Creating Smooth Discharge Planning Transitions

December 5, 2016Aging Parents, Caregivingdischarge planning, hospitalizations, Medicare Callie Daters

For many patients, being in the hospital is like riding a bullet train. Zipping from room to room, procedure to procedure, being jabbed, jostled and poked, and then suddenly being told it’s time to disembark. Taking time now to understand the discharge planning process can help ease stress and ensure you are aware of your patient rights.

So It’s Time to Leave the Hospital, Now What?

by Jullie Gray, MSW, LICSW, CMC – Aging Life Care Association™ Member and Fellow of the Leadership Academy

Ideally, we’d like to think of hospitals as places of rest where we will get better, but these days, hospitals are very busy and often noisy places. It’s easy to feel fatigued, scared and confused by the whole hospitalization process. Feeling overwhelmed starts as soon as your mom or dad walks through the hospital door, there are hundreds of rapid fire questions from the admission clerk, nurse, technicians and doctors. After the initial burst of activity, you and your parent will probably wait many long hours wondering about the results of her tests and what the final diagnosis will ultimately mean for the future.

Sometimes the most frightening part of the whole experience is when your mom is told it’s time to leave the hospital. She may still feel quite weak, unsure of how to manage her new medical problems and may worry about how she will cope back at home all alone. And you might feel a sense of unease about her discharge too; sensing that she isn’t quite herself, that something still might be terribly wrong. You may even worry that she doesn’t have enough or the right kind of help.

Caught off-guard or disagree with the discharge? Medicare beneficiaries have a right to appeal, but you’ll have to act fast. Read “Slowing Down Hospital Discharge Requires Fast Action” from Kaiser Health News to learn more.

Although most people hope to be cured when they leave the hospital, realistically, when your mother is discharged, the difficult journey to recovery may only be starting. That’s because in today’s world, patients are leaving the hospital faster than ever before. Being discharged doesn’t mean your parent is well again, instead discharge indicates the attending physician has determined she is “medically stable” enough to leave the protective and expensive hospital setting. But, because the process of healing is just beginning, older adults usually need more help at the time of discharge than before entering the hospital in the first place.

Role of the Discharge Planner

In the hospital, the person responsible for planning your parent’s discharge is called the “discharge planner”. Discharge planners are employees of the hospital and are generally social workers or nurses. The discharge planner helps each patient move out of the hospital by setting up and coordinating necessary aftercare services before discharge occurs.

Insurance rules, financial pressures and the need to keep beds available for other patients drives the hospital team to plan early for discharge. A well-designed discharge plan helps keep patients from waiting longer than necessary to transition through the healthcare system and ensures that patients are safely cared for during the next leg of their journey.

Derailments can happen

For most hospitals, the focus on discharge is very intense; almost as intense as finding out the reason your parent was admitted there in the first place – but that doesn’t mean things don’t occasionally go wrong when your parent leaves.

Patients and their loved ones often feel unprepared at the time of discharge. Studies show that older adults who are discharged from the hospital are frequently:

unprepared for their role in the next care setting;
confused about how to manage their condition;
unable to contact an appropriate health care practitioners for guidance; and,
left to carry out tasks their health care providers have left undone.

Whether your parent’s admission was planned or was due to an unexpected incident, it is helpful to make sure you are both prepared for the next stage of the journey. At the time of discharge make certain your parent has

the newest prescription(s) in hand, knows what the medication is for, understands the new instructions and has reconciled the discharge medications with the previous list;
schedules a follow-up appointment with the physician, has a way to get to the appointment; and,
is given a list of signs and symptoms that constitute complications to her condition requiring immediate medical attention.

Any of these oversights can lead to serious problems and delayed recovery.

Help is just a phone call away

For families feeling overwhelmed by the discharge planning process, working with an Aging Life Care Manger™ can be a godsend. These highly trained professionals bring years of experience and work only for you (not the hospital or insurance company). They ease transitions by helping your family:

Set priorities
Review options
Make informed decisions
Implement practical solutions
Tie up loose ends

Aging Life Care Managers know the best resources in the community. They can provide individualized recommendations for follow-up services, coordinate those services, and monitor your parent as she recovers to her full potential. As your very own trusted adviser, your care manager works collaboratively with harried discharge planners who frequently have less time than they’d like to provide individualized attention.

Care managers also work closely with your parent’s medical providers to ensure that critical information is passed along through each transition so nothing falls through the cracks.

Advocating for the rights of older adults is a central role of all Aging Life Care Mangers. If problems arise, your care manager will advocate on behalf of your family to make certain that discharge plans makes sense and meet your parent’s specific needs.

It can be a huge relief to have an expert in your corner looking out for your family’s interest. To find your own Aging Life Care Manager go to www.aginglifecare.org and search for a practitioner in your area.

About the author: Jullie Gray is a Fellow of the Leadership Academy, and has over 30 years of experience in healthcare and aging. She is a Principal at Aging Wisdom in Seattle, WA. Jullie is the President of the National Academy of Certified Care Managers and the Past President of the Aging Life Care™ Association. Follow her on LinkedIn and Twitter @agingwisdom, or email her at jgray@agingwisdom.com. Aging Wisdom has a presence on Facebook – we invite you to like our page.

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Five Tips to Help Family Caregivers Balance Responsibilities

November 29, 2016Caregiving, Family MembersFamily Caregivers Month Callie Daters

November marks National Family Caregivers Month – a time to recognize the countless individuals like you who make the everyday commitment to care for a loved one. Today, an estimated 39.8 million Americans serve as caregivers for one or more of their family members.¹ Of that number, many of these individuals care for an aging adult. As a family caregiver, you are the backbone of our nation’s care system, and your dedication does not go unnoticed.

By Claudia Fine, MPH, MSW, CMC – Aging Life Care Association™ Member and Member of the Leadership Academy

When carrying out day-to-day caregiving tasks, it may be challenging for you to balance managing someone else’s life and managing your own at the same time. Here are some tips to help ease family caregiving responsibilities:

1. Set aside time to relax and participate in personal hobbies

When trying to balance work, family, caring for an aging loved one, and numerous other responsibilities, you may begin to feel as if you don’t have time to unwind. It is important that you take a bit of time out of each week to do something specifically for you. Whether it is gardening or yoga, make it a point to participate in a personal hobby. You may even find an activity that both you and your senior family member are able to enjoy together.

2. Identify a potential alternate caregiver

While you may serve as the primary caregiver to your family member, it is important that you have identified another individual who can take on the responsibility in the event that you are away. It is important that this is a person who is comfortable around your senior loved one, and vice versa. Knowing that you have this additional caregiver can help put your mind at ease if an emergency situation arises.

3. Learn more about your employer’s caregiving policies

Sometimes, the time that it takes to manage the care for a family member can conflict with your career. Fortunately, many companies are starting to understand the importance of the family caregiver role and recognize the fact that certain adjustments are necessary for family caregivers. Companies such as Deloitte have started to offer paid leave options for caregiving.

If balancing work and caregiving is becoming overwhelming, you may benefit from speaking to your manager about your company’s caregiving paid leave options.

4. Pay attention to your personal health

When you have the responsibility of caring for someone else’s health, it can be easy to stop paying attention to your own. As a caregiver, it is important that you are listening to your body and taking the proper measures to ensure that you are as healthy as possible. Be sure that you are getting routine medical examinations, exercising, and being mindful of your diet.

5. Consider seeking additional assistance

Caring for an aging adult can be demanding. If you feel as though you need additional support, it is a good idea to seek help. One great option is hiring an Aging Life Care Manager™. An Aging Life Care Manager can help you to create a holistic care plan for your family member that will ultimately help ease your stress. Some organizations that offer care management services can also provide referrals to accredited homecare and private duty nursing. Some care management organizations can even support you seamlessly when your loved one travels seasonally or permanently. Be sure to ask about the scope of services provided and coverage when your care manager is unavailable.

¹http://www.aarp.org/content/dam/aarp/ppi/2015/caregiving-in-the-united-states-2015-report-revised.pdf

About the Author: Claudia Fine, LCSW, MPH, CMC, CCM drives the care management model of care at SeniorBridge, a national organization that provides care management, homecare, and private duty nursing as the Chief of Professional Services. Ms. Fine has served in industry and community leadership roles throughout her 30-year career in elder care. Among them, she served as a president of the Aging Life Care Association (formerly known as the National Association of Professional Geriatric Care Managers).

How Do I Know If Grandpa Needs Help? What to Look for During Holiday Visits

November 21, 2016Aging Parents, Caregiving, Family MembersHoliday visits, warning signs Callie Daters

Holidays are occasions that many of us spend with family, whether we live down the block or across the country. For those with aging parents or loved ones, these visits are an important time to take stock amidst the hustle and bustle, and to make plans.

Make the Most of Holiday Visits: What to Look for When Visiting Aging Adults

By Heather Imhoff, MSW, LMSW – Aging Life Care Association™ Member

Notable changes in an aging person’s appearance, behavior, or environment can be warning signs that his or her health, mentation, and function are changing. Make the most of your holiday visits and note any changes from your last visit. If you notice changes, dig in while you are there to further assess the situation and determine if intervention or help is needed.

Start by Making Observations

Person-centered:

Has your loved one’s hygiene changed?
Is he or she wearing clothing that is dirty, falling apart or inappropriate for the weather?
Has there been a significant weight change?
Has his or her gait changed? Are they “couch surfing” or using furniture items for support while walking through the home?
Any bruises or cuts that you can see?
Are they using mobility or other adaptive equipment properly?

Behavior:

Has mom or dad stopped going out for social engagements? Discontinued activities that were important to them?
Do they have any new friends or organizations who they have a lot of contact with? Is anyone or any organization asking for repeated or large donations or loans?
Do they seem forgetful or more repetitious in conversation?
Does he or she seem more withdrawn or sad?

Environment:

Looking at their home environment, are there areas of disrepair? Obstructed walkways? Burned out light bulbs?
Any changes in cleanliness of the home, especially in the kitchen and bathroom? Are there items piling up on counters, table tops, or spare rooms? Unopened mail?
Check the fridge to see if there are expired or spoiled food items.
Does their car have scratches or other areas of damage?

Important Conversations

If any of these questions lead to concerning answers, it is vital to start a conversation with your loved one about your observations. Try to remain open and curious, not making assumptions or judgement since issues great and small can lead to similar presentations.

Here’s an example:

Dad is wearing light summer clothing even though it seems too cold. This may be because his cognition is declining and he is not oriented to what month or season it is. Alternately, you may learn that most of his warmer sweaters have buttons and his advancing arthritis makes it difficult for him to manage these closures. Perhaps his winter clothing is stored in the attic or a high shelf that is difficult to access because of strength or balance issues. Or he may relay that he’s been very busy with his men’s group and just hasn’t gotten around to switching out his wardrobe.

It is important to understand whether your loved one is aware of the issues you’ve noticed, and if he or she sees it as a problem or not. What are her thoughts, has she attempted to address the situation? What are the barriers that he or she has encountered to resolving the problem.

It can be difficult for someone with a lifetime of independence to admit that they need assistance. Many of these red flag issues are highly personal in nature, so depending on the circumstances and the personality of the older person, these topics may need to be approached gently and with compassion.

Preferences and Health Care Wishes

Also consider talking about what is important to your loved one. What gives them a good quality of life? And a vitally important question: What are their health care wishes? People fall all over the spectrum when it comes to thinking about, talking about, and making legal documents specifying their health care wishes. Wherever your loved one falls on this spectrum, it is important to check-in regularly or in some cases, for the first time about their thoughts and preferences about medical care, where they want to live, and what they want their lives to look like.

If dad has already prepared legal documents designating health care decision-making agents and even some advance directives about treatment options, does he still feel the same? Do the appropriate people and organizations have copies of these documents? If this conversation has never been broached, test the waters. See if this is a topic your loved one avoids or welcomes.

The observations made and conversations that take place during holiday visits are most often starting points rather than final conclusions. Most of these topics are on-going and evolving as your loved one continues to age. There are resources available in all states to help navigate elder support services and having as clear a picture as possible about what your loved one is struggling with will help target these resources.

A good starting point is your community Area Agency on Aging offices or connect with an Aging Life Care Professional™ in the area who can offer assistance. Most importantly, enjoy your time together celebrating and giving thanks!

About the author: Heather Imhoff has eight years of experience as an Aging Life Care Professional in both publicly and privately funded sectors. She is currently a care manager at EGIS Care & Support in Santa Fe, New Mexico. Follow Heather on Twitter at @egis_care or email her at heather.egisnm@aol.com.

Understanding the Stages of Dementia

November 17, 2016Alzheimer's, DementiaAging Life Care Professional, Alzheimers, caregiving, dementia Callie Daters

Understanding the Stages of Dementia Can Help You Provide Better Care

by Heather Imhoff, MSW, LMSW, Aging Life Care Association™ Member

Dementia is a progressive and often times, heart-breaking disease. Though every individual is different, there are three primary stages of dementia, each with its own unique set of symptoms. Different care strategies for each stage allow for a reduction in frustration and needless suffering for the caregiver as well as for the individual with dementia.

Mild Cognitive Impairment (MCI)

In the early or mild stages of dementia, cognitive deficits start to become apparent to close family and friends. The person generally has more difficulty with remembering names, finding words, and concentrating. He/She may get lost while in unfamiliar settings, or have increasing difficulty performing demanding work. Social interaction generally decreases. The person may start withdrawing from situations that have become challenging. Denial of the problem by the individual with MCI is not uncommon.

In this stage, it is helpful to assist the person in creating systems to help compensate for memory impairment. This might include utilizing calendars or planners, or offering to accompany the person to appointments.

dementia, Alzheimer's, memory loss — According to the Alzheimer’s Association, Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Memory loss is an example. Alzheimer’s is the most common type of dementia.

Moderate Dementia

As dementia progresses to the moderate stage, the individual generally exhibits more noticeable deficits in short term memory and loss of memory for significant details such as his/her own phone number or address. He or she may have difficulty recalling details such as the name of the company he/she worked for, where he/she went to school, and the names of some family members.

Repetitious questions and/or development of anxiety are common. Complex tasks including using appliances, computers, or phones can become increasingly difficult, and highly stimulating situations (lunch in a busy deli, sporting events, etc.) can be overwhelming. People with moderate dementia are typically still able to manage personal care tasks including bathing, using the bathroom, and dressing, though they may need limited assistance, such as choosing clothing that is weather-appropriate.

Routines should be modified to help the individual cope with his/her changing cognitive abilities. Consider small gatherings of people in quiet, familiar settings, or investigating adult day centers to meet the person’s social needs. The individual might also need regular support from others for cueing and direction to complete tasks successfully. Consider safety measures including disconnecting stoves, offering alternative transportation options, and supervision if the person is prone to wandering.

Severe Dementia

By the late stages of dementia, the person usually needs reminders or hands-on assistance with most areas of daily living. He or she is largely unaware of events happening around him/her and may forget the faces of close family members (spouse, children). Verbal abilities generally change and diminish. Challenging behaviors, especially with unfamiliar tasks or in unfamiliar settings, are common.

An individual with severe dementia will need support at all times. If living at home, family members or paid caregivers can offer this support. Alternatively, there are memory-specific residential care facilities that can provide the specialized care the person needs. A predictable routine is vitally important as the person’s abilities to cope with new situations are limited. Further, efforts to reorient the person are usually ineffective and can cause more anxiety and confusion. Using music, photographs, movies, etc. from the distant past can be comforting to the person and help caregivers to connect.

Strategies for Caregiving During any Stage of Dementia

Caring for someone with dementia at any stage can be challenging and emotionally taxing. Having patience and compassion for the person and yourself as a caregiver will help alleviate distress and maximize your ability to cope with changes as the dementia progresses.

If you suspect you or a loved one may have dementia, consult with a professional right away. Early intervention and diagnosis allows for the person to receive the maximum benefit to possible treatments, as well as to plan for future care. An Aging Life Care Professional™ can help you build the right team of medical, financial, legal and care providers to manage the journey. Find an Aging Life Care™ Expert neareast you at aginglifecare.org.

Hospice and Palliative Care – Is there a Difference?

November 15, 2016Uncategorizedhospice care, palliative care Callie Daters

Know Your Options! is the theme of this year’s National Hospice and Palliative Care Month. Understanding the difference between hospice and palliative care is an important step in knowing your options when faced with a serious illness. The National Hospice and Palliative Care Organization offer an online, interactive decision tool to help guide you or a loved one in making healthcare choices.

Understanding the Difference Between Hospice and Palliative Care

by Melissa L. Johnson, RN, BSN, MHA, CHPN, CCM – Aging Life Care Association™ Member

Palliative care and hospice care are both specialized healthcare models that focus on palliation or relief of symptoms associated with serious, debilitating illnesses. Such symptoms may include pain, difficulty breathing, nausea or the need for additional emotional support. Palliative care and hospice care focus on improving one’s quality of life. Palliative care is a component of hospice care while hospice care may not be a component of palliative care. In other words, hospice care comprises of palliative care to treat symptoms while palliative care stands alone as a care model. Hospice and Palliative care were once thought of as a service for just the elderly and while the majority of hospice patients are older, about 20% are under the age of 65 (American Hospice Foundation).

Palliative Care

Palliative care, while focusing on symptom management, also allows for aggressive treatment. For example, an individual with cancer may choose palliative care for relief of pain and nausea, as well as undergo chemotherapy and radiation. With palliative care, an individual has access to needed resources throughout the process and can make informed decisions about their care. The synergetic relationship between symptom management and aggressive treatment often yields better results than aggressive treatment alone. If aggressive treatment is no longer feasible or desired, the transition to hospice care may be practical.

Hospice Care

Hospice is a model of care that focuses on the end of life where aggressive treatments are no longer indicated or desired. Hospice care focuses on palliation of symptoms to allow terminally ill individuals to live the rest of their lives to the fullest extent possible. Hospice goes beyond a medical model where all aspects of the end of life experience are considered: physical, emotional, psychosocial and spiritual. A team of specially trained professionals collaborate with the patient and the family to address end of life issues and goals for care.

Does Hospice Speed Up The Dying Process?

While it is believed by some that hospice is “giving up,” research indicates that individuals receiving hospice care may live longer than those who do not receive hospice care. A study published by the Journal of Pain and Symptom Management (March 2007) found that Medicare beneficiaries with either congestive heart failure or certain types of cancer lived, on average, 29 days longer than those who did not receive hospice services (NHPCO, 2010). Another common misconception about hospice care is terminally ill individuals are given medications, such as morphine, that contribute to a hastened death. While medications like morphine are initiated, the dosage prescribed is at the lowest quantity needed to provide comfort. “Start low and go slow” is the motto hospices operate by when prescribing medications.

The Death Experience

Death can be a beautiful and peaceful experience. I have many special memories of my time as a hospice nurse, but there is one that stands out. I was called out to a patient’s house on Christmas night. It was pitch dark and I was in the middle of nowhere. I knew I was approaching the home because there were many people standing outside. I walked into this small home with about 50 people inside; barely able to get in the house to the patient. I saw an elderly gentleman who was nearing the end. I talked to his wife about what had occurred that led to the call. As she explained the decline, I could hear family members arguing in the background. Some family members thought the patient needed to go to the hospital while others stated there is nothing more that can be done and it is his wish to be comfortable.

I did my assessment and told the family that the patient was probably minutes from death. I am not sure what came over the family, but they all surrounded the patient’s bed and started to sing, “For He’s a Jolly Good Fellow.” The patient’s breathing became shallow and slow. As they sang the last line, “which nobody can deny,” the patient took a long, deep breath, let it out and left this earth.

Immediately after, various wind chimes could be heard. The wife stated, “He always loved wind chimes.” A death that I imaged to be difficult was one of the most beautiful deaths I can recall. The family will forever have that memory of their loved one’s death; one that was peaceful, calm and brought the family together.

Aging Life Care Association™

When facing a serious illness, Aging Life Care Experts prove to be beneficial as they are able to be a part of your journey throughout the process. An Aging Life Care Expert provides assessment and monitoring, advocacy, education, resources, problem-solving, and support while you make difficult decisions. An Aging Life Care Expert is also a resource to the family, while providing support and communication. To find an Aging Life Care Expert in your area,visit aginglifecare.org.

About the author: Melissa Johnson has been an Aging Life Care Expert in Phoenix, Arizona since 2012. Melissa specializes in Dementia care and Hospice and Palliative Care. She invites you to connect with her by visiting her blog or following Melissa on LinkedIn and Facebook.

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Aging Life Care Professionals™…The Experts in Aging Well

November 10, 2016Aging Life Care Professionals, Aging Well, Caregivingcaregiving, Experts in Aging Well Callie Daters

Overwhelmed by the choices and decisions involved with caring for an aging loved one? Hit with an emergency and don’t know where to start? Or do you want to plan for your own senior years and make your own decisions? No matter your individual situation or preferences, Aging Life Care Professionals™ offer a client-centered approach to guide families to actions and decisions that ensure quality of care and optimal life.

What is Aging Life Care?

Aging Life Care™, also known as geriatric care management, is a holistic, client-centered approach to caring for older adults or others facing ongoing health challenges. Working with families, the expertise of Aging Life Care Professionals provides the answers at a time of uncertainty. Their guidance leads families to the actions and decisions that ensure quality care and an optimal life for those they love, thus reducing worry, stress and time off of work for family caregivers through:

Assessment and monitoring
Planning and problem-solving
Education and advocacy
Family caregiver coaching

The Experts in Aging Well

The expertise of Aging Life Care Professionals can be summarized into 8 knowledge areas. Let’s take a closer look:

Health and Disability. From physical problems to mental health and dementia-related problems, Aging Life Care™ Managers interact with the health care system effectively and frequently. Aging Life Care Professionals attend doctor appointments and facilitate communication between doctor, client, and family. These professionals help determine types of services – including home health and hospice – that are right for a client and assist in engaging and monitoring those services.

Financial. Services may include reviewing or overseeing bill paying or consulting with a client’s accountant or Power of Attorney. Aging Life Care Professionals provide information on Federal and state entitlements, connecting families to local programs when appropriate. They also help clients and families with insurance concerns, claims, and applications.

Housing. Aging Life Care Professionals help families and clients evaluate and select appropriate level of housing or residential options.

Families. Aging Life Care Professionals help families adjust, cope and problem-solve around long-distance and in-home caregiving, addressing care concerns, internal conflicts and differences of opinion about long-term care planning.

Local Resources. Aging Life Care Professionals know the local resources in their communities like the back of their hands and know how services are accessed.

Advocacy. Aging Life Care Professionals are strong and effective advocates for clients and their families, promoting the client’s wishes with health care and other providers, ensuring that client’s needs are being adequately addressed.

Legal. Aging Life Care Professionals refer to legal experts, like elder law attorneys, estate planners, and Powers of Attorney. Some Aging Life Care Professionals provide expert opinion for courts in determining level of care and establishing client needs.

Crisis Intervention. Aging Life Care Professionals offer crisis intervention when it is needed, helping clients navigate through emergency departments and hospitalizations, rehabilitation stays, and ensuring that adequate care is available to the client. For families that live at a distance, this can be a much-needed 24/7 emergency contact.

A care plan tailored for each individual’s circumstances is prepared after a comprehensive assessment. The plan may be modified, in consultation with client and family, as circumstances change.

The Aging Life Care Professional assists clients in attaining their maximum functional potential. The individual’s independence is encouraged, while safety and security concerns are also addressed. Aging Life Care Professionals are able to address these broad range of issues in a care plan that is tailored for the individual. Monitoring by the Aging Life Care Professional ensures that as circumstances change, the care plan is modified to fit the needs and resources.

With expertise in these areas, Aging Life Care Professionals become the “coach” and families or clients the “team captain.” Search for an expert near you.

What Aging Parents Want Their Children to Remember

November 2, 2016Aging Life Care Professionals, Aging Parents, Family Membersadult children, caregiving, family Callie Daters

The caregiving role reversal for aging parents and adult children is never easy. As an Aging Life Care™ Specialist, I have watched this transition happen in a variety of scenarios all with a different set of circumstances. But through it all, there is a common message that parents want their adult children to know – don’t forget the person your mother or father was before they needed care.

5 Things You Need to Know About Your Aging Parents

By Miriam Zucker, LMSW, C-ASWCM – Aging Life Care Association™ Member

If your family roles are shifting, take these observations and strategies into consideration:

1. SEE YOUR PARENT IN THEIR PAST ROLE

Your mother or father had a profession…proudly served their country during a war…were little league coaches…won awards for their paintings…led Girl Scout troops…volunteered…played the organ at the church…lived through the Great Depression. They have lost many of these roles, often without their consent. Sometimes this makes them angry and depressed. Guess who gets the brunt?

2. WALK IN YOUR PARENT’S SHOES

Three years ago the wheels they knew were on their car. Now those wheels are on a wheelchair, which they may not even be able to maneuver by themselves.

3. DON’T TALK IN FRONT OF YOUR PARENTS

Do not assume your parents can’t hear or don’t understand what you are saying about them. If you don’t want them to hear something, step into another room. How terrifying would it be for any of us to hear unpleasant news, understand it, and not be able to reply?

4. REMOVE PRONOUNS WHEN YOU SPEAK OF YOUR PARENTS

Repeatedly, seniors are referred to as “he” or “she”. Your mother is sitting across from the doctor while you and the doctor talk as though she is not there. Have you ever heard of an illness that makes people invisible? When an older adult is in the presence of others, using nouns and proper nouns give your parent the respect and dignity they deserve.

5. IF YOUR PARENT DOESN’T THINK SHE HAS A PROBLEM OR IF HE KNOWS HE HAS A PROBLEM AND DOESN’T WANT TO CHANGE:

It becomes your problem to figure out how YOU are going to deal with it. If a parent is not compelled to change, time will bring a solution — unfortunately, often triggered by a catastrophic event.

If you need help or advice about caring for an aging parent, connect with an Aging Life Care Professional™. You can find an expert at aginglifecare.org.

About the author: Miriam Zucker, LMSW, C-ASWCM is an Aging Life Care Specialist™. She is the founder of Directions in Aging, based in Westchester County, New York.

How to Age in Place

October 28, 2016Aging in Place, Aging Life Care Professionals, Aging Parentsage in place, eBook, living at home Callie Daters

Do you want to age in place? In this free eBook from the Aging Life Care Association™, you will learn how you can plan for and get the care you need at home. Planning for the Care You Need at Home also shows you how to work with your family to ensure your choices and wishes are supported.

Planning for the Care You Need at Home – a Free eBook from the Aging Life Care Association™

by Phyllis Mensh Brostoff, CISW, CMC – Aging Life Care Professional™ Member and Fellow of the Leadership Academy

While it seems the number and variety of senior housing options has increased — nursing homes, assisted living facilities, continuous care retirement communities (or Life Plan Community )— most people live and die in their own homes.

The Centers for Disease Control defines aging in place as “the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level.”

Planning for the Care You Need at Home walks you through the various care needs and resources you may require to successfully age in place, including:

How to access medical care if you become homebound
Non-medical home care and companion services
Identifying community resources
Technology
End of Life Care
Working with Aging Life Care Managers™

With stories to bring these issues to life, this eBook is designed to help support you in making the decisions that are right for you. Making a plan before a crisis happens ensures your wishes and desires will be known. Download your free copy today.

About the author: Phyllis Mensh Brostoff, CISW, CMC, is a social worker and co-founder of Stowell Associates – a care management and home care company in Milwaukee, Wisconsin She has written numerous articles and presented seminars across the country. More information is available at www.caremanagedhomecare.com. Follow Phyllis on Twitter, Facebook, or email her at phyllisb@caremanagedhomecare.com.

Get Help Navigating Nursing Home Care

October 21, 2016Aging Life Care Professionals, Long-Term CareMedicaid, Medicare, nursing home Callie Daters

Moving to a long-term care facility or nursing home can be a shock to an individual and to the family. And you’ve probably figured out how expensive it is. With questions ranging from cost to quality of care to food choices, you may feel overwhelmed or trapped. An Aging Life Care Professional™ can help you navigate the nursing home maze and be an extra set of eyes and ears.

Aging Life Care Professionals Know the Ins and Outs of Nursing Home Care

By Suzanne Modigliani, LICSW, CMC – Aging Life Care Association™ Member and
Fellow of the Leadership Academy

Why Nursing Home Care

There are many reasons someone may be living in a nursing home. After a hospitalization, your loved one may have been placed in rehabilitation; and during that rehab stay, it may have become clear the person can no longer live alone. If finances preclude in-home care, nursing home care can be covered by Medicaid if the individual is clinically and financially eligible. Or if the individual’s needs are so complex that the care of a registered nurse on a regular basis, a nursing home is a practical solution.

Paying for Nursing Home Care

All of a sudden you are told your loved one’s time in rehab is up and that he/she must go home or move to long-term care. While the rehabilitation stay may have been covered by Medicare, the transition to a long-term care can be confusing. You probably have figured out how expensive nursing home care is. Medicaid will pay for long-term care if the individual meets specific eligibility requirements. There are very specific rules, some depending on if there is still a spouse in the community, as well as others regarding how much money the elder can have spent for certain things. If you are confused or unsure about the Medicaid application process, reach out for professional assistance from an Aging Life Care Professional or even an Elder Law Attorney.

Choosing a Nursing Home

Which nursing home is best for your loved one? A great place to begin your research is with Medicare’s Nursing Home Compare website. Nursing Home Compare allows consumers to compare information based on yearly surveys conducted in person by the Department of Public Health. The website contains quality of care information on every Medicare and Medicaid-certified nursing home in the country – more than 15,000 nationwide.

For information beyond the survey, a local Aging Life Care Professional can offer up-to-date information and insider knowledge based on current or previous experiences with clients at particular facilities. Nursing home staff frequently turn over, so this personal, insider view is invaluable. Aging Life Care Professionals will know the little things like whether all those activities on the calendar actually happen.

Navigating the Maze

An Aging Life Care Professional can be your guide to all things nursing home. Whether you live in the same town or across the country, an Aging Life Care Professional can be your eyes and ears. These experts can also help you answer all of the questions that may be racing through your head, or that may come up along the way such as:

Does my relative get to choose a roommate?
Can she still have her favorite foods?
Who is my contact person at the facility?
Who do I tell that my mother never wears her hair that way, or that red lipstick makes her day?
Who is responsible for laundry and should clothes be labeled?
What if the roommate keeps the TV blasting late into the night?

Though nurses are on staff, the bulk of the care is provided by certified nursing assistants (CNA) who are taking care of a number of people on a daily basis. Forming a bond with the regular CNAs that assist your loved one will help you get timely information and also go a long way towards making sure your loved one is getting the care you hope for.

Nursing homes are required to have quarterly care plan meetings to establish exactly what they are doing for a resident. There need to be goals with progress towards those goals reviewed. Having an advocate attend with you – or in your place – can be invaluable. If the Aging Life Care Professional knew your relative before placement in long-term care, they may have important history to share with the facility staff.

With experience working in and with nursing homes, Aging Life Care Professionals are great partners to work successfully with nursing home staff. Find a local Aging Life Care Expert at aginglifecare.org.

About the author: Suzanne Modigliani, LICSW, CMC is an Aging Life Care™ specialist in Brookline, MA who works with families to find solutions to complicated elder care problems. She has been a leader in the Aging Life Care Association and quoted extensively in the media as seen on her website modiglianigeriatrics.com.

Special Needs Children and the Aging Parent

October 11, 2016Aging Life Care Professionals, Aging Parents, Caregiving, Elder Law, Family Members, Financial Managers, Guardianshipadult children, aging parents, special needs Callie Daters

Having an adult child with “special needs,” and planning ahead for his or her care, is a concern for parents throughout the child’s lifespan. Most of these adult children are extremely dependent upon their parents, counting on them to provide fully for their safety and well-being, as well as love and encouragement. As the parents begin to age, it is necessary to have a plan of care in place for both the adult child and the parents.

Planning for the Care of Your Adult Child with Special Needs Takes a Team

by Linda Fodrini-Johnson, MA, MFT, CMC – Aging Life Care Association™ Member and Fellow of the Leadership Academy

Coming up with a plan for who will take care of their child after they are gone is the greatest struggle for parents of children with special needs. The “What If’s?” are daunting.

Most parents of special needs children have learned to become resourceful in finding ways to make their child’s life the best it can be. They’ve developed special skills for solving problems and finding solutions. They know their child better than anyone and their love and patience know no bounds. They can’t imagine anyone else being able to care for their adult child like they can.

As some of these parents age, their special needs children can actually begin to help their parents. Some higher-functioning adult children with special needs might assist them with light housekeeping, simple meal preparation, laundry, or even personal care.

However, for parents caring for an adult child with special needs of lower functioning abilities, a different scenario can develop: one where the parent can no longer meet the ongoing care needs of his or her adult child.

In either scenario, an Aging Life Care Manager™ can be that much-needed link, helping the “Special Needs Family” plan for the future, setting up a contingency plan for short- or long-term options for ongoing care of the adult child with special needs.

The Aging Life Care Manager works with the family, an attorney who specializes in either Elder Law or Special Needs Planning, and a financial planner to create options for a suitable Plan of Care which meets the needs of everyone in the household. The best plans are based on the family’s set of values, resources (both human and financial), entitlement benefits, and local services.

On an ongoing basis, the Aging Life Care Manager provides a second set of skilled eyes on the care situation of the special needs adult, making sure that the plan remains appropriate, that the care is of excellent quality, and that all needs — physical and emotional — are being met. In some cases, the Care Manager operates in a dual role, advocating for both the adult child with special needs and his or her parent.

To locate an Aging Life Care Manager near you and learn how he or she can help with the care of your adult child with special needs, visit aginglifecare.org.

About the author: Linda Fodrini-Johnson, MA, MFT, CMC, is the Founder and President of Eldercare Services in Walnut Creek, CA. She is also a partner of the VillagePlan. Linda is a Fellow of the Leadership Academy and a past-president of the Aging Life Care Association™. Linda has over 30 years experience working as a Care Manager. You can reach her at linda@EldercareAnswers.com, or connect with her via social media: Facebook, Twitter, and LinkedIn.