All posts by Courtney Pulitzer

An Ounce of Prevention, Two Ounces of Caution

Too many Americans have experienced less than ideal healthcare in recent months as they work through an overwhelmed system. The elderly need to be especially vigilant and prepared as states reopen and seniors begin seeing their doctors again.

The system’s deficits have proven particularly dangerous for elderly persons of color. The COVID-19 pandemic has both magnified and amplified the impact of racial health disparities on its victims in the U.S. There is less access to quality healthcare in many predominantly Black communities—including, perhaps surprising to some, in more affluent districts. Compounding this, Black people are more likely to suffer from diabetes, hypertension and other underlying conditions that make COVID-19 particularly fatal.

Older Americans Protecting Themselves with masks to prevent covid19
Older Americans Protecting Themselves with masks to prevent covid19

The guidelines outlined here will apply to any senior, whether going to a supposedly ‘routine’ appointment with a doctor or nurse practitioner, or having a procedure done at a doctor’s office or a hospital.

Seeking the help of a good care manager can support each of the guidelines below:

• Call a week ahead to find out about the office’s COVID-19 protection protocols.

Ask: Will your temperature be taken and how many people will be allowed in the waiting room? Can a family member, friend or aid accompany you when you see the doctor? Do they have hand sanitizer? Do they enable social distancing? If you are not comfortable with their protocols, can the appointment be converted to a telehealth visit?

• Be sure to wear a surgical mask and take hand sanitizer when you go.

Don’t go solo. If at all possible, have a family member, friend, aide or geriatric care manager accompany you. Inform them beforehand about the topics
you want to cover with your doctor. Ask them to make sure your questions are answered.

Take a ‘self-inventory’ prior to your appointment.

Understand how are you feeling emotionally and physically—and don’t neglect emotionally. Recall if there have been changes to your appetite/eating,
thirst, weight, sleep, memory/cognition?

• Prepare a checklist of items to discuss—then bring it with you and check off each item.

Keep a diary of all related medical tests, procedures or specialty visits since last appointment. Your main doctor should have the list, but it helps to have
your own especially if you saw a doctor who is not in the same system. If you have been to an emergency room since your last visit and/or seen any specialists, make sure to discuss all. If you’ve had x-rays or other tests taken in the interim, make sure your doctor has the results.

• Be on time or early.

There will be forms to complete or vital signs to measure. Bring your insurance card, Medicare card and identification.

• Confirm your ride.

If you’re not driving yourself make sure you have reliable transportation, at least a week before your appointment. This way, if anything changes, you
will have time to make alternate arrangements. If you are booking a community or locally provided transportation, follow their reservation rules. Ask about their COVID-19 safety measures.

• Bring a list of medications.

Review the list with your doctor and explain how you are responding to each. The dosage may need to be adjusted or a different medication may be in
order. If the doctor recommends a new medication, ask about possible side effects and symptoms.

• Be specific and discuss options.

Ask if there are other courses of treatment. Depending on your condition, ask if changes to diet, additional exercise or holistic options will help.

• Ask about the next steps in treatment at the conclusion of the appointment.

Insist on a timeline, even if somewhat approximate. Schedule as many appointments as possible before leaving.

• Always remember to: Be an Informed Patient

Research your health condition and find out about treatments that are considered best practices. If you cannot do this, ask someone
to help you. Advocate for Yourself or Take an Advocate with You Do not be afraid to speak up, question and challenge. Share your research and ask you provider to respond. Take someone with you (or dial them in by phone) who can help you advocate for yourself. Speak freely. Don’t worry about taking too much time and don’t hesitate to broach any topics of concern.

• Take Notes

Document the advice or direction that your physician gives you in case you want to seek a second opinion. This is also something that a family member, friend or care manager can do for you.

• Seek a Second Opinion

If you are unsure about the medical advice you receive, seek a second opinion from another physician. Do not be afraid to seek out a physician with a higher
level of cultural competency. Care managers can be especially helpful with this research. There are also community resources that can provide support.

For more information, these resources can help: The National Institutes of Health publishes a worksheet that can help organize conversations
with your doctors:

About the Author: Abbe Udochi is the CEO of Concierge Healthcare Consulting (CHC) a care management practice in New Rochelle, New York. Abbe founded the practice to make healthcare options easier to find and understand, and to simplify navigation for the aging and/or disabled and their caregivers. Abbe has been a leader in the public health insurance industry since 1996. She is an independent director on the Fidelis Care-NY/Centene Board of Directors. Fidelis is the largest public health insurance health plan in New York State and covers 1.7 million children and adults of all ages and stages of life.

While part of an executive leadership team at another large, New York City-based, public health insurance company, she led the health plan’s Medicaid, HARP and Child Health Plus lines of business. Abbe has held board leadership roles with YouthBridge-NY, New York City Mission Society and the Harlem Business Alliance, all Manhattan-based organizations. She currently serves as Chair of the Board of Directors for the New York Covenant Community Development Corporation in New Rochelle, NY. She is a member of numerous organizations that serve the interests of the elderly including Orion Resource Group, Central Westchester Geriatric Committee and she serves on the Diversity Task Force of the Aging Life Care Association (ALCA).

Aging Life Care Managers – Experts in Aging and Organizing

Older adult children working from home have been contacting Aging Life Care Managers such as those at Careplan Geriatric Care Managers in Cleveland, Ohio to get organized.  Children are taking advantage of the extra time to get their elderly parents health and personal matters organized in the event of an unfortunate event.

Aging Life Care Managers Help You Get Organized
Aging Life Care Managers Help You Get Organized

Karen McGinty of Medina, Ohio a school principal states “now is the perfect time to get the essential “crisis” paperwork in order”.  I should have done this sooner but there was never a good time.  

What is considered “crisis” Paperwork?
Crisis paperwork includes those documents that in a crisis will help advocate and ensure client wishes are honored.

As an Aging Life Care Manager-Licensed Social Worker, I have seen tremendous confusion and concerns rise when a crisis occurs and necessary documents have not been executed or never completed.  During a crisis, emotions are already running high and stress is inevitable. The Aging Life Care Association’s members suggest making it easier for you and/or your loved ones by identifying and completing your crisis paperwork now and organizing it in a designated space away from other miscellaneous paper.  An Aging Life Care Manager can assist in completing documents and place in an Emergency Binder in the event of need.  An Aging Life Care Manager will also keep a copy on file and meet the older adult in the hospital or home in times of emergency.

Here are the healthcare documents elderly parents need to organize their life for a crisis:

Essential Documents as Recommended by An Aging Life Care Manager

There are eight documents you’ll need to access your parents’ medical information and related financial information:

  • HIPAA authorization: This allows physicians and other healthcare providers to share information with you. If there are certain types of information your parents do not wish to share, they can indicate that on the form. You can find generic HIPAA forms online or get one from your primary care physician.
  • Advance directive: An advance directive, which is sometimes also called a living will, outlines what medical care you do and do not want if you are dying or not expected to regain consciousness and under what circumstances these decisions should be applied. For example, do your parents want to undergo CPR or defibrillation if their heart stops, be put on a ventilator, or have a feeding tube? Your parents can write their own advance directive, get a template from their physician, have a lawyer draw up the document, or get a form from their state’s health department or department on aging.
  • Durable power of attorney for healthcare: This indicates who you would like to have power to make medical decisions on your behalf. This person is called a healthcare proxy. Your parents can indicate whether they would like their proxy to be able to make all medical decisions or just specific ones.
  • Durable power of attorney: This allows you to make financial decisions on your parents’ behalf, pay bills, and access financial information, including talking with health insurers, long-term care insurance providers, and hospital and healthcare provider’s billing departments.
  • Comprehensive medical record: Having an up-to-date, easily accessible, comprehensive medical record is especially important if your parents are being treated for several health issues. People with multiple health issues often see several specialists in addition to their primary care doctor and may be prescribed medications by multiple physicians. Their medical record can help make sure that key information is available to everyone who treats them and can lower the risk of overtreatment, duplicate diagnostic testing, and prescription drug interactions or the prescription of duplicate or no longer needed medications.
  • Do not resuscitate and/or do not intubate order, if desired: While this information is often included in an advance directive, if your parents do not want to be resuscitated in the event their heart stops or put on a ventilator, it can be helpful to have a separate order that is shared with their physicians, EMTs, hospital and other healthcare facility staff, and staff at any senior living or rehabilitation facility.
  • Medicare, supplemental, and long-term care insurance policy information: You need the policy numbers and customer service phone numbers for these insurance policies so you can review coverage, file, check, and dispute claims, and pay premiums on your parents’ behalf.
  • Letter of instruction: This document details end of life wishes, for example, funeral and/or memorial service arrangements, burial or cremation plans, and organ and tissue donation. A letter of instruction also often includes important financial information such as the location of the will and any safe deposit boxes, bank, investment, and retirement account locations and numbers, PIN numbers and passwords for banking and investment accounts, life insurance information, and a list of financial and legal advisors’ contact information.

With these documents, you’ll be able to help your parents navigate the healthcare system and support them as they make important medical decisions.

Have questions on any of the listed forms or documents? Reach out to one of our Aging Life Care experts at

 About the Author: Bridget Ritossa, LSW, CMC – Aging Life Care Manager and Founder
of Bridget Ritossa Careplan Geriatric Care Managers. Bridget developed a wealth of knowledge and resources in the areas of aging due to her 20 years of practice working at two major hospital systems in Cleveland and two of the largest nursing home chains in the country. Her grandmother lived with her while growing up. As a result, this helped develop a genuine love and appreciation for the elderly. Studies have shown that living at home is better for the mental health of seniors because they are happier in a familiar environment where they can live independently. When home is no longer the best option, Bridget will help families to find the most appropriate placement with her extensive experience in long-term care. Above all, Bridget’s goal was to create a company that would provide older adults with the resources and knowledge to successfully age at home. Therefore, creating an individualized care plan is at the very heart of Careplan Geriatric Care Managers.

Caregiving Long-Distance Made Easier – One Aging Life Care Professionals® Account

In the pandemic world, we are currently living, long-distance caregiving is further complicated by the litigation set in place to protect our most vulnerable population, the elderly.  Families and friends cannot see their older adults to know they are well and cared for.

A Certified Care Manager and Aging Life Care Professional® such as those at Careplan Geriatric Care Managers in Cleveland, Ohio are the essential healthcare professional you need, where you need it, when you need it.

A care manager realizes how difficult it is for long-distance families to visit older adult parents during the pandemic.  Because it is difficult to travel right now, complicated by the fact that the best a facility may offer an adult child for visitation is a 15-minute window or patio visit behind a plastic shield, an Aging Life Care Manager® is there help.  Aging Life Professionals (aka Geriatric Care Managers) will assess, advocate, and provide the support needed to ensure the older adult is getting the care, socialization, and support they need through onsite 1:1 visits.

Essential for Sure!

Licensed social workers are deemed essential and are able to work with the care facilities to ensure they are providing the care that the older adult pays for, expects, and needs.

Local Examples

Home consultation for senior couple

Careplan has recently received authorization to see clients at a particular assisted living.  Careplan is able to visit older adults setting eyes on them.  Careplan will also meet with the care team to address any questions or concerns. Professionals at our company have worked for the last 20 years advocating for older adults assuring that facilities are following the Ohio Department of Health rules and regulations.  Careplan knows what is expected and what is far-reaching.  Careplan visits facilities ensuring resident’s rights are being honored.  Careplan can then report back to the family, lawyer, or other outside parties.  Careplan is passionate about advocating for clients that are declining due to social isolation brought on by this pandemic.  Careplan has written to Congressional Leaders including Congressmen, Senators, District Representatives, and the Ohio Governor.

The Services Provided by An Aging Life Care Manager Makes a Difference

The first visits with our clients were astonishing, the clients could not express themselves since being isolated for 3 months.  These clients could not make simple decisions and appeared bewildered.  They could not hold a conversation.  After seeing these clients now weekly for one month providing psycho-social visits and advocacy, they are now doing better cognitively as evidenced by being able to make decisions, eating better, and having social visits with me outside where we FaceTime with family around the world and locally.  Clients are using their brain-power again and they feel like someone cares.   We also advocated for physical therapy due to lack of exercise.  Advocacy is what Aging Life Care Professionals do best!

How Does an Aging Life Care Manager Care for Long-Distance Loved Ones?

An Aging Life Care Professional is an expert in assessing situations and developing a plan of care to promote wellness.  Care Managers such as those that are members of The Aging Life Care Association are dedicated to making certain that an older adult is living life as independently as possible in the least restrictive environment.

In today’s world, it is common for families and friends to be separated by great distances.  At some point in the older adult’s life, they will need an advocate to assist and help with navigating.  Aging Life Care Managers help make the right decisions at the right time while considering healthcare needs, finances, and lifestyle.

An Aging Life Care Professional Will Help Answer Questions Such As:

  • Does the older adult need an Institution versus their home?
  • How do I choose a Home Care Agency?
  • Who can provide transportation?
  • How can I make sure Medications are being taken?
  • Would it be beneficial to have the care manager attend Medical Appointments so that family knows what is going on and to ensure the doctor has all the necessary information?
  • How do we afford care? What if the older adult outlives their resources? Discuss difficult topics and complex issues
  • Make home visits and suggest needed services
  • Address emotional concerns
  • Make short- and long-term plans
  • Evaluate in-home care needs
  • Select care personnel
  • Coordinate medical services
  • Evaluate other living arrangements
  • Provide caregiver stress relief

Aging Life Care Professionals are specially trained professionals and can help find resources to make your daily life easier. They will work with you to form a long-term care plan and find the services you need.

Aging Life Care Managers Sort Out Options Helping Long-distance Families To Make The Best Decisions

When it comes to making senior care decisions for a parent or senior loved one, it can be incredibly intimidating.   With a range of senior living choices offering everything from apartments to full-time care, in-home caregivers, and rehabilitation, it can be overwhelming for families to research and understand which services their loved one needs – and when they need them.

That’s where Aging Life Care Managers can help. They have extensive training on senior care options and can present a variety of options, helping families choose the living option that works best for their unique situation.

Aging Life Care Managers Are an Unbiased Often Welcomed Addition

ALCM’s are experts in their fields but have no emotional ties or family history to navigate. Their objectivity is valuable when it comes to navigating tough family conversations about the future of a senior loved one.

The older adult client usually appreciates this outsider who has no reason but to provide their professional honest, unbiased recommendations.

There When You Can’t Be

Acting as advocates and guides throughout the entire process Aging Life Care Managers can help families be present at medical appointments, coordinate complex care plans, facilitate hard conversations, and find residential care.  ALCMs can be a lifesaver for those challenging with living long distance.  To find an Aging Life Care Professional visit

About the Author: 
Bridget Ritossa, LSW, CMC – Aging Life Care Manager and Founder of Careplan Geriatric Care Managers. Bridget developed a wealth of knowledge and resources in the areas of aging due to her 20 years of practice working at two major hospital systems in Cleveland and two of the largest nursing home chains in the country. Her grandmother lived with her while growing up. As a result, this helped develop a genuine love and appreciation for the elderly. Studies have shown that living at home is better for the mental health of seniors because they are happier in a familiar environment where they can live independently. When home is no longer the best option, Bridget will help families to find the most appropriate placement with her extensive experience in long-term care. Above all, Bridget’s goal was to create a company that would provide older adults with the resources and knowledge to successfully age at home. Therefore, creating an individualized care plan is at the very heart of Careplan Geriatric Care Managers.”


This Fall, Prevent Falls For Your Elder Loved One

Fall Prevention Week: September 21 – September 25, 2020

According to the National Council on Aging, one in four Americans aged 65+ fall every year. Having an Aging Life Care Manager as part of your health care plan for your older loved one can help avoid this common, but avoidable, part of aging.

As a supplement, here are some slides with further details and information for preventing a fall for your elder loved one.

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 online coaching team.


How Social Isolation Stole My Mom

 On September 6, 2019, my mother turned 76. As was our birthday tradition, I invited her to lunch and suggested an outing to a local craft store she loved. For the first time ever, she refused to budge from her home. This was new behavior and it really worried me because her world was shrinking. She seemed to prefer solitary activities like beading, knitting, and weaving intricate pine needle baskets, only venturing out when she absolutely had to.

That summer, I informed her that I had been accepted into a Doctor of Social Work program at the University of Southern California and was on a quest to eradicate social isolation, a problem that has been gaining public attention because of its harmful effects on health and well-being. I asked for her assistance on my mission to find answers and spoke to her about how concerned I was about her own situation, which she acknowledged was becoming a problem. A tiny spark of hope suddenly ignited within her at the thought of helping me on my academic journey.

Ten weeks after her birthday she died suddenly and unexpectedly. Her death left me and my siblings shaken to the core. You see, Mom was relatively healthy when she died. The chronic health problems she had were stable. Her diabetes was controlled through exercise and diet. An episode that landed her in the ER in March had been nothing, she said. All diagnostic tests were negative – no stroke or heart attack, and her blood pressure was just fine. Her doctor chalked her dizziness and temporary confusion up to a panic attack and sent her on her way. I was skeptical about the diagnosis but shook off the doubt, preferring instead to embrace the idea that Mom was alright – it was just a false alarm – we had nothing to worry about.

Even though she never finished high school, she owed her own business, and through grit and determination, she raised us six kids, mostly on her own. In her youth, she was vivacious, hard-working, and made friends easily. But as she grew older, her ability to connect with others gradually vanished. At family gatherings, she was grumpy and wanted to return home as soon as her obligations were satisfied.

Mom called me a few times before her death wisely explaining why isolation happens as people age and gave me suggestions about what to do for those caught in the spiral of darkness, she knew all too well. Her observations about her own slide into loneliness dovetailed with all the research findings. Retirement as a hairstylist and closing her salon was a turning point for her, that’s when her all her social connections suddenly evaporated. Vision changes and anxiety caused her to stop driving, limiting where she could go without help. She confided in me about the embarrassment she experienced wearing dentures. Eating with others filled her with so much shame that she purposely avoided social gatherings involving food.

Like many retirees, she said she couldn’t relate to the “old people” who frequented a nearby senior center. When I suggested teaching a class on beading or basket making there, she refused to consider it. Mom had also dealt with panic attacks her entire life and they seemed to worsen as she grew older. The cycle of isolation was self-perpetuating, and she couldn’t seem to find any way out.

Unfortunately, medical providers rarely ask their patients about isolation and loneliness despite the overwhelming evidence linking seclusion to worsening health and early death. In fact, the harmful effects of isolation are so strong that social support is considered a “social determinant of health” – meaning those who are connected live longer and healthier lives than those who aren’t. Researcher Dr. John Cacioppo discovered that loneliness actually changes our brains. That’s why people who are lonely misperceive social cues and have a hard time building relationships. It’s hard to break the cycle once you’re in it.

But if the cycle is interrupted, the benefits of connection are enormous. Older people who regularly interact with others and participate in social activities report better emotional and physical health and have improved cognition. Studies show that those with strong social connections actually require less pain medication after surgery and even recover more quickly. Older people also fall less often, are better nourished and have a lower risk of depression.

It turns out that we don’t need a lot of connections to soften the edges of loneliness. Having a few quality connections that are meaningful and sustained are actually more important than the number of connections someone has.

Answers to the problem of isolation and loneliness will likely be different for each person – there doesn’t seem to be any cookie-cutter approaches that work. Take Mom for example: she had no desire to connect with the older people at the neighborhood senior center, no matter how many nice people she met there. So, we can’t expect that just referring people to places like senior centers or volunteer programs will magically solve the problem. It really comes down to discovering what provides meaning to each individual and then helping make those connections stick. Aging Life Care™ Professionals are particularly well-versed at helping clients enhance wellbeing, rediscover purpose and joy, and make those meaningful, lasting connections.

During this COVID-19 pandemic, we’ve all come to truly appreciate how important our relationships with one another are. While distancing from others protects against the virus, doing so can also make overall health and wellbeing worse. My hope today is that readers take this story about my mother to heart and make time to regularly reach out to people who are isolated. Their lives may depend on you more than you even know. If you feel you or a loved one could benefit from the guidance of an Aging Life Care Expert, visit the Aging Life Care Association website to explore what aging well looks like and to find a professional to help you navigate the journey.

Jullie Gray, DSW(c), MSW, LICSW, CMC, is a trained and licensed as a clinical social worker, she combines over 35 years of experience working in diverse healthcare settings with her passion for working with older adults and their families. Jullie is a principal at Aging Wisdom, an Aging Life Care management and consulting practice serving the Seattle Metro area. She is an award-winning care manager, is the immediate past president of the National Academy of Certified Care Managers and the past president of the Aging Life Care Association. Jullie holds the distinction of Fellow Certified Care Manager. She is currently pursuing her doctorate in social work – focused on eradicating social isolation among older adults.


Cataracts in Seniors | Senior Care Options

“My mother has been complaining about blurry vision, and I am concerned she might be developing cataracts. I don’t know how she is going to adjust if she loses her sight! Is there anything that we can do, or is it too late to save her vision?” – Silvia from Woodstock


If your loved one has cataracts, she is in good company, but it doesn’t mean her sight is gone forever. By the time people reach 80, at least half of the elderly population will either have cataracts or have had surgery to remove them. Usually, you can tell if your loved one has a cataract, thanks to the distinctive cloudy appearance which results from a clumping of protein inside the lens. Let’s talk more about what causes cataracts in seniors as well as how to prevent and treat them.

Nature and Nurture

Cataracts can be hereditary, but they can also come from other health conditions or lifestyle choices. For example, diabetes can cause cataracts, as can prolonged steroid use which may be for other health problems. A history of smoking and alcohol use can also lead to cataract formation as well as prolonged sun exposure. Even an eye injury in the past may result in cataracts as a senior. Now a bit of disturbing news: cataracts can occur in children and people in their 40s. They can be mild to severe, and they do get progressively worse over time.

Signs and Symptoms

Blurry vision is perhaps the most obvious symptom of cataracts in seniors, but it is hardly the only one. Be on the lookout for some of these other signs:

  • A halo-like glare surrounding light
  • Cloudy images
  • A brownish tint or dulled, faded colors
  • Poor vision at night
  • Double vision
  • Frequent prescription changes

Any time your loved one notices vision problems, he or she should visit the eye doctor for a thorough exam. The ophthalmologist may dilate your senior’s eyes to check for cataracts and other conditions, and based on the exam, make recommendations for treatment.

Options and Treatments

Unfortunately, there is no cure for cataracts, and treatment depends on the severity of the vision loss. If your loved one in the early stages, no treatment may be needed. Instead, lifestyle changes can improve sight, at least in the short-term. Simple adjustments such as reading large-print books or listening to audio books, using a magnifying glass, or relying on brighter light bulbs may make daily activities and hobbies easier. Check the home environment for any tripping hazards, as falls can occur in seniors with vision problems. When outside, your loved one should wear a hat and anti-glare sunglasses to prevent harmful UV ray exposure. Of course, it goes without saying that alcohol consumption should be limited (and smoking stopped altogether), and your senior should also eat a healthy diet rich in fruits and vegetables to improve eye health. A new glasses prescription may also correct some of the symptoms.

More severe cataracts may not respond to these home remedies, and in those cases, surgery may be the only option. Luckily, surgical treatment is common, safe, and effective. Only one eye is treated at a time, and the recovery time is roughly four to eight weeks. Because the patient does not need general anesthesia, healing may not take as long as other types of surgery. You can reassure your loved one that cataract surgery has a high rate of success and zero fatalities.

Fortunately, cataracts cannot come back after surgery, and if your senior has a cataract in one eye, it does not mean the other eye will get one. Schedule regular vision checks for your loved one to keep on top of any problems, and while you’re at it, schedule one for yourself too.

Best of luck!

About the Author: 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.

My History with ALCA: Phyllis Mensh Brostoff

Listen to 2009 ALCA Board of Directors President Phyllis Mensh Brostoff talk about her experience and thoughts on the association over the course of its history. She talks about how early members found commonality and strength by sharing their backgrounds, experience, and the challenges. Looking at the business side, in addition to their practices, these members developed all elements essential to an aging life care business.

“Dad resists every suggestion I make! Help!”

Susan is getting burnt out trying to care for her 91 year old father.  She has a part-time job teaching and takes care of her two school-age grandchildren in the afternoons.  Her mother has been gone for three years and Dad is truly struggling to stay independent, and failing at that.  His neighbors and church friends are calling Susan almost daily with stories of his poor judgment or his obvious weight loss.  Susan lives 2 hours from her dad and has tried unsuccessfully to get him to move to a retirement complex near her and her only sibling, a brother who has his own set of health problems but would visit if Dad were closer.

She has tried home-delivered meals, daily visitor programs, emergency response systems, and also purchased him a simple cell phone–all received with a smile and then canceled or not used.  Dad has some memory issues not yet diagnosed; his diet is poor, mostly fast food and salty snacks.  He is still driving to the chagrin of the neighbors; actually, he goes so slow they can’t really go anywhere.

Susan has tried local senior clubs and has even hired a caregiver for cooking and light housework, but Dad fired her too.  He says that he can do everything by himself; however, the house is looking more unkempt and clutter is covering every space.  Susan is amazed that he can find his checkbook to pay his few bills; she did successfully get most bills paid automatically.

Susan just heard a lecture from an Aging Life Care Manager about the importance of planning ahead with aging family members and wonders what will happen when Dad has a major fall or illness.  The Aging Life Care Manager (also called a Geriatric Care Manager), convinced her to have a “strategy meeting” for some “Win-Win” ideas.

She was happy to hear during her time with the Care Manager that her dad might be more likely to accept suggestions from a non-family member than from his “overly worried” daughter, which is what he calls her.

These are some of the suggestions that are working for her father now (all introduced by the Aging Life Care Manager and not Susan):

  • Instead of being called the “caregiver”, they came up with the idea of a “personal trainer.” Dad did like to work out when younger but his eyesight has diminished, making a trainer a welcome change in addition to having another male to talk with twice a week. The trainer now brings healthy meals and has extended his time to 4 hours a day, five days a week over a few months.  The trainer is actually a “home care worker” who loves to exercise – but the daughter learned not to tell Dad all the details or how much it costs.  The daughter has access to the family trust and is keeping a good record of all expenses.


  • The dad’s doctor finally agreed to have him tested for dementia and he does have early-stage Alzheimer’s disease. Dad understands it as an illness that impairs memory, but he still can live at home because he has “Jim” the trainer. Jim is willing to extend his hours as time goes on.


  • Susan was also encouraged to join a support group lead by the Aging Life Care Manager and has learned so many tricks for managing Dad’s needs without a lot of discussions with Dad. That has led to a much better relationship between the two.  She has also found a retirement complex near her and “Jim” the trainer is going to drive up to see it for the future (or so that is the story).


With the assistance of the Aging Life Care Manager, Susan has moved from “worried” to “grateful” that Dad can still have some quality time in his own home that is safe, well-monitored, and in line with Dad’s values for now.  She also has a plan and an ally with her Aging Life Care Manager for the strategy when it is time to move Dad.

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 online coaching team.

My History with ALCA: Vicki Doueck

Member since 1989, Vicki Doueck talks about her practice then, and now. Her words of encouragement to members to get active and join the Board is part of her experience, as well as her yearly conference attendance. Listen to the “tech” (i.e. telephone cards) early members had to use to manage their businesses, and how expanding the professions adds dimensions to the aging life care profession.