The field of geriatric care management is relatively new compared to many professions.  Early geriatric care managers typically started their careers as social workers, geriatric case managers and nurses in various settings such as hospitals and nursing homes.  As more and more families needed guidance and independent advice, as well as coordination assistance (especially for families at a distance), care management practices opened to fulfill these needs.

The National Association of Professional Geriatric Care Managers (NAPGCM) is the professional body representing this industry.  As mentioned, many of its members have backgrounds in various professions and may thus belong to other organizations, be licensed under certain regulations and have additional standards and ethics related to those.  The NAPGCM acknowledged this when it created its professional standards:

“These Standards have been developed because Professional Geriatric Care Management is a human service specialty provided by professionals from diverse backgrounds and academic preparations to a vulnerable and often frail population. No one profession can claim exclusive domain over the knowledge and skills required to provide geriatric care management services. Thus, Geriatric Care Managers (GCMs) may be members of formal professions, such as social work, nursing or psychology, or may hold advanced degrees in gerontology, counseling, public health administration, or other fields of human service specialization.

In addition, these Standards have been developed because certain issues of particular concern to GCMs have not always been included in the standards developed by other organizations. Thus, the purpose of these Standards is to supplement already existing standards of other professions and organizations and to provide guidance to the members (of NAPGCM) in the many complex situations presented by their practices.”

The geriatric care management standards cover a variety of areas including: the client relationship (identifying the client, promoting self-determination, privacy rights, professionalism and recognition of the geriatric care manager’s personal beliefs and values and how that might impact clients), professionalism of the geriatric care management practice (defining the role, care plan, employment laws, decision-making roles, continuing education and certification), and business policies (advertising/marketing, fee, disclosure of business relationships).  To read the geriatric care management standards of practice in more detail click here.

When you hire professional geriatric care managers who belong to NAPGCM you have the added protection of knowing they meet professional standards as well as adhere to a code of ethics.  Additionally, many geriatric care managers will have other professional credentials that may enhance their ability to meet your family’s needs.  Our Hiring a Geriatric Care Manager Checklist helps you to identify important characteristics and understand the business parameters before you make a decision.

We invite you to take a look at our Clearwater-based Florida geriatric care management team.  You can read about each geriatric care manager’s qualifications, experience and certifications.  We are proud of the experienced team we have built and pleased that both our company and team members have been acknowledged with several awards.  However, our most important accomplishments are our day-to-day contributions to the lives of clients and families.

Contact us at 727-447-5845 with any questions or tell us a little more about how we can help:

Caring for a loved one from a distance can be especially challenging.  Because many seniors come to Florida to retire or families otherwise relocate to enjoy all that Florida has to offer, many elders live here without the nearby support of close relatives.  Often, communities and neighbors are very supportive, but as we have written in the past, support from older friends may only go so far especially if neighbors are “snowbirds” who are not around during summer months.

As a long-distance caregiver, you can start by planning visits to your loved one and keeping an eye out for signs of concerns on visits and when you talk.  To help, grab a copy of our “Warning Signs” checklist:

If you have identified some possible concerns, here are some tips and resources to help:

1. Get organized.  Check out our Essential Eldercare Checklist for things to do at various stages, important legal docs and information to have in place.  Keep a list of important telephone numbers and websites in your loved one’s area as well as providers/key contacts (neighbors, doctors, attorney, local hospital).
2. Talk to your loved one about getting a personal emergency response system.  These range from a simple push button system that an elder can push if he/she falls to systems which monitor various points or help with medication management.
3. Get introduced to providers/contacts if your loved one is open to it.  Ask if your loved one would mind if you attend a doctor’s appointment and fill out paperwork to include you as a contact.  Often neighbors and friends are under the mistaken impression that an elder’s family is not involved/doesn’t care, so it helps if you can meet them and provide emergency contact information.  (If all of this feels a little invasive to your loved one, take it slow and explain your concerns and how you will respect their privacy but only wish to be prepared as a “just in case”.)
4. Explore home care services.  Would your loved one consider someone to help around the house with household duties or errands?  Someone to come in and prepare meals once/week or drive to nighttime activities?  Home companion services can be a good way to introduce some help and ensure someone is checking in regularly.
5. Connect with a geriatric care manager.  You may start now with a care consultation, or find out if your loved one might be willing to have a geriatric care manager attend doctors’ appointments or check in on a regular basis.  A care manager’s expertise allows her to spot things that neighbors, friends and even family may not notice, especially if an elder is good at “putting on appearances”.  The care manager can become a trusted resource you can rely on, your “eyes and ears”, while also being a great support for the senior client.  Even if you don’t hire a care manager now, you have a resource you can turn to in the future.

Adverse Effects of Hospitalization on Alzheimer’s Patients: Dementia Precautions

Hospitalization often results in functional decline for elders, with a change in functioning occurring as quickly as day two of being hospitalized.  For elders with Alzheimer’s and other forms of dementia, effects are often more pronounced.  Several studies over the years have demonstrated both physical and cognitive impacts.

The scope of the problem: Evidence shows that persons with Alzheimer’s Disease are more likely to be hospitalized than other older adults.  Amongst older adults, delirium is a particular risk of hospitalization and those with Alzheimer’s are at greatest risk.  Various clinical observations and studies have indicated these increased risks for Alzheimer’s patients as well as longer-term effects such as cognitive decline and increased care needs (often leading to placement in an assisted care or nursing facility).

A recent study published in the Annals of Internal Medicine was conducted to confirm these findings by directly comparing a group of hospitalized patients to similar patients who were not hospitalized to better determine the risk for bad outcomes due to hospitalization and to delirium occurring during hospitalization.

The findings: Patients with Alzheimer’s Disease who are hospitalized for any reason are more likely to die than patients who are not hospitalized. If they survive hospitalization, they are more likely to require placement in an institutional facility, such as a nursing home. Of great importance, the occurrence of delirium in patients with Alzheimer’s Disease substantially increased these risks compared with patients who did not develop delirium. The authors estimate that:

6% of deaths

15% of institutionalizations,

and 21% of cases of cognitive decline

in hospitalized patients with AD can be associated with delirium.

The implications for you: If you are a loved one or someone caring for a person with dementia, this can be scary information to read.  But, it is valuable to know and helpful in working with your loved one’s medical providers. 

First, you can work together on care planning and ways that hospitalization might be avoided in some situations (for example, outpatient treatments, deciding on care priorities).  Second, you can advocate for your loved one when hospitalized and ensure dementia precautions are taken and risks of delirium are reduced (and identified and managed as quickly as possible when occurring).  We encourage you to view our Caregiver Tips for Hospitalization of an Alzheimer’s Patient (good tips for caregivers of any elder).

You might also want to check out our hospital discharge planning checklist for families:

Have concerns for a loved one with dementia?  Want to take dementia precautions when it comes to care planning and hospitalization?  Our professional patient advocates can help.  Contact us at 727-447-5845 or 888-807-8551 to discuss your situation.

Hurricane Season Safety for Seniors: Aging Wisely’s Preparation Package

Aging Wisely offers a special service for seniors and individuals with special needs to help them prepare for hurricane season.

Our care managers have developed a hurricane planning procedure over the years of assisting senior clients, and various professional organizations and colleagues have sought their expertise.  This year, we are offering a stand-alone service for individuals and families who wish to have assistance in putting together their plans.

Natural disasters tend to have bigger impacts on vulnerable individuals, such as those with chronic medical conditions, disabilities or who rely on outside support for daily assistance.  Individuals who are homebound or with limited mobility may also be the least likely to prepare and evacuate due to the challenges involved.  It is vital to recognize the serious impacts natural disasters can have.

To get more information about preparing for hurricanes for someone with special needs, visit Aging Wisely’s “Help for the Elderly in Florida During Hurricane Season” which includes a downloadable checklist for special needs disaster preparedness.

You can reach Aging Wisely at 727-447-5845 for more information or fill out the contact form for senior safety hurricane planning assistance.

Additional Resources for Senior Safety during Hurricane Season in Florida:

EasyLiving’s Senior Safety: Disaster Preparedness Tips for Caregivers

Florida Division of Emergency Management

A lot of families contact us wondering aout getting an elderly parent assessed.  Perhaps “getting your elderly parent assessed” is a bit of a misnomer, as the elder, family and professional take part in a cooperative process to get a picture of the individual situation and solutions that fit.  It is not as simple as an inspection and “diagnosis” but more of a problem solving process with everyone’s involvement.  The process and its outcomes can be beneficial for any family struggling with elder care concerns (or issues related to chronic illness or disability).

A geriatric care management assessment provides a “big picture” of an individual’s (and family’s) situation from a comprehensive perspective, because our lives are comprehensive…not separated in to silos.  An elder’s medical diagnoses themselves do not illustrate much about the person…it is his or her medical conditions, general health, abilities and challenges, support system, life history, belief system and personal strengths that create a picture of the day-to-day situation and should shape any future considerations.

There is a lot of information gathering in the assessment process and the care manager wants to get to know you as well as possible, to make recommendations tailored for you.  However, the care manager is sensitive in trying not to make the process feel like a battery of tests.

The care management assessment brings together the information gathered, the care manager’s professional evaluation, and possible solutions.  This is where the professional geriatric care manager’s expertise really benefits you.  The care manager knows the “ins and outs” of different solutions, so you don’t waste valuable time chasing solutions that won’t work for your family.

What are some of the reasons families feel they benefit from the assessment process?

• It helps bring the family together-creates cohesion around decisions, offers an outside, professional viewpoint which can often reduce disagreements and uncertainties.
• It uncovers information and concerns that were previously unknown.
• It helps them budget and plan for costs of care, future needs, etc.
• It opens up the conversations about elder care needs and options.
• They walk away with real solutions.

A lot of people like seeing real examples of patient assessments to get a better idea of what is included–check out Aging Wisely’s geriatric care assessments here.   

Want to talk to us to see if a geriatric care management assessment is right or your family?  Call us today at 727-447-5845 or click below to get more information:

Trying to figure out what questions to ask when you are considering a geriatric care assessment or other care management services?  Grab this handy checklist:

In this post, we offer some key tips and resources for those of you managing the elder care of a loved one with memory loss, dementia or Alzheimer’s disease:

First, if you have questions about the terminology of memory loss and dementia or are in the process of seeking to find out what might be going on with a loved one who seems to be showing signs of memory loss, grab our easy-to-understand guide with lots of great info:

As someone who may be at one of many stages of elder care management for a loved one with memory loss, you may be encountering a wide range of concerns and issues.  We can’t answer all of those in one post, but we do encourage you to contact us or leave a comment below on particular issues you’d like to see us cover.  Here are a few tips that we think will help anyone in the process of caring for a loved one with dementia:

• Preparation eases the caregiving path.  If you are just noticing some concerns, now is the time to marshal your resources: educate yourself on the disease, resources and your loved one’s situation (such as health and insurance coverage, overall health issues, financial picture and status of legal documents and estate planning).  Check out our Essential Eldercare Checklist for more details.  If you are in the midst of caregiving, read up on the concerns you are facing and the disease stages, and keep a “resource notebook” (or list of online sites) handy.
• Your biggest caregiving role is advocate.  This becomes exponentially important when caring for someone with memory loss.  Your loved one needs (or will need) someone to be his/her “memory” and assist in coordination, ask the right questions and be his/her protector.  You may divide up duties in advocating with other family members or may bring in a professional care manager/patient advocate to help, but good advocacy will make all the difference in your loved one’s elder care.
• Get support (in the way that works best for you, see our resources section below for some ideas).  Not everyone wants to join a traditional support group, but you might find it useful to talk to a counselor, have the one-on-one support of a geriatric care manager, or join in forums online.  The diseases that cause memory loss are particularly challenging for families…you need support, ideas, and places to turn as you face different challenges.

If you are looking for assistance with elder care management, concerned about a loved one with memory loss or have questions, give us a call at 727-447-5845 or tell us a little more so we can get in touch and find solutions for you!

Additional Resources for caregivers:

Alzheimer’s Association: offers great online resources, as well as local offices for support group information in your community and help with community-specific information.

Aging Wisely’s Recommended Reading on Dementia

EasyLiving-Alzheimer’s Specialty Memory Care

Family Caregiver Alliance offers a few online support groups, as well as important caregiver information and fact sheets.

The Medicare program is made up of a variety of parts, covering different services from doctor’s visits to medications and acute care needs.  To get an overview of the Medicare parts and costs, grab a copy of Aging Wisely’s Medicare Fact Sheet for 2012.

Medicare Part A generally covers hospital stays for elders (similar coverage may be provided under Medicare Advantage plans, which are provided by private insurers).  Recipients are subject to a flat deductible as their responsibility for a hospital stay up to 60 days (we provide all the costs and details on the Medicare Fact Sheet).  Doctors’ services are billed separately, under Medicare Part B.

An important issue for Medicare recipients to understand is the concept of Hospital Observation Services vs. Hospital Admission under Medicare.  Staying overnight in the hospital does not automatically mean that one has been admitted, which affects how Medicare covers the costs of the hospital services.  Outpatient services are covered under Medicare Part B (like doctor’s services) so when a patient is not admitted, he or she will generally have a 20% copay for each service received.  The total costs can exceed the Part A one-time copay.

Additionally, Medicare’s coverage of inpatient rehabilitation is based on a qualifying three-day inpatient hospital stay.  Therefore, an individual needing inpatient rehabilitation may find himself footing the bill (many thousands of dollars potentially) for those services.

What can patients and their families do?

When you are assisting in the care of your aging parents or other elders, one of your primary responsibilities may be managing medical care.  You may start by simply assisting with questions or problems your aging loved one has, such as going along when they talk with the doctor about a recommended surgery or analyzing Medicare options or coverage.  As you become more involved in care, you may attend all doctor’s appointments or help to coordinate care.

Our professional patient advocates share their checklist for getting started in helping to manage your loved one’s medical care:

• Get organized.  Pull together a medical history for your loved one and organize old records or files they have of past surgeries and other information.  We suggest a personal health record system online as the easiest way to organize and access this information.
• Be “insurance-informed”.  Find out what coverage your loved one has and get some basic information on the coverage.  Make sure you have the contact information easily accessible.  To learn more about the Medicare program, check out our Medicare 2012 Fact Sheet.
• Open the path to communication with providers.  Ensure your loved one has the proper legal paperwork for you to help if he/she is incapacitated.  Second, contact medical providers to find out what is required for your involvement now (or in the future), when your loved one has capacity but wishes for you to help.  Most doctor’s offices will have a privacy form asking the patient to sign off for individuals who are permitted to receive information.  Also, as you start to attend appointments, introduce yourself to providers and “pave the way”.
• Prepare for appointments.  Prepare a list of questions, bring information on other appointments (medicine changes, etc.) and problems/concerns that have arisen.  Do not speak for your loved one, but offer assistance in going through questions or concerns as he/she feels comfortable.  In some cases, it helps to fax/send over some background information prior to the appointment.

How can an Aging Wisely professional patient advocate help you? 

• Attending appointments and managing local care for long-distance caregivers
• Consulting with you on issues that arise, troubleshooting concerns and making referrals to high quality providers
• Crisis management
• Medicare analysis, insurance advocacy, navigating public benefits programs
• Much more!  Contact us at 727-447-5845 for questions or click below:

We have lots of resources on our eldercare blog about hospitalizations and elders, patient advocacy, Medicare and more!  You can sign up on our blog to get updates or get our monthly newsletter (below).  In our next post, we’ll review some ongoing tips for managing medical care, including hospital stays.

Help for the Elderly in Florida-Preparing and Managing During Natural Disasters

It is that time of year again…hurricane season in Florida.  Realistic disaster planning is especially important to the elder, and sometimes frail, clients we serve.

We are currently of working with clients and families on hurricane season planning, with a procedure we have honed over the years to minimize risk for vulnerable individuals.  During this initial phase, we work together with clients to make an initial plan, gather supplies and discuss alternatives if a storm approaches.  Our expertise on this process has been sought out by various professional colleagues/groups.

Special needs shelters have limited capacity and are not designed to meet the needs of many frail elders (shelters do not have hospital beds and only limited cots, cannot provide special diets or handle acute medical issues, for example).  This SHOULD NOT be any client’s PLAN.  We recommend (and help) clients make alternative arrangements, such as staying with friends or family or a reservation at a hurricane-receiving assisted living or nursing facility (paperwork from the doctor is required and advance reservations are wise as facilities will get many requests as a storm approaches).

Before any storm is predicted, we move in to phase two of planning for our clients: storm-specific preparation.  At this time, we work with families to look at current conditions so they can make up-to-date decisions and put plans in to place well in advance of a storm watch, while help is still available.

To learn more about special needs planning, from how and where to evacuate to preparing the home, making a survival kit and more, grab our Special Needs Checklist.

To further benefit seniors in our local community, we have developed a Hurricane Preparedness Package. We offer this stand-alone service for individuals who do not have ongoing care management services, but could benefit from assistance with hurricane planning.

It is vital to recognize the seriousness of natural disasters for elders who live alone, individuals with chronic conditions or disabilities or those who rely on outside assistance.  Elders cannot rely on caregivers or other services being available during emergencies and even the 911/emergency services shut down during high winds and dangerous weather.  Seniors who wait until the last minute or do not take precautions may be stranded without help, not only during the storm but in the aftermath.