• 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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  • 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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  • 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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  • 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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  • 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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  • June 24, 2013 /  Basics

    help

    I am not an expert. I, like many, am learning. I use resources, I refer people to resources, I take classes, go to seminars and attend groups sessions to gain knowledge and learn from others experiences. What makes a licensed professional Fiduciary different, and me in particular, is that we advocate and serve for a living. There is a bit more experience we have when it comes to administering Trusts and acting as Conservators for person and estate so that gives us familiarity of routine and potential problems/issues that will be faced.

    What I try to do on my website is to give you hope, encouragement and tools to use in your caregiving and/or administration.  There are many people who choose not to use my services or that of my fellow Fiduciaries because, well, because they just want somebody they know to do the work, and you…you may be one of those honored to serve but clueless or just needing some help in performing your service so why should I keep information to myself? I don’t and won’t!

    I have been taking classes and going to seminars on two subjects recently to increase awareness and learn how to serve my clients who are beneficiaries in a Special Needs Trusts or are LGBT (Lesbian, Gay, Bisexual, Transgender). I will be sharing what I learn and how this knowledge has helped me serve my current clients (and my future clients as well).

    While my office is in Lincoln CA, I serve Placer, Sacramento, Sutter, Yolo, Solano, El Dorado, Yuba counties. Depending on what is required I can also serve counties like Humbolt and beyond.

    Call for your free consultation. 916-220-3474

    Yours in Service,

    Michael

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