Advocacy « The Professional Geriatric Care Manager’s Blog

Freedom to Choose

November 9, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Advocacy, Caregiver, Facility, Research, Tips

Recently, we received a call from a concerned daughter whose mother is recuperating in a skilled nursing facility following a recent hospitalization. She called Distinctive Care for advice on managing her mother’s plan of care, including possible options for her care upon discharge from the facility.

When we heard which nursing home her mother is in, we were concerned, because it is not a facility we would ever recommend for our clients. Its reputation has suffered for years due to various ongoing deficiencies, and there are better options in the same market area. We asked why the family selected the facility and learned that they went along with the suggestion of the hospital discharge planner, not really understanding that they could choose from many facilities. Of course, bed space and appropriate levels of care must be available, but clients and their families should always be able to make their preferences known.

As geriatric care managers, we pride ourselves on serving as advocates for our elderly clients. We always tailor our referrals to the facilities and professionals who can best care for the individual client’s needs. We encourage family members to take an active role in evaluating facilities and offer guidance on what to look for in a quality skilled nursing or assisted living community. We continually re-assess facilities in our service area to stay abreast of any changes, and our proposed care plans always include several choices of facilities that we believe are best-suited to meet that individual’s needs.

Distinctive Care Geriatric Care Management serves Bergen, Passaic, Rockland and Orange County with nurses licensed in New Jersey and New York. We help families dealing with various issues related to their elderly loved ones and would be happy to discuss any concerns you may have related to long term care. Please contact us in our Ridgewood Office at 201-587-5283 to schedule a consultation.

Alzheimer’s Disease and Dementia Care Course

September 26, 2011 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Advocacy, Alzheimer's Disease, Education, Eldercare, Family, Help, Seminar

With a new diagnosis of Alzheimer’s Disease being made every 70 seconds in this country, it is important that our healthcare community know as much as they can about working with older adults who have this disease and other forms of dementia. With that in mind, Sophia Heftler, founder of Distinctive Care, decided to become a Certified Dementia Practitioner and Trainer. She is now able to teach others what she has learned. Distinctive Care is offering an all day course entitled Alzheimer’s Disease and Dementia Care on Wednesday, October 26, 2011 from 8:30am to 5:00pm. It will be offered at Van Dyk Park Place, 644 Goffle Road, an assisted living facility in Hawthorne, NJ.

The course modules will provide an overview of Alzheimer’s Disease and other forms of dementia, as well as diagnosis and treatment. Behaviors which are associated with Alzheimer’s, such as repetition, wandering, hoarding, paranoia and hallucinations, aggression and catastrophic reactions, will be covered. Depression, personal care, sleep disturbances and nutrition will also be covered. In order to offer the best possible care of the patient successful, the course will cover activities, environment, staff and family support, as well as diversity and cultural competencies. Spiritual care and end of life issues will also be discussed.

This course is the first step towards becoming a Certified Dementia Practitioner; further information about this process can be found at www.nccdp.org. Continental breakfast and lunch will be provided and a professional binder filled with important information will be given to each attendee. The course gives 7 CEU credits for activity professionals; 7 CEU credits have been applied for nurses and social workers.

Unique Services for Older Adults

August 1, 2011 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Advocacy, Eldercare, Help, Life, Research, Tips

When someone wants to know more about we do at Distinctive Care Geriatric Care Management, I am the person that gets the first call. I am happy to review what we do and how we do it, and am so glad when our services match a family’s needs. As the Director of Community Relations, I am also the person who is out and about in the community in Bergen, Passaic or Rockland County learning about available services, both old and new.

Although some of the services for older adults are obvious, such as home care, it is always nice to learn the differences between each of them. Some employ people who drive as home health aides, or will provide a bed and bath service of minimum hours while others give their caregivers cooking lessons. It is up to me to make the initial determination as to whether the home health aides that they employ are properly screened, trained and monitored and are possibilities for our referral. It seems as it every agency is trying to set themselves apart from the others in some way that will appeal to the families that need help taking care of their elderly loved ones.

In addition to the obvious, I become familiar with unique services, too. Services which caregivers might not be aware of are agencies that specialize in sponsoring trips for older adults who require dialysis, wheelchairs, or oxygen, and the company that provides dialysis services in the home while people sleep. Distinctive Care is in the forefront of knowledge regarding available services. Whether it is a quality of life issue such as clutter clean-up, money management or transportation or a medical need such as a rehab facility that specializes in cardiac care or one that offers a Transition to Home program, I am always happy to learn about what’s new and exciting in the field of elder care. I hope to share more about these services in future blog entries.

Caution with Medications

July 7, 2011 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Advocacy, Eldercare, GCM, Health, Medication

As a registered nurse I am always concerned about my client’s needs and usage of prescription and over the counter medications. Older adults have multiple diseases and because of this, they tend to take many medicines. As they continue to age, the ability to breakdown and metabolize drugs generally declines with age. We see diminished kidney and liver function as we age. The kidneys and liver are where drugs are mainly metabolized. If a client’s kidneys or liver are not functioning properly, this can cause blood concentrations of drugs to reach higher level and take longer to eliminate them from the body. It can be very challenging to diagnosis properly the problem of over-medication; symptoms are not always clear-cut. Please see from the list below, the most common signs and symptoms of over medication can resemble many other conditions:

Fatigue
Motor problems such as walking and standing
Skin flushing and rashes
Weight loss or gain
Falling and problems with balance
Mood swings
Memory problems
Withdrawal
Confusion
Abdominal pain

It is important to remember to look at the elderly adult and really look and listen for all recent changes in their behavior, appearance and speech. Any noticeable change needs to be brought to the doctor’s attention. To improve communication with the physician, keep a log of the behavior or symptom. Write down when it happens, how long it lasts, and describe it in detail. We all need to be considered part of the medical team. When meeting with the doctor, go over the log in detail. Ask him dosage level, interaction effects and alternatives.

Drugs interact with one another, sometimes multiplying or magnifying the effects and causing additional symptoms. OTC (over the counter) medicines and dietary supplements can also have interaction effects. This is why it is critical that good communication with the doctor and tell her or him about all the medications in the medicine cabinet and or bring them to their doctor’s appointment. Periodically do an in-depth review of all medications with the primary physician.

As a Geriatric Care Manager, I oversee the client’s medications and always keep an updated medication list at the client’s home/facility and also in my possession. Their medication list is always provided to the physician at the time of their visit.

Last week I spoke to a physician of the recent decline in one of my client’s behaviors and weight loss. Medications where reviewed and changes had been made to two medications. A big positive outcome had occurred in just one week’s time. I am always so happy that I am a big advocate for my clients.

Speaking from Experience: Stroke

July 6, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Advocacy, Education, Health, Help, Life, Personal

Last week I had the opportunity to attend a very interesting talk given by Dr. Oriana Cornett at the Valley Hospital in Ridgewood, NJ. A promising young physician, Dr. Cornett was two months shy of becoming an Endovascular Neurosurgeon when she suffered an ischemic stroke at the age of 37.

Her lecture, entitled “Stroke Inside Out,” provided an overview of what happens to the brain during a stroke, types of stroke, methods to improve patient outcome, complications of stroke and more. What was most fascinating was her insight into what it was like to actually experience a stroke, combined with her considerable knowledge of stroke as a physician who was specializing in treating stroke victims.

Like my dad, Dr. Cornett suffered left side hemiparesis and sensory loss and left side spatial neglect. But as her stroke was occurring, she did not recognize what was happening to her. In fact, she reports that it was not as if she couldn’t control her left side, but rather, her entire left side ceased to exist. How could you recognize you were having a stroke, if you’re not even aware that part of you exists?

Days later, as realization of the magnitude of her situation dawned upon her, depression began to set in. Dr. Cornett credits two of the nurses who attended to her with giving her hope. Their names were Mercy and Faith. They told her “You will get better. You won’t always be this way.” She says those are the words she needed to hear, far more than any concrete timeline or medical jargon. She points out that doctors are not trained to say such things, but if she returns to practicing medicine, she will never underestimate the power of those words.

Good advice for all of us to remember.

Planning Ahead

May 25, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Advocacy, Love, Personal, Tips

I’ve had a stray cat prowling around my house this week, a newcomer to the neighborhood who looks like she needs a good meal and a good home. So I called a friend of mine who has multiple pets and asked if she has room in her house and her heart for another companion.

My friend replied that she has finally decided she can’t adopt any more pets, for several reasons, but the one that stood out was that she is worried what will happen to them after she is gone. She has no family members to leave them to and worries about what their fate will be when she is no longer able to care for them.

I give her credit for planning ahead in this way. Having worked at an animal shelter, I know how traumatic it is for pets when their owners pass. Suddenly they can find themselves whisked out of their home, locked in a tiny cage in a strange environment, often with little or no chance of adoption due to their own advanced age.

Companion animals can and should be included in estate planning. An attorney who specializes in estate planning can create a pet trust to ensure your pet is cared for after your death. Another option is a pet protection agreement, which can be drawn up online for a very nominal cost and will also cover your pet’s care before your death, should you be unable to provide care. An interesting website which discusses the difference between the two is found here.

Advance Planning

April 20, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Advocacy, Aging, Family, Help, Tips

Did you know this past Saturday was the fourth annual National Healthcare Decisions Day? The National Healthcare Decisions Day Initiative is a collaborative effort of national, state and community organizations committed to ensuring that all adults with decision-making capacity in the United States have the information and opportunity to communicate and document their healthcare decisions. For more information, visit the NHDD.

Even though the “official” day has passed, you can still use information about this event as a way to broach the difficult topic of end-of-life care with your loved ones. Offering a copy of one of the press releases from the above website may be a good way to bring up the subject.

Having a health care power of attorney and a living will in place is important for all adults, regardless of age. As difficult as it may be to discuss end-of-life plans with your loved ones, not having a plan in place puts a greater hardship on families who struggle to make difficult decisions without such guidance.

How to Make the Decision to Enter a Nursing Home

March 28, 2011 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Advocacy, Aging, Caregiver, CEU, Education, Eldercare, Tips

When children see their parents failing in one way or another, whether due to signs of dementia or an illness that leaves them incapacitated, the first thought seems to be a move to a nursing home. Although there are many good nursing homes that are very caring and skilled, a nursing home does not need to be the first or only choice in living arrangement. Sophia Heftler of Distinctive Care Geriatric Care Management has used her twenty years of working in elder care to develop a continuing education program called The Turning Point. Her experience as a Director of Nursing at a Nursing and Rehabilitation Center in Bergen County and as an Executive Director at an assisted living facility in Passaic County brought her a wealth of knowledge as to what should go into making the decision on when entering a nursing home is the best choice. This CEU, which gives 2.0 credits for nurses, social workers, Certified Assisted Living Administrators (CALA) and Licensed Nursing Home Administrators (LNHA), will be presented at Bergen Regional Medical Center in Paramus, NJ at 9:00AM on Thursday, April 7. The general public is also welcome. Come for breakfast and learn the key reasons why the elderly currently enter nursing facilities and factors affecting their decision. Call (201) 225-7674 to make a reservation.

Busy Week!

March 11, 2011 at 10:30 am | Posted in Sophia Heftler, GCM | Leave a comment
Tags: Advocacy, Aging, Caregiver, Eldercare, Help, Support

Wow, has it been a busy week at Distinctive Care! We had two Clients discharged from two different acute care hospitals to a local skilled nursing and rehabilitation center. One is there for rehabilitation and then will be staying on for long-term care in the nursing home section of the facility. The other one is there for a short-term stay and will be returning home where we had previously set up around the clock care for him. The care managers have been great in getting them settled into the routine and are keeping a close watch on their progress. Our therapist has been there to see them and assist them with the transition.

I had to be involved due to the fact that I wanted to ensure that these Clients would get the very best care possible, advising the administrator of my expectations and the fact that our care managers would be there frequently to monitor progress and keep the families apprised of their progress. I wanted her to be able to assure her staff that our role was not to check up on them, and if there was anything we could do to assist with their care for them to feel free to let us know, and we would be happy to pitch in and help out. She was extremely accomodating and actually ensured that the one Client who would be staying on long-term was placed in a room right across from her office! Who could ask for more than that!

Last night I received a message from the care manager who is working with the short-term stay Client. Apparently he was having some episodes of confusion yesterday and was demanding to go home. He was brought to an activity between his therapy sessions and thought he was in occupational therapy when he was there. He was very upset that he had spent an hour in occupational therapy singing! This poor gentleman was watching an opera singer who was there to perform and unfortunately, because of a miscommunication, he thought he had wasted an hour of his rehab time singing. I could understand why he thought “the place was a fraud” and wanted to go home. At any rate, I called to leave a message for the administrator to get back to me and despite the fact that it was well into the evening she took my call. We discussed the Client and how highly motivated he is, discussing his individualized care plan.

Today I went to see all our Clients who are there. Distinctive Care has another Client there in the nursing home so I saw her and her devoted husband. She is doing wonderfully and he is there everyday by her side. The other Client who will be there long-term was happily singing in the activity room with many other residents. She looked so happy, I didn’t disturb her. I stood outside the room watching her for about 10 minutes. It was amazing to see this Client, who had been so lonely in her home, with the group singing the songs she knew from the old days.

And finally I saw the gentleman who wanted to go home last night. He asked me if I had made a phone call last night. I told him that I had and he said he could tell and he had a much better day today. He said he was so embarrassed about the singing incident. I told him not to worry about it! He told me about the rehabilitation he received today and what his goals are prior to returning home. I promised I would return next week with Romeo, our Therapy dog and a special treat for him. He said I spoil him. He blew me a kiss when I left. Who has a better job than me!

If you are looking for placement in a nursing home or subacute center and need assistance please feel free to contact us in our Ridgewood, New Jersey office. We are very familiar with the the high quality centers in Bergen County and the surrounding areas, including Rockland County in New York and will be able to assess your particular situation and help you to find the right place to meet your individual needs.

Changes for the better.

March 10, 2011 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Advocacy, Caregiver, GCM, Help, Life

I decided to talk about a client that we have been working very closely with for the past 6 months. Mrs. K started with Distinctive Care in September, 2010. We started seeing her when she was admitted to a local hospital and then to a rehabilitation center for physical and occupational therapy after a fall, when she fractured some of her ribs. During the 6 months under our care, Mrs. K has been through a multitude of change in her life. She has been hospitalized four times during this time period, twice for medical issues and twice for psychiatric reasons. She has also been taken out of her house for health and safety reasons. She was then moved to three different facilities, assisted living(2) and then to a more skilled long-term nursing facility, where she is currently.

Mrs. K has a known history of psychiatric and behavioral issues that have caused such difficulty throughout her life. I decided to write about Mrs.K to explain that she has overcome so much during these last few months, and there was a point during this time that I was not sure if she was going to have a positive outcome. After her second move to an assisted living facility, and her long time caregiver went on a 3 week vacation, Mrs. K really started to show a big decline in her health and behavior. She was not eating, sleeping or speaking clearing, and was chanting and constantly calling out. She had so many changes in such a short period of time that she was unable to manage and process them all at one time. She did not know how to adapt and instead she shut down.

After her most recent hospitalization and rehabilitation, our team was able to get Mrs K. into an excellent Psychiatric Hospital for proper diagnosis, care and treatment. She did extremely well after 12 days of intense therapy and was discharged to a small, highly recommended longterm care/nursing facility that is close to her home and family. Mrs. K has been doing very well at her new home. She will continue to receive physical, occupational, speech therapies and psychiatric counseling as well.

Mrs. K had a supply of support from her family, friends,care givers and geriatric care managers during this large transition in her life. I am happy to be apart of her continued care and progress of her life.

Distinctive Care Geriatric Care Management serves Bergen, Passaic, Rockland and Orange County with nurses licensed in New Jersey and New York. We help families dealing with various issues related to their elderly loved ones and would be happy to discuss any concerns you may have related to long-term care. Please contact us in our Ridgewood Office at 201-587-5283 to schedule a consultation.