Monthly Archives: December 2012

Expectations of Aging Life Care Managers

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Assessment
A Aging Life Care Manager  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 manager gains an understanding of their client with respect to their values, family dynamics, and expectations without bias.
Plan of Care
The manager 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 life care manager 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 manager 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 Aging Life Care Manager?
A manager 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
Aging Life Care Manager 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. Managers 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 manager is usually involved on an ongoing basis. Aging Life Care Managers 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 care manager to verbalize their expectations and have an understanding with the care manager so a trusting relationship can be built. This relationship is vital for the Aging Life Care Manager to produce positive outcomes.

10 Tips on Storing Medications

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  • Be sure that medications are out reach of children or anyone who might misuse them.
  • Check to see that medications needing refrigeration are stored in the refrigerator in an area which they will not freeze and in where they cannot be easily reached by children.
  • Check to see that medications are stored away from light and heat, which can effect the chemical composition of the medication.
  • When someone is taking medicine, be sure that there is good light so that the medicine label can be seen clearly.
  • Medications should not be moved within the medicine cabinet or storage level. People expect medication to be in a certain place and do not always look at the label.
  • Medications should not be used if there is no label. If the label is torn or defaced, or the medicine is outdated, the medicine should be tossed out.
  • Be sure that medications that look like water or soft drinks are not put in containers from which children or others might drink.
  • Post on or by the telephone, the emergency phone numbers of important family members, the poison control center, and the rescue squad and the doctor.
  • If you’ve been instructed to dispose of medications, do not put them in the garbage or trash where children and animals can get them.
  • Store all medications in their original containers. Some medications can become less potent, or ineffective, if taken out of its original container.

The Caregiver’s Bill of Rights

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Caregivers often lose themselves in providing care. Remember ? you have rights too. Post this Bill of Rights where you can see it to remind yourself of your value.

  1. You have the right to receive the knowledge, resources, training and support you need to be successful as a caregiver.
  2. You have the right to acknowledge your own needs and to expect those needs to be met.
  3. You have the right to enjoy a well-rounded and meaningful life that includes family, friends, work, activities you love and time to yourself.
  4. You have the right to seek and accept help from community, family, friends and support services.
  5. You have the right to access quality services that treat you and the person you are caring for with dignity and consideration.
  6. You have the right to all of your feelings as a caregiver, from the moments of unexpected joy to those of anger and frustration.
  7. You have the right to be a part of a caregiving team rather than having to do it all by yourself.
  8. You have the right to ask for ? and receive ? appreciation and respect for your caregiving.
  9. You have the right to acknowledge that the unique gift of your time, energy and emotions has as much value as any caregiving task.

When to ask for Help

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By asking for help before reaching a crisis point, caregivers can head off feelings of frustration and resentment. Organizing caregiving meetings is one way to ensure that help is available on a regular basis.
Knowing when to ask for help is just as important as acknowledging that you do need help. Too often, caregivers wait until they are at the end of their rope before seeking assistance. Waiting too long can cause you to unconsciously phrase your requests as demands, allowing pent up feelings of frustration and anger to surface unexpectedly. The person you have finally asked for help may react to your emotions and not respond as you had hoped. Unfortunately, this can push caregivers back into a negative cycle of resisting help and then resentment builds up even further. Many caregivers have vowed never to ask for help again, when if they had only asked for help a little earlier, things could have gone more smoothly. So to reiterate?it is important to know when to ask for help.

Do Not Wait for a Crisis to Ask for Help!

Have regular meetings. Ideally, you should have regular meetings with all the people involved in a senior’s care. Regular meetings ensure that people have an opportunity to discuss their needs and any other issues they may have. It is important that people know that they will have the opportunity to be heard. This lessens anxiety and gives people a chance to talk about concerns before they become issues.

Meetings Can Help All the Pieces to Fall Into Place

During these meetings, people can discuss their needs and responsibilities. Caregivers can bring up items that need to be addressed, identify days that they need help, and just generally solicit assistance. Participants can make a caregiving schedule to ensure that everybody understands their responsibilities and that all the pieces fall into place.

Express Appreciation, Get Appreciation

Regular caregiving meetings are also an important time to validate all the hard work that caregivers do. Appreciation, coordination, and acknowledgement are all key to getting the help you need

Organize Caregiver Tasks

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Involving the elderly person in the process of gathering information will increase their willingness to accept change and to improve their situation. Allow them to make choices whenever possible, and provide them with the information they need to make a good decision. Let them decide which issues to address first. Remind them that you are available to assist them with these important issues but that they have control over the final decision.

How to Gather Important Information and Organize Your Caregiving Tasks
 
 Write out an itemized list of all the things you need to do, and clarify your objectives. Then, review the list one item at a time. Don’t become overwhelmed by trying to do everything at once. Remember that information gathering and organization are the first steps.
Go over the items with the elderly person and ask them questions directly. Allow time for reflection and listening. For instance, the gathering of marriage documents may evoke memories of their wedding day. This can be a good opportunity to learn about the life of the person you are caring for. Don’t get so caught up in the information-gathering process that you miss a chance to reminisce.
Never try to talk someone out of their feelings. Acknowledge any fears or anxieties an elderly person may have regarding sensitive topics such as financial issues. Don’t deny the reality of their fears or concerns; instead, allow them to express them and move on.
Skip over difficult items and return to them later. Don’t become stymied by one item. If information is unavailable or refused, move on to the next item. Begin with the easy items ? those that are obvious and not emotionally heavy.
Be willing to compromise. Perhaps you are working with your parents and they don’t feel comfortable sharing certain financial information with you. Let them choose a mediator or agent to whom they can entrust this information. You can work with the mediator if necessary.
 Explain the reason for each question asked. For example, if you ask for access an elderly person’s financial accounts, explain that it is a precautionary measure in case they are unable to pay their own bills.
 Explain their rights, and give them options. Many seniors fear the loss of their independence and will feel more in control if they know their rights and options. Introduce them to attorneys who can explain their legal rights and other professionals who can offer them guidance.

Are you a Caregiver?

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Most people who provide care for a friend or family member don?t think of themselves as a caregiver.

You may not consider yourself a caregiver, but do you regularly:

  • Drive a family member, friend or neighbor to doctor?s appointments?
  • Make meals for someone?
  • Help someone with household chores such as cleaning, grocery shopping, lawn care, etc?
  • Make regular phone calls to someone to ?check in? on them?
  • Provide hands-on care, including bathing, help eating, toileting, or other help?
  • Help someone make decisions about medical decisions?
  • Assist someone with personal business affairs, such as bill paying?
  • Are you managing Mom and Dad?s checkbook or paying their bills?
  • Do you go grocery shopping for an older family member or friend?
  • Do you miss work to care for your parents or spouse?
  • Are you under a great amount of stress due to the needs of your aging parents?
  • Are you caring for both your parents and young children?
  • Are you worried about an older family member who lives in another city?
  • Are you neglecting your needs to meet the needs of others?

    If you answered yes to one or more of these questions you may be a caregiver.

    Caregivers provide support to someone who needs help. It doesn’t matter how many hours per week are spent providing support. Caregivers may live with the person they are caring for, providing assistance with daily needs, or may visit the person weekly or call regularly. Being a caregiver involves an investment in time, energy and support.

Selecting a Aging Life Care Manager

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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.

Advantage to Hiring a Aging Life Care Manager

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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.

A 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, wills, powers of attorney, health 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?

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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.

When hiring a care manager . ..

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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.