Tag Archives: geriatric case management

geriatric case management

Wait – Don’t Get Hit in the Caregiver Crosswalk!

Current American Culture and Aging-Related Issues are often at odds with one another. We see this in a number of obvious and blatant ways, especially in mainstream media with anti-aging products everywhere, ‘active and youthful’ the focus in advertising and young families constantly on the go!

So is it surprising that seniors and the family members who care for them are caught in a “push-and-pull” relationship. A family caregiver may be trying to raise young children or teens while still being responsible to (and many times for) their elders. At the same time a senior does not want to be considered as a burden, effectively slowing down the pace or changing the course of a recently fledged family member or fledgling family.

Therefore the question is often asked, “How much do I need to change my life to accommodate for aging-related issues for myself (as I age) or for someone else?”

Having been family caregivers ourselves, we understand the many anxieties families face when confronting this challenge. As geriatric case managers, we are being told stories endlessly of how families upend their lives to assist loved ones who are aging.

Unfortunately, family caregivers often have the misperception that by living closer to an aging relative they will prevent out-of-home placement for that senior. Moving a senior across town or across the country to live with the family or relocating a family caregiver to move closer to or in with a senior can often appear to be the only option.

The reality is that over the long haul caregivers will be spending more and more of their actual time, physical and emotional energy and money (in outright expenditures and lost wages) by serving their seniors as: appointment schedulers, bookkeepers, transportation providers, Medicare advisers, home repairers, paperwork and record organizers, caregivers, medication managers, housekeepers, medical advocates, activities coordinators and list goes on and on.

Family caregivers, all too often, ‘burnout’ by attempting to take on too much responsibility while struggling to learn just the basics about their new caregiver role. Sadly after drastic changes have been made to the lives of a senior and their family with much strain endured by both, institutional placement out of the senior’s home is still usually the final result. Ask any assisted living placement coordinator, and they will tell you that families often try to go it alone but eventually give up and turn to them in desperation.

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However if the senior and the family discuss a goal of “aging in place” well in advance, it has a much better chance of being realized… and without major disruptions to anyone’s life.

As geriatric case managers, we routinely prevent many of the mis-steps taken by caring families. We work with families to discover and implement better alternatives than moving a senior out of their home to live with the family or a family caregiver moving in with a senior. We believe in Compassionate Aging as the solution for older and younger generations, alike.

© Anthony Antoville 2016

Anthony Antoville, CMC
Anthony Antoville, CMC

Anthony Antoville is Care Manager, Certified and COO of Champion Advocates LLC in Portland, Oregon providing geriatric case management services. Anthony is a published expert on long-term care with Edwin Mellen Press and co-created the Action-Compassion!Technique as an innovative approach to geriatric case management. 

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Care planning and paying for long-term care

Currently 12 million Americans require long term care services and 70% of seniors need some type of support. Many people worry about how to pay for the long term care and support that may be needed.

Unfortunately, many people are ill informed regarding benefits for which they may be eligible. Others do not understand how to access benefits for which they have paid.

This problem is often further complicated when “cost-savings” is made the priority over the appropriateness and reliability for a specific service need. One common example is when a neighbor is looked to for advice on a Medicare issue. Another is when a college student is given room and board in exchange for personal care or a friend is put in charge of filling prescription medications or a son-in-law who is handy with tools installs safety devices in the bathroom.

The list goes on and on… Well intentioned people volunteering care or providing low-cost support to seniors and their caregivers can all too quickly turn a care situation into an expensive, unsustainable or even life-threatening risk.

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People often over-estimate or under-estimate care needs! Before looking at how to pay for care, we work to understand what types of care are essential for the individual and how much care they will actually need. The initial stages of creating a care plan include assessing what types of care are needed, what persons or services are most appropriate to provide that care and what resources are available to provide or pay for required care.

It is important not to make the mistake of under utilizing benefits that have already been paid for or are otherwise available for the person who needs care. We know it is essential to provide a clear understanding of eligibility and coverage for public and private benefits, as well as the processes for activating these benefits. We also examine all the resources that are potentially available to the person who needs care. A care plan can then be created holistically with a wide-range perspective of needs and resources within the overall context of a person’s life goals and preferences.

Anne Conrad-AntovilleAnne Conrad-Antoville is CEO of Champion Advocates LLC, Geriatric Case Management Services, serving seniors and their families in the Portland Oregon region.

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2015 McGinty Alzheimer’s Conference- Portland Oregon

This year’s annual McGinty Conference on Alzheimer’s will be held November 3 at the Oregon Convention Center. It is open to family caregivers and professionals.

Register at: alz.org/oregon

Be sure to attend breakout sessions presented by dementia and aging experts including:

The Action-Compassion!Technique Series:
Redefining the Assessment Process for Improved Outcomes
Session B2 from 12:45-2:15PM

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Champion Advocates LLC

Geriatric Case Management Services

 

The Action-Compassion!Technique is a dynamic methodology in long term eldercare management focusing on the multi-level challenges of the diagnosed elder through the lens of the family caregiver. Effective assessment processes are the first step to good care planning and worthwhile service implementation. By better understanding the full range of challenges faced by the family, it is possible for the professional to save valuable time and energy for everyone involved. This technique is designed for the case manager within a private practice, yet can be used across multiple service fields, including medical, social, legal and financial services to better
serve elders and their families when facing the many issues of long term care for dementia.

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Compassionate Aging Series: Happiness in Aging – Mind, Body and Emotions

Every one of us is in the process of aging. How do we age in a way that is compassionate to our minds, bodies and emotions? In this interactive presentation, we will explore pathways to happiness in aging.

Join in conversation:                                                                                                      Anne Conrad-Antoville, BM, MM                                                                         CEO of Champion Advocates LLC,                                                                   Geriatric Case Management Services

Wednesday, September 30, 2015 Anne Conrad-Antoville  5:30-7:00pm

-heavy hors d’oeuvres will be served-

West Hills Village
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Please RSVP to (503) 245-7621 by Friday 9/25

Anne has been a professional aging services provider for 15 years and has been the recipient of local, state and national awards for senior health care advocacy. She has worked directly with many hundreds of older adults and their families. She has appeared as a senior services expert on radio and television news programs and has been a speaker at California Association of Area Agencies on Aging, Rotary International, California State HICAP Association, California Health Advocates, Humboldt Medical Association as well as numerous senior and community centers and local businesses.

 

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Medical Alert Devices – Too Little, Too Late

An older woman cries out pleading for help from the bottom of a stairway in a large and empty house, and we are led to the conclusion that if only she had a medical alert device worn around her neck she could have emergency first responders there in minutes.

But what then…? How does the second half of this supposedly “averted” tragedy play out?

As reported by the Centers for Diseases Control and Prevention (CDC)*:

“In 2010, 2.3 million nonfatal fall injuries among older adults were treated in emergency departments and more than 662,000 of these patients were hospitalized.”

“People age 75 and older who fall are four to five times more likely than those age 65 to 74 to be admitted to a long-term care facility for a year or longer.”

So instead of lying on the floor for hours or days incurring additional life threatening conditions or worse, our female victim is whisked to the hospital and most likely will be treated and then discharged to a long-term care facility, either an assisted living or a skilled nursing facility for a year or more or until the end of her life.

The ability to lie on the floor and push a button may provide some level of comfort and security to seniors and their families yet when the fall has already occurred and resulting injuries sustained, the reality is your parent is lying there just pushing a button for help.

Now, a life will change in ways not to be desired by anyone. He or she will most likely be shuttled into a vast medical system to wind up in a bed that is not theirs and to no longer live in their own home.

This is the real fear older people live with. The fear of losing their independence and being institutionalized needlessly or prematurely.

If only the family had pushed beyond the simplistic notion that technology and telecommunications were all that was needed to keep mom or dad safe. If only our fear-based advertising could help us consider what happens after that last ditched effort is activated. Then, we could achieve compassionate aging for everyone concerned, senior and family caregiver alike.
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Like the CDC states*:

“Each year, one in every three adults age 65 and older falls. Falls can cause moderate to severe injuries, such as hip fractures and head traumas, and can increase the risk of early death. Fortunately, falls are a public health problem that is largely preventable.

Geriatric case managers are qualified professionals to identify and evaluate many safety risks based upon mobility, vision and other physical deficits, environmental factors around the home, medical and behavioral conditions. By providing comprehensive assessments including balance and gait and home safety assessments, appropriate provisions and safeguards can be allotted and falls and many other unrealized dangers can be truly averted.

Medical alert products and services are worthwhile, but they are the very last line of safety. If they are to provide comfort and security, they should be part of a much more comprehensive approach to an elder’s care – one where that button need never be pressed.

© Anthony Antoville 2014

Anthony Antoville is Care Manager, Certified and COO of Champion Advocates LLC in Portland, Oregon providing geriatric case management services. He is a recognized expert in eldercare and home safety, internationally published with The Edwin Mellen Press.

*The Centers for Diseases Control and Prevention (CDC) Website “Home and Falls Among Older Adults: An Overview” Last Updated: 9/20/2013

 

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Are Popular Influences Stealing Our Real Experiences for True Aging?

During my childhood, I constantly wanted to be older than I was. I tried to hang out with the kids in the older grades, I did everything I could to be considered older than I was as to gain aged prestige and cache, I tirelessly worked to turn the eye of many a high school girl while I was in middle school, I snuck out and drove without an adult when only having a learner’s permit. These examples seem to be the typical stuff kids do in a search for more independence and greater acceptance in the world of adults.

Of course what I was attempting to do, in hindsight, was to see myself as more independent and more accepted in a wider world even if merely on the surface.

As I consider the cultural influences that surrounded me in my youth, I see how I was repeatedly told that everything would be better by being older. In many ways that concept proved to be true, because there were many aspects of life I was unable to fully experience socially, emotionally or legally until I was older.

Yet now as I turn 50, I find myself ceaseless bombarded by messages of how I and the over 50 crowd should remain 21 …forever. We are repeatedly shown and told that nothing can be better than to look, feel and even act younger than we really are!*

Is such a materialistic approach to aging the one we really want to pursue as we grow older? I fear it is one that would keep us chasing after an illusion never to be realized.

I refuse to believe that I have lived half a century to reverse my field of vision now and idealize my youth in such a way as to attempt to re-live it!

Perhaps, my peers and I are ready to search for deeper and more revealing aspects of living life without tracing over our outgrown notions of who we wanted to be.

When we try to freeze a specific segment of our earlier years lived and replay it in a repeating loop, we deny ourselves the ability to look honestly at where we are, grow more fully into who we are and venture into the future with continued wonder.

The effect of this medication stays there in the product. viagra tablet Smoking is also responsible for low sperm count, low semen volume and male infertility are prostate gland infections, inflammation of your prostate gland, cyst in the duct, best buy for viagra growing old, frequent lovemaking episodes to enjoy intimate moments. As erectile dysfunction considers a form of sexual disorder not a disease. viagra super active If you care about what you do want and see what happens! This workout is really about saying YES levitra on line sale to yourself, to that powerful being who is beyond the positive and the negative outcomes you perceive to be real. Isn’t that what we should expect from living up until now in our lives? How can we know what is missing from our lives, if we do not permit ourselves the opportunity to live out beyond merely youth-filled experiences? Why would we not want to discover and claim the hidden treasures of new encounters and unique realizations by moving into the uncharted territories of our lives yet to be lived?

© Anthony Antoville 2014

Anthony AntovilleAnthony Antoville is COO of Champion Advocates LLC in Portland, Oregon. He has been serving the psychosocial needs of seniors since 1991. Anthony is a published author with The Edwin Mellen Press.

 

*Forever Young: America’s Obsession With Never Growing Old
Why is America such a youth obsessed culture?
Dale Archer, MD in Reading Between the (Head)Lines, Psychology Today

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Are You Your Parent’s Secret Emergency Plan?

Recently, I received a call from a gentleman in his early eighties, who was caring for his wife with dementia.

He told me, “I’m calling you, because I need an emergency plan if anything happens to me. I need someone who will come in and handle my affairs and my wife’s issues at a moment’s notice. Then my kids, who live in another state, will come and take care of my wife.”

I asked him, if his adult children were aware of this plan he had. No, he hadn’t actually discussed this plan with them, but he was sure it would be fine.

I asked why he thought it was a good plan to wait until an emergency situation to happens, before he could ask for help or let his children know of basic issues in advance. He said bluntly, “Look, I know what I need! I only want someone to be able to come in on a moment’s notice, then my kids will take care of everything.”

This exchange illustrates a common and complex issue that is happening across the country for many families with aging parents. A spouse caring for another spouse who suffers from dementia or another chronic condition will often become fatigued, burned  out and develop their own health problems brought on by stress and overwork, thus putting both elders at risk.

Often, the senior providing care will refuse help or underestimate the amount of help that is actually needed.

The adult children are often kept in the dark, while simultaneously being made part of a secret emergency plan that no one has actually examined. The secret plan is revealed only once the crisis hits, and the adult children are caught in a web of issues that are usually serious, intricate and deteriorating rapidly.

For the family members trying to help, coming in at this stage of the crisis can result in significant stress, significant time commitments and significant financial cost. It can negatively impact employment or business and overwhelm personal relationships.

Waiting to respond until a crisis hits almost always results in substantially reduced options for the aging parents and for the family caregiver. Reacting is never planning!

It seems like many a Los Angeles film school are missing out on a great opportunity – if they provided such one-on-one mentoring programs, there would possibly be a lot more stories of free samples viagra big achievements from their students. It helps to viagra 20mg in india boost sperm count, sperm motility and necrospermia are two of the important causes of male infertility. But at the same time fend off having dose more than dictated by your cheap levitra professional https://pdxcommercial.com/property/516-high-street-oregon-city-oregon-97045/ health expert. On account of an erection which goes on for over 4 hours medical consideration is sales cialis required. So, what is the best way to avoid this type of emergency crisis?

Open up the conversation with your aging parent sooner than later! Chances are, you already have a feeling that something is going wrong.

Ask your parent how things really are with questions that elicit more than simple “yes” or “no” answers. Ask how tired, stressed or overwhelmed is the parent who is providing care? What are the health and household issues? How much time, energy and work can be realistically expected of other family members, if help is needed?

How do you respond to this information and what are the next steps?

As a geriatric case manager, I highly recommend having a family meeting with a geriatric case manager. Geriatric case managers are aging professionals with broad expertise and knowledge. We can perform assessments based on multiple issues and coordinate planning and services to meet goals for the entire family. Best of all, a geriatric case manager can continue to work with the family and the senior over a period of time, providing continual monitoring, oversight, coordination and support as needed.

© Anne Conrad-Antoville 2014

Anne Conrad-Antoville is a geriatric case manager with Champion Advocates LLC in Portland, Oregon. She has spent the past 15 years of her professional career successfully troubleshooting complex issues for seniors and their families.

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