Family « The Professional Geriatric Care Manager’s Blog

So Many Services for Seniors!

May 17, 2011 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: bergen county, Family, GCM, Help, News, Personal

We are in the process of developing a new brochure for Distinctive Care Geriatric Care Management. So we had a meeting today in our office in Ridgewood to brainstorm about all the great things we do. In addition to our brochure, we also use a folder that we give to potential clients and those suppliers of services that we meet face to face. In it, we have a diagram which shows a client surrounded by “geriatric care management.” Reaching out from geriatric care management are all of the services which we use and refer to in our care plans. Well, actually, the diagram doesn’t cover all of them but it notes many, such as doctors, nursing homes, hospitals, assisted living facilities, home care agencies, counselors, Medicaid , Veterans Benefits, insurance providers, financial planners and elder law attorneys.

What it doesn’t show are the myriad of other services which we work with or research on behalf of our clients. I didn’t realize how many other unique ways we help seniors and their families until our newest care manager mentioned that she had never heard of many of the services for seniors that we use to keep our clients independent and happy, and improve their quality of life. And she has worked in a doctor’s office for many years, with a large population of older adults and the elderly.

So here are a few examples: Once our clients have made progress by completing their round of physical therapy, we don’t want them to slide backwards. That’s why we refer them to a person who specializes in home-based exercise programs for senior citizens that will increase their balance and stamina. Another of our clients was bored at home so we developed an activity plan that included brain stimulating games. We have another client that needs to apply for Medicaid for his parents. The process is very involved, time consuming, and detailed—difficult for someone who holds a full time job and has a family. We have connected him with someone who knows the ins and outs of the process and can help him for a reasonable fee. And of course, since many of our clients have dementia, we are always on the lookout for ways that we can both help them with the disease but also help their families that are caring for them.

Services for the geriatric population are changing—at least that’s what I see in Bergen County. There are so many niche services with a specialty that it’s hard to know them all. But we always try to find the best services for those that need them if we can’t provide them ourselves.

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.

Plan Ahead, Be Prepared

May 11, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Family, Health, Life, Tips

As a veteran of the sandwich generation, I find myself juggling a lot of medical records for three generations of my family. And as we all age, those folders in my filing cabinet are only getting fatter.

At Distinctive Care, we’ve had some discussions in our care manager team meetings about some of the latest products on the market, such as memory sticks, which promise to provide doctors and emergency personnel with your complete medical history simply by plugging them into a USB port. Some of these are no larger than a credit card and enable you to carry a huge amount of data in your wallet, which may be crucial information in an emergency situation. Unfortunately, as rapidly as this technology is evolving, I don’t think we’re at the point yet where there is widespread usage or even acceptance on the part of practitioners to utilize this new technology.

In the mean time, there are programs available which enable you to store your personal health record online and be able to print it out to share with your family and your physician or other health professionals. You can save and update data at any time. I personally like the idea of creating a family health history for my children to be able to access when they’re older. And I think these tools could be really helpful for the family members of our geriatric clients, who may need to provide details about their loved one’s health history at a moment’s notice.

Here are a few options for creating and storing your personal health record. Each of these resources is free and promises to safeguard your private information in compliance with government regulations.

The Office of the Surgeon General.

Microsoft’s Health Vault.

Google Health.

WebMd.

A Different Perspecive

April 25, 2011 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Aging, Family, Help, Life, Love, Personal

I’ve been very lucky all these years to have a mother who is in excellent health. That is especially important since I live two hours away. Mom still lives on her own, and drives – safely, I might add! But last week I got an email from my sister who lives close to Mom. She poured her heart out that Mom is feeling a downturn in her social life, and now that she has returned to work, she can’t provide the extra stimulation. That’s what happens when you are 89 and you’ve lost many of your friends. My sister thought it was time that Mom move to a facility for seniors.

So I drove from New Jersey to Philadelphia to tour an older adult community with my Mother – one that she has been looking at for quite a few years in readiness for the time when she would be forced to leave her home. I was sure that a nursing home was not what Mom needed, but I thought assisted living might fit the bill. No, Mom was looking at a continuing care retirement community, otherwise known as a CCRC for adults 55 and older. You enter into independent living and, if further care is needed, you then move to their assisted living/nursing home facility.

I was prepared to hate it. Working for a geriatric care management practice, I was prepared to ask lots of tough questions. I was pleasantly surprised. The community appeared to be fun and well maintained. The staff and residents were friendly. My questions were answered before I asked them. In spite of finding a great community, Mom realized that she isn’t quite ready to give up her present lifestyle. However, the trip was enough to start a much needed but difficult conversation on things that needed talking about, like her living will and health care proxy, and the state of her finances. It was a worthwhile and enjoyable visit for both of us and we both saw things from a different perspective.

Overcoming Dysphagia

April 21, 2011 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Aging, Caregiver, Family, Health, Help, Life, Prevention, Tips

I wanted to provide a follow-up on my blog from last week about one of my clients that was having difficulty swallowing (Dysphagia). I found out earlier this week that she has been upgraded back to a regular diet coupled with thin liquids. I was so ecstatic that she has bounced back and has regained her happy state of mind and comfort level to return to her usual diet. She had announced to her family, her caregiver and myself that she is in a much better state of mind and feels very safe and comfortable in her new nursing home facility. It was very important to her family, geriatric care managers, caregivers, doctors and therapists that we get our client back to where she once was with her eating habits, nutritional intake and requirements. This client knew that we were not going to give up on her.

With determination, perseverance, positive reinforcement and a great speech therapist team, a person who is having problems with Dysphagia can truly work through it. Here are some good exercises that may help you or someone you know regain the ability to swallow normally.

Tongue exercises are a very effective way to improve swallowing ability.
Lip exercises are very important for the movement of food around the mouth, as well as subsequently swallowing. The lips create a tight seal which prevents food and liquids from leaking out of the mouth during the initiation of the swallowing reflex.
Jaw Exercises. These muscles used during chewing are controlled by the brain, and if a stroke or accident occurs, it can affect the way we chew. Jaw exercises can dramatically improve the ability to swallow.
Swallowing Exercises. When dysphagia results from a stroke of emotional problems, the best way to regain swallowing ability is by performing actual swallowing exercises that are taught by a speech therapist.

Sometimes dysphagia is so severe that a patient is required to have a temporary, or even permanent, placement of a feeding tube. It is an extremely difficult decision for someone to make whether or not a feeding tube is needed for you or someone close to you. Talk with your doctor, about the possibility of the being an absolute necessity. I know it was a very hard for my client’s family to think about placement of a feeding tube. But, again I am so thrilled that my client had overcome so many obstacles and returned to her regular diet and food that she enjoys so much.

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.

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.

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…

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.

Outside the Box

February 2, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Caregiver, Eldercare, Family, GCM, Prevention, Tips

Working in the elder care field and having two parents facing debilitating health problems while they still live at home, I’ve learned a few things. I’ve learned that sometimes, we have to be a little creative in how we tackle new challenges. For example, for years Dad has needed routine monitoring of his blood due to the blood thinners he takes. But due to other health conditions, it was becoming more of a challenge to get him to his doctor every month. Thankfully, his Geriatric Care Manager, an R.N. from Distinctive Care, offered us an alternative. She advised us that we could test his PT/INR right in the comfort of his home, using a simple test kit and reporting the results by phone to the testing company. Who knew?!! If the results warrant attention from his doctor, they are relayed immediately to the doctor’s office and we receive instructions by phone. This has saved Dad numerous trips to the doctor and even allows us to monitor his blood levels more frequently than before.

Another elderly client we work with is not inclined to leave her home, and has consequently postponed –for years—seeing a doctor. Her nurse care manager had been visiting her weekly and observed a change in her condition which required a doctor’s evaluation. Respecting the client’s desire to avoid going out, her care manager found a wonderful Bergen County, NJ physician with a specialty in Gerontology, who is willing to make house calls to provide the ongoing care this client needs.

Being open to new ways to tackle old tasks can lead to solutions that make the caregiver’s job a little less stressful. Sometimes it helps to get a professional Geriatric Care Manager involved because they bring a fresh perspective and can suggest a new and easier way to do things. Sometimes it’s the little things that can make the difference between your loved one having to move to a nursing home, or being able to remain in the comfort of his or her home for a few more years.

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