Caregivers: this holiday season, give yourself the ultimate gift. The geriatric care management assessment will save you time, money and a lot of headaches. Why not check into how a geriatric assessment could help you?

 Why is the geriatric care management assessment a gift for the caregiver?

• It gives you the feeling you have a handle on the situation with your aging parent or other elderly loved one. You get a baseline of different aspects of the person’s situation and care needs. This can also be a wonderful tool in discussions (or disagreements) with other family members, professionals, etc.
• You walk away with actionable tips, thus feeling less overwhelmed.
• It offers realistic solutions. The internet and your friends may offer a lot of advice…some of it may or may not be for you. It may be just plain wrong, or just not apply to your loved one. A geriatric care management assessment is specifically built for your loved one’s unique situation.
• The geriatric care management assessment is a plan, built on a thorough analysis of the situation. Having a plan saves you time and minimizes the chances of crisis.
• Rather than having to learn an entire field from scratch (caregiving already feels like getting several Ph.Ds sometimes!), you get an expert who can share their years of experience and knowledge with you. You can quickly gain access to all sorts of resources and information that could take a long time to uncover otherwise. The care manager is hired just to help you…they aren’t a gatekeeper for an organization or focused on one specific program. Care managers can therefore offer you a world of options, so that your loved one gets the best care and you have a smoother journey as a caregiver.

How do I get a care management assessment done on my loved one?

It’s simple, contact us and we’ll set it up. If you aren’t in the Clearwater/St. Pete/Tampa Bay area, we can refer you to a colleague in your area. Worried that your loved one won’t like the idea? We encounter that all the time, so we know how to help. You’ll be delighted by how smoothly things will actually go. We have a dedicated Senior Care Consultant who does complimentary phone consultations and attends the initial face-to-face meeting to ensure everything goes well. She’s an expert in the process and the best approaches for sensitive issues. One of the most frequent compliments our care managers receive is about their ability to handle sensitive situations and guide the family in a dignified approach.

What happens after we get the geriatric care management assessment?

You have an actionable plan with specific resources, so you can follow through or hire our care managers to help guide you. With their help, you can put the suggestions into place with ease. As mentioned, their approach often helps and is especially useful because of the personal separation they have versus family members. It is easy for them to see things objectively and offer your family advice backed up by their deep experience. Depending on the priorities outlined in the geriatric care management assessment, you may hire home caregivers, begin seeking out alternative care arrangements or make some modifications to the home or care situation.

Give yourself the best gift to start 2015 off on the right foot…contact us (phone: 727-447-5845) to discuss getting a geriatric care management assessment done by “your family’s advocate”, Aging Wisely.

Paying for long-term care services is a top financial concern for a majority of consumers today (research from the nonprofit LIFE foundation and LIMRA). Families often struggle to navigate the various long-term care options, while trying to match these choices up with their budget or access financial help. Although states, including Florida, have worked to make accessing long-term care easier for individuals and families, the public benefits system remains confusing for families, especially in times of turmoil.

For all these reasons and more, families should consider getting a geriatric care management assessment when eldercare issues begin to arise. The earlier in the process a family accesses this help, the more opportunity there is to play an active role in choices and save valuable time and money.

How does the geriatric care management assessment help specifically with paying for long-term care?

• It gives you, your family and the professionals helping you a better picture of the situation (and your preferences) to pursue the right options and save time pursuing unrealistic options.
• It helps define the costs associated with those options and the resources you have to cover costs and needs (including non-financial resources like assistance from friends, families, non-profit groups, etc.) and possibly creates a budget (and alternative budgets for comparison).
• It explains the related public benefits you might need to access and the steps to take. Timing and details can be very important to the eligibility process, so understanding those before you get started gives you the best chance to avoid problems. It also makes recommendations for planning professionals and resources, so you have the opportunity to plan ahead.
• It  takes all the puzzle pieces of a fractured system and puts them together. Geriatric care managers created the profession for this reason. Many of them helped clients in specific settings or with a specific concern, but there was really no one for the family to rely on to bring things together and offer continuity. For most people, long-term care is a journey during which they access different types of care, make various transitions (if not in actual place they receive care, then in the types of services accessed) and have varying needs. The medical, financial, familial and personal situation evolves and often requires multiple resources at any given time to cover the needs. A specific service or provider may conduct an assessment but it tends to only be focused on one aspect or perspective of that long-term care journey.

We have been working on our upcoming presentation for the Florida Conference on Aging, which further details how the assessment can play a valuable role for both families and practitioners, especially as it relates to Florida’s Statewide Medicaid Managed Care Program. Under this program, Floridians now receive Medicaid-covered long-term care services from private, managed care companies. This adds another layer of decision making for individuals and families, furthering the need for the assessment. The independent assessment can also provide valuable information to the care providers involved and help families make more informed choices, which saves time and difficulties for everyone involved.

For those of you who might be attending the 2014 Florida Conference on Aging, we hope to see you at our session! Our workshop, conducted by Senior Care Consultant Susan Talbott, is tentatively scheduled as follows:

Public-Private Partnership: Why an Independent Level of Care Assessment Benefits Providers and Clients

Wednesday, August 6, 2014

8:30 AM – 9:30 AM

You can find the conference information on the Florida Conference on Aging website.

For help with Florida Medicaid and other long-term care needs or to inquire about a geriatric care assessment, give us a call at 727-447-5845 anytime!

Our Aging Wisely care managers have prepared a quick reference guide and checklist that family members can refer to in order to plan ahead as parents age and as families move through various stages of caregiving and eldercare.

Preparing Ahead

Encourage your loved one to meet with a financial advisor and estate planning/elder law attorney. Know who your loved one’s advisors are and encourage open communication.

Execute important legal documents such as: Durable Power of Attorney, Healthcare Surrogate/POA, Living Will, Will/Trust.

Know the location of important papers-see our “document locator list”.

Ask if your loved one has thought about what they would like to do if assistance is needed (educate yourself on basic options/costs, consider family situation and realistic alternatives). Discuss expectations and what is realistic.

Open up the lines of communication: the more discussions can begin prior to crisis, the better. It helps if you have basic understanding of the financial situation and talking regularly can alert you to concerns and encourage discussion.

Offer assistance with areas in which your loved one feels comfortable letting you help. Consider hiring a home caregiver to help with household tasks, transportation, meal preparation and other needs.

First Signs

See “Am I in Denial?” handout for signs to watch for in your loved one.

Other potential red flags to watch for: your parent takes multiple medications or visits several medical specialists, recent hospitalizations, falls or injuries, confusion/memory loss, difficulty with financial management or excessive concerns regarding finances.

Try to ensure family visits regularly and/or hire a professional geriatric care manager to do spot checks if you cannot be there.

Watch carefully for concerns regarding proper handling of medications.

Have a home safety assessment/evaluation of resources to maintain independence.

Begin keeping a health record by creating a file or using an online system to maintain basic records, medical contacts, records of surgery or interventions (consider attending key medical appointments or hiring a patient advocate to do so).

Research potential assistance in the area-know key numbers and what might be available now and in future.

Get contact information for key professionals (attorney, tax advisor, financial advisor, doctors), friends and neighbors and make contacts where possible. Attend meetings and establish relationships with these professionals as your loved one allows. These relationships can “multiply your eyes and ears” and ensure professionals have the permission to contact you with concerns.

Have a family meeting or conference call to discuss concerns, duties and how to approach the situation.

Offer assistance with items such as financial management-bill paying, Medicare/insurance, coordinating medical appointments or engage professionals where needed.

Offer help with shopping, errands, driving, housecleaning.

Begin a more in depth look at resources and discussion regarding options.

Deteriorating Health/Crisis

Call on trusted professionals and ask them about resources.

Hire a geriatric care manager to do a professional assessment, which can assist with the following:
>>Understanding your loved one’s income and asset picture and how this will affect care options/resources. Do they have sufficient income stream to pay for care at home/up until what point? Can they afford privately paying for care facilities? What are costs in local area? If limited resources, what public benefits are available and how do they intersect with needs? How scarce are public benefits? What planning can be done? What does their various insurance cover?
>>Understanding care options and levels of care.
>>Putting monitoring systems into place and managing medical concerns and care.

Take advantage of windows of opportunity (parent has a fall, becomes hospitalized, brings up a concern or need for help with a task–these are key times to discuss wishes, look at options, and bring in help).

Is it Time for a Move?

Has it become too difficult to manage at home?

Have your parents been scammed or become particularly vulnerable or easily influenced by others?

Is the care needed to stay safe at home too costly?

Could your loved one benefit from the socialization of a group environment? Is your loved one isolated or relegated to contact primarily with care providers?

Understand what is available to help in home/community based services so you will know when those options are no longer enough or inappropriate. Similarly, understand the levels of care and settings available in facilities.

Consider the emotions involved and what the best approach might be. Confer with siblings and ensure you are on the same page first.

Know the reality: have you or your loved one visited a retirement community? Put aside past prejudices by seeing what there is to offer today in your area.

Consider professional assistance in choosing the right facility. A care manager can pinpoint options that are appropriate, save you a lot of time and frustration, give you the background on the quality and levels of care provided, and help coordinate the process.

Other resources that may be needed: moving company, estate sales, realtor, junk removal, storage unit, appraiser, cleaning service, home staging company, property manager, attorney, etc.

As Things Progress

Revisit your loved one’s wishes and take a step back to consider them as decisions need to be made.

Confer with medical professionals on prognosis, treatment options, and expected results. Ask questions and prepare ahead for appointments. Make sure the medical specialists are the right fit.

Take time to process emotions, care for yourself, share memories, and be with family.

Keep in mind quality of life and its meaning to your loved one. Don’t overlook small things: the comfort of favorite pajamas, the dignity of having a nice hairdo, a homemade treat or favorite drink or meal, a book or newspaper, or someone acknowledging the person’s memories and accomplishments.

Inquire about options such as hospice and palliative care. Educate yourself and talk to medical professionals about options, even if they do not raise them.

Take some time to work on organizing and simplifying, to cut down on the stress of dealing with financial and estate matters during caregiving and after death.

Ensure funeral arrangements have been made or you have at least talked to your loved ones about their wishes.

If you want to discuss your family’s eldercare situation or concerns about an aging parent, contact us for help. We also encourage you to sign up for our monthly email newsletter as a good way to stay educated on eldercare topics such as Medicare, caregiver resources and aging health.

Financial exploitation of seniors is a growing problem and often goes unreported. Many seniors are embarrassed to report scams or exploitation and fear losing independence if they admit they have been victimized. All too often, family members are the exploiters (Florida elder exploitation statistics indicate about 27% of cases were committed by a son or daughter.)

Some common Florida elderly scams and abuses include:

• Durable Power of Attorney Misuse
• Identity Theft
• Imposter Fraud
• Moving Scams
• Investment Fraud
• Annuity Fraud
• Home Repair Scams
• Charity Fraud
• Telemarketing or sweepstakes Fraud

Some examples of scams that are frequently targeted to elderly individuals living at home alone include: excessive or unnecessary home repair work or devices (water softeners for example) or work paid for but not completed; sweepstakes and lottery scams; “fishing” for personal information over the phone or email for identity theft purposes; distraction techniques (coming in to the home for a stated purpose and stealing items while the person is distracted).

Reducing social isolation and having trusted parties checking in on someone as they age can help reduce the likelihood of being a victim of a scam, or assist in quickly identifying concerns and stopping any ongoing fraud.

Resources for elder exploitation:

Safeguard Our Seniors http://www.flseniors.net/
National Center on Elder Abuse http://www.ncea.aoa.gov
Florida Abuse Hotline: 1-800-96ABUSE
Florida Elder Help Line: 1-800-96ELDER

Additional senior safety tips:

• Elders should talk with legal and financial advisors about how to prepare for aging and possible incapacity-what legal documents are needed, how to set up financial accounts and especially share any concerns about family members or family conflicts to be taken in to consideration when planning.
• Open conversations about wishes, paying for care, priorities and beliefs help families to better handle their loved one’s needs and possibly to be more aware of changes in patterns. A neutral party may help in facilitating these conversations.
• Families at a distance should consider having a trusted party(ies) to check in on a loved one who lives alone. A geriatric care manager can visit to provide some oversight and help to pick up on any changes that might be cause for concern.
• Always check out any parties hired to do work for an elder. It is best to use reputable companies/licensed agencies or providers. You can at least check to ensure it is a legitimate business and does not have a history of complaints. Talk to your loved one about some of the common scams and remind them that they should not hire unknown parties or let individuals in to the home.
• For in-home care in Florida, use a licensed home care agency which must adhere to state-required rules and standards. If your loved one has private caregivers, see our handout Caregiver Concerns to learn more and be aware of signs that might be red flags.
• Professional advisors can help families by being aware of major changes or red flags. In discussing future planning, discuss procedures and options if the professional has concerns and seek to open communications between family members. Help clients with alternatives and protective measures when family conflict exists or there is a concern raised about a particular family member. Be aware of mandatory reporting statutes and report possible abuse to the state hotline.

We’re here to help if you have concerns or questions about help for elderly loved ones in Florida. Contact Aging Wisely for elder advice, geriatric care management assessments, family caregiver consultations.

In previous posts, we have covered The Benefits of a Geriatric Care Management Assessment and The Nutritional Components of an Elder Assessment.

A major area of any geriatric assessment is a review of the client’s functional status. A functional assessment reviews the client’s abilities to perform daily tasks. These can generally be divided in to ADLs (Activities of Daily Living, such as bathing, dressing, grooming/hygiene, eating and transferring/mobility) and IADLs (Instrumental Activities of Daily Living, such as cooking, household maintenance, driving, using a telephone, shopping, financial management). The assessment also reviews cognitive status and any potential limitations there, which may affect functioning, safety and awareness.

The care manager reviews current daily routines, abilities and challenges with:

* eating
* dressing
* bathing
* hygiene/grooming
* toileting/continence
* mobility & fall risk
* household cleaning & maintenance
* meal preparation
* laundry
* pet care
* transportation

In looking at these various areas, the assessor reviews the person’s:

* cognition (memory, insight, judgment, problem solving)
* psychological well-being(mood, emotions)
* social supports
* sensory systems(hearing, vision)
* physical skills (strength, movement, mobility)
* use of adaptive equipment/environmental safety

The assessment provides an excellent picture of current status, gaps/concerns as well as recommendations to ensure continued safety. By conducting a face-to-face assessment in the home environment, the care manager observes the client’s abilities within the real-life environment. Gathering information from the client, family, and providers as well as careful, expert observation enables the care manager to form a complete picture. The assessment may be conducted over a few visits during different times of day or situations for gathering accurate data.

The findings of the functional assessment result in recommendations for immediately improving quality of life and safety, as well as considerations for the future and issues to anticipate as chronic conditions impact abilities and function. The geriatric care manager may recommend community services, home care assistance, home modifications, technology for aging in place, physical or occupational therapy and other specialty services. The care manager makes specific, easy-to-follow recommendations so that the client and family has a detailed road map for accessing good help, and the care manager can also assist in implementing recommendations if desired.

CONTACT US TODAY for more information or to schedule your geriatric care management assessment. We provide elder assessments in the Tampa, Florida area (Clearwater, St. Petersburg, Pinellas, Pasco and Hillsborough counties) as well as eldercare consultations for families throughout the U.S.

A professional patient advocate is someone trained to help individuals (and their families) navigate the often complex healthcare system. Many family members and friends act as an advocate on a regular basis as a loved one faces a hospitalization, health crisis or chronic illness and treatment path. However, a professional advocate such as a care manager offers experience, training and in-depth knowledge of how to ensure the best care and pathway to good health and quality of life.

As stated by the Professional Patient Advocacy Institute, “The cost of healthcare increasingly is the responsibility of the individual consumer, which has made consumers more and more cognizant of the true cost of services and the value of traditional sources of care and information. Yet still today, the healthcare system is not set up like other commodities where comparisons can be made easily. To provide advice when faced with healthcare challenges, an emerging group of healthcare professionals known as patient advocates are positioned to assist consumers in making informed decisions while providing guidance, advice and direction in navigating the complex healthcare system.”

What are some of the ways a professional healthcare advocate helps?

*Providing a professional assessment and recommendations for resources, education and care plan options.
*Reviewing your chart and medical records to identify any concerns, questions and to help you and your family understand your health situation and options in lay terms.
*Accompanying a patient to appointments, treatment, ER visits for care continuity. Helping to formulate questions for providers and ensure good communication.
*Helping organize your medical information and create an online, personal health record.
*Assisting during key transition periods (such as hospital discharge, transfer to a care facility, or a switch in providers, where most problems occur) to ensure continuity and anticipate and avoid concerns.

When does someone use a professional patient advocate?

*When recently diagnosed with a chronic illness or acute problem–to locate good providers, evaluate options for treatments and handle the emotional and practical impacts of the diagnosis.
*During key transitions or health crises such as an Emergency Room (ER) visit, hospitalization, hospital discharge to home, inpatient rehabilitation or choosing a care facility.
*On an ongoing basis, especially when managing a chronic illness, multiple diagnoses or some form of dementia, to ensure continuity of care and be a liaison between providers, patient and family.
*To help in organizing records, putting together a care plan, creating an online personal medical record and to generally get a better handle on one’s medical situation and be proactive in managing chronic conditions.
*During end of life care, to support patient and family in decision making, emotional support and navigating options.

What are the benefits of a professional patient advocate?

*When you work with an independent advocate, such as our geriatric care managers, you get an independent assessment, someone who works for you and can ensure you get what you need.
*Expertise in the healthcare system (as well as eldercare, social services and related support services).
*Professional training and specialized expertise in the areas you need–someone who can quickly point you to resources and has knowledge of some of the issues you might not even anticipate.
*Emotional support for you and your family. Health crises can be emotional and it can be difficult to manage the practicalities and make clear decisions when facing these emotions. A professional advocate is your sounding board.

Who are professional patient advocates?

Patient advocates come from a variety of backgrounds within the medical world. Some may work for insurance companies, employers or healthcare systems or providers. Others, like our Aging Wisely care managers, work directly for the individual and family–objectively, independently–navigating a range of healthcare systems and providers and providing patients with continuity.

Our Florida geriatric care managers not only have strong professional backgrounds (both academic and experiential) in social work, gerontology, and case management, but continue to pursue specialized training areas. Our team offers experts in areas such as end of life care, Multiple Sclerosis (MS), Alzheimer’s/dementia, transitions to care facilities and much more. To read more about our professional care management and patient advocacy staff, we invite you to review our team section.

Contact us today so we can answer all your questions about patient advocacy and to find out how we can help if you or a loved one is facing chronic illness, a healthcare crisis, or just want to be assured the best quality of care.