When is it Time To Intervene With Your Parents Care?

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 nearby 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 duplicated 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 malnourishment.  Check the pantry for outdated canned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. A Professional
Certified 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 or Geriatric Care Management?

Geriatric 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
Geriatric 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.


Geriatric
care managers
Geriatric 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
Geriatric 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
issues.

       

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.

References:
www.caremanager.org
www.seniormag.com/services.caremanager.htm

Consumer Awareness WHAT’S IN A NAME?

Geriatric Care Management (GCM)
is a rapidly developing, newly recognized profession which helps
families adjust and cope with the challenges of an aging loved one.
Professional Care Manager’s
(PCMs) are advocates for seniors and disabled adults. PCM’s provide needs
assessments, screening, arranging and monitoring in-home help, counseling and
support including family conflict mediation and crisis intervention.
They assess the ability to
remain safely in the home or need for relocation. PCM’s help facilitate legal,
financial, medical and end of life services. They act as liaisons for families
who live far away from their elderly or disabled loved ones and will alert them
to any concerns that may arise. PCM’s have extensive knowledge about the
services and resources in their communities.
PCM’s hold Bachelor Degrees, Masters
Degrees, or Doctorates in a human service related field such as Gerontology,
Social Work, Psychology, or Nursing. The National Association of Professional
Geriatric Care Managers (NAPGCM) recognizes the following credentials as
exceeding the standard of expertise in being a PCM; CMC, CCM, A-CSW &
C-SWCM. The certification exam to be a PCM is facilitated by the National
Association of Certified Care Managers (NACCM). These certifications require
testing and ongoing continuing education and peer review.
Because there are some
individuals working either independently or for a different professional and
who refer to themselves as “Care Coordinators, Care Managers or Eldercare
Consultants”, it is important for the wise consumer to ask questions when considering
hiring a true PCM.
Some of these include:
What are the credentials,
education and licenses of the Professional Care Manager?
How much experience does the
Professional Care Manager have in healthcare?
  • Are they and their staff
    Degreed, Licensed, Bonded and Insured?
  • Are they a member of the
    National and State Associations of Professional Geriatric Care Managers?
  • Can they provide references
    from professionals and previous clients/families?
  • What are the fees and costs
    for services? Do they offer a complimentary consultation?

The process should be
comprehensive and cautious when determining if the Professional Care Management
Agency or Individual has the qualifications nec-essary to work with your loved
one.
To Locate a Qualified
Professional Care Manager, call us at 727-443-2273

Where do I start? Whom do I contact? What is the best solution for Mom or Dads problem?

Some of us have been there and asked those questions, or we may find ourselves
in that situation in the future.

We want to take care of Mom or Dad, but it is not an easy task — especially if
we are working full time and raising our own family. But eldercare issues do not
wait for convenience of time or place. For example:

Sherry stopped by her mom’s house every day after work. Her father had
passed away last year and he had been the caregiver of Alice, Sherry’s mom.
Now it was up to Sherry to fill the caregiver role. Alice suffered from mild dementia.
She could still function on her own, but was showing more signs of forgetfulness
and confusion. Sherry would find her morning medication still on the cupboard
in the evening and wasn’t sure Alice had eaten during the day. Sherry
couldn’t quit her job to take care of her mom, as she was a single mother supporting
her own family. Sherry had a lot of questions. What type of help was available
to her? Are there resources in the community? Who would she contact to find out
about home care or assisted living? Should she get legal power of attorney and
when is the right time to do it? What about selling mom’s home if mom goes to assisted
living? How will that affect Medicaid eligibility?

A Geriatric Care Manager can be a valuable asset to family members when it
becomes necessary to look at alternatives for their loved one’s long term care.
They work with all members of the family in educating about resources and making
decisions. A small sample of some services provided are.

  • Perform a comprehensive assessment on level of care needs
  • Develop a Care Plan for both current and future care needs
  • Work with physicians in getting medical support
  • Find home care and other services that work with the families needs
  • Provide assistance with legal, financial and end of life issues

For more information or to find a Geriatric Care Manager near your loved
one, go to www.advsrs.com or www.caremanager.org

When should we hire a Professional Care Manager?

·        
When there’s no
local support system in place or family lives too far away to assist regularly.
·        
Family members
are unable to determine needs, agree on options, arrange for or oversee care.
·        
If the burden of
providing care is threatening the health of the spouse or primary caregiver.
·        
When placement in
a facility is necessary and your not sure what fits both care needs and budget.
·        
Your loved one
displays inappropriate behavior, uses poor judgment or may be easily
victimized.
If
you’re experiencing any of these or other concerns, call
Advanced Senior Solutions. 727-443-2273 www.advsrs.com

Not All Geriatric Care Managers Are Created Equal

Geriatric Care Management
(GCM) is a rapidly developing,
newly recognized profes-sion which helps families adjust and cope with the
challenges of an aging loved one.
Professional Care Manager’s
(PCMs)
are health advocates for
seniors and disabled adults. PCM’s provide needs assessments, screening,
arranging, and monitoring in-home help, counseling and support including family
conflict mediation and crisis inter-vention. They assess the ability to remain
safely in the home or whether the person may need to be relocated to an
alternative residence. Determining appropriate living arrange-ments and
necessary supportive assistance are among the many services they offer.
Additionally, PCM’s help to facilitate legal, financial, medical and end
of life services.
Professional Care Managers become liaisons to families who are separated by long
dis-tances from their elderly loved ones making sure they are managing well,
and alerting them to any concerns or problems that may arise. PCM’s have
extensive knowledge about the services and resources in their communities.
Professional Geriatric
Care Managers
hold Bachelor
Degrees, Masters Degrees, or Doctorates
in a human service related field
such as Gerontology, Social Work, Psychol-ogy, or Nursing. As the aging
population continues to grow, the need for strict PCM stan-dards is
increasingly critical.
The National Association
of Professional Geriatric Care Managers (NAPGCM)
rec-ognizes the
following credentials as exceeding the standard of expertise in being a PCM;
CMC, CCM, A-CSW & C-SWCM. The certification
exam to be a CMC is facilitated by the National Association of
Certified Care Managers (NACCM)
. These certifications re-quire testing,
ongoing continuing education and peer review in order to re-certify.
Because there are some
individuals working either independently or for a different professional and
who refer to themselves as “Care Managers”, it is important for the wise
consumer to ask questions when considering hiring a PCM. Some of these
questions include:
How much experience does PCM
have in healthcare?
● What are the credentials and
education of the PCM?
● Are they Licensed, Bonded and
Insured? Ask to see it
● Are they a member of the
National and State Associa-tions of Professional Geriatric Care Managers?
● What types of services do they
offer?
● Can they provide references
from clients/families?
● What are the fees and costs
for services? Do they offer a complimentary consultation?
When Selecting either a
Professional Care Management Agency or an Individual, the process should be
compre-hensive and cautious. The answers to your questions will assist you in
determining whether that particular Agency or Sole Proprietor has the
qualifications important to you for a successful relationship. To locate a PCM
near you, Visit: www.caremanager.org or www.naccm.net

Expectations of Geriatric Care Managers

Assessment
Professional Care Manager (PCM) must first evaluate and assess ones needs, including medical psychosocial, functional, living environment, legal and financial. All of these indicators are important to the welfare of the older or disabled person. The PCM gains an understanding of their client with respect to their values, family dynamics, and expectations without bias.
Plan of Care
The PCM develops an individualized plan of care which focuses on the areas of concern that is recognized during the assessment process.  A plan of action is agreed upon by both client and PCM and then implemented.
Services are prioritized and arranged according to the action plan taking into consideration the client’s health, emotional and safety risk factors. Oversight of care can be set in place to continually monitor the plan of care for appropriateness and to make any necessary changes.
A PCM can get as little or as much involved as the client or family needs them to be. Some only prefer the initial assessment and care plan to be completed which offers them with enough direction while others prefer ongoing Care Management to stay proactively involved in the client’s care.
When is it time to call a PCM?
A PCM is called when the situation can no longer be taken care of by others involved. It could be that the family lives at a distance or the burden of care giving becomes too great for the spouse or loved one. Most of the time, the call comes from other professionals already involved with the client such as physicians, home care, bankers, or attorneys.
Flexibility and Cost Control
PCM services are flexible as to where, when and the length of involvement. Clients are cared for at home, in retirement centers, assisted living or nursing homes. PCMs also are asked to review charts and oversee ones care while in the hospital or skilled rehab. When there’s no local family willing or able to manage their loved ones care, the PCM is usually involved on an ongoing basis.  PCMs help manage the costs associated with health care by accurately matching services to needs, reduce overuse or duplication of services and work proactively to help avoid a costly crisis.
Trust

There can be different expectations from those involved pertaining to Care Management. It is the responsibility of the one hiring a PCM to verbalize their expectations and have an understanding with the PCM so a trusting relationship can be built. This relationship is vital for the PCM to produce positive outcomes

Selecting a Geriatric Care Manager

geriatric care manager (GCM) is a professional who specializes in helping older people and their families with long-term care arrangements. GCMs 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, GCMs 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 GCM carefully. The field of geriatric 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 GCM 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 GCM or several?
  • Determine the scope of the GCM’s practice. Some GCMs 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 GCMs 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 GCM’s practice setting and specialties meet your needs and your parent’s.
  • Investigate the GCM’s track record and reputation. Ask for letters of reference or names of previous clients you may contact. Is the GCM active in professional associations? Does the GCM perform volunteer work?
While there are no licensing requirements for GCMs, 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 GCM’s billing rates and how charges are calculated. Fees vary depending on the GCM’s 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 GCM 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.

Advantage to Hiring a Geriatric Care Manager

Very often children take on the responsibility of looking after their parents as they grow older. While this is admirable, the increasing complexity of health and financial issues facing today’s elderly can become overwhelming. And the stress of trying to negotiate the maze of financial and health-related issues can often put strain on the parent-children relationship.

geriatric care manager (GCM) can help. A GCM will look after the client’s finances search and apply for helpful programs and benefits, and administrate claims on insurance and Medicare. They can use their experience and contacts to suggest high quality assisted living facilities, in-home care providers, and nursing homes should the need arise. A GCM can also help locate reputable legal help for estate planning, willspowers of attorneyhealth care directives, and Medicaid. When children live too far away or lack the considerable time it takes to care for a loved one, a GCM can even do shopping, pay bills, balance the checkbook, and protect a senior from scams.

The primary benefit of a good GCM is peace of mind, but choose with great care. Unscrupulous individuals are out there, so be certain your GCM has a spotless reputation. Monitor the GCM’s handling of your loved one’s affairs closely. An excellent resource is the National Association of Professional Geriatric Care Managers website, www.caremanager.org.

NYNewsday.com, 2-28-04

What’s the cost of care?

One potential downside of care management is the cost.  Geriatric care managers charge between $80 and $150 an hour, so over time the costs can add up significantly.
Long-term care insurance policies often cover the costs of a geriatric care manager, but Medicare does not.
Despite the price Jan Collins, a South Carolina attorney who specializes in elder law, frequently recommends geriatric care managers to his clients.  “Dealing with the elderly is a multidiscipline event,” he says.
He points out that a care manager may actually save money by connecting families to useful community resources, including free ones, and steering them away from expensive living arrangements where fees may quickly rise without warning.  “[Families] who have the least,” Collins says, “have the most to lose.”

EARNING TRUST IS KEY

For a geriatric care manager, “the most important job is to develop trust in the relationship,” says NAPGCM’s LaBier.  As an example she cites a retired physician she cared for.
Accustomed to controlling every aspect of his life, the doctor had retreated at age 94 into a life of “sitting in his sunroom watching the grass grow,” LaBier recalls. He was also trying to care for his wife, who had dementia.  Bills piled up on the dining room table, no one made meals and their home was a mess.
Furthermore, LaBier says, “stockbrokers were churning him left and right,” talking him into buying and selling stocks at an alarming clip.
The couple had outlived their children and had no relatives nearby, but a nephew in Germany discovered their situation and hired LaBier.
Suspicious at first of LaBier, the physician eventually allowed her to bring in help to clean up the kitchen and cook some meals.  She gradually persuaded him to deal with the bills and call the investment firm that was hounding the doctor to report the broker.  The doctor was able to fulfill his wish of staying in his own home until he died.
Unfortunately, it’s usually a crisis—a broken bone, a hospitalization—that prods families to plan for elder care.  Care managers say they are having some success, however, in getting families to have a plan before a crisis develops.
The NAPGCM reports that even retirement-age people who are still healthy are arranging for their own eventual care needs so their younger relatives won’t have to.
Article By: Linda Greider
Published in: AARP, December 2001, Vol. 42 No. 11, Washington D.C. p 9-13.