Posts Tagged ‘Geriatric Care Manager’

Who Was Supposed To Be Watching Grandma?

Monday, December 14th, 2009

There is a popular tune played this time of year called “Grandma Got Run Over by A Reindeer” which relates that Grandma — after drinking too much eggnog — went out into the winter cold to get her medication and was run over by a reindeer. The question is . . .  “Who was supposed to be watching Grandma?”

Though this little tune is just for fun, it may very well raise alarms to many caregivers of the elderly. Caregivers know that even at a holiday party they cannot let down their diligent watch over their elderly loved one. As far-fetched as it may sound, with all the people and noise, an elderly family member with dementia or Alzheimer’s may be enjoying the family gathering and then suddenly become confused and walk to the door and leave.

For family caregivers the added stress of the holidays with decorating, shopping, parties and keeping up with all the family traditions is an overwhelming quest. Feelings of isolation, depression and sadness come with this added stress. There are millions of Americans who are caring for elderly frail loved ones and most of these caregivers will go through some of these emotions, especially this time of year.

There are some things you can do as a caregiver to help you and those you care for enjoy the holiday season.

First take care of yourself. Try to eat right, get plenty of sleep and exercise. This will help reduce stress and strengthen your ability to cope with caregiving responsibilities.

Prioritize your holiday traditions. Perhaps instead of cooking a large family dinner, have everyone bring his or her favorite dish. Use paper plates. Forfeit the traditional outside light decorating for a lighted wreath on the front door. Choose one or two parties or concerts to attend instead of trying to do it all.

Arrange for help. Call on other family members to help with the caregiving while you do your shopping or go out for the evening. If family is not available, ask your church group or a neighbor if they would donate a few hours.

Use community services. Many senior centers provide meals for the elderly and supervised activities, onsite, at no charge or a minimal charge. For locating senior services in your state, call your state Area Agency on Aging or check the national locator website at http://www.n4a.org/

Use adult day care services. Some assisted living facilities provide day activities and meals for seniors on a day by day basis. Other organizations called “adult day service providers” specialize exclusively in this sort of care support at a reasonable cost. These support services provide respite for caregivers from their caregiving responsibilities as well as social interaction for their elderly family members. There is a cost for adult day services, but the benefit for all is worth it.

Technology to the rescue. Here is a solution that would have kept “Grandma” from going out in the winter cold and getting run over by a reindeer. Companies that have created monitoring systems, security alarms and other safety equipment are “tweaking” them to adapt to the needs of seniors and their care givers.

Here are a few examples:

  • Ankle or wrist bands that monitor location and alert the provider when a person has gone beyond the designated perimeter, such as out the front door of the house.
  • Motion detectors. Set throughout the home, motion detectors allow someone outside the home to follow a senior as he or she moves through the house.
  • Smart medication dispensers. Live monitoring and dispensing of pills.
  • Emergency response alert. At a touch of a button on a desktop monitor, bracelet or necklace, emergency help is summoned.

Whether providing care in your home or helping senior family members in their own homes, your use of monitoring and “tech” help aids can provide extra safety for your loved ones, and peace of mind for you.

You are not alone. Join a caregiving help group. Your local senior center may have one or go on the internet to find one. Hearing about other caregivers’ problems and solutions and being able to share your own and ask questions is a great way to relieve stress and gain a new perspective. Check out websites like the National Family Caregivers Association at http://www.nfcacares.org/

Work with a Senior Care Professional. Recognize that you are doing the very best you know how. You are not a geriatric health care practitioner, geriatric care manager, home care nurse or aide, hospice provider or family mediation counselor, nor do you have the years of training and experience these professionals have, but you can definitely use their experience. In fact, using a senior care specialist will make caregiving easier for you and more beneficial for your elderly family member.

You can find a wide variety of care professionals in your area on the National Care Planning Council website at www.longtermcarelink.net and on our website at http://www.virginiaelderlaw.com/TrustedReferrals.htm.

One more thing to remember. As a family caregiver, the greatest gift you are giving this holiday season is “Love.”

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Holiday Blues: Depression in the Elderly

Thursday, November 13th, 2008

The holiday season is quickly coming upon us. If you are a caregiver for an elderly loved one, you may notice a change in your loved one’s mood as the holidays approach. Perhaps you are one of many who live a distance away and visit elderly parents and family during the holidays. When you visit, you may notice that your loved one is not as physically active, or is showing symptoms of fatigue or sadness and has no interest in the holiday or in their surroundings.

According to the National Institutes of Health, of the 35 million Americans age 65 or older, about 2 million suffer from full-blown depression. Another 5 million suffer from a less severe forms of the illness. This represents about 20% of the senior population — a significant proportion.

Depression in the elderly is difficult to diagnose and is frequently untreated. The symptoms may be confused with a medical illness, dementia, or malnutrition due to a poor diet. Many older people will not accept the idea that they have depression and refuse to seek treatment. 

What causes depression in the elderly?

It is not the actual holiday that causes depression, but the fact that holidays tend to bring memories of earlier, often happier times. Additional contributing factors that bring on depression may be the loss of a spouse or close friend, or a move from a home to assisted living, or a change with an older person’s routine.

It is not the actual holiday that causes depression, but the fact that holidays tend to bring memories of earlier, often happier times. Additional contributing factors that bring on depression may be the loss of a spouse or close friend, or a move from a home to assisted living, or a change with an older person’s routine.

Depression may also be a sign of a medical problem. Chronic pain or complications of an illness or memory loss can also cause depression. In addition, diet can also be a factor when proper nutrition and vitamins are lacking.

Symptoms to look for in depression might include:

- Depressed or irritable mood
- Feelings of worthlessness or sadness
- Expressions of helplessness
- Anxiety
- Loss of interest in daily activities
- Loss of appetite
- Weight loss
- Lack of attending to personal care and hygiene
- Fatigue
- Difficulty concentrating
- Irresponsible behavior
- Obsessive thoughts about death
- Talk about suicide

How do you know if it is depression or dementia?

Depression and dementia share many similar symptoms. A recent article on Helpguide gives some specific differences.

In depression there is a rapid mental decline, but memory of time, date and awareness of the environment remains. Motor skills are slow, but normal in depression. Concern with concentrating and worry about impaired memory may occur.

On the other hand, dementia symptoms reveal a slow mental decline with confusion and loss of recognition of familiar locations. Writing, speaking and motor skills are impaired and memory loss is often not acknowledged by the person suffering dementia.

Whether it is depression or dementia, prompt treatment is recommended. A physical exam will help determine if there is a medical cause for depression. A geriatric medical practitioner is skilled in diagnosing depression and illnesses in the elderly. If you are a caregiver of an elderly person, it may be beneficial for you to seek out a geriatric health care specialist.  

Treating depression in older people.

Once the cause of depression is identified, a treatment program can be implemented. Treatment may be as simple as relieving loneliness through visitations, outings and involvement in family activities. In more severe cases antidepressant drugs have been known to improve the quality of life in depressed elderly people. Cognitive therapy sessions with a counselor may also be effective.

Once the cause of depression is identified, a treatment program can be implemented. Treatment may be as simple as relieving loneliness through visitations, outings and involvement in family activities. In more severe cases antidepressant drugs have been known to improve the quality of life in depressed elderly people. Cognitive therapy sessions with a counselor may also be effective.

As a caregiver or family member of a depressed older person, make it your responsibility to get involved. The elder person generally denies any problems or may fear being mentally ill. You can make the difference in and remove the Holiday Blues from seniors suffering from depression.

The Geriatric Mental Health Foundation offers a “Depression Tool Kit.” To read more about the tool kit and depression in the elderly go to:

http://www.gmhfonline.org/gmhf/consumer/depression_toolkit.html

For more information on senior health services, see the following lists from Evan Farr’s book, the Virginia Nursing Home Survival Guide:

List of Geriatric Physicians
List of Geriatric Care Managers

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Care Management for Your Child With Special Needs

Friday, June 13th, 2008

When establishing a special needs trust (SNT) for your child, it’s important to consider how much care the child may need in the future and who will oversee any arrangements related to that care. In many cases, either a family member or the SNT trustee can assume responsibility for care management. But when care needs are significant or family members cannot be available, parents may wish to include instructions in the SNT documentation for the trustee to retain a professional care manager. This can help ensure that care decisions will be handled professionally and consistently throughout the beneficiary’s life while allowing the trustee to focus on other responsibilities.

What Is a Care Manager? 

A care manager is a professional with the expertise necessary to develop, implement and monitor a plan for all aspects of an individual’s care. Often trained in nursing or social work, care managers are available primarily through private care management companies, many of which also deliver services to the elderly. Generally, a care manager will be knowledgeable about everything from health care and rehabilitation options to residential alternatives. Care managers also should be familiar with the alternatives for funding an individual’s care — both private resources and public benefits.

What Does a Care Manager Do?  

A care manager coordinates, monitors and advocates for services to help ensure that an individual with special needs can maintain the greatest possible degree of independence, safety and comfort at the most reasonable cost. Working closely with family members as well as financial advisors, attorneys, health care providers, the SNT trustee and others involved in the individual’s care, the care manager may:

- Assess the individual’s needs based on visits to the home and one-on-one interviews.

- Develop, or help the family develop, a care plan covering living arrangements, medical and therapeutic needs, social preferences, educational opportunities and other relevant issues.

- Implement the care plan. This may include coordinating physical therapy, medical care, social services and equipment needs; improving the home’s safety and comfort through repairs or modifications; and hiring home health aides or training family caregivers.

- Work with the SNT trustee to ensure that private and public resources are used appropriately, helping to preserve trust assets and avoid improper distributions that could jeopardize the beneficiary’s eligibility for benefits.

- Address emergency or crisis situations.

- Consider housing alternatives and oversee placement, handling such details as admissions paperwork and moving arrangements.

- Monitor care in the home or at residential facilities and recommend changes as necessary.

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Using a Professional Geriatric Care Manager

Friday, June 8th, 2007
Utilizing the services of a professional geriatric care manager should be something that every family considers, but in reality very few families know about care managers or use them.  Geriatric care managers can go a long ways toward helping a family find better and more efficient ways of providing care for a loved one .

The concept is simple. The family hires a professional care maanger to act as a guide through the maze of long-term care services and providers. While a family is often experiencing it for the first time, professional care managers have been there many times. 

Hiring a care manager should be no different than hiring an attorney to help with legal problems or a CPA to help with tax problems. Most people don’t attempt to solve legal problems on their own. And the use of professional tax advice can be an invaluable investment. The same is true of using a care manager.  

Unfortunately there are too few care managers and the public is so poorly informed about the services of a care manager, that valuable resources that could be provided go lacking.  

The irony of not using a care manager is that most families — when given the opportunity to use the care manager — think they can do it themselves and will not pay the money. Yet the services of a care manager most likely will save them considerably more money then do-it-yourself. The cost of the care manager might be only a fraction of the savings the care manager could produce. Care manager services can also greatly reduce family and caregiver stress and help eliminate family disputes and disagreements.  

Below is a partial list of how a care manager might help your family:

  1. Assess the level and type of care needed and develop a care plan
  2. Take steps to start the care plan and keep it functioning
  3. Make sure care is received in a safe and disability friendly environment
  4. Resolve family conflicts and other family issues relating to long-term care
  5. Become an advocate for the care recipient and the family caregiver
  6. Manage care for a loved one for out-of-town families
  7. Conduct ongoing assessments to monitor and implement changes in care
  8. Oversee and direct care provided at home
  9. Coordinate the efforts of key support systems
  10. Provide personal counseling
  11. Help work with your attorney in connection with Medicaid qualification and application
  12. Arrange for services of legal and financial advisors
  13. Manage a guardianship and/or conservatorship for a care recipient
  14. Provide assistance with placement in assisted living facilities or nursing homes
  15. Monitor the care of a family member in a nursing home or in assisted living
  16. Assist with the monitoring of medications
  17. Find appropriate solutions to avoid a crisis
  18. Coordinate medical appointments and medical information
  19. Provide transportation to medical appointments
  20. Assist families in positive decision making
  21. Develop long range plans for older loved ones not now needing care

To find a geriatric care manager, go to  www.caremanager.org, which is the Web site of the National Association of Professional Geriatric Care Managers.

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