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Aging Wisely March 2013 - Aging Wisely

Senior Care Signs: You May Need a Geriatric Care Manager If…


calling for help from a geriatric care managerHere’s our “top 10 list” of signs that you might want to seek help from a geriatric care manager with your aging parents’ care or eldercare concerns.  These are some of the common patterns that begin to build in our lives as we strive to care for loved ones as they age or suffer from various health issues.  If these patterns sound familiar, it is a perfect time to reach out to a geriatric care manager in your parents’ local area to plan a consultation and/or geriatric care management assessment.

You can reach Aging Wisely at 727-447-5845 or complete our online senior care request for geriatric care management assistance in Pinellas, Pasco, Hillsborough counties in Florida (St. Pete, Clearwater, Palm Harbor, Tampa and more).

Top 10 signs it’s time to call a geriatric care manager:

10.  You sleep with your cell phone by your bed, not as an alarm clock, but because you are worried about what emergency might crop up with your elderly loved one overnight.

9.  You are racking up frequent flier airlines miles, not on taking vacations or business trips, but on trips down to visit your aging parents in Florida to handle multiple crises.

8.  Your office assistant is on a first-name basis with your elderly Mom, who calls with emergencies (or perceived emergencies) throughout the day.

7.  Every question you ask your Dad is answered with “I’m fine” or “it’s fine” despite the various health problems he has had and the concerns you spot every time you visit.

6.  Every visit to your aging parents for the past two years has consisted solely of doctor’s appointments and running errands.

5.  You have your parents’ local hospital programmed in to your phone.

4.  You know more than you ever wanted to about your Mom’s medical condition, but still don’t understand what the doctors are recommending or why.

3.  Your used to visit websites about a favorite hobby or celebrity gossip, now you stay up late reading senior care websites and eldercare advice blogs.

2.  Your worries span the generations: one moment you are thinking about your oldest daughter finding a job and the next moment you are wondering if you need to move your Mom in to your home.

And, the #1 reason why you might need a geriatric care manager is…you want to do the right thing for your aging loved ones and sometimes it is hard to know what the right thing is or how to make it happen.

Calling a geriatric care manager does not mean you are giving up the responsibility or somehow shirking your duty to help your aging parents.  A geriatric care manager can be your partner in ensuring the best care for your aging parents or other elderly relatives. 

How?  Tools, resources, specific recommendations, patient advocacy and expertise as well as help managing tasks and ongoing monitoring to ensure things are going well…and giving you back peace of mind (and more quality time with your loved ones)

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Managing the Dangers of Medications: Senior Care Resources


medication management and senior care resourcesAt least 1.5 million Americans are sickened, injured or killed each year by errors in prescribing, dispensing and taking medications

30% of hospitalizations for elders are thought to result from drug-related problems/toxicity.  Adverse drug effects have been linked to falls, depression, constipation, confusion and immobility.  If medication errors were counted as a disease, they would be the 5th leading cause of death among seniors 65 and older.

Did you know? Some interesting facts about medications, medication management and senior medication issues:

  • Some foods can interact negatively with medication and certain medications should be taken properly in relation to food/drink.
  • Over-the-counter medications, vitamins and herbal remedies should all be analyzed when your treatments are being reviewed. These can have side effects or interactions with prescription medications.
  • Medications are metabolized differently in elders.
  • Certain medications commonly prescribed for behavioral issues can have serious negative effects on elders with dementia and can, in fact, exacerbate the various behaviors they would typically treat.

Need help with medication management concerns in the Tampa Bay area?  We can provide a range of services from assessments through ongoing senior care management–in Pinellas, Pasco and Hillsborough counties (Tampa, Clearwater, St. Petersburg):

When properly managed, medications can be a vital part of the good senior healthcare.  When not properly managed, the dangers can have a significant impact.  For older adults who tend to take multiple medications, the risks are inherently high.  This may be complicated by poor coordination and communication among multiple clinicians, patient compliance difficulties due to memory issues or practical problems and interactions/sensitivities.

Research shows that multi-faceted medication management programs lead to the best treatment outcomes and minimize mistakes.

Aging Wisely’s geriatric care managers support clients in staying safe and healthy with an individualized approach to senior care coordination, with benefits such as:

  • Assessing comprehensive areas including medication management and overall management of your medical conditions and senior care needs; providing senior care resources that best meet your individual needs.
  • Ensuring your clinicians are equipped with the best information: attending your medical appointments, keeping your records updated and communicating with your medical team and providing feedback so they can pinpoint problems early.
  • Advocating with your medical providers to review medications, reduce overuse of medication and simplify schedules.  Fewer medications make it easier for people to correctly take their medications and can reduce interactions/side effects.
  • Ensuring your medications work most effectively by linking you to specialists, such as a geriatric pharmacy consultant, to review and pinpoint the best regime.
  • Providing solutions that help YOU: offering advice on devices and technologies that will best meet your needs, from pill boxes to medication dispensers and reminder systems.
  • Determining what type of personal assistance might be needed, such as engaging home health medication management including a Registered Nurse to set up your pill box and home health aides for medication reminders and assistance.
  • Assisting with communication and advocacy: tracking allergies and history, providing background information to clinicians and helping you to ask the right questions.
  • Managing transitions (such as a move to a care facility, hospitalization and discharge) to reduce mistakes, redundancies and problems.

It is vital to assess and manage medication regimes on an ongoing basis since they can have such major impacts on a person’s health and quality of life.  If you have questions or know someone who might need help getting better senior care outcomes, give us a call at 727-447-5845!

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Senior Living Issues: Nurse Refuses to do CPR at Retirement Community


CPR on elderlyBy now, it’s likely you have heard the news story about the nurse who refused to do C.P.R. on a retirement community resident who later died.  Sally Abrahams did a good review of the story on her AARP blog.  It was a startling story for many and readers weighed in all over the internet with comments.  The reactions range from shock and anger that this nurse would not perform CPR to questioning the facility’s policy and contemplating the senior’s status regarding wishes (i.e. did she have advance directives or a DNR?).  Rather than delve in to the facts of this specific case, we’d like to broaden the discussion to a number of important issues for all families to consider.  Here are a few key take-away lessons and tips for families and elders:

  1. When it comes to choosing a retirement community, understanding what you’re getting is vital.  Your best bet to cutting through the array of choices is to hire a care manager to help.  Even the reporters of this story were quite confused about the type of facility in question here, reported variously as a CCRC (Continuing Care Retirement Community), Independent Living Facility and Retirement Community.  Each state has different regulations for different types of facilities, and beyond that of course there is a wide range of care quality and scope. It can take a lot of research to figure all of this out, and it can still be hard to know all the questions to ask without some help.  Contact us at 727-447-5845 to talk about how we can help, if you are looking at Florida senior living options or retirement communities in Tampa Bay.
  2. “Level of care” is a confusing issue for the public and families.  Facilities provide different levels of care, from the broad categories such as independent living and assisted living to specialty licenses and extra services. The big question is: what should I be expecting and how does this fit with what my aging parent needs?  It sounds like perhaps in this family’s case they did understand what this facility provided (and didn’t) and accepted the limitations, but often this is not the case.  “Level of care” is not only understanding what an elder may need, but also knowing when that level of care may no longer be sufficient and what your expectations should be in different scenarios.
  3. Independent living retirement communities are often misperceived as offering more assistance than they are designed to provide.  Residents are entering retirement communities at later ages with more needs.  For a number of reasons, elders or their families may not be clear on the parameters of a retirement community.  The facility may indicate these issues on a contract, but during the emotional time of a major move the detailed parameters may not be evident.
  4. Regardless of senior living situation, advance care planning issues must be addressed.  While we don’t know the status of this person’s advance directives, it is a reminder about the issues of resuscitation and life support.  C.P.R. is addressed through a document called a Do not resuscitate order (DNR) which is a doctor’s order and handled very specifically (by each state’s laws).  It is not included in other types of advance directives (though a person may state preferences and provide guidelines in those documents, the DNR is needed in order to direct emergency personnel not to start resuscitation). These are important issues to talk about with your family members and medical providers.  Make sure you really understand the documents you complete and the laws and policies about treatments and life sustaining measures.

Some additional resources and notes on senior living, C.P.R. and advance care planning:

Independent living retirement communities are especially misunderstood many times, because they may offer some supportive services on-site but should not be mistaken for a healthcare facility.  Most of the time a purely independent community is not regulated by state requirements that other healthcare facilities are, but is viewed just like an apartment complex.  For the various levels of care for assisted and nursing care in Florida, you can check out our overview of Florida Assisted Living Definitions.

Guide to Choosing the Right Assisted Living Community for You

Florida Department of Health Information about D.N.R.: Top Questions about Do Not Resuscitate Orders such as who should have one, the legal requirements, and the differences between a living will and do not resuscitate order.

Family Caregiver Alliance offers a helpful overview regarding end-of-life choices regarding C.P.R. and D.N.R.  It is useful to read some information about C.P.R. and the elderly and talk to experienced professionals, as many people have misperceptions about the process of resuscitation (and the realities of it for frail elders).  This is one of the issues our care managers often talk through with clients and families, to help gain a fully informed perspective.

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Work-Family Balance, The Work From Home Debate and Eldercare


work from home eldercare issuesYahoo’s CEO has stirred up some controversy and debate with her recent work-from-home ban for her company’s employees.  In case you have somehow missed the story, a memo was leaked in which the company’s head of human resources ordered telecommuting employees to begin reporting in to the office.   Yahoo’s CEO has decided to end telecommuting for her employees, in efforts at improved collaboration via face-to-face interaction.

The question of telecommuting is one that each company’s leadership must address, to determine if it makes sense for them.  A lot of the rancor on the internet about this decision comes from the fact that telecommuting is seen as a positive option for flexibility in the workforce–a way to keep employees engaged (or recruit employees) who are balancing work and other responsibilities (parenting, or caring for aging parents for example). Simply taking commute time out of the equation can give employees back extra hours even with the same level of productivity/hours worked.

This decision feels like a step backwards to many in terms of our modern work options and developing work-life balance options.  However, different jobs require different parameters and there are still a wide array of jobs with more flexibility than in years past.  In addition to attracting and retaining valuable workers, companies often benefit in cost savings (less physical infrastructure needed) and improved efficiency (a lot of studies verify this–at least with certain jobs/workers). 

The good news is that this decision has really opened up the dialog on work environments and work-life balance.  This issue is near and dear to our hearts at Aging Wisely as we assist so many working caregivers.  Overall our society benefits from having options, and supporting good, productive employees in various ways.

Framing this within the context of eldercare, here are a few statistics on caregivers and employment*:

More than one in six Americans working full or part time report assisting with the care of an elderly or disabled family member, relative, or friend.

Caregivers working more than 15 hours/week said caregiving significantly affected their work life.  70% of working caregivers suffer work-related difficulties due to their eldercare duties.

About 50% of caregivers report working full-time, 11% work part-time and 17% are retired.

Impacts on work and the caregiver’s economic situation range from having to quit to reducing work hours, giving up promotions and more demanding jobs or duties.  As with most work-family issues, the impact continues to disproportionately affect women.  Studies indicate women caregivers suffer a particularly high level of economic hardship, more frequently having to make alternative work arrangements.  This makes people particularly incensed about seeing these options go away.

Recruiting and retaining high quality employees remains a top issue for most industries, so companies cannot overlook these issues.  AARP offers an “Insight on Issues” regarding workplace discrimination against elder caregivers, including current legal protections for caregivers and policy and practice suggestions for companies.  Each workplace will be different as will its workers’ needs and what the employer can reasonably provide. 

However, ignoring the issue is not only bad for our society but it doesn’t make for good business.  This Forbes article demonstrates the value of employer support for eldercare and the benefits it can bring to the employer as well as the employee.  Employers can look at a range of benefits and resources they can offer employees to support them, including: flex time and flexible working arrangements such as telecommuting or job sharing, leave time (short term leave, reduced work schedule temporarily, FMLA), backup care or reduced cost care/access to eldercare help, education and support resources (EAP, counseling, support groups, seminars, online resources, referral services, a geriatric care consultation or assessment).

What can you do if you are a working caregiver–an employee facing increasing eldercare responsibilities?

  • Find out more about the possible benefits your employer currently offers.  Ask your human resources department or leadership about what kind of assistance might be available.  You can explain your desire to remain productive and discuss ways to ensure continued job performance.  Even making them aware that you are going through this issue and looking for resources can help your employer with awareness (the more they hear from employees having this issue, they may see the value in providing solutions).
  • Marshal your resources.  Plan a family meeting early on in your caregiving duties, to create as much of a team approach as possible to caring for your aging parents.  How can various family members, friends, neighbors, other helpers pitch in?
  • Evaluate your options carefully.  Consider long-term financial impacts of quitting a job or reducing hours.  Obviously the decision is personal and you have to consider many factors, but make sure you have a clear picture of options and costs (immediate and long-term).  Are there other resources (non-employer) that could help?
  • Talk to key professionals.  Before you make any major decisions, you may want to talk it over with your financial advisor and CPA (to understand your economic situation, how retirement saving would be impacted, possible tax deductions, and more).  Consider meeting with a geriatric care manager to get a handle on your parent’s immediate and potential future needs, and support options.  Plan a meeting together with your loved one and their advisors to evaluate resources (for paid care and/or qualifying for assistance).
  • If you need to ask for some concessions at work or make changes, lay out your accomplishments/contributions, offer suggestions of ways you might remain productive or contribute differently, and give specific plans for how such concessions could work while benefiting the company (i.e. specific ways your productivity can be measured and a process for “checking in” and evaluating if the new arrangement is working).
  • Take advantage of education and information.  If you have an EAP at work, they likely have disease-specific information, lists of resources and educational topics related to caregiving.  If your employer doesn’t offer anything, seek out information.  You can start with some focused research on the internet, gather some information from the local aging organization or disease-specific group (i.e. the Alzheimer’s Association) or consult with a geriatric care manager.

Working caregivers are vital to our society.  Their numbers are too big to ignore and in order to care for those in need and remain a productive society, we need to support them.  This does not mean every company should let everyone telecommute or provide on-site adult day care…but it does mean that family-work balance is a real issue that companies must contend with, and create their own balance of sorts.  

Aging Wisely offers an eldercare resource center, with fact sheets and educational materials for caregivers–it is a great place to start if you are facing these issues, along with our Florida eldercare websites and senior care linksYou can give us a call any time at 727-447-5845 or click below to get advice and resources for your eldercare concerns:


*Statistics from Family Caregiver Alliance

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Our goal is to enable every individual we work with to live the most fulfilling life possible, with utmost dignity, focusing on their physical, mental, spiritual, family and financial wellbeing.