deliver a Good End of Life- Add Death and Dying to Your Care Management Agency

     

    Join me Thursday March 11 and learn why End of Life Services Are a perfect new service for care managers

     Sign Up   

    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 care3.Give the family/caregiver tools to manage care

    4. Provide family center care to caregiver 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

    Sign Up 

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

     

     See more about Cathy and her book Care Manager’s Working With The Aging Family

  • DyingGriefandBurial in the AgingFamily

Filed Under: Advanced Directives and Covid-19, Aging, Aging Community & Covid-19, Aging Life Care, aging life care manager, ALCA COVID-19 Crisis, ALCA Role Death and Dying, Blog, care manager, case manager, CIRCLE OF CARE, coronavirus, Coronavirus emergency plan, coronavirus shut down, Covid 19, COVID-19 & Care Management, Covid-19 Death, Death and Dying, Death and Dying Care Management, death and dying care manager, elder care manager, End of Life, Families, FREE WEBINAR, GCM role Death and Dying, GCM Working With Aging Family, Geriatric Care Management Business, geriatric care manager, Geriatric Care Manager, geriatric social worker, Good Death, nurse care manager, Therapist Specializing in Aging Tagged With: adding end of life services, aging life and geraitric care manager, death and dying, death and dying in COVID-19, Death and Dying in hospital, end of life care manager, geriatric care manager, Hospice at end of life, Hospice Care, hospice for elderly parent, Navigation through END of LIfe, Palliative Care at end of life, Technolog COVID-19 in Hospital, Tools to manage end of life

What Is a Care Manager’s Role in the Hospital during COVID in End of Life

February 2, 2021

Care managers cannot meet dying  COVID-19 patients and their bereft children in the emergency room or Hospital. They are not allowed in due to COVID restrictions. However, care Managers play a big role in end of life issues, while family remains in the community and the client is isolated from them in the hospital.

Procedures for the family when loved one in the hospital.

The care manager was help by

1.creating a communication plan from the outset and figuring out who’s the “medical quarterback” in charge of monitoring a loved one. Typically, this is a specialist, such as a hospitalist, critical care medicine doctor, or intensivis2.

 2.Facilitating family meeting for family while loved one in the hospital

3.Suggesting technology family can use to communicate with loved one and with other family members or friends

4.. Help family understand the part family can play I admissions- preparing a go binder ahead of time etc.,

  1. By designating one person to speak for the whole family- the process to improve family getting information from overloaded hospital staff

6 Preparing family & loved one’s medical team for communication death in the hospital – what care manager can do to assist

7.. Supporting the family member when they are dying while not being present

8.. Bereavement of family post-death- use of hospice

Care Managers are their navigators through all five stages of dying

They many times can introduce palliative care or hospice and often GCM’s can help the family and client to bring in hospice or palliative care long before the average time, which is the last month or 15 days before death.

 The final passage through life can be 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 and now COCID -19 regulations. Care managers 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 the 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.

 Care Managers can often help facilitate throbbing discussions

They can 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 the family.  It relieves the family of the burden of having the responsibility of making decisions that may not be what their parents want. Turning this around can also avoid family conflicts when adult children may have differing values.

Helping family Legally plan for Death

 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. They can point the family to legal guidance to prepare end of life documents, that are so important, especially now with COVID when death can come so quickly but geriatric care managers do much more with clients and families who are facing the end of life

 

 

Free Webinar-Deliver a Good End of Life- Add Death and Dying to Your Care Management Agency

 

Serve Your Client until Death Do You Part

 

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  FREE 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 caregiver 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

Sign Up 

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

 

Gwendolyn LAZO Harris MA, CT,Seniors at Home , San Francisco and Diane LeVan MA both highly expert care managers, created a seminal chapter on Palliative Care and End of Life Care Manager in my book Care Manager’s Working With the Aging Family 

Filed Under: Aging, Aging Life Care, aging life care manager, Blog, care manager, case manager, Death and Dying Care Management, death and dying care manager, elder care manager, Families, Geriatric Care Management Business, Geriatric Care Manager, geriatric care manager, geriatric social worker, ife care manager, nurse care manager Tagged With: 5 stages of death, adding end of life services, aging family, aging life and geraitric care manager, aging life care manager, aging parent care, aging parent crisis, ALCA COVID benefits, death and dying, death and dying in COVID-19, disputes at end of life, elderly at end of life, end of life care manager, end of life family meeting, Fighting and Feuding at end of life, GCM Family Coaching end of life, geriatric care manager, Hospice at end of life, Hospice Care, hospice for elderly parent, nurse advocate, nurse care manager, Palliative Care at end of life, support services in death, Tools to manage end of life

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