All posts by Courtney Pulitzer

Ambiguity and Acceptance in the Time of COVID-19

On March 25th, 2020, I had the honor of meeting with some of the top women business leaders in the Seattle area. These ladies are some of the hardest working women I know. They are smart, creative and committed to not only making their businesses succeed, but they also want to make the world a better place. We meet regularly through our connection to WPO – The Women Presidents’ Organization.

Over the past two years, we have all been planning for a possible recession, examining ways to strengthen our businesses and readying our team to be nimble come what may. Little did we know that a pandemic would be the force that knocked the wind out of everyone’s sails in the blink of an eye. Yet even in the midst of fear, sadness and disbelief, these women are resolute and ready to lead their teams no matter what it takes.

As a social worker and Aging Life Care professional™, my life’s work has been to manage a myriad of crises with my clients. I liken what is happening in business today to what families go through when their parent receives an Alzheimer’s diagnosis. First, the stages of grief ruthlessly unfold, and then, seemingly hopeless ambiguity sets in. Ambiguity in terms of wondering how long this will go on, questioning what it means for the future, worrying if their savings will last as the bills begin to mount, and figuring out how to marshal necessary support.

These parallels remind me that business owners can be resilient and get through this pandemic just as countless families I have worked with have year after year.

Dr. Pauline Boss, Emeritus Professor of Marriage and Family Therapy at the University of Minnesota, wrote extensively about ambiguous loss in her books: Ambiguous Loss: Learning to Live with Unresolved Grief and Loving Someone Who Has Dementia. She defines ambiguous loss as “a loss that is unclear, it has no resolution and no closure.” It’s a duality of being present and absent at the same time.

Business owners I know feel this ambiguity in their bones right now. They have staff, expenses and their businesses are closed – yet still open. Many things continue as usual – yet, they don’t – nothing is usual right now. It’s hard to make decisions because it’s uncertain how long this will go on, what the outcome will be, and when the financial reserves will dry up. These are the exact uncertainties families caring for someone diagnosed with dementia experience every day, year after year – and still, they make it and are often stronger for having gone through the journey. But how?

Dr. Boss’s tools for caregivers can be applied to business:

  1. Accept the ambiguity. Acknowledge that things have changed – they are different now.

 

  1. Think both-and (not either or). Businesses can be both opened and closed. Recognize that two contradictory ideas can be true at the same time. We must trust that things will work out, that challenges can be managed, and that businesses can be resilient.

 

  1. Change your perceptions. Business owners thrive on and make decisions with data and facts. But when there is ambiguity, data is not as clear cut as it used to be. Business owners can learn to work in the gray zone where information is opaque and make the best decisions possible based on what we think we see.

 

  1. Foster resilience. Nurture your optimism, know that you and your business are not alone. Build a community of support and take care of your own health so you can care for those that matter most to you. It helps to find meaning and your purpose during the journey – it’s there – keep your eyes and heart open even when you are scared. Look to your company and personal values to guide your decisions. If you do, you’ll have little to regret.

My clients have taught me that a crisis is the best time to make transformative changes. This time of challenge can foster our innovative spirit and lead us to unexpected success. Even though no business owner would volunteer to steer through these choppy pandemic waters, we can weather this storm, make it safely to shore and discover new possibilities, just like my clients and their families have.

Jullie Gray, MSW, LICSW, CMC, is a Fellow Certified Care Manager with over 30 years of experience in healthcare and aging. She is a principal at Aging Wisdom, an Aging Life Care/geriatric care management practice serving King and south Snohomish Counties. Jullie is also past-president of the National Academy of Certified Care Managers and the past-president of the Aging Life Care™ Association.

Should I move mom back home?

By: Lisa Mayfield

As more residents in retirement communities are diagnosed with COVID-19, some families are struggling with the decision of whether to bring their parents back home. With all the uncertainty surrounding COVID-19, this is an understandable and important question. Yet any consideration of a move should not be taken lightly, especially with so many unknowns about the future.

In our work as Aging Life Care Professionals, we help families examine their unique situations and provide guidance about developing the best approach for their parent. Having these conversations are tough, yet, preparing in advance can ease a lot of anxiety. I thought it would be helpful to share some of the most important points to consider when contemplating a move back home.

First, it is important to remember there are many advantages retirement communities provide:  

  • Nursing support on-site
  • Team of caregivers to provide 24/7 care and oversight
  • Quick and easy access to medical advice
  • Social engagement (even during quarantine)
  • Team of professionals to problem-solve issues that arise
  • Meals and access to food, groceries, and supplies
  • Coordination with pharmacies and pharmacists
  • Clear protocols for staff about COVID-19
  • Most retirement communities are regularly communicating with their local public health experts to ensure they are keeping their residents and staff safe
  • Many senior communities also have the financial support and leadership from a much larger corporation or non-profit entity and the support of their industry colleagues

No one knows how long our new reality will last or how it will evolve. These additional resources create a safety net that is difficult to replicate at home.

Before bringing a parent back home, addressing the questions below will help ensure a safe and well thought out plan:

  • What level of caregiving support will your parent need at home (how many hours of care, how many caregivers, how will these shifts be staffed)?
  • What will the cost of this care be and how does this compare to what you are paying now?
  • Will your parents be able to sustain this cost over the long-haul, even if care needs increase?
  • How will you manage if your parent becomes diagnosed with COVID-19?
  • How will you manage if a caregiver is diagnosed?
  • How will you handle getting groceries and supplies to the house, especially if these supplies become more complicated to access?
  • Who will prepare meals?
  • How will you keep your parent socially connected?
  • To prevent isolation and depression, is there a plan in place for oversight and support of the caregivers?
  • Are there systems in place to ensure caregivers are not coming to work sick?
  • If you become sick, is there a back-up plan?

If after weighing the risks and benefits, you determine that the advantages of keeping your parent in a retirement community outweigh the current risks, you can always re-evaluate your decision down the road.

These issues are so complex, and each family needs to weigh the risk and benefits of their own individual situation. The reassuring news is that an Aging Life Care Professional can help you navigate this decision and support you to implement a safe plan if you do decide to move your parent back home.

You can find an Aging Life Care Professional in your area at: www.aginglifecare.org.

You can locate a local home care agency at: http://www.hcaoa.org/.

For additional ideas about social engagement: http://bit.ly/3d9XwtN

Lisa Mayfield is the founder and co-Principal of Aging Wisdom®, an Aging Life Care™ practice in Seattle. Trained and licensed as a Mental Health Counselor, Geriatric Mental Health Specialist, and a Certified Care Manager, Lisa brings over two decades of experience working with older adults and their families. She is currently serving as the Past-President of the Aging Life Care Association board of directors.

Engagement During Isolation

by Lisa Kaufman

Even if I have been a member of the Aging Life Care Association for nearly 20 years, I have always thought of myself as the “red-headed stepchild”  (yes, go ahead and laugh if you know me…) of ALCA. And now I see an opportunity for my “particular set of skills” to be of use to our organization.  You see, I am a certified Therapeutic Recreation Specialist, in addition to my CMC.

I have been mulling over some suggestions and recommendations for my employees and colleagues to help increase engagement and sensory stimulation during this delicate time of social distancing even within the Senior Living Communities. This is of great concern to me, especially for our clients with cognitive impairments and/or sensory impairments. So here are some ideas I would love to share with you.

Caveat: do not recommend items that could be toxic or a choking hazard.

These ideas could be used for independent sensory stimulation, or use with a caregiver to help engage. They will increase cognitive and sensory stimulation, and reduce stress. Please be cognizant if the client becomes overstimulated, or needs a break that you be observant and aware.

Be a source of good ideas for your Senior Communities by speaking with the Executive Director about implementing some building-wide ideas. Be the invaluable resource for your clients’ families by sharing general ideas and you be their procurement:

For a PA system within buildings:

  • Play music at certain times of day, with themes to help reorient. I.e.: upbeat Swing Band in the morning or Calming Classical in the later evenings.
  • Have someone read a chapter a day from a classic novel
  • Have someone read Bible, Torah, Quran passages – or something non-denominational and uplifting

For Closed Circuit TV within buildings:

  • Sittercise
  • Videos of travel or animals
  • Travel or the free access to the Arts that are available free or charge online at this time

For individuals at home or in Communities:

  • People miss the calming touch of their pets – order stuffed animals to stroke and touch ( Perfect Petzzz – $38.99)
  • Objects for “twiddling” or “fidgeting”
  • Aroma therapy, again use under supervision.
  • Things that make sounds, are visually stimulating or tactilely stimulating

Here is one of my favorite resources of all time S&S Worldwide www.ssww.com

Here is the link for the Sensory Stimulation section with great Auditory, Sensory Balls, Tactile, and Visual products and ideas.

https://www.ssww.com/senior-activities/sensory-stimulation/

Be creative and share ideas. We are better Together.

Lisa Kaufman, MS, CMC, CTRS, C-EOLD is a certified Aging Life Care Manager™, and most recently, a certified End of Life Doula. She has owned and operated SeniorCare Options since 2001, and she is an active member of the Aging Life Care Association™, and is one of only a handful of certified care managers in Georgia. She is a Past-President of the ALCA™ South Eastern Chapter and is the only Fellow / Certified member of ALCA™ in Georgia.

Tips to Managing Anxiety in Challenging Times

By:  Linda Fodrini-Johnson, MA, MFT, CMC, Walnut Creek, CA

 

The current worldwide pandemic is causing sleepless nights, hand wringing and some strange behaviors having to do with fear that can sometimes bring out the worst in us.  However, we are also seeing some incredible acts of kindness and selflessness in neighbors helping neighbors.  As, well as creativity in professionals delivering care to older adults.

The anxiety that many of us are experiencing related to the current Covid-19 epidemic is not the same as an “anxiety disorder” which is more of a long-standing mental health condition that is treated with a combination of medication and behavioral therapy.   What we have been experiencing is more a “situational anxiety” brought on by something we can’t very well control outside changing our behaviors for a period of time.

Here are four tips and a few resources to help you or your family member manage anxiety:

1. Focus on the positives in your life and in the world. Start your morning with a gratitude prayer or list of what you are thankful for.  Read the comic strips before you read any news and save a positive story to read last.  I receive a spiritual reading daily that is written in “affirmation” style, it gives me a sense of peace to start my day.

You could limit your news watching to every other day or once a week if you find it distressing.

https://www.goodnewsnetwork.org/10-positive-updates-on-the-covid-19-outbreaks-from-around-the-world/

2. Mindfulness exercises are a wonderful way of disconnecting from all emotions by being connected with your inner being and at the same time  disconnecting from all the negativity and to-do’s of our daily lives.  This does not happen with one try; it is something that you need to do daily and increase the time of the exercise as you become more comfortable.  Just learning to focus on your breathing can be a great first start – helps with sleeping too!

Other resources:

https://www.pocketmindfulness.com/6-mindfulness-exercises-you-can-try-today/

https://www.drweil.com/health-wellness/body-mind-spirit/stress-anxiety/breathing-three-exercises/

3. Distraction or avoidance is a great mind diversion when you are ruminating on your fears or unfounded beliefs. Have a list of projects you would like to complete and tackle one of them every time you get yourself in a worry-knot.   Put together a play list of joyful, happy music that makes you smile.

https://www.goodnewsnetwork.org/tips-for-making-your-time-at-home-pandemic-positive/

4. Exercise if you start to worry or become anxious. Take a walk or, do an exercise CD, yoga is a great exercise that is both a mindfulness practice and moves your body in order to be more flexible. If you can’t go to a class, order a beginner’s CD on the internet. If getting on the floor is a challenge look for chair yoga.  I think you will be seeing more on-line offerings as well because this current crisis is bringing out creativity.

Diet is extremely important to mental health.  Remember to eat well, look for immune boosting foods to add to your diet like citrus, blueberries, almonds, mushrooms, green tea, and red bell peppers for a start.

If you need to process your worries, reach out to a friend or professional.  Sometimes it is just good to talk through our anxieties. If you find yourself or your older family members unable to follow the four tips in this newsletter and feel your or your relatives feelings are interfering with daily life, (such as having trouble concentrating or increased use of alcohol, or that chronic health problems getting worse), seek help.

Finding a local professional Aging Life Care Professional could ease your worry about aging parents at a distance; they can arrange for all the local supports systems your family member might need during this time of “shelter in place”.   They can provide reassurance and comfort especially when family is at a distance.

A good handout to share with friends is:  https://emergency.cdc.gov/coping/pdf/Coping_with_Disaster.pdf

For more information or to access a nationwide directory of Aging Life Care Professionals, please visit www.aginglifecare.org.

About the Author: Linda Fodrini-Johnson, MA, MFT, CMC

Head of Corporate Care Management for Home Care Assistance

Linda is a Licensed Family Therapist and a certified Professional Care Manager.  She is also a past President of the Aging Life Care Association.  In 1989, Linda founded Eldercare Services in the San Francisco Bay Area and became a pioneer in geriatric care management.  Linda has always been a passionate educator to families and professionals in the “aging space”.

Eldercare was sold to Home Care Assistance last year and Linda now serves as the Head of Corporate Care Management.  She is also a consultant with Dr. Leslie Kernisan’s, Better Health While Aging/Helping Older Parents – an on line coaching team.

Love In the Time of COVID-19

by Lisa Kaufman

I received a call this morning. A man who has never spoken with me before wanted my opinion about the care needs of his 80-year-old mother. He explained that she has moderate to severe (read severe) dementia, visual impairment, is hard of hearing and is in renal failure requiring dialysis.

He went on to tell me she lives in a little Assisted Living and he doesn’t really think they provide the best care. Because of the Corona Virus (COVID-19), she is quarantined in her studio room. They bring her meals on a covered Styrofoam tray, which she doesn’t eat because she doesn’t know what to do with that. He tells me she has been “belligerent” recently and refusing her meds.

His question to me was: what am I to do for her when I cannot even get into the building? Followed closely with: How can I be there for her? Should I move her? Should I consider Hospice?

Well, dear colleagues, this is the tip on the iceberg… We see the most impaired, frail or dysfunctional of people, and their situations are going to be unique, and heartbreaking.

He and I talked through some options and some realties of the options presented to him. If he chooses Hospice, his mother will no longer get dialysis, and she will die. If he moves her, the caregiver shortage and a new team will compound her current isolation.

First things first, get her checked out for a UTI, I say. Secondly, she could be so under-stimulated by both her cognitive impairment and her lack of sensory input that she could be hallucinating or acting out.

But can she thrive in this kind of environment? he asked. “No,” I told him, “she will not thrive. People with severe cognitive impairment make profound non-verbal decisions at end of life. The choice not to eat may be one of the last decisions she can make.  Listen to her, be observant, and she will find a way to tell you what she wants to do.”

This is incredibly hard and the current crisis is making families make the most difficult decisions they may ever have to make. “Know that you are doing the best you can with the information you have, and you are doing it out of love and compassion for your mother. No matter what you choose, it will be the right decision,” I said.

The man thanked me for listening so openly and offering him solace.

Here is my take-away. We, as Aging Life Care Managers, will have even more challenging ethical dilemmas, and we will brave them as we do best. And our hearts will break and we will cry and we will survive. We must be even more compassionate and strong than ever before. We are needed. We make a difference. We are here, now.

Love and blessings,

-Lisa

Lisa Kaufman, MS, CMC, CTRS, C-EOLD is a certified Aging Life Care Manager™, and most recently, a certified End of Life Doula. She has owned and operated SeniorCare Options since 2001, and she is an active member of the Aging Life Care Association™, and is one of only a handful of certified care managers in Georgia. She is a Past-President of the ALCA™ South Eastern Chapter and is the only Fellow / Certified member of ALCA™ in Georgia.

Social Distancing-Social Engagement in the Age of Covid-19: What We Can Do

by Miriam Zucker

I live in New Rochelle, New York, a city whose fame is rooted with the Petrie’s of The Dick Van Dyke show. That image of a suburban family living on a quiet tree-lined street changed dramatically on March 10.  New Rochelle became the first COVID-19 containment area in the United States.

On that date, I was visiting a client. Twenty minutes into my visit, the governor made his announcement. Although I felt fine, after checking with the caregivers to make sure food and medications were in good supply, I left. Not yet knowing what a containment area meant, I shamefully headed to the supermarket, one thirty minutes away from the city where I have lived and shopped for forty years.

For people over 60, of which I am one, the instructions, even before this declaration, was to stay home. I had not taken the directive seriously. But the time had come. So instead of home visits, the telephone has become my link to clients. My weekly tutoring sessions at a local elementary school stopped. The library where I volunteer closed. My world had narrowed. Like the icon I tap when I take that occasional selfie, I now had to reverse my focus, making sure that my social engagement trumped my social distancing.

So, what have I learned that we can all practice and share with adult seniors?

First, is the heightened importance of staying in touch. Communication whether it be by phone, emails or the use of video conferencing is paramount. But sadly, the oldest of the old are the least technologically savvy. This is where letters, especially with a photo enclosed, and cards and drawings from grandchildren will go a long way. Also, contacting a senior’s house of worship can result in congregants phoning members to fill the void created by COVID-19. Local aging in place organizations have volunteers who are also calling community members.

Beyond communication, the significance of a daily routine is important. For older adults who were going to senior centers or adult day programs, their regular schedule has been disrupted. Taking a walk has both mental and physical benefits. Combining this with in-home activities such as watching The National Park Virtual Tours or The Georgia Aquarium Live Cams can lessen the isolation and provide mental stimulation.

Is there a “What not to do?” Definitely.  Cutting back on watching or checking the news continually should be avoided. Dr. Laurie Archbald-Panno, a geriatrician at the University of Virginia, suggests a “news diet.” One news viewing in the morning and one in the evening. That’s it.

The Aging Life Care Association (ALCA) has been creating forums where members can share tips on technology and other creative ways to help clients to minimize the social isolation that can come from social distancing. Aging Life Care Managers are a wealth of resources, and members can log-in to the AgingLifeCare.org website for these. Many resources are also being posted on the ALCA COVID-19 web-page.

Our seniors have seen much in their lifetimes. They have lived thru wars, TB, and Polio epidemics and some, the Great Depression. Our government has assured us that at some point the COVID-19 virus will pass. But who better to give us this reassurance than our true survivors, our seniors. Let’s help them as they help us.

Miriam Zucker LMSW, ACSW, C-ASWCM is an Aging Life Care specialist proudly based in New Rochelle, New York.  She is the founder of Directions in Aging, providing consultation and guidance to older adults and their families throughout Westchester County.

Caring for Someone with Coronavirus (COVID-19)

By: Tasha Beauchamp

What we know as of 3/1/20

COVID-19 is spread much like the regular flu—through coughs and sneezes that put droplets in the air and on surfaces. It may be 2–14 days after exposure before a person has symptoms. That means people can spread the virus without knowing it. And many have symptoms that seem much like a cold, so they don’t think to alter their behavior.

The good news is that 81% of those who get COVID-19 seem to have a fairly mild case—between a cold and the seasonal flu.

But 14% of those infected have a severe case, involving pneumonia and low blood oxygen levels. About 5% have a critical case involving respiratory failure, septic shock, or multiple organ failures.

So far it appears that only 2%–4% of those who get COVID-19 actually die. Scary as that sounds, bear in mind that means 96%–98% recover fully. Just like the seasonal flu, frail older adults and persons with respiratory problems, such as COPD, are hit the hardest.

Planning 

As a family caregiver, plan ahead just in case:

  • Prepare to work at home. Talk to your employer about contingency plans. You may need to stay home to care for someone who is sick, or for children if schools are closed.
  • Designate a separate room and bathroom for persons in the household who become sick.
  • Make a list of emergency contact people (doctors, pharmacist, friends, family, local hospital). Also bookmark the online Centers for Disease Control and Prevention (CDC) coronavirus page (cdc.gov/coronavirus/2019-ncov/). And find your regional public health department website (naccho.org/membership/lhd-directory) for local updates.
  • If the person you care for does not live with you, plan how he or she will get medicine, food, and supplies during an illness or potential lockdown. Also, who might monitor their condition and call the doctor, or 911, should illness occur.

The signs of COVID-19

  • Fever • Cough  •  Shortness of breath

Call the doctor before you go

The doctor’s office will guide you concerning the need for an office visit. Ask about suggestions for relieving symptoms and guidelines for calling 911.

Do not leave home except for medical care. The entire household is now contagious.

Care at home

  • Follow viral prevention strategies. (See next article.)
  • Employ the doctor’s recommendations to improve breathing, reduce fevers, and ease discomfort.
  • Monitor your loved one’s symptoms. If you need to call 911, tell them your concerns about COVID-19.
  • Isolate the patient from others in the house. He or she should stay in a separate room, ideally with a separate bathroom.
  • Wear facemasks—both you and the patient—when in the same room. Throw disposable facemasks away. Do not reuse.
  • Use disposable facemasks and gloves when you touch or have contact with the patient’s blood, stool, or body fluids such as saliva, sputum, nasal mucus, vomit, urine. Throw out the disposables after using them. Do not reuse.
  • Avoid sharing household items with the patient, such as dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items. Wash these items thoroughly after use.
  • Clean laundry thoroughly
    • Immediately remove and wash clothes or bedding that have blood, stool, or body fluids on them.
    • Wear disposable gloves while handling soiled items and keep soiled items away from your body.
    • Use normal detergent and set the dryer to the highest appropriate temperature.
  • Place all used tissues, disposable gloves, and facemasks in a lined container. Tie off before placing in the trash.
  • Isolate pets from the patient. At this time, it is not known if domestic animals can contract COVID-19.
  • Turn away visitors who do not have an essential need to be in the home.
  • Monitor your own symptoms. Have a Plan B for who will care for you and the patient if you become sick.

Viral prevention strategies

Because there is no cure for COVID-19, your best protection is to follow these guidelines put out by the Centers for Disease Control and Prevention (CDC).

  • Avoid close contact with people who are sick (stay at least 6 feet away).
  • Avoid touching your eyes, nose, and mouth.
  • Stay home if you feel unwell.
  • Cover your coughs and sneezes with a tissue. Throw tissues away immediately. Do not let them collect on tables or chairs around the house or at work.
  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom, before eating, and after blowing your nose, coughing, or sneezing. Be sure to clean the backs of your hands as well as the palms. Also clean between your fingers and under your nails. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol.
  • Clean and disinfect frequently touched objects and surfaces such as tables, countertops, light switches, doorknobs, cabinet handles, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables).
    • Use a household cleaning spray or wipe. Follow instructions for safe and effective use of the cleaning product, including precautions to take such as wearing gloves and making sure you have good ventilation while using the product.
    • If you do not have cleaning spray, make a solution of household detergent and water.
  • Facemasks
    • Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others.
    • People who are well do not need to wear a facemask unless they are in active contact with someone who is sick.

SOURCES

 

ABOUT Tasha Beauchamp: 

Tasha Beauchamp, MSc is the founder of Elder Pages Online, a health education, online content marketing firm that assists eldercare providers in promoting their brands while offering evidence-based information to family caregivers. As a research scientist, she worked for 18 years on projects funded by the National Institute on Aging, coordinating large, multi-million dollar multimedia interventions for families. She has her graduate certificate in Geriatric Care Management and is an active participant on the ALCA list serve. She works with 90 elder care providers across the country and was chosen as ALCA’s Outstanding Corporate Partner in 2013.

Aging Life Care Professionals: Caring For Yourself As We Care For Others

  • By Kate Granigan

In this trying time with the Coronavirus (COVID 19) upon us, the one thing that seems certain is uncertainty.

Creative and out-of-the-box thinking, flexibility and need to think on your feet is critical with the rapidly changing tides. Who better than Aging Life Care Professionals® to meet this challenge?

As a midsize practice in Newton, Massachusetts, we, like you, have been vigorously reviewing the protocols of the CDC, the protocols and requests of the communities and facilities that we work in every day, and inserting our own thoughts and ideas around creatively meeting the needs of our clients, protecting our staff and responding to rapidly changing circumstances.

I am hoping by sharing information, that we as a community of professionals can support one another and together overcome what is a challenging time in history.

First, breathe. Lower your shoulders and unclench your jaw. Take time to focus on relaxing your body and releasing stress. Without this practice you will be less likely to think creatively and innovatively which is of the upmost importance at this time.  Studies show that when we are in stress mode or “fight or flight” our focus is narrow and aimed towards survival rather than innovation and creativity.

Next, we are better together. Reach out to colleagues, corporate partners, and professionals in your area and work together to support one another and your practices in different and creative ways than you may otherwise do in normal circumstances.

Lastly remember, this too shall pass. We are resilient and have all struggled and come through difficult times, and in normal circumstances we, as Aging Life Care Professionals, are tasked with meeting what may seem like insurmountable challenges daily.

Here are some suggested strategies that you may employ for your practices and your clients:

  • Proactively write a letter to all clients, families and responsible parties ensuring them that you, and your staff if applicable, are taking this very seriously, following the CDC guidelines and also the protocols and restrictions of the communities, hospitals and other locations that you frequent. (see links below)
  • Communicate all protocols and precautions to staff and any other professionals that may come into contact with you and your clients.
  • Review your client’s individual circumstances and implement the suggested “on-hand” supplies and necessities. (http://blog.aginglifecare.org/blog/corona-virus-how-aging-life-care-managers-can-help-families-prepare-for-emergencies/)
  • Consider canceling any non-essential appointments for clients, including the appropriate decision-makers if applicable, and/or explore alternative ways to meet the same needs (i.e.: videoconference options with doctors and medical providers).
  • Reduce exposure for clients that typically go into the community by arranging home-delivered food, medical supplies, or other needs.
  • Explore options for “face-time” or video call with families or other groups to keep client engaged while reducing exposure.
  • Ensure that any provider of home care services is themselves following CDC guidelines.

Aging Life Care Professionals are dedicated, smart, and responsive and can support clients as they need during illness outbreaks. The coronavirus epidemic is concerning but having an Aging Life Care Professional at your side can be another preventative measure to keep stay calm in the face of uncertainty.

Helpful Links:

Kate Granigan is CEO of Life Care Advocates, a life care management practice in Newton, Ma.  Kate began her career with the Visiting Nurse Association as a medical social worker and went on to found her own care management practice, CARE, in 1999. For the next 10 years, Kate grew her practice until, in 2009, it was acquired by Masonic Health Systems, a nonprofit organization, where Kate acted as the Vice President of Care Management until joining LifeCare Advocates as CEO in 2016.

The Power of Planning: Taking Charge of Your Own Aging Journey

by: Lisa Mayfield

At 72, Betsy is doing all the right things to ensure she enjoys good physical, emotional, mental, and financial health.  She eats a Mediterranean diet, doesn’t smoke, drinks in moderation, exercises regularly, has adjusted her spending and investments for retirement, goes for regular check-ups with her doctor, and gets the recommended health screenings. She gardens, spends quality time with family and friends, takes classes, travels, and volunteers. Her life is busy, full, and fun.

However, Betsy lives by herself in a large, two-story home with a generous yard she maintains herself in a remote part of western Washington. Her home is a 20-minute drive from the closest family member. For all her planning and thoughtful preparation, Betsy didn’t anticipate how a chronic back issue could flare up. Yet it did, resulting in a panicked call to her daughter (then 911), followed by an ambulance ride to the ER and a three-day hospital stay.

On her homecoming, Betsy’s new normal was obvious from the moment she left the car and slowly, cautiously navigated the walkway and stairs to her front door. She began taking note of changes she would need to make as she healed and to support her moving forward.

This scenario is far too common. Fortunately for Betsy, she fully recovered and has adjusted activities to keep the back pain at bay. She’s also making practical changes she’s sorry she hadn’t made earlier.

What are some of those areas we often overlook that are essential to successful planning and preparing for longevity? Here’s a list to review:

Legal documents

Make this the first step. If we don’t have basic legal documents in order, it can easily and unnecessarily complicate everything else. According to the National Academy of Elder Law Attorneys, estate planning documents should include durable powers of attorney for health care and finances; advance health care directive to physicians (living will); a will; and anatomical gifts/burial instructions.

Incapacitation for any reason puts the burden of decision making on people who may not be prepared for the responsibility. These binding legal documents are like a love letter: They spell out our wishes and can relieve a loved one’s concern about making the right choices.

Community

Being able to draw on social networks of friends or family is an important contribution to general well-being and quality of life. Living in a community where we feel safe, that is affordable, and where our goals and needs are met is essential.

Finances

Whether the plan is to continue working full time or part time, retire and travel, move closer to family, or stay put, we need to understand the financial landscape and how our money will support us in the years ahead. We also need to get a sense of how our finances might be impacted if our health changes.

Health

We all have concerns about our health as we age. Perhaps our memory isn’t as sharp as it once was. A family history of high cholesterol or cancer can cause worry. What can we do or change now to ensure a healthy future? How do we stay positive as we grow older?

Home

Take a discerning look around. Betsy now wishes she’d moved sooner to a community closer to her adult children with everything on one level, including a barrier-free entry to her home. She has made this move and feels better prepared if she has another emergency. If you have a steep incline or stairs that are more difficult to navigate with each passing year, it may be time to move.

Home adaptions are one possibility and can be cost-effective. They include improved lighting, grab bars in bathrooms, a low- or no-barrier shower entry, and removing rugs to reduce the likelihood of a fall. A certified aging-in-place specialist can help you navigate these home modifications.

Transportation

Betsy was homebound for a time—and if she later found herself unable to drive, she had very limited options for transportation where she used to live. Having access to public transportation, ride share services, or living in a walkable, accessible community can make a huge difference in your mobility, as well as your ability to access entertainment, social and community engagement, shopping, and health care.

Planning is empowering. We should all give these key areas serious consideration and reflection. If we find there is a gap, engaging the advice of an elder law attorney, financial adviser, and aging life care professional can be a smart investment in preparing for our longevity.

Don’t leave your future to chance. Don’t leave it to family or friends to figure out. Start to prepare now. Planning can safeguard our happiness, our health, and our peace of mind. Are we ready?

Lisa Mayfield MA, LMHC, GMHS, CMC, Fellow Certified Care Manager is founder and principal of Aging Wisdom, an Aging Life Care consulting, care management, and creative engagement practice that strives to bring peace of mind by both directly improving the quality of life for older adults and by providing consultation and coaching services for their families. She currently serves as Past President of the Aging Life Care Association (ALCA).


Resources

Books

  • Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life by Louise Aronson
  • Enlightened Aging: Building Resilience for a Long, Active Life by Dr. Eric B. Larson and Joan DeClaire
  • Who Will Take Care of Me When I’m Old? by Joy Loverde
  • Women Rowing North: Navigating Life’s Currents and Flourishing as We Age by Mary Pipher
Aging Life Care Manager can help in emergency situations

Corona Virus: How Aging Life Care Managers® Can Help Families Prepare for Emergencies

  • By Anne Sansevero

As Aging Life Care Managers® one of our important roles is helping clients and their families look ahead to assist them with emergency preparedness. We do this with advanced directive planning and health education by ensuring their vaccinations are up to date. However, there are times when certain situations pose new and unprecedented challenges and require extraordinary measures. Hurricane Sandy comes to mind. I vividly remember when we were delivering hot meals and medications to clients who were sheltering in place in buildings that lost power and coordinating to ensure continuity of their home care services in a challenging situation. We got through it and it made us stronger and more knowledgeable and our clients were deeply appreciative.

The COVID-19 (corona) virus now presents us with a new public health challenge and we need to be informed and prepared to assist our clients in their emergency preparedness in a compassionate, competent, and controlled manner. We also need to keep the communication channels wide open.

Scientists are still gathering data and updating their recommendations on a daily basis. Both the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have the most up to date information available on this novel virus.

The current recommendations from the Centers Of Disease Control (CDC) is to practice every day preventative measures. Individuals and families should follow the everyday preventive measures listed below – this means we need to educate our clients, families and their caregivers on the following them and most importantly follow them ourselves!

  • Voluntary Home Isolation if sick with viral symptoms: Stay home when you are sick with viral or respiratory disease symptoms. At the present time, these symptoms are more likely due to influenza or other respiratory viruses than to COVID-19-related virus. Stay in touch with your primary care provider on what testing may be needed. Do not engage with others in a work or social setting until you are symptom and fever free for 48 hours and have been medically cleared
  • Respiratory Etiquette: Cover coughs and sneezes with a tissue, then throw it in the trash can.
  • Hand Hygiene: Wash hands often with soap and water for at least 20 seconds; especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
  • Avoid Touching your eyes, nose, mouth and ears
  • If soap and water are not readily available, use an alcohol-based hand sanitizer with 60%-95% alcohol.
  • Environmental Health Action: Routinely clean frequently touched surfaces and objects with disinfected wipes especially mobile phones and computers

I would add that as Aging Life Care Professionals® we should look ahead to ensuring that our clients have at least a month’s supply of medications in the home and that there is a supply of fever-reducing over the counter medications, gloves, and disinfecting wipes in the home

Routine use of these measures by everyone will increase community resilience and readiness for responding to an outbreak. As of 2/26/20, the CDC is also recommending to be prepared for potential community outbreaks or hot spots in the US within the next few weeks. Here are their recommendations if a community hotspot is identified–

  • Personal Protective Measures. During an outbreak in your community, CDC recommends the everyday preventive measures listed above—especially staying home when sick—and taking these additional measures:
    • Keeping away from others who are sick.
    • Limiting face-to-face contact with others as much as possible
    • Consulting with your healthcare provider if you or your household members are at high risk for COVID-19 complications
    • Wearing a facemask if advised to do so by your healthcare provider or by a public health official
    • Staying home when a household member is sick with respiratory disease symptoms, if instructed to do so by public health officials or a health care provider (Voluntary Home Quarantine)
  • Community Measures. If COVID-19 disease is occurring in your community, state and local public health authorities may decide to implement:
    • Temporary closures or dismissals of childcare facilities and schools
    • Other social distancing measures that increase the physical space between people, including:
      • Workplace social distancing measures, such as replacing in-person meetings with teleworking
      • Modifying, postponing, or canceling mass gatherings.

According to the CDC, decisions about the implementation of community measures will be made by local and state officials, in consultation with federal officials as appropriate, and based on the scope of the outbreak and the severity of illness. Implementation will require extensive community engagement and ongoing and transparent public health communications.

ALCA’s Aging Life Care Professionals are dedicated, smart, and responsive and can support clients as they need before and during illness outbreaks. This Covid-19 outbreak can be concerning, but knowledge is power and implementing best practices helps create the best outcomes for all.

Anne C. Sansevero, RN, MA, GNP, CCM – Anne Sansevero is the founder and CEO of HealthSense LLC, an Aging Life Care™ management consulting practice. She is a master’s prepared geriatric nurse practitioner, and a seasoned nursing professional with over 30 years of experience in the field. Anne has a sub-specialty in neurological disorders and is well versed in all aspects of geriatric nursing. She has particular expertise with communication disorders relating to stroke and dementia and has developed a number of innovative nursing assessment tools and standards to improve the nursing care for frail elders. Anne is a member of the Aging Life Care Association® (ALCA) and Fellow of the Aging Life Care Leadership Academy. She is currently serving on the board of the ALCA, and is Vice President of the New York Chapter. In addition, Anne is a member of the American Academy of Nurse Practitioners and the Nurse Practitioners of New York. Anne is a registered nurse, certified case manager, and a master’s prepared geriatric nurse practitioner.