Caregiver « The Professional Geriatric Care Manager’s Blog

My Perfect Job

April 8, 2011 at 10:30 am | Posted in Sophia Heftler, GCM | Leave a comment
Tags: Aging, Caregiver, Driving, Family, Life, Love, Personal

I am so fortunate that, as the owner of Distinctive Care Geriatric Care Management, I have the opportunity to spend quality time with our Clients on a routine basis. It provides me with an opportunity to observe the Client and make a comparison, not only to the last time I saw him/her, but also to compare what I’m seeing to what I have learned about the Client at our weekly interdisciplinary care conferences. It also affords me the opportunity to be in touch with the families to provide them with my perspective on their loved-one as well as the chance to find out if they have any concerns that I should be looking into.

This week I had the privilege of spending the afternoon with one of our Clients who has Primary Progressive Aphasia. She moved into an assisted living facility several months ago. Last month when I visited I brought her a wreath for her door and spent time with her at her new home observing her and seeing that she was adjusting well to her new environment. It had been a while since I had last seen her, as I had been out on medical leave for some time. After spending time with her I reached out to her daughter and her Care Manager about some concerns I had and we were able to obtain an order for physical and occupational therapy for her. I was able to note a decline in her physical functioning which was not as evident to the family and Care Manager who see her on such a routine basis. The changes were subtle, but since I hadn’t seen her in some time they were very obvious to me.

Anyway, back to this week: I obtained permission from her daughter to take her out for lunch and shopping (two of her favorite things!) but was advised by her daughter that we should only do one thing because it was really difficult to get her into the car. So I arranged to take her to a nearby Lord & Taylor that has a cafe so we could do both.

When I arrived to pick her up she was waiting for me. She was all dressed up in a beautiful purple outfit (my favorite color!) and had beautiful jewelry on. We went up to her room to get her coat and I was able to observe that there was some improvement in her gait since beginning physical therapy. All of the caregivers we ran into were so happy that she was going out and asked if I could purchase her some new pull-on pants in a size medium since she had gained some weight since her move into assisted living (as most new residents do). I obtained the “okay” from her daughter to do so and off we went.

The first thing I noted was that it was not so much that she was having difficulty getting into the car, but that she was doing it incorrectly. I showed her how to do it properly and safely, and had no problem getting her into or out of the car. I will review this with the Care Managers on Monday at the meeting so that when they take her to appointments they will have no problem with this issue. I have already reviewed the procedure with her daughter, who said she understood, and although she has not taken her out since she moved to the assisted living she will keep it in mind when she does.

We had a wonderful time. I helped her to order her lunch and observed how she did when eating. She had no problem and used the appropriate utensils and did not demonstrate any difficulty swallowing. Of course I did all the talking since she has really declined in this area. But she can still laugh, and we had lots of fun while I poked fun at her and her hearty appetite.

Then off we went shopping. I had to remind her frequently to take bigger strides when ambulating, but other than that she did fine. She was able to follow directions and we went to see if there were any pants she liked. She picked out two pairs and also a blouse that matched well with both of them.

We had so much fun trying on colorful scarves and I modeled several pairs of shoes for her in the shoe department. (Everyone who knows me, knows about my wild taste in and huge collection of shoes.) She was laughing and smiling the whole time! And I was having a wonderful time too!

After almost 4 hours it was time to go home and when I dropped her off I gave her a kiss goodbye and she spoke the only full sentence of the afternoon…”You really listen to me!”. What a wonderful gift…what a wonderful day!

Distinctive Care is a full-service geriatric care management practice. All of our Care Managers are Registered Nurses and we have a Transitional Coach on staff who assists Clients as they experience the changes that come with aging. We are located in Bergen County, New Jersey, in Ridgewood, New Jersey. We serve northern New Jersey including Bergen, Passaic and other counties as well as Rockland, Orange and Westchester County in New York. We can be reached at 201-857-5283.

Bravo, NJPAC!

April 6, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Caregiver, Family, Help, Tips

Kudos to the staff at the New Jersey Performing Arts Center (NJPAC) in Newark, where my brother and I recently took our parents to a concert by the New Jersey Symphony Orchestra. I was so impressed by the ease with which we were able to get my father and his wheelchair into the concert hall. We had made advance arrangements for handicapped-access seats (patrons can remain in the wheelchair or transfer to a regular seat, and those accompanying them may purchase adjacent seats.) We were able to pull our car virtually up to one of the doors of NJPAC, where we were met by an usher who assisted us before and after the concert. He escorted us to and from the seats, and even reappeared at intermission to assist with a trip to the restroom.

For more information, visit NJPAC and click on Visitor Info/Accessibility.

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.

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.

Book Group for Two

March 23, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Aging, Caregiver, Family, Help, Life, Personal, Tips

I visited my dad last weekend in the sub-acute rehab facility where he is presently recuperating. We made the usual rounds, pushing his wheelchair to the lobby, out for a few minutes of fresh air and back to his room before finally parking in the library. It dawned on me that I hadn’t seen Dad reading any books since he arrived at the facility two weeks ago. At home, I usually keep him stocked with several large-print books from the local library, but such routines went out the window with his hospitalization and subsequent rehab.

I scanned the shelves and happened to come upon a book that I’m in the middle of reading at home. I knew it was one he would enjoy, so we adjourned to his room with it. He suggested we take turns reading it aloud to each other—what a great idea! We hadn’t done that in more decades than I care to admit. It also gave me the opportunity to assess his reading ability, which has been a concern of mine since his stroke. He did very well! We each vowed to keep reading the book on our own and compare notes as we progress.

I just might have to start borrowing duplicate copies of those library books…

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.

Can You Hear Me Now?

March 9, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Advocacy, Caregiver, Hearing, Personal, Tips

As I mentioned last week, I’ve been doing a lot of advocating lately for my dad, who remains hospitalized. In addition to numerous other health issues, one of his challenges is the severe hearing loss he suffered after years of working in a very loud environment. Even with hearing aids, it can be difficult for him to understand others. At home, family members and his caregivers have learned the techniques that work: minimize other distractions, get closer to him, make eye contact, speak a little slower, and above all, speak louder than normal. It’s also necessary to look for clues that he understands you, or use checkpoints in your story to make sure he’s still following you.

When Dad is out in the real world, or in this case, at the hospital, it’s even more of a challenge for him. There are new distractions, new voices, new topics with new vocabulary. Sometimes people assume he is not capable of following instructions or responding, but the truth is that he’s very sharp and capable once he understands what’s been said. We don’t hesitate to alert people to his hearing loss right up front, but it’s amazing how many people don’t adjust their speech accordingly.

Last night, Dad’s nurse and his CNA came in and gave him some instructions how to get out of bed. I could tell from his expression that he had no idea what was said, and I told them, “He didn’t hear you.” The nurse repeated himself, exactly as before, without making any accommodations for Dad’s hearing loss (which, by the way, is noted on a sign above his head.) At that point I realized I needed to be more specific: “If you get closer to his head and speak much louder, he’ll be able to hear you.” Above all, he wants to know what the plan is and be an active participant in his care.

Ideally, caregivers of the elderly should know how to communicate better with those suffering from hearing loss. By my speaking up, maybe they’ll be a little more sensitive to the next hard-of-hearing patient they encounter.

You Can’t Be Too Careful

March 2, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Advocacy, Caregiver, Family, GCM, Health, Safety

This week I’ve been juggling issues related to three of my family members being ill, the most serious being my dad, who is currently hospitalized. Over the years I’ve learned that you must always advocate for your loved ones when they are unable to do it themselves, and this week is no exception.

Upon Dad’s arrival at the ER, my brother handed the nurse a list of his current medications. Dad’s general physician was consulted and has seen him every day of his stay. And the hospital is the same one that has treated my father regularly in recent years and retains his medication history in the computer system.

Yet somehow, Dad’s heart medication disappeared from his orders. We noticed it after I requested a printout of his meds from his nurse. When reviewing details like these, it’s just as important to ask yourself “what’s NOT on the list?” as it is to ask “what IS on the list?” After bringing it to the attention of the nursing staff, the doctor was consulted and the heart medication reinstated.

When it comes to the health of loved ones, I’d rather be guilty of asking too many questions, than too few.

There’s Lots of Training Behind a CMC

February 28, 2011 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Caregiver, CMC, Education, Research, Tips

CMC. In the profession of caring for older adults, those three letters, CMC, stand for Care Manager Certified. Three simple letters but there is a lot behind it. This designation is conferred by the National Academy of Certified Care Managers (NACCM) when a professional has demonstrated a wealth of experience, sufficient education and sits for a rigorous national exam.

Before someone can even be eligible to take the exam, they must first qualify under three areas of criteria. The first is education. Each candidate must have either an RN diploma, a bachelor’s degree, or a Master’s degree. The second criteria is experience. Each candidate must have 2 – 3 years of paid, full time, supervised experience in the field of care management. The third criteria is direct client contact. Two to four years of recent experience in a field related to care management is required; that would include nursing, social work, counseling, psychology, rehabilitation, gerontology and public health or human services.

In order to become a full member of the National Association of Professional Geriatric Care Managers, (NAPGCM), one must have a CMC or other similar credential, such as Certified Case Manager, CCM; Certified Advanced Social Worker in Case Management, L-ASWCM or Certified Social Work Case Manager, C-SWCM.

Why would someone want someone who has met the qualifications to become a member of the NAPGCM? When you hire someone who is a member of the National Association of Professional Geriatric Care managers, you know you are getting the help and expertise of a geriatric care manager with a CMC or other similar credential. You are assured that you are working with a trained professional whose skills and competencies in the field of health and human services are well rounded, up-to-date and backed by experience, whether it be in a hospital, nursing home, assisted living facility, home health or any other similar background that helps the elderly. That’s the kind of help that can help in the best way possible. And that’s the kind of help that we provide at Distinctive Care Geriatric Care Management in Ridgewood, NJ.

First Week Back

February 4, 2011 at 10:30 am | Posted in Sophia Heftler, GCM | Leave a comment
Tags: Advocacy, Caregiver, Love, Work

This is my first week back to work in a very long time as I was out on an extended medical leave. I knew that I missed working with my geriatric clients and their families as well as my professional staff, I didn’t realize how much until I returned.

We have a weekly clinical meeting every Monday morning which I have been receiving summaries of from my office manager each Monday afternoon. I have also been copied on every email regarding every client so I have been aware of what’s going on and contributing my suggestions and advice as needed. It felt wonderful to be able to contribute in real time, discussing how we could best help one of our family member who visits his wife in a nursing home daily, often neglecting his needs, to using my clinical background in making suggestions about medical testing I felt would be appropriate for a client. It felt great to be helping our Registered Nurse Care Managers in careplanning and developing interventions to best assist our elderly clients and their families. It was wonderful to hear about the goals our Therapist is working on with her clients as I think the mind-body connection is so important.

Yesterday I was advocating for a client of ours with a geriatrician we work closely with. I wanted him to understand the importance of doing everything possible for this particular client to ensure that she reached her maximum potential which included some things he did not necessarily agree with. At one point I said to him, “I bet you wish I wasn’t back yet!” and his response was “I enjoy the advocacy and it’s good to see things shaken up in the right way. I missed you very much.” It’s good to shake things up in the right way and ensure the very best of care for those who can no longer advocate for themselves. This isn’t work…this is what I love.

Distinctive Care Geriatric Care Management serves Bergen, Passaic, Rockland and Orange Counties with nurses lisenced 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 have related to long-term care. Please contact us in our Ridgewood office at 201-857-5283 to schedule a consultation.

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