• Constructive Conversations about Loss and Grief by Felicia Juntunen

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    November 18, 2025 /  Basics, Difficult Conversations

    By Felicia Juntunen, Director of Care Management at Elder Care Management

    “No one has taught us how to act or what to say when someone dies. More important, no one has taught us what it feels like to grieve. We don’t know how to heal the hurt created by grief or how to live with it.”- Barbara Karnes, RN,

    My Friend, I Care: The Grief Experience

    As Aging Life Care Professionals, our work and service to aging individuals and their families frequently intersect with experiences of loss and the grief that accompanies it. We recognize the profound and varied impact grief has- on our clients, their families, and ourselves- and remain committed to fostering healthy coping and resilience following loss.

    Discussions about death and grief are often among the most challenging we encounter. As Barbara Karnes observes, few of us have been taught how to respond to death or how to grieve. By deepening our understanding of the nature of grief- its expressions, complexities, and effects- we can better facilitate constructive conversations that honor individual experiences and support the healing process.

    Understanding the Dimensions of Grief

    Grief is both universal and deeply personal. It is not confined to emotional pain alone but influences all aspects of human well-being:

    • Emotional: sadness, anger, guilt, relief, anxiety, loneliness
    • Cognitive: difficulty concentrating, decision-making challenges
    • Behavioral: withdrawal, restlessness, or disruption of daily routines
    • Social: isolation or diminished engagement with others
    • Physical: sleep disturbance, appetite change, chest / stomach discomfort
    • Spiritual: loss or renewal of faith, questioning meaning and purpose

    It is also important to recognize anticipatory grief- the process of mourning a loss before it occurs. This experience is quite common among caregivers, particularly those supporting loved ones with progressive conditions such as dementia. Anticipatory grief is often complex, as individuals navigate the dual experience of holding on while beginning to let go.

    The commonly referenced stages of grief- denial, bargaining, depression, anger, and acceptance– represent potential emotional responses rather than a prescribed sequence. Grief is not linear, and there is no uniform progression. Each individual’s journey is unique and influenced by their personal, relational, and cultural context.

    Facilitating Constructive Conversations About Grief

    Supporting individuals and families through grief requires sensitivity, patience, and a willingness to engage in authentic dialogue. Conversations about loss can evolve into meaningful opportunities for connection when guided by three key principles:

    • Pace: Acknowledge that each person’s grief journey is distinct. Healing unfolds over time and cannot be rushed or standardized.
    • Presence: Offer genuine presence without an agenda. Simply being with someone in their grief- listening attentively and empathetically- can be deeply comforting.
    • Permission: Provide opportunities for individuals to speak about their loved one, to share stories, and to express the full range of emotions associated with grief. Encourage healthy outlets for expression and connection to supportive resources.

    Sources of Support

    Encouraging individuals to access support can greatly enhance their ability to cope and adapt following a loss. Helpful resources may include:

    • Family members and close friends
    • Hospice bereavement and aftercare services
    • Faith-based or spiritual communities
    • Peer and community support groups
    • Licensed grief counselors or therapists

    Moving Forward

    “Healing the wound of grief is allowing ourselves to feel the pain, to recognize ‘I’m missing her,’ to cry, to experience the intensity of the moment and then to move on. We wipe our eyes, dust ourselves off and move forward into living the day. We know the pain will come again. It will be felt and experienced again. We will move forward again, and on and on.”- Barbara Karnes, RN

    Grief is an evolving process rather than an endpoint. Through compassion, understanding, and open communication, Aging Life Care Professionals can play a vital role in helping individuals and families navigate loss while continuing to find meaning, purpose, and connection in life.

     

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  • Constructive Conversations: From Curative to Comfort Focused Care by Felicia Juntunen

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    October 21, 2025 /  Basics, Difficult Conversations

    By Felicia Juntunen, Director of Care Management at Elder Care Management

    In previous newsletters, we’ve explored how families can transform challenging discussions into constructive conversations. One of the most sensitive topics in aging families is end-of-life care- a subject many find difficult to approach. As Aging Life Care professionals, we believe that informed families are better equipped to navigate these moments with compassion and clarity.

    Understanding what matters most to the older adult, recognizing the signs of frailty, and knowing what resources are available all contribute to meaningful conversations and supportive decision-making.

    From Curative to Comfort Care: Asking the Right Questions

    Changes in medical technology and cultural attitudes have reshaped how families think about health care and end-of-life decisions. It’s essential to ask questions that help clarify the older adult’s values and goals:

    • Will medical procedures prolong life at the expense of quality?
    • Is the goal to live longer- or to live better?

    Early conversations about personal preferences help guide families later, especially if they’re called upon to make decisions on behalf of their loved one. Care managers emphasize the importance of documenting preferences through advance directives, designating a decision-maker, and ensuring that person understands the older adult’s wishes.

    Recognizing Frailty: A Signal to Reassess Care

    Families often wonder when it’s time to shift the approach to care. Frailty is a key indicator. Aging Life Care professionals frequently work with individuals in their 80s and 90s, helping families assess whether medical interventions will truly benefit their loved one.

    Signs of increasing frailty include:

    • Sleeping more than being awake
    • Difficulty rising from a chair
    • Moderate to advanced dementia
    • Trouble swallowing and significant weight loss

    When frailty is present, the likelihood of recovery from surgery or invasive procedures diminishes. In these cases, care managers often encourage families to speak with medical providers about adjusting goals and being selective with the care they pursue.

    Understanding Support Options: Palliative and Hospice Care

    Early awareness of supportive care options helps families prepare for transitions when the focus shifts from prolonging life to preserving comfort and dignity.

    Palliative care provides relief from symptoms and stress at any stage of a serious illness. It can be delivered alongside curative treatments and is often provided through clinic visits, virtual care, or occasional home visits.

    Hospice care is designed for individuals with a life expectancy of six months or less. It focuses on comfort rather than cure and is delivered by an interdisciplinary team that addresses physical, emotional, and spiritual needs. Hospice care is available 24/7 and can be provided wherever the patient resides.

    Building a Foundation for Constructive Conversations

    Families can foster more compassionate and informed end-of-life discussions by:

    • Understanding the older adult’s preferences
    • Recognizing the impact of frailty
    • Becoming familiar with palliative and hospice care resources

    These strategies help families make decisions that honor their loved one’s values and promote dignity in care.

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  • Constructive Conversations: Honest Conversations about Senior Living Options by Felicia Juntunen

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    September 8, 2025 /  Basics, Miscelleaneous

    By Felicia Juntunen, Director of Care Managment, at Elder Care Management in Sacramento, CA.

    Throughout this year’s series, we’ve explored many challenging conversations that aging families face. One of the most emotionally charged topics is the idea of moving an older adult from their long-time home to a new setting.

    Home represents more than a physical space- it’s a symbol of autonomy, familiarity, and comfort. For older adults, especially those who have lived in their homes for decades, the prospect of leaving can feel deeply unsettling. Recognizing and honoring these emotions is crucial to maintaining constructive and respectful conversations. Proactive discussions about the possibility of a move- before a crisis occurs- can help families prepare thoughtfully and collaboratively.

    When Is It Time to Consider a Move?

    Aging Life Care professionals often support families through transitions between home and care settings. While there’s no universally “right” time to move, several factors may signal that it’s worth exploring:

    • Health needs exceed what can be managed at home
    • Safety concerns arise due to mobility or cognitive decline
    • Isolation begins to affect the quality of life
    • Home maintenance becomes burdensome
    • Financial strain makes in-home care unsustainable

    Care managers encourage families to plan ahead by educating themselves about various care levels, associated costs, and available services. Consulting with local placement professionals can also help tailor decisions to the individual’s needs and preferences. Early education and open dialogue foster realistic expectations and informed choices- especially around finances and care requirements.

    A Real-Life Example: Elizabeth’s Story

    Elizabeth*, a longtime Elder Care Management client, lived in her home for over 30 years. She and her husband had chosen it with the intention of aging in place. After his passing, Elizabeth continued to enjoy her independence- gardening, driving to church, and staying active in her community.

    In her mid-80s, however, her health began to decline, and maintaining the home became difficult. Her family, noticing the signs, gently initiated a conversation about assisted living. Elizabeth wasn’t ready to commit but agreed to consider it. When she stopped driving, her isolation increased, prompting deeper discussions. With the help of a care manager, Elizabeth and her family found a community that matched her lifestyle and needs. Because the conversation had started early, Elizabeth was able to participate fully in the decision-making process- preserving her autonomy and dignity.

    Planning Ahead for Constructive Outcomes

    Most older adults wish to remain at home as long as possible, and families often want to honor that desire. The key to successful planning lies in:

    • Early conversations about preferences and care needs
    • Acknowledging the difference between expectations and reality
    • Educating oneself about housing options and resources

    By leaning on the expertise of Aging Life Care professionals, families can turn a difficult topic into a constructive, empowering dialogue- one that respects the older adult’s values while preparing for future needs.

    *names have been changed to protect client identities

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  • Let’s Talk about Estate and Financial Planning by Felicia Junstunen

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    February 10, 2025 /  Basics, Difficult Conversations, End of Life Issues

    Constructive Conversations:

    Let’s Talk about Estate and Financial Planning

    Felicia Junstunen, Director of Care Management

    Elder Care Management hosts educational events throughout the Sacramento region. Here are three for March and April.

    March 11, Tuesday, at 10:30 am

    “Compassionate Communication for Aging Families”

    on Zoom, hosted by Del Oro CRC as part of the Kaiser education series

    Register at www.tinyurl.com/KA031125 

    March 17, Monday, 9am to 1:30 pm

    Sun City Roseville Senior Resource Fair

    Elder Care Management will host an information table

    April 9, Wednesday, at 10:00 am

    “Successful Aging: It Takes a Plan”

    Davis Senior Center: 646 A Street, Davis

    Register at www.tinyurl.com/ECM040925

    Last month we introduced our newsletter series for the year: turning difficult topics in aging families into constructive conversations. Most people agree that talking about their estate and especially finances is one of the most difficult issues to broach. Our money and how we manage it is a sensitive topic and typically a very private aspect of our lives, so it stands to reason that it is a hard topic to discuss with family members. However, care managers observe that those who take the initiative early on in their aging family’s journey to boldly enter conversation about this topic tend to report greater satisfaction and overall success later, when that information becomes vital. For those who own any property or have any assets to manage, the estate plan will influence their wellbeing as they age and impact their designated agents if they are called to act on their behalf.

    Facilitating a constructive conversation about the topic of financial planning starts with a purposeful approach- the desire to understand the means available for care as the older adult ages. There may be some education necessary for all family members to understand the cost of care, the expectations of where and how care will be accessed, and how assets might impact access to benefits. These are all questions that can be used to enter the conversation in a constructive and purposeful manner. Purposeful discussions can help clarify expectations about who is designated to represent the interests of the older adult when they need assistance managing their financial affairs. Talking about some typical scenarios can be a springboard for discussion: if you are hospitalized, who will pay your bills? This one question can cascade into many others to help unpack the estate plans that are in place, or not. Be prepared to thoughtfully listen, avoid judging, and remain intentional in your quest to keep the conversation constructive. There are times when third party resources may be helpful to carry a message of concern and support a constructive conversation. A trusted friend, physician, or clergy member may be effective in supporting the importance of a discussion. Leaning on the expertise of others can provide the assurance of objectivity- especially in financial matters.

    Several years ago, Elder Care Management was engaged to provide support for a couple, John and Karen*. John was living with dementia, and his wife Karen was his sole caregiver. Their only relative, Kathy, lived many states away and was herself caring for an ill husband. Kathy was concerned because she had no understanding of John and Karen’s estate plan, a limited understanding of their resources, and had recently learned of another distant relative who had been defrauded of their estate because of lack of oversight. Kathy recognized John and Karen were vulnerable but knew she could not be solely responsible for assisting them. She planned a visit with the couple and in advance contacted a reputable licensed fiduciary and arranged a meeting with Karen. Together, Kathy and the fiduciary helped Karen discuss the couple’s estate planning, and assisted her to put other supports in place, including fiduciary services and care management. Kathy had the assurance of a professional team to safeguard John and Karen, and the couple benefitted from local support as their aging journey continued.

    Discussions about financial and estate planning can be challenging, but positive outcomes are more likely when conversations happen early on, ahead of crisis or health decline. This strategy provides older adults with the opportunity to clearly state their plans and decisions to their designated agents and provides an opportunity for family members to help if those plans have not been clearly developed. Families may also benefit from the expertise of neutral third parties to help discuss this topic or provide the professional objectivity required in some estate planning discussions. Talking about money may not be easy but conversations that lead to well thought out plans are priceless.

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  • 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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  • Faith and Socialization

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    March 1, 2024 /  Miscelleaneous

    guardian visit
    I have found that faith can be a profound aspect of an individual’s life but something that can be set aside as we age because transportation and mobility obstacles can prohibit attendance to weekly services. However, a desire to strengthen one’s faith can also be most profound at this stage of life, when reminded of our mortality, pulling us towards our foundation of faith. Studies of participation in spirituality and religion have also shown to slow cognitive decline, instill a sense of hope and purpose, and foster needed socialization for the aging individual. Providing a ride to Sunday service, helping an individual live stream their church service on their home TV, or otherwise helping a loved one maintain their access to worship can be a meaningful means of connection and support. Many churches will send a volunteer to visit a homebound senior if they are unable to attend service and need a spiritual connection, and hospital and Hospice Chaplains can be a comfort to those who are ailing or in need of spiritual guidance as they face the end of life. If your loved one has had a strong foundation in faith earlier in their lives, allowing them opportunities to rekindle or maintain their faith in the latter years of life can be a true gift.

    I think that part of the benefit is from not only the faith factor or the act of worship but also the socialization factor. I helped clients whom I know to be social beings go from isolation to a group environment and watched them blossom.

    It is worth thinking about.

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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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