When is it Time To Intervene With Your Parents Care?

How do you know when it’s the right time to intervene with your parents care?  This can be a very delicate situation. You don’t want to alienate your parents by prying too much into their affairs, but you certainly don’t want to wait until you get a call from the hospital ER or worse, your State’s Department of Children and Families.  To know when it’s the right time to intervene might take “seeing out of the box”.  As adult children of elderly parents, we tend to see them as they once were, instead of how they are today. Look at your parent as if you were someone other than their adult child, such as a neighbor or a caregiver.

Of course most families are ready to act when there are obvious issues or serious incidences, but here are some early signs to look for that indicate your parent may need some intervention sooner rather than later: They drive only when absolutely necessary, only during daytime hours and only to places near home. I suggest to my client’s families that when they are here visiting they have their parent drive them around and go outside of their local comfort zone.  If you’re not comfortable with them driving you around, then that’s a red flag.

Unopened mail, insurance or bank statements and junk mail are hidden out of view in drawers, under sheets of a spare bed or under the table cloth. (I’ve really seen this). Of course some obvious clues are late notices and returned checks because of duplication or over payment. Household maintenance projects are left unattended because maybe they can’t see the water leak stain on the ceiling or ants crawling on the counter. Maybe they can’t hear the toilet running. Look for signs of mal-nourishment.  Check the pantry for outdated canned foods and the refrigerator for spoiled moldy food. Have they had to tighten their belts to the next hole or two? You can tell this by looking at their belt – there will be a wear line from the buckle from where they normally had it positioned.

Missed medical appointments, vague responses to your questions related to their latest doctor visit (“I’m fine, don’t worry”), or they are using more than one pharmacy. Any of these can be cause for concern.

Above are just a few examples of some early signs that your parent’s functional status is declining to a point of concern.  An Aging Life Care Manager with a background in social work, public health, or gerontology can help assess their level of functioning and recommend the most appropriate types of intervention and services.  To reach one of our Advanced Senior Solution’s team members, either go to the Contact Us tab or call 727-443-2273. We’re here to help with all of your elder care questions, care needs, and much more! Call us today for a free no-obligation care consultation via phone or in person.

What is Aging Life Care Management?

 

Aging Life Care Management , also known as “elder care management”, senior health care management” and “professional care management,” is the process of planning and coordinating care of the elderly and others with physical and/or mental impairments to meet their long term care needs, improve their quality of life, and maintain their independence for as long as possible.
It entails working with people of old age and their families in managing, rendering, and referring various types of health and social care services. Geriatric care managers accomplish this by combining a working knowledge of health and psychology, human development, family dynamics, public and private resources and funding sources, while advocating for their clients throughout
the continuum of care. For example, they may assist families of older adults and others with chronic needs such as those suffering from Alzheimer’s disease or other dementia.
 
Overview
Aging Life Care Management integrates both health care and psychological care with other needed services such as housing, home care services, nutritional services, assistance with activities of daily living, socialization programs, as well as financial and legal planning (ex. banking, trusts). A care plan made for specific circumstances is prepared after an individual assessment, and is continuously monitored and modified as needed.
 
 
Aging life Care Managers
Aging Life care managers typically have prior training in nursing, social work, gerontology or other health service areas. They are expected to have extensive knowledge about the costs, quality, and availability of services in their communities. In some countries and jurisdictions, they may obtain certification from various professional associations, such as the National Association of Professional Aging Life Care Managers in the United States. Professional care managers help individuals, families and other caregivers adjust and cope with the challenges of aging or disability by.
1. Conducting care-planning assessments to identify needs, problems and eligibility for assistance.
2. Screening, arranging, and monitoring in-home help and other services.
3. Reviewing financial, legal, or medical issue
4. Offering referrals to specialists to avoid future problems and to conserve assets.
5. Providing crisis intervention.
6. Acting as a liaison to families at a distance.
7.  Making sure things are going well and alerting families of any issues.
8.  Assisting with moving their clients to or from a retirement complex, assisted living facility, rehabilitation facility or nursing home.
9.  Providing client and family education and advocacy.
10. Offering counseling and support.

Selecting a Aging Life Care Manager

An Aging Life Care manager is a professional who specializes in helping older people and their families with long-term care arrangements. Aging Life Care managers often have training in gerontology, social work, nursing or counseling. They also have extensive knowledge about the cost, quality and availability of services in an older person’s community.

As a result an Aging Life Care manager can help:
  • Conduct care-planning assessments to identify problems and determine eligibility for assistance and the need for services
  • Screen, arrange and monitor in-home help or other services
  • Review financial, legal or medical issues and offer referrals to geriatric specialists to avoid future problems and conserve assets
  • Provide crisis intervention
  • Act as a liaison to families living away from the parent, making sure things are going well and alerting families to problems
  • Help move an older person to or from a retirement complex, care home or nursing home
  • Provide consumer education and advocacy
  • Offer counseling and support
Choose a Aging Life Care Manager carefully. The field of Aging Life Care management is relatively unregulated and many people without specialized training identify themselves as care managers, care coordinators or care advisors. Therefore, it’s wise to screen candidates to ensure that you’re working with a person qualified in this new profession.
  • Ask about candidates’ training, education and background in care management and geriatrics. Ask how long they’ve been a care manager and whether they belong to the National Association of Professional Geriatric Care Managers or any other professional associations.
  • A care manager’s ability to be responsive is important. Ask candidates what their average response time is to return calls from clients and their families. Have them describe their communication system. Do they use pagers, portable phones, an answering service or voice mail? Learn about their agency’s size, hours and staff composition. How are after-hours emergencies handled? What are the back-up systems for covering vacations and days off? Will you and your parent work with one care manager or several?
  • Determine the scope of the aging life care managers practice. Some managers or agencies specialize in assessments and care consultation, but typically don’t follow people on an ongoing basis. An assessment is a thorough review of the client’s physical, medical and mental status, and financial resources. It serves as the basis for a comprehensive plan for the client. Other managers offer psychotherapy, money management, or home care. They also can act as conservators, appointed by a court, to manage the financial and/or personal affairs of someone unable to manage his or her own affairs. It’s important that the managers practice setting and specialties meet your needs and your parent’s.
  • Investigate the aging life care manager’s  track record and reputation. Ask for letters of reference or names of previous clients you may contact. Is the manager active in professional associations? Does the care manager perform volunteer work?
While there are no licensing requirements for care managers, there are certification programs. Ask each candidate you interview if he or she is certified, and by whom.
Confusion about fees and billing can be a problem. Be sure you understand the billing rates and how charges are calculated. Fees vary depending on the work setting – private practice, public agency or private non-profit agency. Get a written service agreement that outlines the fee structure and practices.
Finally, ask aging life care candidates if they subscribe to a code of ethics or are guided by professional standards of practice. Get a copy of the standards. They should deal with the right to privacy, fiduciary responsibilities, full disclosure, fostering self-determination, fees, continuing education and professional relationships. Ask how complaints are handled.

When hiring a care manager . ..

HERE ARE THINGS to consider when enlisting the services of a Aging Life Care manager:

ASK ABOUT LICENSES, experience and training in gerontology and human services.  Ask for references, and call them.
DISCUSS CARE PHILOSOPHY:  For example, is the care manager’s first interest always the elderly person?  How does the care manager feel about home versus assisted living?  Under what circumstances would he or she resign from the case?
ASK THE CARE MANAGER to specifically define the range of his or her services.  Take notes.
DISCUSS FEES.  Get a clear idea of what rate is charged and under what circumstances.  Do phone calls count?  Find out what a basic assessment and plan of care cost.
IS THE CARE MANAGER available in emergencies 24 hours a day?  Are there other managers in the office who can handle emergencies?  Are there backup systems?
BE FAMILIAR WITH the National Association of Aging Life Care Managers’ standards for care managers.
 

What does a geriatric care manager do?

 

  1. Compiles an assessment of an older person’s needs and situation.
  2. Encourages the person to accept help and provides a “plan of care” with specific recommendations.
  3. Finds and secures services such as legal counsel, home care, nursing care or home maintenance.
  4. Supports and counsels family members.
When Hugh McGuire made a business trip to the Chicago area, he decided to visit his wife’s 90-year-old aunt and 88-year-old uncle, who lived nearby in their own home.
What McGuire found alarmed him.  While the couple was still ambulatory and proud of their independence, there was no food in the house and the formerly fastidious couple were no longer taking care of themselves or their home.
Like a growing number of Americans taking care of aging relatives from afar, McGuire responded to the situation by hiring a geriatric care manager, a relatively new type of professional who helps plan and organize care for disabled elderly people.
More and more people “are learning that geriatric care managers are out there and that they can help with these problems,” says Erica Karp, who runs a geriatric care management firm in Evanston, Ill.
She was able to help McGuire’s relatives by arranging meals for them, straightening out their legal affairs and eventually finding placement for the wife in a nursing home, where Karp continues to visit her regularly.
McGuire’s situation is hardly unusual. At least one in every four American families provides care for an older relative. Many live hundreds of miles apart, compounding the stress and concerns of caregivers.  How can they be sure their relative is not refusing to eat or misusing medications or mismanaging finances or feeling depressed?
Family members may also face tough decisions—such as choosing between assisted living, home care or a nursing home—which may be complicated by a limited knowledge of available options.
Geriatric care managers aim to help families in these circumstances.  They may be hired either by family members or individuals needing care.
While care managers aren’t regulated by state or federal government, they’re usually licensed in a field of specialization, typically social work or nursing.  That means most care managers are subject to disciplinary action by a state licensing board should a violation of standards occur.  Technically, however, anyone can hang out a “geriatric care manager” shingle.
Even so, more care managers are joining groups like the National Association of Aging Life Care Managers, a voluntary organization with newly 1,600 members.  To qualify, the association says applicants must be licensed in their fields and train in geriatric, and they must adhere to professional guidelines and ethics.
 
National Association of Aging Life Care Managers has developed grievances procedures and will dismiss members who violate its requirements.

Ethics Aging Life care managers follow

PROVISION OF SERVICE
I will provide ongoing service to you only after I have assessed your needs and you, or a person designated to act for you, understand and agree to a plan of service, the results that may be expected from it, and the cost of service.
SELF-DETERMINATION
I will base my plan of service on goals you, or a person designated to act for you, have defined, and which enhance the decisions you have made concerning your life.
LOYALTY
My first duty is loyalty to you. I will always provide services based on your best interest, even if this conflicts with my interests or the interests of others.
TERMINATION OF SERVICE
I will end service to you only after reasonable notice. I will recommend a plan for you to continue to receive the services as needed.
SUBSTITUTE JUDGMENT
I will not substitute my judgment for yours unless I am acting in the role of your guardian, appointed by a Court of Law, or with your approval, or the approval of someone designated to act for you.
CONFIDENTIALITY
I will hold in trust any confidence you give me, disclosing information to others only with your permission, or if I am compelled to do so by a belief that you will be seriously harmed by my silence, or if the laws of this State require me to do so.
REFERRALS/DISCLOSURE
I will refer you only to services and organizations I believe to be appropriate and of good quality. I will fully explain to you any business relationship I have with any service I propose, and give you information on alternatives, if at all possible, so that you, or a person designated to act for you, can make an informed decision to accept or reject the services I recommend to you.
COOPERATION
I will strive to ensure cooperation between all of the individuals involved in providing service and care to you.
QUALIFICATIONS
I am fully qualified in my profession to provide the services I undertake. I continue to improve my skills and knowledge by participating in professional development programs and maintaining certification and licensing in my profession.
DISCRIMINATION

I will not promote or sanction any form of discrimination.

Frequently asked questions of Aging Life Care managers

What is a Aging Life Care Manager? Generally, a Care Manager is a professional who specializes in assisting seniors and their families with assessing needs, developing a plan of care, and arranging for community services to meet their needs and their budget. They continually monitor the plan over time and adjust the services according to changes in level of care.
2) What qualifications should one look for in a Aging Life Care Manager? Beware that not all “Care Managers” are created equal. What sets apart a Aging Life Care Manager  from the self-proclaimed ones are expert credentials, high level of education, extensive experience in a healthcare related field, active memberships in professional associations, and a national certification in the field of care management.
3) Why is it important for a Care Manager to be a member of the National Association of Aging Life Geriatric Care Managers  and be Certified in Care Management? Care Management is relatively new in health care therefore it is not as regulated as other health care professions such as nursing. Being a member of the Aging Life Care Managers is a means of regulating and governing our industry.  Each member has to uphold strict standards of practice and a code of ethics. Obtaining a national certification in Care Management further distinguishes the care manager from those who are not.
4) What are some important questions to ask a Aging Life Care? Ask specific questions such as are you available after hours for emergencies, who covers for you when you are away, how often and in what form will you communicate information to me, what is your fee structure, can you provide me with both client and professional references.  A care manager should be comfortable in answering all of your questions openly and honestly.
5) Who may benefit from hiring or referring to a Aging Life Care Manager?
  • Seniors who live alone and have little or no support system;
  • Family members who are geographically distanced from their loved one;
  • Family members who live nearby, but do not know how to tap into the appropriate local community resources;
  • Attorneys or trust officers needing assistance with their clients’ health care related issues;
  • Physicians wanting to streamline communication between their patients and family members or possible concerns with their patients current living arrangements;
  • Hospital and nursing home social workers seeking a safe discharge plan and assurance that their patient will have someone coordinating their care and assisting them on a long-term basis;
  • Home care companies looking for assistance in dealing with their patients’ social issues, help with linkage to other community resources, or possible placement options;
  • Senior communities seeking adjunct services to help increase contentment for some of their more challenging residents
6) What are some ways a senior or family member can benefit from a Aging Life Care Manager’s assistance?
  • Flexibility: Services are provided in a variety of settings; homes, retirement centers, continuing care communities, assisted living facilities, or nursing homes;
  • Assurance:  On-going monitoring and regular reporting to long distanced loved ones gives them a peace of mind and reassurance that their family member is well cared for;
  • Cost Control: Carefully matched community services to specific needs reduces overuse or duplication of services keeping expenses contained and possibly helping to prevent costly crisis from reoccurring;
  • Quality of Care:  care managers who are Aging Life Care Management members, nationally certified, and have many years of experience in healthcare will provide a higher degree of quality of in the care and treatment of the senior
7)  Why should a senior or a family member hire a Aging Life Care Manager? They  can help streamline the sometimes complicated and confusing process involved in managing ones health care related issues.  They are most familiar with the local community resources and will know the specific services and costs of those services. With the care manager  being proactively involved in your care and treatment, costly crisis can be reduced and sometimes even avoided.
8) What does the Aging Life Care Manager evaluate during the assessment process?   A basic assessment concentrates on areas such as medical, psycho-    social, functional status, living environment, home safety, legal and financial concerns.  Other assessment tools that may be used include the Geriatric Depression Scale or the Mini Mental Status Exam.  The care manager should maintain an extensive database of assessment tools and should know which tools to use to yield the specific results.  Then an individualized plan of care is drafted outlining areas of concern and listing recommendations for improvement. The care manager will implement the plan by arranging and coordinating services and monitoring those services over time making the necessary adjustments as ones needs change.
9) What is the most important job of a Aging Life Care Manager in working with seniors and their families? The most important job of a care manager is making sure the needs of our seniors are being met in the least restrictive way and without sacrificing their dignity, respect, or quality of life, along with giving their families a peace of mind and a support system they can rely on.

What is Geriatric Care Management?

A geriatric care manager is a person who has specialized training to provide care for older adults. Most GCMs hold graduate degrees in nursing, gerontology, psychology, social work or health and human services.

Geriatric care managers interface with family members and professionals in a variety of areas, such as legal services, health care, counseling and housing. Depending on their training, GCMs may provide assessments; placement; education; psychotherapy; counseling; advocacy; information and referral; crisis intervention; care management; entitlements; home care; insurance; and direction on guardianship or conservatorship.

The National Association of Professional Geriatric Care Managers evolved out of an earlier organization that was established in 1984. This organization boasts a membership of 1,100 professionals throughout the United States who work in a variety of aging-related settings. Members must comply with relevant state and professional licensing and certification requirements as part of the GCM membership requirement.

It is the forte of geriatric care managers to answer questions involving in-home assessments; care options; arranging for the payment of social security taxes; finding the best living arrangements; community resources; alerting children who live at a distance; estate planning; and other legal and financial issues. By being able to explain options, arrange for services, coordinate care and monitor the changing needs of individual clients, GCMs provide continuity and serve as valuable resources.

Geriatric care management fees are dependent upon the combination of services to be provided and the complexity of the individual situation. In the case of my friend and her parents, a typical scenario might play out as follows: The client contacts ADVANCED Senior Solutions, Inc. and requests an initial consultation. The consultation is followed up by an agreement to perform a needs assessment, after which a meeting is scheduled between the GCM and the client(s) to discuss the findings. After the assessments are done, the GCM presents a range of care plan options, including a description