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  Check the pantry for outdated canned foods and the refrigerator for spoiled moldy food.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.

Power of Attorney v. Guardianship

Two types of Power of Attorney:
 
      1. Standard Power of Attorney
 
·       A standard power of attorney document provides the authority for another person (the agent or attorney-in-fact) to make decisions and take actions on the principal’s (the person  needing assistance) behalf when he or she is unable to do so.
· If the principal becomes physically incapacitated, then the power of attorney document would authorize the principal’s chosen agent or attorney-in-fact to; For example – sign documents, receive/pay bills, and make banking transactions on the principal’s behalf.
· A standard power of attorney would become invalid if the principal became mentally incapacitated.
       2.     Durable Power Of Attorney
 
·  A Durable Power of Attorney document would authorize the principal’s chosen agent or attorney-in-fact to: For example – execute documents, receive/pay bills, and make banking transactions just like a Standard Power of Attorney, but would remain effective if the principal became mentally incapacitated.
·  The Power of Attorney document can be drafted to be broad, giving the agent or attorney-in-fact the authority to make any and all property, financial, and personal decisions for the principal or can be drafted to authorize the agent or attorney-in-fact to perform very limited, specific duties.
 
Guardianship:
 
·  A guardianship is a legally binding relationship where a Probate Court authorizes a Court appointed Guardian (Professional or Family Member) to make all personal and/or financial decisions for the incapacitated person as determined by the Court.
·  The Court could determine that the person only requires a Guardian to make decisions regarding his or her finances and property (Guardian of Property), or health and medical decisions (Guardian of Person), or both (Plenary Guardianship).
·  The Probate Court decides on the extent of the person’s incapacity at a hearing.
.  The hearing is to determine what rights the person should retain, if any, and what needs the person is able to meet for his or her health, safety, and well-being.
 
Power of Attorney v. Guardianship:
  •     Incapacity (Medical Status)
    •        The inability to make decisions that affect
      personal health, welfare, and safety, as initially determined by the attending
      physician, and if disputed, by a court.
    •       If a judge determines that someone is legally
      incapacitated, the court has the authority to appoint a guardian to manage the
      person’s property and ensure their daily needs are being met.
  •      Incompetency (Legal Finding)
    •      Incompetency is a finding by the court that an individual lacks the ability to make all decisions, including health care decisions and decisions about creating a health care proxy. A person is considered physically or mentally incapacitated.
    •  Incompetency can also refer to a lack of legal qualification of a person, not measured in terms of mental ability but to act. For example, a person deemed legally incompetent does not have the power to enter a legal contract.
When a Person Cannot Consent:
  • Florida recognizes that the following
    individuals (in particular order) may consent to medical treatment on behalf of
    the incapacitated person:

    •  Surrogate (competent adult expressly designated by the patient/individual to make health care decisions on behalf of the patient). Designation should be in writing.
    •  Court Appointed Guardian (in the absence or a Surrogate, or where a court revokes the\ authority of the Surrogate). All persons who have been adjudged incompetent should have a judicially appointed guardian.
    • A person holding a valid power of attorney (durable POA) which contains language giving the right to make health care decisions for a patient.
    • A proxy (in the event the patient is incompetent or incapacitated) Pursuant to Section 765.401 a proxy may consent (where the patient has not executed an
      advance directive, or designated a Surrogate to make health care decisions).
What is a Proxy?
  •  A substitute, competent decision maker in the
    following order of priority:

    •   Patient’s spouse
    •  An adult child, or if the patient has more than 1 child, a majority of the adult children reasonably available for consultation.
    •  A parent of the patient
    •   The adult sibling of the patient (if more than 1, then a majority of such adult siblings)
    •  An adult relative of the patient who has exhibited special care and concern for the patient and maintained regular contact with the patient.
    •  A close friend of the patient
    •  A licensed clinical social worker (LCSW)
By: Julie DiSalvatore and Lory Smeltzer, MPH, CMC, CDP

Hiring a Aging Life Care Manager

Caring for an elderly loved one can be quite a daunting task, particularly if you live far away or have other competing responsibilities, like work or a young family. There are thousands of people in this situation. The media refers to some as the Sandwich Generation, caught between two generations of family that need them. If you are in this predicament, there are professionals available to help you make the important decisions and arrange for the care of your loved one. There are doctors, elder care lawyers, social workers and a relatively new breed of professionals, Geriatric Care Managers. Selecting the best care solution for your loved one is critical and selecting the right Care Manager can help achieve that goal.

What is a Aging Life Care Manager? 

An Aging Life Care Manager is an individual who specializes in helping families who are caring for older relatives. These professionals are often trained in other fields like nursing, gerontology, social work, psychology or a more business oriented field, like finances. They apply this background knowledge to issues related to aging and caring for the elderly.

Most Aging Life Care Managers have been working in the field for several years. They often have knowledge of and access to services that most individuals don’t know exist. Additionally, they may know of financial benefits, government funds or low-cost services that your loved one qualifies for.ht care manager can help achieve those goals.
What services do they offer?
  • Aging Life Care Management usually includes the following:
  •  Assessment of the individual.
  •  Developing a personalized care plan.
  •  Arranging for services.
  •  Monitoring care. Life Care Managers can be hired for a single task, such as arranging a particular service, or they can take on a long term responsibility. For example, an Aging Life Care Manager can oversee the care-giving process for a long-distance caregiver and, since the Aging Life Care Manager is local to the loved one, be available in the event of an emergency. Many Aging Life Care Managers’s also offer customers a financial assessment with regard to care-giving, including finding potential money wasters such as duplication of services.
Why hire a Aging Life Care Manager?
Identified below are some benefits that may help you determine if you need to hire a Aging Life Care Manager:
  • You are new to elder care and need advice and guidance.
  • You are a long distance caregiver and would like someone close to your loved one that you can count on 24/7.
  • Your other responsibilities make it too difficult to provide the desired level of care and attention to your loved one’s needs.
  • The issues that you or your loved ones are facing are becoming larger and more complex than you can comfortably manage.
  • You have trouble dealing with a family member (whether it is the patient or another relative) and need an unbiased intermediary.
How do you find a Aging Life Care Manager in your area?
There are a few ways to find a reliable care manager:
  • Referral: Absolutely the best way to find a good professional. Seek out the advice of others that are in similar circumstances, ask a trusted local health professional or consult an elder law attorney.
  • Government resources or organization websites: 
  • Local agencies or hospitals may also provide a list of local professionals.

Trying to make the best decisions about care-giving can be difficult for you and your aging loved one. Asking for help is a big step. There are many organizations and professionals that can help you. A Aging Life Care Manager is just one of your options.

Elder Care Abuse Awareness

Elder abuse, neglect, and exploitation can occur at the hands of anyone that interacts with him or her. It is important for those who care to know the signs of abuse, either physical
or psychological.

Physical abuse includes beating, hitting, shoving, neglect and other acts that can cause harm to an elder’s fragile body. Look for physical signs such as: bruises, abrasions, poor coloration, malnutrition, dehydration, and soiled clothing or bed.
Psycho-logical abuse includes verbal berating, harassment, intimidation, threats of punishment, demeaning comments or isolation from family and friends. Look for these signs of psychological abuse: fear, anxiety, agitation, anger, isolation, or depression. He or she may withdrawal, be non-responsive or hesitate to talk openly.
Another common way the elderly can be abused is through financial or material exploitation. This includes improper use of an elder’s funds, property or assets. The abuser could cash the elder’s checks without permission, forge his or her signatures, force or deceive the elder to sign a document or use an ATM/debit card without permission.
To report Abuse call: 1-800-96-ABUSE (1-800-962-2873) and to learn more call
1-800-96-ELDER (1-800-963-5337).
How Prevent
Identity Theft
NEVER:
1. Carry a Social Security card
2. Give personal information over the telephone
3. Carry multiple credit cards
4. Print Identification numbers on checks
5. Answer unsolicited email that asks for your personal information.
ALWAYS:
1. Review statements & bills promptly
2. Shred personal mail and information
3. Stop mail while you are on vacation
4. Shop online only with merchants that have se-cure websites.
5. Copy all items in your wallet and keep with personal papers in a safe place.
Preventing Financial Exploitation
1. Use direct deposit for check payments you receive.
2. Don’t sign blank checks allowing another person to fill in the amount.
3. Don’t leave money or valuables in plain view.
4. Don’t sign anything you don’t understand.
5. Be aware of scams. If it sounds too good to be true, it probably is.
6. Don’t pay for any prize or send money to improve your chances to win or receive a prize.
7. Don’t give any caller your credit card number or any other form of personal identification.
8. Don’t give anyone your ATM access code, and cancel your ATM card immediately if it is stolen.
9. Be cautious of joint accounts. Both parties are equal owners of the account and both have equal access to the funds in the account.
10. Build good relationships with the professionals who handle your money.
Advanced Senior Solutions are members of the American Association of Daily Money Managers and are insured and bonded in order to assist you with Bill Paying and
Financial Services. Call: 727-443-2273.

Long Distance Caregiving

Care-giving is a difficult task in itself without adding the challenge of living a distance away from the one being care for. The only information you receive is either when you call (which means you have to trust when you are being told everything is fine) or when you visit (which may not be very often).
When you are able to visit there are some things to look out for that are signs that your parents or loved ones are not doing as well as they have led you to believe.
1. Check the stove top for dust, which would indicate they are no longer cooking for themselves.
2. Check the fridge and pantry for food that is expired, which means they are not shopping as often as needed.
3. Check the bathroom for a wet shower or wet towels, indicating they are still taking showers regularly.
4. Count their pills in their prescription bottle and compare it to the date it was filled and the quantity prescribed which will indicate missed dosages or non-compliance.
These are all signs that your loved one may not be managing well and is no longer caring for themselves. You may need to take action. This could be hiring a Aging Life Care Management agency to be your loved one’s local point of contact or hiring a homemaker / companion to help pick up groceries, cook, clean and monitor medication compliance. The important thing is that these decisions need to be made before everything gets out of hand. This proactive response will prevent you from having to make hasty decisions during an emergency and give your loved ones a better quality of life.
Call Advanced Senior Solutions for a consultation. 727-443-2273

Ways to Help Your Aging Parent

As a member of the “Sandwich Generation”, whereby having an adult daughter living at home after college due to the economy and a 12 year old son with Tourette’s, along with managing my aging father from a distance, I truly understand the difficulty both on a personal level as well as a professional level as a Geriatric Care Manager Elder Care Consultant. I can only imagine how difficult this process is for those with little or no experience in navigating through the confusing maze of health care. In managing your aging parent, there are some recommendations to help you understand the aging process and what you can do to help.

1. Recognize sudden changes. Quick onset of confusion or falling frequently is likely an acute episode indicating possibly an infection, medication side effect or even a heart attack or stroke. Be aware of their baseline behavior so you’re more in tune to the changes that occur.

2. Find the source of the decline. To often, a person with dementia symptoms are mis-diagnosed with Alzheimer’s. Some easily treatable medical conditions such as urinary tract infection, plugged ears, vitamin B12 deficiency or underactive thyroid can mimic the signs and symptoms of Alzheimer’s. Note the ways the decline has presented itself such as short term memory impairment, loss of appetite, or poor hygiene and how long these changes have been going on. Share this information with their physician at their next appointment.

3. Familiarize yourself with their medicines. Note medication name, dosage, frequency, what it’s prescribed for and the prescribing doctor. Many times medications are prescribed for a secondary effect rather than the most common one. Find out about the potentially dangerous side effects to be on the alert for. Inform their doctor of your parent’s other substance use such as alcohol, tobacco, caffeine and even vitamins, supplements and nutritional drinks.

4. Curb ageist attitudes. Don’t assume all that anguish your parent is experiencing is age related. For instance left hip pain in an 87 year old may not be from age if there’s no discomfort in the right hip. Also, not every elderly person becomes depressed. And avoid saying things like “What do you expect at your age?” (Which is something my daughter says to me in jest, and I’m only pushing 50!)

5. Address the symptoms but don’t ignore the emotions. During the aging decline comes all the emotions of insecurity, fear, grief, boredom, sadness and embarrassment. Emotional distress can exacerbate dis-ease symptoms and even spark new illnesses. Uncover what causes the most stress and find solutions to help ease their concerns.

6. Maximize quality of life. Help your parent to find ways to enjoy life to its fullest and have the capability to do the things they want to do. Helping them through a problem or providing them with companionship and love. As they experience loss of loved ones coupled with their loss of some of their functional abilities, they may feel lonely or isolated. Help them meet new people and develop new interests through senior centers, adult day care or even through their local retirement or as-sisted living communities.

7. Know when to ask for help. You cannot assist your parent with the aging process alone. Your own immediate family support is a must and even with that, you may need to call for some professional guidance.

Call us today for help 727-443-2273

Independent Living and Assisted Living What’s the difference?

What exactly is “Independent Living”? What is the difference between that and “Assisted Living”? What sounds like a simple question to those of us who work in the industry, may seem like a mass of confusion to those of you that are exploring these options for yourself or a loved one.

While there is plenty of support in most Independent Retirement Communities such as housekeep-ing, meals, transportation, and maintenance assistance, the minute the need increases to the point where “hands on” care is needed such as physical assistance with showers, dressing, grooming, or transferring, then Assisted Living would likely be needed.

Each Community provides a different “package” of services, even if their licenses are the same. Some offer Levels of Care where certain services are included within each level and that level comes with an additional fee above and beyond room and board (base fee). Other communities offer services associated with time involved, such as 1-5 hours a week is this much, 6-10 hours a week is that much and so on. With each increase in increment of time, additional fees are added above base fee.

Ask for any additional costs such as transportation fees, utilities, laundry service or other services that may not be included in base fee. Do they have a physician that makes rounds in the building? Do they offer other mobile services such as eye doctor, podiatry, home care services, and more.

As you search for the right fit, comparing apples to apples can be a challenge. Just remember to keep it simple. Start with the basics then compare and contrast. Most importantly trust your instincts. How does each community “feel”? Talk to residents as you pass in the halls and ask how they like living there.

Remember, this information is more important than the bricks and mortar. A beautiful building does not always make a good home! Also remember, if you’re touring on behalf of a loved one, keep in mind their likes and dislikes, not what you would like if it were you moving in.

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 Aging Life 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.advancedseniorsolutions.com

When should we hire a Aging Life 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