Eldercare « The Professional Geriatric Care Manager’s Blog

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.

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.

What a Good Read!

July 25, 2011 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Alzheimer's Disease, Caregiver, Eldercare, Life, Memory, News, Research

I read a good book recently, Finding Life in the Land of Alzheimer’s by Lauren Kessler. The author is a journalist who feels that she failed in the role of caregiver for her mother who had Alzheimer’s. So when her mother passed away, she decided to give it another try, but in a different way. She went undercover as an aide in a dementia care facility.

What Lauren found was that aides in dementia care facilities are underpaid and usually living from hand to mouth. Their workload is heavy and their day is challenging both physically and emotionally. In many cases, the job of aide is not the only one that they hold. Their day is repetitive in the tasks they do but not in the challenges that interrupt those tasks. Quite often they are the caregiver that is there when a resident falls or has an accident or has an aggressive episode.

What Lauren also found was that she became attached to these elderly men and women with Alzheimer’s and other forms of dementia. Yes, they experienced behaviors typical to the disease, such as repeatedly asking the same question or experiencing episodes of paranoia, but they also had personality. And each one was an individual in many of the same ways that they had always been an individual before they were diagnosed with Alzheimer’s. They were able to experience emotions like you or I, and although they didn’t have a memory of things that just passed, they were able to enjoy life in the moment.

The statistics for Alzheimer’s are staggering and worth us paying attention to as a nation, and as a world. Today, 5.4 million Americans are living with Alzheimer’s disease. By 2050, as many as 16 million Americans will have the disease. Of Americans aged 65 and over, 1 in 8 has Alzheimer’s and nearly half of people aged 85 and older will have the disease. For more information on this devastating disease, go to Alz.org. Geriatric care managers and other healthcare professionals can help families in caring for a loved one in caring for those with dementia. To find a geriatric care manger in your area, visit CareManager.

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.

My First Year As a Geriatric Care Manager

June 16, 2011 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Caregiver, Eldercare, GCM, Life, Love, Personal

I usually never write about myself in these blogs. But, I thought that it would be nice to express myself this week about what I have liked so much about my new career choice as a Geriatric Care Manager (GCM). I have now completed my first year as a GCM. It is so hard to believe a year has gone by so quickly. I was worried when I left my previous position. Was this new path going to be as rewarding to me as I hoped it to be? I always need to feel that I have accomplished something big. This GCM position had to really make me feel it was so worth my while. So far, it really has. I find this newly found career as a GCM so satisfying. It has really made a large difference in my life. I treat each of my clients as if they were part of my own family. Seeing my clients happy and medically stable is what I can only strive for. I am constantly using my nursing skills. Great nursing skills are very much a part of this position. Being able to help people with all my years of experience and knowledge is a wonderful feeling. Also, learning about all these new resources that are available for our older adults in our community is so remarkable; Home Health Care Agencies, Transportation Services, House Cleaning and Maintenance Services, Pet Therapy, Senior Exercise Specialist, Geriatricians, Psychiatrists, Neuro-Psychiatrists, Elder Care Lawyers and the list could go on.

Having so many exceptional resources available and working with a wonderful staff has in fact made my change to becoming a GCM a relatively easy transition. I am learning something new about the geriatric patient and medicine every day. I really enjoy this and always want this to transpire in my career as a Registered Nurse and GCM. I can see what a difference I have made on my clients well being as I see the change on my weekly visits.

Falling…Up?

June 1, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Aging, Caregiver, Eldercare, Falls, Help, Life, Tips

According to the American Academy of Family Physicians, falls are the leading cause of injury-related visits to emergency departments in the United States and the primary cause of accidental deaths in persons over age 65. Falls account for 70 percent of accidental deaths in persons 75 years of age and older.

Risk factors for falls in the elderly include increasing age, medication use, cognitive impairment and sensory deficits. Here at Distinctive Care, our R.N. geriatric care managers try to identify these risk factors and implement changes to minimize these risks wherever possible. We conduct a comprehensive assessment of each new client. Among the many components of the assessment is a 130-point safety checklist of the home, which includes looking for things like loose throw rugs, as well as a complete medical history and review of all medications which can increase fall risk.

Clients are often unaware of little changes that can be made to improve the safety of their living environment. After all, in many cases, their furnishings have been in place for years, and they’ve never had a problem. But they fail to realize how increasing age and increasing fall risk go hand in hand. It helps to have a trained eye review the living environment to identify potential pitfalls.

Depression in the Senior Years

May 20, 2011 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Aging, Depression, Education, Eldercare, Health, Seminar

I attended a conference this week entitled “The Golden Years? Medical, Legal, Ethical Challenges Facing Seniors and their Caregivers.” One of the topics of the program was “Depression in the Senior Years.” The speaker started off with saying depression is a medical disease, just like diabetes, heart disease and cancer; one in five people will develop depression in their senior years.

Depression is characterized as an all-encompassing low mood, accompanied by low self-esteem, and by the loss of interest and pleasure in normally enjoyable activities. The causes of depression can include psychological, hereditary, or biological factors. Certain medications can cause depression. The abuse of alcohol and drugs can cause depression. In the elderly, depression can often coexist with physical disorders, such as stroke, cardiovascular diseases, Parkinson’s disease, and chronic obstructive pulmonary disease.

Symptoms of depression in the elderly include headache, pain, fatigue, insomnia, and digestive problems. There exists a low rate of detection of depression in the elderly by primary care physicians, and depressed older adults have the highest risk of suicide in our society. Once depression is diagnosed there are varying treatment plans. Depression can be successfully treated with antidepressant medication, psychotherapy, electroconvulsive therapy, or a combination of therapies.

As geriatric care managers, we observe for symptoms of depression. We know that changes in an older person’s behavior or mood should not be ignored. Many of our clients suffer from dementia, or have a history of other physical disorders such as stroke. The risk of major depression has been shown to increase with neurological conditions such as stroke and Parkinson’s disease. If we suspect depression, we will bring it to the attention of the client’s primary care physician, who can prescribe a course of treatment after a medical examination. The primary care physician may also refer the client to a neurologist or psychiatrist for further evaluation. Additional testing is also performed to eliminate causes of the symptoms. Blood tests, such as thyroid tests, to rule out a metabolic disturbance; and a full blood count with ESR, to rule out a systemic infection are drawn. Cognitive testing and brain imaging are done to help distinguish depression from dementia. A CT scan of the brain eliminates any evidence of physical problems, such as brain tumors. As care managers, we arrange for any testing ordered and accompany the client to the scheduled test. At weekly visits we can continually assess the patient. We set up weekly pill boxes to make sure clients are compliant with their medications, particularly if medications have been prescribed for depression. We engage clients in activities, such as working with a senior fitness trainer, sessions with a psychotherapist, or our therapy dog Romeo. The goal is to eliminate feelings of hopelessness and emptiness a client may be experiencing, to aid in the diagnosis and treatment of depression in the elderly, and not just view it as a natural consequence of aging.

Come to BoomerFest!

April 11, 2011 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Aging, Education, Eldercare, Help, Life, Tips

BOOMERFest! It’s a FREE health fair for boomers, complete with food, entertainment, screenings and “one stop shopping.” I am part of a committee of health and service professionals in Rockland County who feel very strongly that older adults and their families need a place to go for resources concerning their health and safety. So BoomerFest came into existence. This health fair will provide screenings, such as blood pressure, memory, and depression and will also offer chair massages and reflexology, and all of it is free. Many people are offering their time and services to make this event a success. The keynote speaker will be Harriet Cornell, a member of the New York State legislature who has a passion for older adults and their needs. The Rockland Players from the Antrim Playhouse have developed some timely, realistic and humorous skits related to aging that you won’t want to miss. There will be refreshments and light snacks to make the day more enjoyable. And there are over 60 exhibitors from home care agencies and nursing homes to travel to hospitals and financial services.

The event is being held at: Felix Fest Middle School, 30 Parrott Road, West Nyack, New York 10994 from 11Am to 3PM on Sunday, May 1. It is easy to reach from Bergen County, New Jersey, too.

For more details, contact boomerfst@gmail.com.

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.

Nursing Home Stigma

February 25, 2011 at 10:30 am | Posted in Sophia Heftler, GCM | 2 Comments
Tags: Aging, Education, Eldercare, Help, nursing home

I have been doing CEU presentations all week about when the time comes for families to consider nursing home placement. There is a huge stigma associated with nursing home placement however as I went about educating professionals this week about the importance of nursing homes in our society. Many families I have dealt with have made promises to their loved-ones that they would never place them in a nursing home. Unfortunately in many circumstances this is a very unrealistic promise. For many Clients there comes a time when nursing home placement is actually the desired outcome because the nursing home is truly the place where their loved-one will receive the best care possible. There are times when it is just impossible to provide the necessary level of care in the home environment or in an assisted living facility.

It is important when looking for nursing home placement that you do your homework, and many times families do not know where to begin. Often they are handed a list of nursing homes from a hospital discharge planner and feel overwhelmed. Of course at Distinctive Care we can help with placement; however, I realize that frequently families cannot afford to pay for assistance with placement.

This is when it is very important that you check the nursing home, compare information available at medicare.gov and do the actual leg work. Visit the different facilities and use the checklist available at the website. Evaluating the nursing home’s 5 star rating and their survey results are extremely important, but nothing can take the place of an actual site visit.

At Distinctive Care, we make referrals to local nursing homes that have undergone our vigorous review and continued unannounced visits to ensure they continue to meet our stringent standards to remain on our referral list.

In the event you require assistance with nursing home placement Distinctive Care, located in Ridgewood, New Jersey can provide you with the help you need. We have evaluated nursing homes in Bergen, Passaic and Essex Counties in New Jersey and in Rockland and Westchester Counties in New York. Assessing your loved-ones needs and assisting with placement in and the transition to nursing home placement is one of our specialties. We also are able to provide the family with counseling to assist with the guilt often associated with this major change.

The most important thing to remember is that by and large the folks working in nursing homes are doing so because they are caring people whose goal is to provide quality care for your loved ones. The professionals and paraprofessionals who provide care genuinely want to do what is best for your loved one – sometimes it is more difficult because of constraints placed on them related to ownership issues – these are the things you should be able to learn about when reviewing the nursing home compare at medicare.gov.

« Previous Page — Next Page »