All posts by Courtney Pulitzer

Sibling Relationships and Older Parents

As adult children age many unresolved conflicts are swept under the carpet and avoided.  Often with parents as buffers, and contact limited, relationships remain stable. All this can change when adult children must share the task of caring for an aging parent. When the focus becomes their own unresolved conflicts, this can interfere with the task at hand and further destroy family relationships.


Here are a few tips that can help resolve these pitfalls:

  1. Focus on parent’s needs –- If siblings are spending time and energy arguing with one another it takes away the focus from the aging parent.  Unresolved issues that exist can be reduced by making parent’s needs a priority.  If siblings disagree then an evaluation and plan by an objective third party can be very instrumental. An Aging Life Care Manager can assist (
  2. Avoid childhood roles — Reliving past roles that siblings played in their childhood can often lead to competing issues including favoritism, controlling behavior, and decision making. Identifying childhood reactions so siblings can move forward as adults can make a difference. Identifying may not be enough.  The engagement of a licensed mental health professional with backgrounds in Marriage, Family, Clinical Social Work or Aging Life Care, who is experienced in dealing with family conflict, as it relates to aging, can assist.
  3. Put gender stereotypes aside — The role that men and women play in both the workplace and family has changed dramatically in the last generations. By eliminating these stenotypes and focusing on each sibling’s specific situation and attributes can lead to better outcomes when it involves caring for an aging parent.
  4. Avoid keeping score — Siblings often differ in geographic distances, financial situation, personality, relationships with parents, outside responsibilities, and other factors. Any of these inequalities, once recognized, can lead to a more efficient care plan for parents and reduce conflict. Regular family communication or the formal use of a family therapist can help set up a realistic distribution of tasks.
  5. Acknowledge another — Dealing with the complex issues associated with aging is often stressful for all involved. This is particularly true when parents are resistant, difficult, or their feelings are ambivalent.  Siblings can recognize that there might not be anyone more able to understand the situation than themselves. Being able to vent and express frustrations can make a difference.  A counselor or other mental health professional can be that ear if more support is needed. Hiring an Aging Life Care Manager to share the burden and understand the challenges can make all the difference.
  6. You may not be able to do it alone — Families are different. For those that need a more formal process, elder mediation can assist. In addition to the aforementioned issues, hiring an elder mediator to resolve conflicts involving potential neglect, undue influence, medical treatment, trust, and inheritance issues can be vital in not only resolving family issues but avoid costly and stressful legal proceedings.

About the Author: 

Bunni Dybnis, MA, MFT, CMC, President of Aging Life Matters, has over 30 years’ experience as Aging Life Care Manager, Family Therapist, and trained mediator working exclusively with aging adults and their families. She is a proud Fellow in the Leadership Academy of the Aging Life Care Association.  She has served on the National Board and Western Board of ALCA, holding several leadership roles including past president of the Western Regional Chapter. Contact her on LinkedIn or at or at bdybnis

“Home” for the Holidays? Common Signs Your Older Loved One May Need Help

ALCM Help With Virtual Assessment
This year the holidays and holiday gatherings will look a bit different for most of us because of the pandemic. Experts advise us to stay home and limit our in-person celebrations to those living in our immediate household.

Observing the holidays with loved ones outside our household will likely take place virtually or physically distanced. You may observe, during this time of distanced or virtual gathering with your older loved ones, uncharacteristic behavior, or lifestyle changes and routines that may prompt concern.

The following are some common signs that could signal a cause for concern and action. Use this list for clues or changes that warrant attention:

  1. Concerned friends and neighbors. They are noticing worrisome changes and step in to provide help, but when the changes are such that they are concerned for your loved one’s safety, it’s time to step in.
  2. Their home. It does not seem as clean or sanitary as before. Routine home care and maintenance, inside and outside, is being neglected. You may start to notice hoarding tendencies, or perhaps see trash isn’t being taken out – maybe you notice food that seems old.
  3. Finances. Bills are unpaid or paid more than once; you notice an unusual number of payments to telemarketers, charities, and television advertisements; utilities are at risk of being shut off; money is hidden; and/or the mail or newspapers are piling up.
  4. Eating habits. Has your loved one lost weight? Does he/she have no appetite or missing meals? Your parent tells you that they just ate lunch but there is no sign of plates, pans or cups to support this statement. Or perhaps a friend or neighbor has commented the refrigerator has a strong odor or there’s molding, rotten food in the kitchen, or a burnt pan on the stove that your loved one can’t explain.
  5. Medications. Medications are being taken incorrectly. Your parent doesn’t know why they are taking certain medications and they can’t tell you what they are taking them for. They are confused about their doctor’s advice, not filling their prescriptions, or missing medical appointments.
  6. Safety. Your parent is having difficulty getting up and down their stairs, or they have had repeated falls in their home. Your parent seems less cautious about strangers and you are worried that they may be vulnerable to individuals with bad intentions. They do not seem to have the same safety awareness that they once had, and you wonder what they would do in an emergent situation.
  7. Hygiene. Your parent’s clothing may be soiled, worn for several days (or video calls), not appropriate for the weather, or may not coordinate like usual. They may be bathing infrequently and not attending to oral hygiene. You may notice neglected nails and teeth, sores on the skin, or your neighbor of friend may report of body odor or bad breath.
  8. Driving. The car has new scratches or dents that can’t be explained, and regular car maintenance is being ignored. Your parent may have mentioned that they got lost while out driving or ran out of gas. Or, they may seem too nervous to drive, have trouble purchasing groceries, or don’t have insight that it’s time to give up the keys.
  9. “Dad is fine,” your mother says. Dad agrees, though your gut tells you otherwise. They have learned to compensate for one another or may be afraid or embarrassed to share that they are struggling.
  10. Uncharacteristic behaviors. You notice your parent is being unusually loud or quiet, paranoid, agitated, making phone calls at all hours. Your parent no longer seems to initiate activities, is more withdrawn and isolated, and you wonder if sleeping all day is now the norm.

What next? Be proactive!

Whether you live close by or at a distance, there are steps you can take to support your loved one’s health and well-being:

  • Start with a conversation. Talk about your concerns. Consider including other people they trust and who care about your loved ones in the conversation, such as family, close friends, or clergy who may be able to come alongside your loved one as they make these changes.
  • Regular checkups. If you’re worried about weight loss, depressed mood, memory loss, or other signs and symptoms, such as those described above, encourage your loved one to schedule a doctor’s visit. This can help identify and address any possible causes of changes. Ask about follow-up visits as well. Offer to go with them and take notes. Remind them how nice it is to have an advocate.
  • Take care of safety issues. We can’t cover our loved ones in bubble wrap to protect them, but we can review any potential safety concerns with them. Start by prioritizing what needs to be addressed first. Then suggest small, manageable changes so they don’t become overwhelmed. Include your loved one in the discussion and decisions. Go at a pace they can accept.
  • Engage an Aging Life Care™ expert. Also known as a geriatric care manager, an Aging Life Care expert is a health and human services specialist who acts as a guide and advocate for families who are caring for older relatives or disabled adults. Aging Life Care experts know the ins and outs of the various resources in your area and can connect you to appropriate resources, provide education and advocate for your loved ones needs. By engaging an Aging Life Care Professional®, you are working with someone who takes a holistic, client-centered approach to caring for older adults. Visit the Aging Life Care Association website to locate an expert near you.

It’s not always easy or comfortable talking with parents or other older loved ones about concerns. Sometimes they won’t admit they need help, and other times they don’t realize they need support. Assure your loved ones that their health and well-being are a priority for you and that you are in this together. Fortunately, there are many options and resources for supporting them and you.

About the Author: Wendy Nathan, BSc, CMC is a Certified Care Manager with Aging Wisdom, an Aging Life Care practice based in Seattle, WA. Wendy also facilitates a family caregiver support group for the Alzheimer’s Association.

Eldercare as Art and Ministry – combining life’s passions

Aging Life Care Association® members are distinguished for their high qualifications, adherence to standards of practice, and a drive to care for older adults. And it is this distinction as an Aging Life Care Manager® that separates them from people who are geriatric care managers.

And one such notable member is Irene V. Jackson-Brown, Ph.D., CSA, CMC, CDP who has published her book Eldercare as Art and Ministry. Irene is an author, speaker, consultant, caregiver’s coach, and educator.

Focusing on eldercare as an art, with ministry, is a unique angle where someone like Irene has special insight.

After earning a Ph.D. in cultural anthropology, Irene held several academic appointments and then moved to the not-for-profit sector. When her father grew ill, she juggled work, her family and personal life, along with responsibilities as a hands-on family caregiver.

About two years into her father’s illness, Irene learned about geriatric care management through a newspaper article. Without hesitation, she made an appointment with one of the few nearby care managers. “With her guidance, I got through one of the most tortuous, but satisfying, periods of my life,” Irene admitted.

It was soon after her father’s death, in 2005, that Irene created Jackson-Brown Associates, LLC, d/b/a “The Art of Eldercare” as an applied gerontology practice. This is where Irene’s unique twist on eldercare comes in: her practice (and book) benefit from the partnership with Enrique R. Brown, her husband of forty-six years. As an Episcopal priest (retired) with extensive pastoral experience, administration, and program development, Irene acknowledges how her husband helps her, “Enrique offers care and helps steady me in this work. He is my caregiver.”

Irene holds several certifications as a senior-servicing professional — CMC (Care Manager Certified) from the Association of Aging Life Care Professionals (ALCA); CSA (Certified Senior Advisor) from the Society of Certified Senior Advisors; and a CDP (Certified Dementia Practitioner) from the National Council of Certified Dementia Practitioners.

Like her counterparts at ALCA, Irene has a wealth of continuing education experiences, including a multi-year, post-graduate certificate from the Washington School of Psychiatry’s program entitled, “The Study of Aging and Clinical Application.” She was also a Fellow in a year-long program on clinical-related topics in psychanalysis at the Washington Baltimore Center for Psychoanalysis. And she has a certificate of completion from the Georgetown University Medical Center’s Herbert B. Hercowitz Mini-Medical School Program.

Irene earned credits from The George Washington University’s School of Business and Public Management’s Project Management Program to enhance already notable communication and successful goal achievement skills.

The book is a guide to navigate the challenges of eldercare and to find meaning in this important work through stories, lessons, and poignant vignettes. Jackson-Brown calls each one of us whether young or older, ordained or laity, fortunate or less fortunate, prepared or not, to serve and care for an aging loved one.

Dr. Kumea Shorter-Gooden, Ph.D., a psychologist with a consulting practice spoke at Jackson-Brown’s virtual book launch on November 17, 2020. Dr. Shorter-Gooden has known Irene for more than 44 years, starting when Irene was first caring for her newborn son and pursuing life as an academic in Ethno-musicology, through now, as an Applied Gerontologist and an expert on eldercare.

Dr. Shorter-Gooden stated:

Eldercare as Art and Ministry

Eldercare as Art and Ministry brings to the fore Irene’s knowledge and wisdom — to help us navigate in this complicated arena – caring for our mothers and partners and loved ones.  And, frankly, wondering about our own care as we age — what it will look like, and how we can shape it and make it what we want!

Irene’s deep well of experience and expertise comes from her training as a cultural anthropologist, her work as an educator, her service on behalf of the Episcopal Church, and her lived experience as a caregiver of aging, ailing parents. That experience in particular taught her that we, as a society, can do better, and led to her pursuit of education and practice in this arena.

Eldercare as Art and Ministry is a beautifully written resource that combines important facts and little-known information with stories that resonate. It normalizes the challenges and struggles of caring for elders, while broadening our perspective on the interplay of art and ministry and the meaning of this life-supporting work.

Over the years, Jackson-Brown Associates, LLC, located in Washington, D.C., has served clients along the East Coast and as far away as California through consultations and guidance. With two divisions, Care Management and Project Management, Jackson-Brown Associates centers on issues and projects that impact the lives of seniors and their loved ones.

Living in Washington, D.C. with her husband, a retired Episcopal priest, Irene has an adult son and a partner, Irene’s “daughter-in-love.” At the time of publication, she has grand-dogs but is now expecting her first grandchild, a girl!

Alzheimer’s and the Family Caregiver

November is National Family Caregivers Month and National Alzheimer’s Disease Awareness Month.

These observances help raise awareness about the challenges of caregiving for families, especially Alzheimer’s caregiving, as well as increase support for and educate caregivers and their communities. The current COVID-19 pandemic has also presented new realities and stresses.

According to the Centers for Disease Control and Prevention (CDC), more than 5.8 million people age 65+ in the U.S. are living with Alzheimer’s disease and more than 16 million family members and friends who provide uncompensated care for people living with Alzheimer’s and other dementias.

What is Alzheimer’s disease? The Alzheimer’s Association defines is as “a type of dementia that affects memory, thinking and behavior. Symptoms eventually grow severe enough to interfere with daily tasks.” In the early stages, one common symptom is difficulty remembering newly learned information. While we all experience occasional challenges with recall, someone living with Alzheimer’s might experience this with more frequency as the part of the brain that supports learning is impacted. Alzheimer’s disease is progressive and continues to change the brain.

Aging Life Care Managers® are in a unique position in their direct work with families, helping them to anticipate, understand and manage the emotional, mental, financial, and physical demands of caring for someone who is progressively losing the ability to care for themselves. Aging Life Care Managers also help families care for themselves while they care for their loved ones.

“As Aging Life Care Professionals®, we honor the many family members and friends who provide care and support to individuals living with Alzheimer’s and other dementias. Through our work, we understand why Alzheimer’s is called a family disease. We have an intimate view of the stress families experience and the challenges they face as they care for a loved one,” reflects Lisa Mayfield, founder & principal of Aging Wisdom, an Aging Life Care practice based in Seattle, Washington, and past president of the Aging Life Care Association (ALCA). “Our holistic, client-centered approach to care provides expert navigation and answers at a time of change and uncertainty.”

Aging Life Care Professionals regularly work with clients living with Alzheimer’s and other dementias, and, as part of their membership with the ALCA, they continue to educate themselves to remain experts in aging well and caring well.

The Latest Discoveries in Alzheimer’s and Dementia Research

2020 Alzheimer's Disease Facts and Figures
Statistics on Alzheimer’s Disease for 2020

In the U.S., more than 5.8 million people age 65+ are living with Alzheimer’s disease and over 16 million provide unpaid care for people living with Alzheimer’s and other dementias.

Aging Life Care Professionals regularly work with clients living with Alzheimer’s and other dementias, and, as part of their membership with the Aging Life Care Association, they continue to educate themselves to remain experts in aging well.

They follow developments such as what Dr. Maria Carrillo, Chief Science Officer at the Alzheimer’s Association, shared in a recent presentation — Advancing the Science: The Latest Discoveries in Alzheimer’s and Dementia Research – which provided promising insights. Carrillo’s presentation came on the heels of the Alzheimer’s Association International Conference® 2020 (AAIC®), the largest and most influential international meeting dedicated to advancing dementia science.

“This is such a hopeful time. Research is getting us the answers we are looking for, though we are confronting a very complex set of diseases under the umbrella of dementia,” said Carrillo, providing an overview of the latest research advances in prevention, detection, diagnostics, and therapeutic interventions.

AAIC Research Highlights

  • Early Detection, Diagnosis and Finding a Cure

Biological markers, or biomarkers, help researchers measure change in the body and are accelerating the speed of research.

Two biomarker hallmarks of Alzheimer’s disease are amyloid plaques and tau tangles. A promising blood test in development detects p-Tau217, the tau specific to Alzheimer’s, at a low cost and possibly up to 20 years before symptoms occur.

Biomarkers can assist with early detection and diagnosis. This in turn can help individuals prioritize their health, possibly delay or slow disease progression, plan ahead, and become eligible for a wider variety of clinical trials to help advance research.

Bill Gates, Jr., who recently lost his father to Alzheimer’s, has joined fellow philanthropist Mikey Hoag to help fund the Alzheimer’s Association “Part the Cloud” global research program. This partnership is funding sixteen neuroinflammation research studies. You can learn more at

  • Risk and Lifestyle

While age, family history, and heredity are risk factors we can’t change, research reveals clues to other risk factors we may be able to modify: lifestyle, cardiovascular health, physical activity, diet, sleep, social/cognitive engagement, education, and traumatic brain injury.

A two-year clinical trial, the U.S. POINTER study is currently underway. This study evaluates whether lifestyle interventions – specifically physical activity, cognitive and social stimulation, healthy diet, and health coaching – that simultaneously target many risk factors, protect cognitive function in older adults who are at increased risk for cognitive decline.

  • Drug Trials and Approvals

In 2020, the largest number of drugs in the Alzheimer’s clinical trials pipeline are treatments that prevent or slow down the loss of function. The developer of an anti-amyloid therapy to treat mild cognitive impairment (MCI) due to Alzheimer’s and mild Alzheimer’s, is seeking FDA approval. Researchers reported a reduction in clinical decline, benefits on cognition and function, and a reduction of amyloid/tau biomarkers. FDA approval is anticipated March 2021.

  • Flu and Pneumonia Vaccination

New research presented at AAIC 2020 suggests flu and pneumonia vaccines may be associated with a lower risk of Alzheimer’s. One study found a single flu shot was associated with a 17% lower prevalence of Alzheimer’s, while another study reported that for people between 65 and 75, a pneumonia vaccine reduced the risk of Alzheimer’s by 40%. More frequent flu and pneumonia vaccinations were associated with an even greater risk reduction.

“These new findings make an even stronger case for the potential of behavioral interventions throughout life to reduce risk of Alzheimer’s and other dementias,” said Carrillo.

Without effective treatment or cure, the impact of Alzheimer’s will continue to rise. Until there is a cure, Aging Life Care Professionals® will continue to serve as key supports, helping individuals and families navigate the psychosocial, emotional, and financial challenges associated with a dementia diagnosis.  We take a holistic, client-centered approach to caring for older adults or others facing ongoing health challenges. CLICK HERE to find an Aging Life Care Expert in your area.

About the Author: Keri Pollock is director of marketing & communications for Aging Wisdom, an Aging Life Care® practice based in Seattle. She serves on the Alzheimer’s Association Washington State Chapter Conference Advisory Council, the Age Friendly Coalition for Seattle and King County, and the Frye Art Museum’s Creative Aging Programs Advisory Committee.

Tips to Staying Healthy While Managing Incontinence During COVID

Americans have adapted new ways of doing things as a result of coronavirus 2019 (COVID-19). Coughs and fevers have become more serious and result in closer-than-usual attention. There are more and more signs everywhere we go about the importance of handwashing. And, many physicians and health care professionals have turned to telehealth to interact with sick patients. Whether these new norms become a permanent way of life is yet to be determined.

The Red Cross states the most important thing to do when someone is not feeling well is to limit the spread of germs and prevent infection. This is especially important for individuals who are immunocompromised and have other chronic medical conditions.

According to Harvard Health, individuals with heart failure, diabetes, chronic kidney disease and neurological conditions are more susceptible to developing more serious illnesses.

Coronavirus Safety Tips from American Red Cross

No one knows the exact amount of time an illness will last, but health care providers strongly advise people to take precautions to prevent it from getting worse. A key first step, when diagnosed, is to reduce contact with others. See below for other ways to stay safe.

Hand Washing 101

The CDC states that staying home when sick, increasing handwashing, and avoiding close contact with others are good ways to prevent the spread of a virus.

Father and two children washing their hands

Handwashing is essential, yet some of us may not be washing our hands correctly. Below are some tips from the CDC on proper handwashing techniques:

    • Wash hands with regular soap and water; antibacterial soap is not required
    • Scrub hands for at least 20 seconds (about the time it takes to say the alphabet)
    • Clean under fingernails, an often overlooked area where germs live
    • Use hand sanitizer that contains at least 60% alcohol after handwashing to be extra careful


Social Distancing

It can be difficult not to see friends and family during “stay-at-home” guidelines. But, there are other ways to engage with loved ones, including:

    • Use FaceTime video calling, which allows up to 31 people to participate at a time
    • Download Google Duo or WhatsApp, both free, to do a video call for non-iPhone users
    • Post texts of inspiring videos, uplifting photos and positive articles to family members and friends
    • Send puzzles, books and greeting cards to frail and at-risk seniors

Using Incontinence Products

With paper products flying off store shelves recently, people have been concerned about running out of food, household items and necessary medical supplies. It’s important to know where to buy quality products offering superior protection and timely delivery.

If you’re managing incontinence or caring for someone who is, it’s important to make sure quality supplies are stocked at home to avoid running out of these essentials.

NorthShore offers convenient, discreet and reliable shipping. Our Auto-Ship Subscription Program makes it easy to stay at home and have products on hand at all times, and our partnership with FedEx ensures accurate and timely deliveries.

Having the right mindset, exercising caution when interacting with others and staying inside when sick are some key steps to staying healthy, especially when feeling ill.

Our most reliable products such as MEGAMAX briefs, GoSupreme underwear, Booster Pads, and Supreme Quilted Wipes are great to have available when managing incontinence.

We hope you found this article to be helpful in staying healthy and safe. If you are interested in any of the products mentioned, browse our Online Product Catalog or call (800) 563-016

About the Author: NorthShore Care Supply helps individuals and caregivers manage incontinence with high-absorbency adult diapers, pull-ons, pads and liners that provide up to 3x better leak protection than leading store brands. Kind, caring customer support is available seven days a week to answer questions, provide information and make recommendations. Featuring discreet, same-day shipping. Free samples available upon request by calling 800-563-0161 or visiting

COVID-19 Meets Flu Season

After months of social distancing, hyper hand washing, and vigilant mask-wearing, are you ready for flu season? It’s coming, and it’s important to understand how the flu is similar—and different—from COVID-19, and what you can do to protect yourself and others.

According to the Centers for Disease Control and Prevention (CDC), influenza (flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. They have many similarities and some important differences.

Since many of their symptoms are similar, it may be hard to tell them apart. The following will help you understand what features the two viruses have in common, and which are unique to each.

Common to both: Fever or feeling feverish/chills, cough, fatigue (tiredness), sore throat, runny or stuffy nose, muscle pain or body aches, headache, or diarrhea and vomiting (more common in young children with influenza). New onset of shortness of breath or difficulty breathing has been reported with COVID-19 infection. These symptoms also can occur with influenza infection, but are usually seen among those with severe illness or other complications of influenza, such as pneumonia. For both viruses, symptoms can range from no symptoms (asymptomatic) to severe. It’s important to note that it is possible to spread the flu or COVID-19 when you are asymptomatic.

COVID-19 only: One symptom that is unique to COVID-19 is a change in (or new loss of) taste or smell.

Common to both: Older adults, people with certain underlying medical conditions, and pregnant women.

Common to both: Both COVID-19 and flu can spread from person-to-person, especially those who are in close contact with one another. Frequent handwashing, mask wearing, covering coughs and sneezes, social distancing, and regular cleaning of high-touch surfaces are all ways to reduce the spread of both viruses.

COVID-19 only: COVID-19 is transmitted through smaller droplets that are dispersed into the air when people with the illness cough, sneeze, or talk. These small droplets make it easier for COVID-19 to spread from one person to another because they can be inhaled through the nose or mouth or can enter through the mucous membranes of the eyes.

Flu only: Influenza is transmitted through large droplets that are made when people with the illness cough, sneeze, or talk. These droplets can then land on surfaces. If a person touches a surface or object that has virus on it and then touches his or her own mouth, nose, or possibly their eyes, they may get infected.

COVID-19 only: Most people who become infected with COVID-19 develop symptoms within 5 days. However, symptoms can develop anywhere from 2-14 days after initial infection. A person infected with COVID-19 may be contagious to others beginning 48 hours before symptoms develop and may remain contagious for up to 10 days after symptoms first appear. People with severe illness or people with weakened immune systems can be contagious for up to 20 days from when symptoms first appear.

Flu only: Most people infected with the flu develop symptoms within 1 to 4 days. Those infected with the flu can be contagious to others beginning one day before symptoms develop. They are most contagious during the initial 3-4 days of their illness, but many remain contagious for about 5-7 days after symptoms begin. Children and people with weakened immune systems may pass the virus for longer than 7 days.

Common to both: Both COVID-19 and flu can result in complications, especially among those at high risk. Some complications include pneumonia, sepsis, or organ failure.

COVID-19 only: COVID-19 also can cause life-threatening blood clots in the veins and arteries of the lungs, heart, legs, or brain.

COVID-19 only: The recovery time frame for COVID-19 can vary depending upon severity of illness, but most people experience improved symptoms within 10 days.

Flu only: Most people with the flu will recover in a few days to less than two weeks.

COVID-19 only: Currently there is no approved vaccine against COVID-19.

Flu only: There are multiple, safe influenza vaccines produced annually, including a special high-dose vaccine for people 65 and older. The CDC is strongly recommending vaccination against influenza for 2020-2021 season.

Protect yourself with a flu shot!
The best way to protect yourself against the flu is to get vaccinated. It is a simple step you can take to protect yourself, your loved ones, and others in the community.

The CDC is strongly recommending that everyone 6 months or older get a flu vaccine by the end of October.

Getting a flu vaccine is more important than ever during 2020-2021 to protect yourself and the people around you from flu, and to help reduce the strain on health care systems responding to the COVID-19 pandemic. If we can keep more people healthy this winter, we can ensure that resources are available to care for those who are critically ill from influenza, COVID-19, or other serious medical conditions.

Are flu vaccines safe?
Yes. For more than 50 years, hundreds of millions of Americans have safely received seasonal flu vaccines.

What to do if you’re not sure if you have the flu, COVID-19, or something else
Contact your physician to discuss your concerns and follow their advice regarding testing, treatment, and symptom management.

About the Author: Bayada: When you connect your clients with BAYADA, a nationwide company, for high-quality personal care and household support services, you can trust that we are committed to keeping them safe at home as long as possible. That means independence for them and peace of mind for their families. With BAYADA as a partner, you and your clients can rely on 24/7 clinical support, long-term care insurance expertise, best-matched and trained caregivers who love what they do, and ongoing communication and collaboration. BAYADA is also a Corporate Partner of ALCA and the Sapphire-Level Conference Sponsor.

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.”