Before your next visit to your long distance family member , call a geriatric care manager in their area. Do it before you your visit. Make an appointment to go to their office and meet with them. Most GCM's will see you to discuss their services at no charge. You can shop around and interview a few if you wish. Geriatric care managers can be located on the GCM website. Use your long distance family’s parent’s zip code.
It’s a preventative and prudent idea to have a geriatric care manager in the town where your older relative resides. If there is a crisis, it is cheaper to have them solve it. In an urgent situation , they can go to the hospital or emergency room,. This is more sane and cost effective than you getting on last-minute, expensive flights. You can still go but they can immediately be there to deal with the crisis. They are good insurance.
Before any crisis, you can have the GCM do an initial assessment and visit your older relative periodically (once a month, once every two months).This is preventative. That way they are there for you when you need them and have all the information to solve the problem. Think of them the way you do one of those blow-up beds. You can pump them up when you need them in a crisis—perhaps avoid that crisis, and you yourself can sleep more soundly and with more peace of mind in your own bed. Some of the things a geriatric care manager can do for you are:
1.Save you money by helping keep your parent out of the hospital and you off emergency long distance flights.
2.Facilitate a family discussion of needs, resources, and division of labor among friends family
3. Recommend ways to proactively prepare and plan for a parent’s possible health care crisis.
4.Work on family cooperation to formulate realistic parent-care plan.
5.Assess strengths and weaknesses of all of the potential caregivers
6. Help adult siblings resolve conflicts about care decisions.
7.Help siblings act together in the best interest of the parent
8.Decrease the tension between hometown and long distance siblings
9. Help the long-distance care provider deal with guilt and frustration that may result from their inability to provide more of the day-to-day care.
10.Locate aging resources ( both no -cost trough the older Americans Act) in your aging parents area quickly and without you having to do it
Friday, February 5, 2010
Tuesday, February 2, 2010
Talking To Your Aging Parents
How do you discuss needed changes with an older family member? If you ran into risky signs while visiting your older relative in December, try talking to them.
Convincing an older person that they have problems - can be a row to hoe as my mother used to say. But, you can’t get that crop to grow without planting the seed in your parent’s head. This is a tough job.
If they’re mentally clear, include them in decisions. If you suspect confusion, have the older person's doctor check mental status on their next medical appointment.A level of dementia could mean you have to make decisions for them. If there is a serious personal or financial risk, you may have to intervene, even if they are mentally clear.
Don’t be “Miss Full Charge”, coming in with guns blazing. Open up a non- threatening dialogue . The idiom , you get more flies with honey than vinegar works here. Suggest that they would be doing you a favor to make certain changes .Tell them ,you’re worried about them staying independent and you want them to be safe. This can bring out the mother or father instinct in your parent/relative and can help in introducing change.
If it is not an emergency, take time to reconnect with them before you introduce the alteration .Listen to their point of view, worries, troubles and day to day news . Whatever their joy in life, do it with them . Go to plays or concerts, play mahjong. Connect with them on their level of happiness and then begin to introduce change.
If your plea lands on empty ears, use the next doctor’s visit to discuss the issues. He or she can be a point person. Make sure those problems are on the list of items to discuss with their primary physician .Phone the office RN or fax the concerns ahead of time. Avoid an argument in front of the physician .Let the physician do the prescribing.
If a doctor tells an older person they need a careprovider or anything else,they are much more likely to do it . Old/old elders,over 85,tend to still see doctors as experts and listen to what they say. Young/ old ,65 and over are more skeptical but a doctors say so, still carries weight.
In the meantime, contact a geriatric care manager. I will cover this in my next blog.
Convincing an older person that they have problems - can be a row to hoe as my mother used to say. But, you can’t get that crop to grow without planting the seed in your parent’s head. This is a tough job.
If they’re mentally clear, include them in decisions. If you suspect confusion, have the older person's doctor check mental status on their next medical appointment.A level of dementia could mean you have to make decisions for them. If there is a serious personal or financial risk, you may have to intervene, even if they are mentally clear.
Don’t be “Miss Full Charge”, coming in with guns blazing. Open up a non- threatening dialogue . The idiom , you get more flies with honey than vinegar works here. Suggest that they would be doing you a favor to make certain changes .Tell them ,you’re worried about them staying independent and you want them to be safe. This can bring out the mother or father instinct in your parent/relative and can help in introducing change.
If it is not an emergency, take time to reconnect with them before you introduce the alteration .Listen to their point of view, worries, troubles and day to day news . Whatever their joy in life, do it with them . Go to plays or concerts, play mahjong. Connect with them on their level of happiness and then begin to introduce change.
If your plea lands on empty ears, use the next doctor’s visit to discuss the issues. He or she can be a point person. Make sure those problems are on the list of items to discuss with their primary physician .Phone the office RN or fax the concerns ahead of time. Avoid an argument in front of the physician .Let the physician do the prescribing.
If a doctor tells an older person they need a careprovider or anything else,they are much more likely to do it . Old/old elders,over 85,tend to still see doctors as experts and listen to what they say. Young/ old ,65 and over are more skeptical but a doctors say so, still carries weight.
In the meantime, contact a geriatric care manager. I will cover this in my next blog.
Tuesday, January 26, 2010
Be A Loving Sherlock Holmes-Clues for Long Distance Care Providers
As the holidays dim and your January/February to-do’s fill up with worries about your aging parents , let’s help you focus. If you found it was actually frightening to be home for Christmas , let’s turn you into a loving Sherlock Holmes . On your next visit to see your older family members , get out your magnifying glass and look for these clues .
➢ Curb Appeal- Does your parent’s home look more like an unmaintained rental.Is there disrepair, a weedy yard,uncleaned carpets or furniture?
➢ Housekeeping- are there dirty dishes ,unwashed sheets,a mess where things use to be tidy? Does the house look like it needs a scrubbing,at least someone to help with cleaning?
➢ Medication: can you find a stash of outdated medication in the bathroom , bedroom or anywhere?
➢ Driving. Is driving with your older family member or friend frightening ? How is their reaction time, or judgment . Can they drive at night? Do they have traffic tickets? Assess the car. Is it worse for wear , dented or telltale signs of accidents?
➢ Trash- are their bags of trash in the basement or out back? Look in closets
➢ Collections- are their growing collections that appear to be out of control? Designer plates from the U S Mint , antique dolls, ashtrays, cookie cutters.--any accumulation that appears to be taking over space and looks excessive is suspect. This is a sign of hoarding
➢ Shopping- When they go shopping out for a meal, does the older person have problems with checks credit cards, figuring tips, forgets their purse , calculating discounts?
➢ Change in Behavior- Is the older person quiet when they used to be loud ? Are they paranoid, having mood swings, unsocial when they were the belle of the ball or life of the party?.
➢ Odors- Did you smell urine?
➢ Refrigerator- Are there science experiments aka moldy food in the refrigerator. ?
If any of these clues turn you need talk the older person, the subject of my next blog. You may also need to call in a geriatric care manager for help.
➢ Curb Appeal- Does your parent’s home look more like an unmaintained rental.Is there disrepair, a weedy yard,uncleaned carpets or furniture?
➢ Housekeeping- are there dirty dishes ,unwashed sheets,a mess where things use to be tidy? Does the house look like it needs a scrubbing,at least someone to help with cleaning?
➢ Medication: can you find a stash of outdated medication in the bathroom , bedroom or anywhere?
➢ Driving. Is driving with your older family member or friend frightening ? How is their reaction time, or judgment . Can they drive at night? Do they have traffic tickets? Assess the car. Is it worse for wear , dented or telltale signs of accidents?
➢ Trash- are their bags of trash in the basement or out back? Look in closets
➢ Collections- are their growing collections that appear to be out of control? Designer plates from the U S Mint , antique dolls, ashtrays, cookie cutters.--any accumulation that appears to be taking over space and looks excessive is suspect. This is a sign of hoarding
➢ Shopping- When they go shopping out for a meal, does the older person have problems with checks credit cards, figuring tips, forgets their purse , calculating discounts?
➢ Change in Behavior- Is the older person quiet when they used to be loud ? Are they paranoid, having mood swings, unsocial when they were the belle of the ball or life of the party?.
➢ Odors- Did you smell urine?
➢ Refrigerator- Are there science experiments aka moldy food in the refrigerator. ?
If any of these clues turn you need talk the older person, the subject of my next blog. You may also need to call in a geriatric care manager for help.
Friday, January 22, 2010
Texting For Help in an Emergency- Nana Technology ad PERS for Long Distance Care Providers
If anyone texted their donation to the Red Cross after the Haiti earthquake- you know the power of technology in an emergency. If you are a long distance care provider worried about an sudden crisis with your aging parent, technology is your friend. Protecting older people , when you live far away. includes all sorts of technology. Reactive technology includes Personal Emergency Response Systems or PERS. What’s that? It's a lightweight wristband or necklace that is set off by pushing a button . If your parent falls, has a heart attack- any kind of emergency -they can push the button . A signal will be sent via a telephone line to a response center.
The operator at the response center keeps contact with the older person and can call rescue personnel, like fire or police who respond to the crisis. The response center can also call you, the long distance care provider ,so it is a fabulous back up system when you are not there.
You want to shop around and look for a service that has a 24 hour response, works 7 days a week, including holidays and is manned by trained operators. Emergency response centers can be provider-based, usually in the older person’s local area and operate out of hospitals or social service agencies. There are also manufacturer-based centers which usually work from one national center. Contact your local Senior Information and Referral in your local AAA to get a list of providers in your relative’s area.
There are drawbacks. The system is great but relies on the elder's ability and willingness to press the button and call for help.” There can be times when the older person lose consciousness or forgets to push the button due to confusion . So if they do not push the button, the system will not be activated.
For an excellent article with much more detail.
An in depth chapter “Working With Long Distance Families: Tools the Care Manager Can Use”, By Julie Menack appears in, Care Manager’s Working With Aging Families, Jones and Bartett, 2008
There is an unimaginable crisis in Haiti. Use technology-
Donate now - hopeforhaitinow.org
The operator at the response center keeps contact with the older person and can call rescue personnel, like fire or police who respond to the crisis. The response center can also call you, the long distance care provider ,so it is a fabulous back up system when you are not there.
You want to shop around and look for a service that has a 24 hour response, works 7 days a week, including holidays and is manned by trained operators. Emergency response centers can be provider-based, usually in the older person’s local area and operate out of hospitals or social service agencies. There are also manufacturer-based centers which usually work from one national center. Contact your local Senior Information and Referral in your local AAA to get a list of providers in your relative’s area.
There are drawbacks. The system is great but relies on the elder's ability and willingness to press the button and call for help.” There can be times when the older person lose consciousness or forgets to push the button due to confusion . So if they do not push the button, the system will not be activated.
For an excellent article with much more detail.
An in depth chapter “Working With Long Distance Families: Tools the Care Manager Can Use”, By Julie Menack appears in, Care Manager’s Working With Aging Families, Jones and Bartett, 2008
There is an unimaginable crisis in Haiti. Use technology-
Donate now - hopeforhaitinow.org
Tuesday, January 19, 2010
Toxic Signs When Visiting Long Distance Family in a Nursing Home
If recently -or over the December festivities-you made a long distance visit to a family member in a nursing home and you found toxic signs like the smell of urine, poor care or defeat in your parent’s eye
1)- right now call the ombudsman.
2) on your next visit ,make contact with staff who care for them.
1)If something is really a serous concern - immediately contact the ombudsman at the facility and introduce yourself. This is a national Older Americans ACT program that monitors care in nursing homes and other facilities.
2)Your visits make care good. Periodic drop ins by a long-distant caregiver to a long-term care facility where the care recipient is residing are critical. It is important for the long distance caregiver to establish good contacts with employees (aides, the social worker, the RN charge nurse, the director), and let the contact person at the facility know that the long distance caregiver appreciates what they’re doing.
Don’t be reluctant to talk to the aides about care. They are on the front line. Facilities, especially nursing homes, have low staff-to-patient ratios -- like 1 aide to 10–15 patients. Things get missed, call lights stay unanswered. Get the business cards of the SW, RN and Administrative staff. Make those contacts and perhaps get a geriatric care manager to monitor and visit for you weekly or monthly if you are getting nowhere with them.
Eat a meal while you are there. Check out the quality of the food and the presentation. Remember, this is your relative’s house. They deserve a great kitchen. Is the place spotless? They deserve a clean home.
Talk to other residents and ask what they think of the care. Are there religious services, people talking, activities that are more than numb TV? Are people calling for their mother endlessly?
Bring a gift to enhance the older person life in a nursing home- bring your family and have them there. Try CEIVA a digital photo frame. You can automatically update the pictures from your computer as can the rest of your long distance family.
You can also have one of the friends, old or new, that I suggested you contact go by and visit, and let you know how things are going. In a facility the squeaky wheel is often the only voice heard. Make it heard.
1)- right now call the ombudsman.
2) on your next visit ,make contact with staff who care for them.
1)If something is really a serous concern - immediately contact the ombudsman at the facility and introduce yourself. This is a national Older Americans ACT program that monitors care in nursing homes and other facilities.
2)Your visits make care good. Periodic drop ins by a long-distant caregiver to a long-term care facility where the care recipient is residing are critical. It is important for the long distance caregiver to establish good contacts with employees (aides, the social worker, the RN charge nurse, the director), and let the contact person at the facility know that the long distance caregiver appreciates what they’re doing.
Don’t be reluctant to talk to the aides about care. They are on the front line. Facilities, especially nursing homes, have low staff-to-patient ratios -- like 1 aide to 10–15 patients. Things get missed, call lights stay unanswered. Get the business cards of the SW, RN and Administrative staff. Make those contacts and perhaps get a geriatric care manager to monitor and visit for you weekly or monthly if you are getting nowhere with them.
Eat a meal while you are there. Check out the quality of the food and the presentation. Remember, this is your relative’s house. They deserve a great kitchen. Is the place spotless? They deserve a clean home.
Talk to other residents and ask what they think of the care. Are there religious services, people talking, activities that are more than numb TV? Are people calling for their mother endlessly?
Bring a gift to enhance the older person life in a nursing home- bring your family and have them there. Try CEIVA a digital photo frame. You can automatically update the pictures from your computer as can the rest of your long distance family.
You can also have one of the friends, old or new, that I suggested you contact go by and visit, and let you know how things are going. In a facility the squeaky wheel is often the only voice heard. Make it heard.
Friday, January 15, 2010
January Long Distance Doldrums- Social Network Solutions
After your year end holiday visit, if things just did not seem right- here’s another tip.
A long distance caregiver should build bridges to the older person’s formal support system . What’s that? It’s a social network of community people who see the care recipient regularly (real life Facebook- community volunteers, church members, nurses ,social workers ). These contacts can be a gold mine of present and future information .
My last two blogs mentioned friends and spiritual groups. If your older relative belongs to a community program ,introduce yourself to someone in the group and ask if they will give you periodic updates via e-mail.
Make an appointment meet with the group leaders . Set up occasional check-ins.
Also consider helping the older person join new social, recreational or physical support programs. Weave a web around them to keep them independent and you informed. Take home the telephone directory, and go on the internet .Go to the link for your relatives’ county Area Agency on Aging. There you should find the local Senior Information and Referral program . E mail or call them about any community program you think you might enrich your family or friend’s lives and inform you of how they are doing at the same time..
A long distance caregiver should build bridges to the older person’s formal support system . What’s that? It’s a social network of community people who see the care recipient regularly (real life Facebook- community volunteers, church members, nurses ,social workers ). These contacts can be a gold mine of present and future information .
My last two blogs mentioned friends and spiritual groups. If your older relative belongs to a community program ,introduce yourself to someone in the group and ask if they will give you periodic updates via e-mail.
Make an appointment meet with the group leaders . Set up occasional check-ins.
Also consider helping the older person join new social, recreational or physical support programs. Weave a web around them to keep them independent and you informed. Take home the telephone directory, and go on the internet .Go to the link for your relatives’ county Area Agency on Aging. There you should find the local Senior Information and Referral program . E mail or call them about any community program you think you might enrich your family or friend’s lives and inform you of how they are doing at the same time..
Tuesday, January 12, 2010
Long Distance Care Provider's Post Holiday Visit- Got Friends ?
Following the next visit to your aging family member, post-December holidays, consider friends. Kindness is a bank you can count on. Friendship pays huge dividends and friends can deliver a dual service to you . They can offer socialization for your older relative and monitor for any signs of trouble.
Make two calls - contact both an old and new friend of the older person. You want to find people who live nearby. If possible, call in advance of your visit to make sure they'll have time to meet with you while you're nearby.
The record in our mind plays the deepest groves, so an older person will usually have great trust in a pal from their past. That old friend could come through for you in a crisis or or just renew the old relationship. See if you can arrange lunch with that friend and your elderly relative, so that they can get reacquainted.
Arrange another meeting without the older person, so that you can talk privately. Ask the old friend if they would to go by your family member’s home on a regular basis. Next ask if they could tell you what they found. This gives you a way to monitor your relative through someone who should have easy and regular access to your relative and their home. Be sure to collect all of their contact information, and give them all of yours, before returning home.
Also, try and be in touch with a new friend . Ideally choose a or neighbor or someone who lives in the same building. That way they can easily check on your family member in the event of an emergency. Privately, ask them if they would be willing to go by your relative’s house from time to time and give you updates on anything out of the ordinary. Also ask if they would be your “point person” who would contact you if they become aware of an emergency involving your relative.
You might offer to buy them calling cards so that they don't incur any expense while keeping your abreast of your loved one's health, safety and home situation. If they have e-mail that’s another great way for them to give you periodic updates.
With both friends, you have a steady support system from people who can come through in a crisis and visit on a regular basis.
Religious communities are a great way to provide someone to visit your relative plus offer socialization. You might contact the church, synagogue, mosque, or spiritual center where your relative is a member. Many times the religious leader will do on- going visits. If your family member needs transportation to services, often you can arrange that through the religious group at the same time.
All in all, you will rest easier knowing that you've got a local support network in place that can make observations and share worrisome trouble signs when you're far away. It's also nice to know that your relative is socializing and being looked in on when you are unable to do so yourself. Travel is tricky, flights can be delayed, weather is unpredictable – having someone down the street to take care of details until you can get to your relative yourself gives the long distance caregiver great comfort.
Make two calls - contact both an old and new friend of the older person. You want to find people who live nearby. If possible, call in advance of your visit to make sure they'll have time to meet with you while you're nearby.
The record in our mind plays the deepest groves, so an older person will usually have great trust in a pal from their past. That old friend could come through for you in a crisis or or just renew the old relationship. See if you can arrange lunch with that friend and your elderly relative, so that they can get reacquainted.
Arrange another meeting without the older person, so that you can talk privately. Ask the old friend if they would to go by your family member’s home on a regular basis. Next ask if they could tell you what they found. This gives you a way to monitor your relative through someone who should have easy and regular access to your relative and their home. Be sure to collect all of their contact information, and give them all of yours, before returning home.
Also, try and be in touch with a new friend . Ideally choose a or neighbor or someone who lives in the same building. That way they can easily check on your family member in the event of an emergency. Privately, ask them if they would be willing to go by your relative’s house from time to time and give you updates on anything out of the ordinary. Also ask if they would be your “point person” who would contact you if they become aware of an emergency involving your relative.
You might offer to buy them calling cards so that they don't incur any expense while keeping your abreast of your loved one's health, safety and home situation. If they have e-mail that’s another great way for them to give you periodic updates.
With both friends, you have a steady support system from people who can come through in a crisis and visit on a regular basis.
Religious communities are a great way to provide someone to visit your relative plus offer socialization. You might contact the church, synagogue, mosque, or spiritual center where your relative is a member. Many times the religious leader will do on- going visits. If your family member needs transportation to services, often you can arrange that through the religious group at the same time.
All in all, you will rest easier knowing that you've got a local support network in place that can make observations and share worrisome trouble signs when you're far away. It's also nice to know that your relative is socializing and being looked in on when you are unable to do so yourself. Travel is tricky, flights can be delayed, weather is unpredictable – having someone down the street to take care of details until you can get to your relative yourself gives the long distance caregiver great comfort.
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