Unfortunately, somewhere in the process of caring for aging parents or other loved ones, a caregiving crisis will probably occur. It may be that late night phone call that your parent has fallen or been taken to the emergency room. Sometimes it is the point where the doctor says Dad can no longer live at home alone. Many times, the stress of the caregiving crisis is at its worst when you find yourself sitting at the hospital trying figure out what is going on and anticipating what will happen next.

These are times when our EasyLiving Aging Life Care Managers commonly get a phone call from the caregiver looking for help. When a caregiving crisis occurs, families often get referred to us or find us online when searching for answers. Today we’ll share a little bit about getting help in a caregiving crisis, as well as some ways to reduce the possibility of a crisis occurring and how to be prepared when they hit.

What makes Aging Life Care Managers a unique resource in times of crisis?

There are many services out there to help elderly clients and caregivers. Most, however, are focused on a specific area or system. Aging Life Care Managers navigate between various systems, locations, and providers with a focus on the multidimensional needs of the client and family. This means we can work with you in any setting and help navigate the transitions. Fortunately, there is now a greater emphasis on care coordination within the medical system, but there are still restrictions on the type of help that can be offered through a doctor’s office, insurance company, hospital, etc.

Aging Life Care Managers are uniquely positioned to help in a crisis because of their knowledge of resources and how to navigate more than just one silo of healthcare and eldercare. Additionally, most Aging Life Care Managers offer specific crisis/”on call” services in which they can provide support no matter when you need them. For example, our EasyLiving care management team offers an on-call program for clients who wish to have access to 24/7 crisis response. If you’ve ever been in an E.R., you know the value of ensuring someone is there with your elderly parent (and able to communicate to you about what’s happening). Even for families who live nearby, it is worthwhile to have an expert who understands how to get answers and knows the ins and outs of the system.

Being Prepared for a Caregiving Crisis

Though you can’t avoid a crisis, taking steps now can help prevent unnecessary problems. Consider starting with a care management consultation to get some advice on your situation and steps you should take. If your loved one lives at home, a home safety evaluation can reduce the likelihood of falls and other accidents. Engaging support services can be an affordable way to help your loved one stay safe and healthy (examples include transportation, medication management, household help, meal preparation, and care coordination of doctor’s visits).

Because not all crises will be avoidable, take a few steps to be prepared. Check out our aging wisely tips for being prepared as well as our thorough tips for long-distance caregivers (and additional long-distance caregiver hacks). Having easy access to the information you’ll need at the time of crisis is vital, so organizing documents and key contacts is one of the most important tasks. In addition to knowing the doctors’ and other professionals’ phone numbers, it is good to know a few local resources. This is why a care management consultation right now can be so useful.

Contact Aging Wisely for help with crisis management or to set up a consultation. You can also reach us via phone any time at 727-447-5845.

Memory Disorder Diagnosis Workshop

You’ve been diagnosed with a memory disorder such as Alzheimer’s Disease, Lewy Body Dementia, or Vascular Dementia…now what happens? The memory disorder diagnosis is a very important step to understand what is going on when someone’s having memory and cognitive issues. A full diagnostic workup helps to rule out possibly reversible/treatable causes (such as medication effects, deficiencies, and depression). But, after you get the memory disorder diagnosis, what happens next?

This workshop will address the important steps you and your family should take after a memory disorder diagnosis. This is a vital time for planning, as there is a lot that can be done to prepare for the future. At the early stages of diagnosis, the individual can be involved in planning and decision-making in a way that often becomes impossible as the disease progresses. We will share key resources and steps to take, so you’ll be prepared but also not completely overwhelmed. We know it is an emotional time and we want to help put some control back in your hands.

Workshop: You’ve Been Diagnosed with a Memory Disorder: What Happens Now?

September 13th, 2016 1pm to 2:30pm

EasyLiving Offices, 1180 Ponce de Leon Blvd., Suite 701, Clearwater, FL 33756

Flier for Memory Disorder Workshop: download to print/share.

RSVP to reserve your seat today. Call 727-447-5845 or contact us online. We receive great feedback on these workshops and seats fill up fast!

We offer free Aging Wisely workshops each month. You will get tons of great information from our experts and we limit attendance to 20 so you’ll have the chance to ask questions. Sign up for our newsletter to make sure you know about the latest workshops.

Prevalence of Hospital Infections

CDC data on hospital infections shows that:

• On any given day, about one in 25 hospital patients has at least one healthcare-associated infection (HAI).
• Every year there are more than 700,000 HAIs in U.S. acute-care hospitals and about 75,000 patients with HAIs die during their hospitalizations.

Progress in Decreasing Hospital Infections

Research indicates that when healthcare facilities, care teams, and individual practitioners (and we’d argue to add patients, families, and advocates) are aware of infection problems and take specific steps to prevent them, rates of HAIs can decrease by more than 70 percent. A CDC report which compared rates of infections between 2011 and 2014 showed a decrease in many types of infections following new regulations and programs.

Fortunately, hospitals are now required to report infection rates and are penalized with reduced Medicare payments for high rates. You can view Medicare’s Hospital Compare for hospital data, including infection rates.

Patient Safety Tips for Preventing Hospital Infections

What can you do to stay safe? The CDC recommends six important steps for patient safety, which we further elaborate on below:

Speak up. This is where having an advocate at the hospital is so important. Someone else often has to keep an eye on these issues for patients who are too ill to do so. Family members should ask the doctors and nurses about what to watch for. Our care managers visit their clients regularly at the hospital to troubleshoot potential issues like this. We may notice some changes in you that indicate a possible infection (knowing our clients and focusing solely on you, we can often spot things first) and we sometimes observe some gaps in infection-control measures which need to be corrected. Speaking up includes asking about procedures and care plans, to make informed medical decisions. Some procedures come with infection risks (and some people are at higher risk such as those with multiple medical conditions, diabetics, obese patients and smokers); it’s important to understand all risks and benefits.

Clean hands and infection-control for supplies. Hospital staff are generally well-trained about this issue (but occasionally slip up) but visitors also need to be educated. No one should visit you when they have even a minor illness and everyone should wash their hands before entering and leaving your room (watch this video on the proper technique). Staff should always use gloves when drawing blood or doing any procedure on you–and often should change gloves when working on different areas of your body, especially if there’s an infection present. Here’s a video on the proper way to take off gloves to avoid contamination. Infection control is also very important for the equipment and supplies being used on you, to avoid cross-contamination. Hospitals also do many things within the environment to help control infections, such as isolation procedures, specialized cleaning and air ventilation. Be informed about how well they are following protocols by checking out their rates online, especially when factoring which facility might be best for your needs.

Wise use of antibiotics. Check with your doctor about any antibiotics being prescribed to make sure they are necessary and best suited to your condition. Overuse of antibiotics has led to powerful, antibiotic-resistant bacteria (“super bugs”). Of course, when used properly antibiotics can be a life saver.

Infection awareness. Your advocates play a vital role in awareness and monitoring. If you or your loved one notices something unusual, bring it to the providers’ attention. Make sure staff is monitoring your surgical sites, dressings, drainage tubes, ports, catheters, etc. Confusion and sudden changes in mental status often indicate some underlying medical problem, such as an infection. Staff may be less aware of these changes if they do not know the patient well, so family and/or the care manager may be the ones to bring these to their attention.

Watch for gastrointestinal symptoms. C. difficile (Clostridium difficile or C.diff) can be deadly; it tends to affect patients in hospitals and long-term care facilities who have conditions requiring frequent or high dose antibiotics (which kill off the good bacteria that normally help keep your system’s microorganisms in balance). Your medical professionals can best help you when they’re thoroughly informed. Let them know of any changes and ask questions if something doesn’t feel right.

Get vaccinated. Talk to your doctor to make sure you’re updated on vaccinations, especially before entering the hospital or a skilled nursing facility.

This information also applies to other healthcare settings such as dialysis centers, long-term care/skilled nursing facilities, outpatient clinics and surgery centers. When deciding on a skilled nursing facility, you can view their state inspection report as well as check out Medicare’s comparison to see their measures on a variety of factors including infection control.

Get help from our Aging Life Care Managers with patient advocacy, ER and hospital care management, and coordination of medical services from choosing the right provider through ensuring the best outcomes.

A hospitalization is stressful for patients and their families; navigating the different tests, providers, payment concerns and more can be overwhelming. Hospital patient advocacy has therefore played a large role in what Aging Life Care Managers do for their clients. This process often starts from the moment of an emergency room visit through admission, various tests and procedures and ensuring a safe transition post-discharge.

Hospital Patient Advocacy: Crisis Response at the ER

Aging Wisely offers a service in which our Aging Life Care Managers are on-call for you in case of emergencies any time. This provides peace of mind for elders and their families knowing an experienced professional who knows their situation will be there during the emergency. If you’ve ever visited an ER, you can understand why a family doesn’t want their sick, elderly (and possibly confused) loved one to be there alone. In our years responding to such situations, patients and their families have been extremely grateful for the support but ER staff have also expressed the value of having more information about the patient and someone coordinating.

Understanding Tests, Care, Treatment Plans and Costs

Another area where our care managers have consistently helped in the ER and beyond is asking clarification questions about tests, treatments, and understanding the care plan and vital issues like observation status. Many patients (and their families) find themselves surprised when they learn that even though they’ve been spending the night at the hospital they have been classified as “outpatient” while under “observation”. This can have significant implications for hospital and after-care bills. Read more.

Fortunately, a law called Notice was passed August 6, 2015 to ensure patients receive written and verbal notification of this status with an implementation deadline of one year later (8/6/16). As of this date, hospitals will be required to provide a MOON (Medicare Outpatient Observation Notification) in writing within 36 hours to anyone undergoing observation or being treated as an outpatient for more than 24 hours. Aging Life Care Managers will ensure that you receive these notifications as required and help you and your family understand all the implications and options.

Aging Life Care Managers coordinate between your providers, help make sure they have the information they need (your medical history, preferences, etc.), and make sure everything is clear so that you (and/or your decision makers) are part of the process. Sometimes this helps avoid an unnecessary/repeat testing procedure. At other times, it means your medical team can recommend a more appropriate course of treatment for you with a full understanding of your past history and your current situation and wishes. It means you and your family can make more informed choices and not feel as overwhelmed.

Eyes and Ears: Observing, Asking Questions, Focus on the Individual

An Aging Life Care Manager is hired by you and your family as your personal advocate. This means the focus is on you as an individual…and your goals and wishes, not institutional goals or requirements. We understand the institutions and systems we are helping you to navigate, but we approach the situation to find solutions that work, within the realities, for YOU.

A care manager will typically do various things on any hospital visit, including observing and talking with you and hospital staff, reviewing your chart and asking follow-up questions. With our experience and the time and attention to focus on you, we often spot little things that can turn into big issues. This could be a change in your typical cognition or mood, which might indicate an infection or some underlying medical change. The care manager’s chart review or discussions might turn up an order for a new medication which has had poor results for you before. Sometimes, the care manager notices a fall or infection prevention protocol is seemingly not being followed. The care manager’s role is to observe and raise this information with the medical professionals, who can then use this information to provide even better treatment.

Discharge planning and ensuring a smooth transition is a whole other aspect of hospital patient advocacy. We’ll cover more on that later, but you can read a few of our past articles on hospital discharge in the meantime. Make sure you’re signed up for our newsletter so you always get the latest news and information!

For help with hospital patient advocacy: