Organize Caregiver Tasks

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?

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

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

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.

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 Aging Life 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.

THE ABCs OF MANAGING CARE

 

The first thing Lory Smeltzer, a Aging Life Care Manager in the Tampa Bay region, does for a new client is assess the older person’s life—physical and mental health, family relationships, living conditions, finances and legal affairs.
She then draws up a “plan of care” based on her evaluation.  Like her colleagues, Lory says one of her most crucial tasks—and one that professionals sometimes do better than family members—is to convince the person to accept advice and help.
Competent care managers are able to find and hire needed help—home care workers, lawyers, nurses or even someone to mow the lawn.  Many straighten out finances and kitchens.  They may persuade clients that it’s no longer safe for them to drive.
 If a hard decision must be made—a move to a nursing home or hospitalization, for example—it may be easier for the care manager than a family member to be the “bad guy.”
In some cases, the role of care managers is narrower.  They simply evaluate the older person’s needs and draw up a plan for the immediate future.  If the situation changes, they may do subsequent “tuneups.”
Not all Aging Life Care Managers are created equal.  Some may lack the necessary training or experience. Some may give poor advice.
A Silver Spring, Md., man discovered this to his dismay a few years ago.  After his 94-year-old mother suffered a heart attack, he wondered what type of future living arrangement would be in her best interest:  living alone in her Santa Ana, Calif., apartment?  A nursing home?  Or some other facility?
He hired a geriatric care manager suggested by a friend to evaluate his mother and make a recommendation.
By the time he arrived in California 10 days later the care manager was waiting with her appraisal, which she said was based on a day of visiting the older woman and watching her in a rehab unit of an Orange County nursing home.
She concluded his mother could not live safely outside a nursing home.  She charged $300 for this advice and offered to stay on the case.
Unconvinced by this assessment, the son hired a professional nurse and enlisted the support of the Orange County ombudsman program.  A new evaluation came up with a different conclusion.  His mother had the physical and mental prowess to live a quasi-independent life.
The man fired the geriatric care manager and moved his mother to an assisted living facility, where she lived successfully for several years. click here for our other services…..
 
Article By: Linda Greider
Published in: AARP, December 2001, Vol. 42 No. 11, Washington D.C. p 9-13.

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.