• Reducing Hospitalizations: Insights from a Care Manager

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    August 1, 2024 /  Basics, Special Needs

    This is an article from Felicia Juntunen, Director of Eldercare Management. I have used them in a variety of situations over the last 12 years and have been pleased with how the relate to and care for my clients. They are also involved with community education such as the Dementia Caregiver series (next one is August 28, 2024 (2:00pm – 3:30pm), in collaboration with the Del Oro CRC at the Senior Center of Elk Grove: 8230 Civic Center Drive, Ste. 140, Elk Grove 95757. Please contact maureen@eldercm.com for reservations and other educational opportunities.

    Reducing Hospitalizations: Insights from a Care Manager

    Imagine finally being discharged from the hospital, feeling a sense of relief, only to find yourself back in the emergency room just weeks later. This frustrating cycle happens all too often for many patients, especially those dealing with complex or fragile health issues. Not only does it disrupt recovery, but it also puts a strain on the healthcare system and drives up costs. An Aging Life Care Professional can help break this cycle and ensure a smoother recovery, significantly reducing the chances of readmission.

    Aging Life Care Professionals, or care managers, play a crucial role in today’s healthcare environment. They act as a bridge between medical providers and community resources, leading to better outcomes for their clients. Their job involves comprehensive care coordination, with a focus on communication and advocacy. By ensuring these aspects are covered, they help prevent unnecessary rehospitalizations and improve overall patient outcomes.

    Avoiding rehospitalization begins with careful planning and coordination. Care managers start by thoroughly assessing a client’s needs and creating personalized care plans, which they continuously refine as needed. They also educate clients and their families about available community resources and guide them on how to access these services. Managing medication is another critical area they handle, ensuring accurate communication between the patient’s old and new care settings. They keep the lines of communication open with medical providers to relay important information about symptoms and medical history, ensuring continuity of care. Additionally, they facilitate communication among the various healthcare professionals involved in the patient’s care.

    Care transitions or the movement between different healthcare settings—such as from a hospital to a skilled nursing facility, or from these settings back home—are crucial moments in a patient’s rehabilitation. Effective management of these transitions is essential to avoid complications and ensure a smooth recovery. Aging Life Care professionals excel in this area, guiding patients through each stage of their care journey. They address common challenges like medication errors, communication breakdowns among healthcare providers, inadequate follow-up care, and insufficient support from family or caregivers.

    For patients recovering from illness or surgery, these challenges can disrupt their progress and potentially lead to relapse. For example, a patient might return home and struggle with preparing meals or accessing medications due to transportation issues. Care managers work proactively to identify and resolve these obstacles, aiming to prevent setbacks and rehospitalization.

    Care managers use several effective strategies to support their clients and reduce the risk of rehospitalization. They keep everyone informed about the client’s status during hospitalization and help facilitate communication between hospital staff and family members. They also provide essential information for developing safe and effective discharge plans and assist in finding suitable alternative care settings when home care isn’t feasible. Helping clients understand their discharge plans and supporting follow-up care, including home health services and medical appointments, is another crucial aspect of their role. They manage medications post-discharge, address polypharmacy issues, and adjust care plans as necessary.

    Through these efforts, Aging Life Care professionals make a significant impact on improving patient outcomes, reducing rehospitalization rates, and ensuring a smoother transition between care settings. Their expertise in coordination and communication is invaluable in helping clients achieve the best possible results.

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  • Hoarding and Older Adults

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    May 6, 2024 /  Basics, Special Needs

    I have worked with Elder Care Management since 2015 and support their advocacy for
    my clients as well as other fiduciaries’ clients. For questions regarding trainings,
    community events, and supporting May as National Aging Life Care Month, contact
    Maureen Lawrence at maureen@eldercm.com

    Hoarding and Older Adults

    By Felecia Juntunen, Director of Elder Care Management – Posted May 2024

    Among the challenges that confront Aging Life Care professionals, working with a client
    who has hoarding behaviors is one of the most perplexing. Families may engage a care
    manager when they’ve discovered an aging parent or loved one’s safety and well-being
    are jeopardized by excessive clutter in their home. In our practice, we have encountered
    situations with varying degrees of hoarding: from a client who collected shopping bags
    full of drugstore items that were never unpacked or used, to those whose homes were
    impassable because of many saved items including garbage and old food. A care
    manager’s task in these circumstances is multifold as they work to address the needs of
    their client while also helping families or other concerned individuals understand how the
    issue can be addressed. Care managers collaborate with other service providers to
    discern how and when to intervene in a hoarding situation, how to overcome an
    individual’s resistance to help, and how to evaluate whether the hoarding behavior is a
    choice or the result of diminished capacity.

    In her article, “Hoarding and Elders: Current Trends, Dilemmas, & Solutions,” Emily Saltz
    explains the basic tenets of hoarding behavior. Hoarding behavior typically begins early
    in life – usually by the time a person is adolescent, and it can take years or decades to
    develop until it becomes an obstacle to functional living. A central characteristic of
    hoarding is continuously bringing items into one’s home – whether with excessive
    purchases or collecting random items. Those with hoarding tendencies cannot categorize
    or organize their belongings and are disabled by the thought of discarding or parting with
    an item. They typically have little or no insight into the problem and experience significant
    denial about their situation. People who hoard may be prone to experience depression,
    social phobia, isolation, anxiety, or substance abuse. Hoarding is further complicated by
    aging. The effects of chronic illness, physical and mental decline, and increased isolation
    compound the problem. When dementia is present, hoarding can present a significant
    obstacle to health and safety as those with dementia are even less able to differentiate
    the importance of items or deal with the effects of their hoarding.

    While the cause of hoarding behavior can vary from individual to individual, it is
    understood that previous trauma and unresolved grief are common driving factors. Those
    who hoard receive emotional comfort from acquiring items and have a compulsive need
    to control and manage their belongings. It’s important to understand that denial is a
    prime characteristic of those who hoard and presents a formidable obstacle to treatment.
    Hoarders would prefer to live in a cluttered and unsafe space than forfeit their
    possessions. There is no easy solution for hoarding and current forms of treatment have
    limited success. It is now recognized that the forced removal of possessions without an
    individual’s permission can cause feelings of violation and additional trauma. Care
    managers tend to concentrate their efforts on what is referred to as a harm reduction
    approach – focusing on helping the individual with hoarding tendencies to live more safely
    rather than eliminating the hoarding.

    Providing compassionate support begins with the hallmark of quality care management:
    a good assessment. Aging Life Care professionals will screen for capacity and consult with
    other professionals for an objective and clinical perspective. Determining if the person is
    legally competent to choose their lifestyle is critical in determining how to mitigate any
    issues created by their hoarding. The goal is to protect the autonomy of the individual
    (their fundamental right to their own decision-making) and balance that with their
    safety. Developing a trusting relationship with the person who hoards is essential to any
    success in working with them toward some resolution. As trust develops, care managers
    can encourage treatment for underlying conditions like depression and anxiety. When
    empathy is conveyed that respects the individual and the meaning of their possessions,
    goals can be developed that enable them to maintain a sense of personal control as they
    collaborate with the care manager to improve their safety and wellbeing.

    Saltz, Emily B., “Hoarding and Elders: Current Trends, Dilemmas, and Solutions.”
    Journal of Geriatric Care Management, Fall 2010, pp. 4-9.

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  • Caregiving: It’s a Balancing Act

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    August 3, 2023 /  Basics, Special Needs

    Elder Care Management is still my go to care managers because they can respond to a broader range of needs for my clients. They have ongoing seminars that help give guidance for you, the family caregiver, as you care for your loved ones.

    August 7th, 1:00pm Successful Aging: It Takes a Plan, Felicia Juntunen, Director of Care Management for ECM. This will take place at Eskaton Village Placerville

    There is a second presentation of this topic on August 15th, 2:00pm at Revere Court 7707 Rush River Dr. Sacramento 95831 (RSVP by 8/11/2023).

    Please contact Maureen Lawrence at maureen@eldercm.com for questions about these events.

    Caregiving: It's a Balancing Act

    Caregiving: It’s a Balancing Act

    by Felicia Juntunen, MA, CMC, ECM Director of Care Management

    Just a sampling of the statistics on caregiving provides a sobering perspective on why the topic of caregiving and support for caregivers is so important.

    According to The Family Caregiver Alliance, in 2015:

    ·    34.2 million Americans provided unpaid care to an adult over 50 years old.

    ·    16.1 million provided unpaid care for someone with Alzheimer’s Disease or dementia.

    ·    34% of caregivers were over the age of 65 and two-thirds were women.

    ·    25% of caregivers are “sandwich generation” providing care for an older adult and a child under age 18.

    ·    Americans provided 18.5 billion hours of care valued at $234 billion.

    Figures like these make it clear that we all have an interest in understanding the impact of caregiving, knowing the signs of stress and caregiver burnout, and knowing how to promote caregiver well-being.

    Whether care is provided by a family member or paid caregiver, the financial impact can be significant. Many family caregivers use after-hours, weekends, and vacations to meet the needs of their loved ones. To fulfill caregiving responsibilities, family caregivers often sacrifice time spent in other relationships and commitments. For those who utilize or plan to use paid caregivers, it’s important to understand the cost of care. In the last two years, due to labor shortages and new regulations, the hourly rate for in-home care has increased to approximately $38 an hour. An Aging Life Care Professional can assist a family in examining their options for care at home, and how to supplement and locate support resources. Care managers regularly help family caregivers by suggesting services, evaluating in-home care needs, attending medical appointments, and providing emotional support.

    The physical and emotional impact of caregiving is significant. Caregivers tend to put their own needs after that of their loved one, sometimes neglecting their own health and well-being. Studies show that the stress associated with caregiving increases the occurrence of chronic illness. Signs of caregiver stress include isolation, sleep deprivation, poor eating habits, failure to care for personal health needs, and frequent illness. Some signs of caregiver burnout may include becoming easily angered with the person being cared for, ongoing feelings of despair, and chronic insomnia. Understanding the signs of caregiver stress can help prevent the onset of caregiver burnout. A caregiver may not recognize these signs in themselves. A care manager can encourage family caregivers to recognize the importance of pursuing some balance between their own needs and the needs of their loved one.

    Aging Life Care Professionals provide support and education to family caregivers, recognizing their value and encouraging them to practice self-care so they can ‘go the distance’ in their role. It’s vital to help caregivers understand that considering and meeting their own needs does not mean they are selfish. Rather, it means they are dedicated to their role and understand they must remain healthy. Taking regular breaks and attending to their own health care is a good place to start. Attending a caregiver support group can ease isolation, offer information, and the value of a shared experience. Asking for and accepting help is also part of self-care. Help may mean asking someone to provide the caregiver with a few hours of respite by staying with their loved one. Help may mean hiring some paid caregiving assistance to supplement care. Even small increments of time a caregiver spends on themselves can have big dividends for their well-being and the well-being of their loved one. Chances are you know someone who is a caregiver. Offer them a helping hand and the encouragement they need to balance their caregiving responsibilities with their own self-care.

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  • Benefits of Hospice and Palliative Care by Felicia Juntunen, CMC, ECM Director of Care Management

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    November 2, 2022 /  Basics, End of Life Issues, Miscelleaneous, Special Needs

    I continue to work with Elder Care Management and have found them responsive, attentive, and knowledgeable. They have ongoing seminars related to care of our seniors. There is a seminar, Thursday, November 17, 2022, 3:00pm titled: The Final Chapter: A Discussion on Death and Dying. This requires advance registration ( www.tinyurl.com/ElderCMNov ) You can also view and register on their website: www.eldercm.com For other questions, please contact Maureen, their Outreach Coordinator at 916-206-4420.

    Among the many privileges of care management work is the opportunity to journey with clients to the end of their lives. Because we spend time developing familiarity with our clients, regularly provide advocacy for their care, and understand what their priorities are for their well-being and quality of life, they trust us to contribute to the conversation about end-of-life care. We provide insight and guidance to help families determine when it’s time to consider palliative care or hospice as an option for their loved one.

    The primary difference between palliative and hospice care is their curative intent. Both levels of care emphasize relief from pain and other symptoms of a serious illness, but with hospice, attempts to cure a person’s illness are no longer pursued; the comfort of the patient is the sole focus.

    To qualify for hospice, a patient must have a diagnosis that their physician believes is terminal, with a life expectancy of six months or less, or the patient is in the end stages of Alzheimer’s Disease or another dementia. Hospice care provides a team of professionals trained to address the physical, psychosocial, and spiritual needs of the person and provide support to family members. Services are delivered to the patient where they reside and include weekly nursing visits, a home health aide who helps with bathing, and chaplaincy and social worker visits, if desired. Importantly, hospice providers are available to respond 24 hours a day, 7 days a week if concerns arise. Hospice agencies provide bereavement care to patient families. Hospice is a fully covered benefit under Medicare and is covered under most insurance.

    Palliative care is specialized medical care with a focus on providing relief from symptoms of an illness while improving the quality of life for the patient and those caring for them. Palliative care, unlike hospice, is based on the needs of the patient and not their prognosis, and services can be provided along with curative treatment options. Like hospice, palliative care teams include physicians, nurses, social workers, and chaplains, and may also include nutritionists and other professionals who offer support to patients. Unlike hospice, palliative services may be limited, according to the patient’s needs. Most palliative care programs are run by hospice agencies. Palliative care is often covered by Medicare, other insurance, or non-profit hospice agencies.

    Care managers can assist families in recognizing changes in their loved one that may indicate a need for the kind of support offered by either palliative or hospice care. Because a care manager develops familiarity with and regularly monitors a client’s situation, we often recognize when
    there is a significant decline in their physical or cognitive status. We can help a client and families understand they don’t have to be in the final days of life to receive hospice care but can receive care early and take advantage of the many benefits hospice and palliative care can offer. For a patient whose family may be unavailable, a care manager can provide the hospice agency with important information about the client. Elder Care Management care managers collaborate with hospice agencies as they deliver care to their patients, and we are grateful to the hospice community for the enhanced quality of life and comfort they provide our clients.

    Palliative Care is a relatively new offering and can certainly benefit individuals suffering from a debilitating disease with the additional support they need. However, some worry that the emergence of Palliative Care ultimately dissuades physician’s from referring to Hospice, when it is actually more appropriate. “The Future of Hospice in the age of Palliative Care“, an article by the CSU Shiley Haynes Institute for Palliative Care touches on this concern.

    When discussing the topic of death and dying, it would be remiss to not also touch on the importance of finding support for those individuals left behind. Whether a death is sudden and unexpected or part of a long journey that has come to an end, loved ones will face their own unique experience of grief and loss. “Salt Water: Find Your Safe Harbor” is a website created by Margo Fowkes to share and offer support to individuals during the difficult period after a loss. Another helpful website, “Cake“, provides education on “navigating mortality” and support for loved ones.

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  • Planning, Preparing, and Procuring…Successful Aging Takes Some Effort! by Gail Arno

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    October 1, 2021 /  Basics, Miscelleaneous

    Elder Care Management logo  I continue to work with Elder Care Management and have found them responsive, attentive, and knowledgeable. This is a guest blog from Gail Arno, CMC, Director of Care Management at Elder Care Management of Northern California. They have ongoing seminars related to care of our seniors. There is a Zoom training October 7, 2021 on Care Management 101 and another Zoom meeting October 21, 2021. In the first Zoom meeting, participants will gain a better understanding of Care Management and the profound benefits it provides and in the second, the importance of planning and recognizing. You can view and register on their website: www.eldercm.com For other questions, please contact Maureen, their Outreach Coordinator at 916-206-4420.

    Each day, our Care Managers meet our senior clients who are in the midst of their own crisis. Often, the issues we tackle are mild and manageable. Sometimes, however, the situation is serious and life-altering. As Care Managers, we accept these challenges and are honored to be able to step in to educate, support, navigate, and advocate for the best possible outcomes for every client we serve.

    We do believe, however, that these crises can be better managed when a preemptive plan is created and collective decision-making is put in place well ahead of the event. We certainly recognize that none of us knows exactly what we will face as we age.  But, by researching options, sculpting plans, identifying resources, and making our wishes known to our designated decision-makers, we will at least have a fighting chance to get what we want as our aging journey progresses.

    Elder Care Management is often brought into a client’s crisis and to find that there is no legal paperwork completed and that the client is in need of a properly designated and empowered decision-maker. At times, the family surfaces hoping to provide support only to find that no previous discussions have been had and there is no clear idea of what the wishes of the loved one might be. We also find ourselves diving into unresolved conflict within a family, charged with unraveling the disconnect and making sure that the client’s wishes are honored. Often, we are traversing that fine line between parent and adult child and encountering the inherent discomfort that comes with discussing the “tough stuff” with mom and dad. Releasing control and decision-making from parent to adult child can be so very challenging in the best of scenarios.

    Getting your legal house in order is critical.  Educating yourself and your loved ones on options that exist to support your goals in aging is invaluable, especially when done prior to a crisis. Making sure that your designated support systems know your wishes from the start of aging through the close of life is a gift you give not only yourself but those you love. Gathering information, determining your desires, setting out a course or plan of action, and letting those who will walk with you on that journey know your personal wishes should be the goal for all of us.

    We plan and prepare for births, educational journeys from kindergarten through college, weddings, growing a family, even travel, and yet many of us hesitate and refuse to plan for our own aging experience. With the assistance of a Care Manager, you can get the guidance necessary for planning, educating, and determining your wants and wishes. Identifying your choices and understanding your options is a huge part of being able to make wise decisions. We feel well equipped to offer you this opportunity. We come to you with no vested interest in the outcomes – we are a neutral party who is happy to answer your questions directly and honestly. We are happy to provide you with the research and resources to make your wishes come to fruition.

     

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  • When the Hits Just Keep Coming… by Gail Arno

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    August 9, 2021 /  Basics, Miscelleaneous

    I have worked with Elder Care Management for several years and have found them responsive, attentive, and knowledgeable. 

    I have worked with Elder Care Management for several years and have found them responsive, attentive, and knowledgeable. This is a guest blog from Gail Arno, CMC, Director of Care Management at Elder Care Management of Northern California. They have ongoing seminars related to care of our seniors. There is on coming August 19th, 2021 on Care Management 101. This presentation will focus on summarizing the roles and responsibilities of a Care Manager. Participants will gain a better understanding of Care Management and the profound benefits it provides. You can view and register on their website: www.eldercm.com For other questions, please contact Maureen, their Outreach Coordinator at 916-206-4420.

    This time we revisit the experience of our client BettyJean and the challenges she faced being vulnerable, alone, and aging with both physical and cognitive challenges. BettyJean was living in her own home, had hired caregiving support with a caregiver who was slowly taking more and more control of BettyJean’s life. The caregiver was exerting undue influence upon BettyJean to insert herself into a decision-making role and ultimately become the exclusive beneficiary of BettyJean’s hard earned assets.

    Thankfully, Adult Protective Services and the legal powers involved continued to investigate and pursue support for BettyJean. While this can often feel like a slow-moving effort, the persistence of a system questioning what appears to not be in the best interest of our seniors served our client well. Eventually, temporary emergency conservatorship was put in place and legal battles began in earnest. The manipulative and insincere caregiver continued to take advantage of BettyJean by entering her into financial contracts, altering documents to her advantage, and even pursuing a rouse of a marital union that BettyJean was not capable of understanding or agreeing to. Through much legal wrangling, permanent conservatorship was granted to a professional entity. Elder Care Management was then able to engage an agency for full-time caregiving support, allowing BettyJean to live at home and be given the proper and attentive care that she needed. All legal matters were corrected and the work of making sure BettyJean was properly protected was accomplished.

    With the absence of the predatory companion and the support of the appropriate legally responsible party, Elder Care Management was then able to focus on returning BettyJean to the life she had worked so hard to enjoy. We brought in cherished friends to visit BettyJean, took her on outings to see familiar sights, engaged her with her favorite activities, and attempted to envelop her in the best elements of her prior life. There was calm and comfort in her home once again as ECM supported BettyJean in every way possible, making sure that her needs were met, and her voice was heard, encouraging her to live a full life void of the trauma that had defined her life in the past year.

    BettyJean made her way through the pandemic and fought a good battle against the ravages of cognitive decline, smiling for the most part and finding support, comfort, and greater ease until her life came to an end. BettyJean was vulnerable and fell victim to someone who put her own wants at the forefront and took advantage of the situation. Unfortunately, this is just one of the heart-wrenching examples we have seen of the vulnerability of an aging individual without proper support and advocates. In BettyJean’s journey, the combination of solid and persistent legal efforts, skilled and proper caregivers, and the expertise of Care Management, BettyJean found peace and calm through to the end. Elder Care Management feels honored to have been a part of her journey.

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  • The Vulnerability of Aging Without Support by Gail Arno

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    July 12, 2021 /  Basics, Miscelleaneous

    I have worked with Elder Care Management for several years and have found them responsive, attentive, and knowledgeable. 

    This is a guest blog from Gail Arno, CMC, Director of Care Management at Elder Care Management of Northern California. They have ongoing seminars related to care of our seniors. You can view and register on their website: www.eldercm.com For other questions, please contact Maureen, their Outreach Coordinator at 916-206-4420.

    Aging can be a daunting effort and isn’t always easy for many of us, even those with supportive family members and friends, or those who have done their planning for the future and have set a course for a successful retirement and beyond. There are many people who are aging without support and are void of a safety net of friends, children, relatives, and decision-makers in their lives. How do they successfully traverse the many challenges of aging and not end up vulnerable and taken advantage of in emotional, physical, and fiscal ways?

    Too often as Care Managers, we walk into scenarios that expose the most vulnerable seniors. It is our task to support the client, untangle the mess they are in the midst of, knowingly and unknowingly, and begin the process of making their lives safer and more fulfilled. One such example can be found in our client, Betty Jean*. Never married, a professor of economics, no children, no spouse or partner, no immediate family members within a 500+ mile radius, and a number of medical issues beginning to surface with some mild cognitive concerns as well. Betty Jean agreed to well-intended family member pressure to have a caregiver come into her home a few days a week and help her with household chores and to provide companionship as her friends had fallen off with their own lives and she was finding herself more alone and more confused about things that previously came so easily to her.

    Things seemed fairly smooth for a while and then some issues began to surface. A bank teller reported Betty Jean and her caregiver to Adult Protective Services (APS) as the caregiver was bringing Betty Jean in numerous times a week, making large cash withdrawals. Betty Jean became more and more silent with each transaction and the tellers and executives at the bank became more and more concerned with each withdrawal. Adult Protective Services made a home visit, found a pleasant and very engaged (in hindsight, too engaged) caregiver at the home who spoke for Betty Jean and assured them that things were fine. On the surface, things appeared acceptable and APS went away, seemingly satisfied. More trips to the bank occurred and soon it was just the caregiver coming in alone. No Betty Jean, and now along with withdrawals, there were requests to change documents, add names to accounts, and transfers of money. Adult Protective Services was notified again and another visit was made. This time it was clear that the caregiver had taken a role not only as Betty Jean’s companion but had inserted herself in her financial world as well. Things were about to unfold and were far more complicated than imagined but thankfully with the help of the court system, legal intervention, and the wise and tender support of Elder Care Management, Betty Jean would come through this experience safely and mostly unscathed. Next month we will share another story of elder vulnerability, the entanglements of a senior’s life being taken over by a less than caring, very self-seeking, and unscrupulous caregiver who nearly got away with her devious efforts.

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  • The Difficult Decision We Often Face, to Stay at Home or Make a Move by Gail Arno

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    June 2, 2021 /  Basics, Miscelleaneous

    This is a guest blog from Gail Arno, CMC, Director of Care Management at Elder Care Management of Northern California. They have ongoing seminars related to care of our seniors. You can view and register on their website: www.eldercm.com For other questions, please contact Maureen, their Outreach Coordinator at 916-206-4420.

    Making the monumental decision to move from your home where things are familiar, routine, and comfortable into a senior housing setting can be one of the biggest and most challenging decisions of a lifetime. Routine and comfort at home are key and very important but equally critical is making sure that one is safe and well served in their own home. As we age, our needs, strengths, and abilities to care for ourselves change, and often one can have difficulty keeping pace with their own needs. The question then becomes, “When is it time to consider moving, and what are the steps involved in making such a move?”

    Last month we focused on John and Sarah, a lovely couple married over 60 years with four adult children, none of them living nearby and all busy with their own lives. John and Sarah were determined to remain at home together, but at times struggled to stay safely at home. After much discussion, planning, and a formal assessment conducted by our team at Elder Care Management it was determined by John, Sarah, and their supportive family that they would remain at home with support coming to them. They needed additional formal support mechanisms in their home to stay at home and we worked closely with their family and the couple to reach their goals.

    As John and Sarah remained at home, we walked alongside them offering and facilitating more formal support primarily via caregiving services which was eventually expanded to provide around-the-clock care. We assisted them in making numerous adaptations to their home such as installing ramps at the entrances of their home, removing a glass shower enclosure for easier access for caregiving assistance with bathing, altering the guest bedroom to facilitate a caregiver living in, John moved into a hospital bed located in the living room while Sarah stayed in their master bedroom. Grab bars and toilet seat risers were added in all toileting areas for ease in getting up and down and a transfer pole was placed bedside to assist Sarah so she could get in and out of bed more easily. Ultimately, a second caregiver in the home during the day was needed to assist John while Sarah was experiencing some Sundowning behaviors. Oxygen was delivered and utilized to support John as he struggled for every breath. At the close of their journey, hospice services and support were welcomed first for John, and then shortly after his passing, for Sarah. John and Sarah worked with their family to plan and communicate their wishes regarding what they wanted as their aging journey progressed. In the end, their wishes were honored and they remained safely at home with formal support all around them and a loving family to ensure their efforts were successful.

    Many of our seniors don’t actively educate themselves regarding the services, programs, and options they might have available to them as they age. Some necessitate a move into senior living such as assisted living, memory care, or skilled nursing and benefit from guidance and information to make an informed and educated decision. This month we will continue our educational series on Successful Aging where we will discuss the idea of moving, how to approach making plans, and what the best decision might be. We hope you will join us as we tackle the complicated topic of “Moving On”.

    *Names have been changed to protect the clients’ identity

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  • The Divergent Paths Couples Often Face as They Age by Gail Arno

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    May 26, 2021 /  Basics, Miscelleaneous

    This is a guest blog from Gail Arno, CMC, Director of Care Management at Elder Care Management of Northern California. They have ongoing seminars related to care of our seniors. You can view and register on their website: www.eldercm.com For other questions, please contact Maureen, their Outreach Coordinator at 916-206-4420.

    Imagine an adult child, niece or nephew, or the spouse of an individual who is aging, tasked with trying to balance and meet the needs of both individuals, all while trying to continue on with their own life. This is likely the most challenging scenario we manage with our clients; couples who have spent a lifetime together working in unison (for the most part!), tackling whatever life throws their way. Then along comes the aging process, a journey rarely done in tandem with others as we are all unique individuals who face different medical and emotional journeys. How do you plan so that you are addressing each individual’s needs while at the same time honoring each one’s wishes?  As Aging Life Care Managers, it is our job to make sure that our client’s needs are met, both from individual planning efforts to honoring the wants and wishes of a partnership. Planning is key for everyone in their pursuit of successful aging.

    A good example can be found in our clients, John and Sarah. A couple married for decades, who together raised four children, had active careers and lives, and were living independently in their own home without any formal assistance. John had numerous medical issues mostly focused on his need to attend dialysis three times weekly, along with a significant and complex medication regime.  Sarah, his devoted wife of 60+ years, had mild to moderate confusion, didn’t drive anymore, was no longer able to get meals on the table, and could not manage the tasks necessary to run the home as she did in the earlier years. John had to be transported to and from his thrice-weekly dialysis sessions as he had given up driving, stating he was often too tired to even consider getting behind the wheel (Thank you, John, for willingly making that decision!) All four children lived out of town and worried constantly about mom and dad’s well-being and showed genuine interest in their parents’ situation.

    As Care Managers, we came into the home and assessed the client’s needs, individually and with full respect to their shared history as a long-established couple. We were able to ascertain that the couple’s legal house was in order, by confirming the completion of their power of attorney documents, their Advanced HealthCare Directives, and POLST. We organized and documented their medical diagnoses, treatment plans, facilitated support systems, and opened good lines of communication with the remote adult children. Ultimately, we were able to put into place formal support mechanisms such as experienced caregivers and meals prepared by a professional chef. We brought durable medical equipment into the home after a safety evaluation that recommended adaptations made to the home to assure their ability to remain at home as desired.  A Care Manager accompanied them to all their medical appointments, making note of detailed changes of the clients’ status and of their evolving medical needs. These steps honored their wishes, supported the adult children’s vision of their parent’s living arrangement and allowed the couple to remain successfully and safely at home together. Their aging journeys were quite different and had to be addressed differently but with the same end goal of staying together at home.

    Next month we dive deeper into the details of managing couples and facilitating the ups and downs and twists and turns of the aging process with a particular focus on the divergent paths each person faces as they age.

    *names have been changed to protect the client’s identity

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  • Gratitude During a Pandemic … a good practice by Gail Arno, CMC, ECM Director of Care Management

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    November 3, 2020 /  Basics, Miscelleaneous

    Gratitude During a Pandemic ... a good practice by Gail Arno
    As Aging Life Care Managers we have the opportunity, privilege, and responsibility to keep our client’s mental and physical well-being at the forefront of our service. We focus on our client’s health and overall well-being as our mandate and our commitment, particularly in this uncertain and challenging time of the ongoing pandemic we face. As such, our job broadens as we aim to support our clients physically and emotionally. We are charged with getting even more creative in mitigating the effects of isolation for those clients living at home or in residential care settings. We are more determined than ever to bring to our clients the medical resources they need to remain healthy. We are grateful to be given this opportunity and we find ourselves often practicing gratitude and counting our blessing. It is particularly important this time of year to practice gratitude both professionally and personally.

    Gratitude is a human element and at times (trying times such as this pandemic we face) may take mindful effort and energy to embrace. Giving thanks is one of the oldest concepts in society, with this practice at the core of most traditions and religions. Thanksgiving is shortly upon us and this American secular holiday is centered on gratitude. While we can impact others by expressing gratitude directly, we can enhance our own well-being by articulating gratitude in written or spoken form, to ourselves and to those around us. Research shows gratitude strengthens relationships, improves health- both mentally and physically, affords better sleep, gives one greater resiliency, lowers fatigue, and encourages the development of patience, humility, and wisdom. How can one argue with gratitude when these are the benefits one gains?

    This season, Elder Care Management is encouraging everyone to embrace the gratitude around them- we feel we are afforded this opportunity daily as we support our clients day in and day out with our services. We remind everyone to focus on the positives that exist and encourage you to share with those near and far who impact your lives. While there is no immediate panacea for these current ills we face, regularly practicing gratitude can help ease the uncertainty. Notice the goodness in our lives, not the things that are missing, and share that feeling with others. Let us all practice gratitude allowing us to generate a climate of positivity that both reaches inward and extends outward.

    How ECM Can Help…

    Oftentimes when we are facing crisis situations and feeling overwhelmed it is near impossible to highlight the positive in our lives. Elder Care Management can provide essential advocacy, guidance, and support for those facing seemingly insurmountable obstacles. Having a clear path for moving forward can alleviate worry and stress and offer an opportunity for families to regain perspective and highlight the blessings they have been given. Whether families need a care plan or ongoing Care Management, the Care Managers of Elder Care Management are here to assist. We are grateful for the opportunity to support those you care for.

    In this article by Positive.News,  “Why gratitude is good for us- and five ways to practise it this winter,” we learn more about the diverse benefits of gratitude. Practicing gratitude has been found to have profound impacts on physical, psychological, and social well-being. If you want to experience more joy, sleep better, connect more fully with your loved ones, and overall have a better outlook on life, you should start your daily gratitude practice today.

    The question, “Are Empathy and Gratitude Linked to Each Other?“, is addressed in this Psychology Today article. The findings presented from recent studies suggest a clear overlap of the role of the medial prefrontal cortex(MPFC) activation in both gratitude and empathy. Also, the more empathetic a person is as they age the less likely they are to experience feelings of loneliness. The gratitude mindset has long-standing benefits, including helping us be more compassionate towards others.

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