The Professional Geriatric Care Manager’s Blog

A Week in the Life of a Geriatric Care Manager

I have had the privilege of working with Ms. A for over two years now. At 95 years of age, in good overall health but with mild dementia, I recently started to see her withdraw from her family and her caregivers. I know that dementia is a progressive disease without a cure, but I started to see signs of depression which can sometimes be mistaken for dementia. Although her family agreed with me, they were reluctant to start any medication to treat the questionable depression. They wondered if she was already on too much medicine for her hypertension.

After observing Ms. A and speaking with her candidly about how she was feeling, we decided to call her geriatrician to discuss her feelings of continued sadness.

The geriatrician explained to Ms. A that she agreed she may be suffering from depression. After a complete examination, which included blood work, the results excluded any medical conditions that may have caused the change in mood. The discussion was then opened up with Ms. A and her family on the benefits of starting on an antidepressant medication.

Possible side effects were discussed, as well as the importance of understanding that it could take a few weeks to see positive results from the antidepressant.

The new medication was started three weeks ago. So far the only complaint that Ms. A had was a feeling of tiredness the first two weeks. She is now back to her baseline energy level.

We are all hopeful that the antidepressant will improve her mood and help her enjoy her life once again.

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 Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ  07446

45 N. Broad St., Suite 503, Ridgewood, NJ  07450

A week in the life of a Geriatric Care Manager in Bergen County NJ

Last week I reached out to Ms. S.’s Geriatrician. He gladly agreed to visit Ms. S. in the facility she resides in. Now that Ms. S. is wheelchair bound, her Geriatrician agreed that it would be in her best interest for him to visit her at her facility. As her Geriatric Care manager and Registered Nurse, I was present during his visit. I provided him with her most recent medication list and her chart for him to review. I introduced him to the director of nursing, her nurse, and her caregiver. The occupational therapist was not available, but we were quickly updated on Ms. S’s progress. The professional team at the facility who work with Ms. S. were very happy to meet her longstanding Geriatrician and witness the care and concern that unique to their relationship.

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 Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ  07446

45 N. Broad St., Suite 503, Ridgewood, NJ  07450

A Week in the Life of a Geriatric Care Manager

Ms. S. has had a long standing relationship with her Geriatrician. She was diagnosed with dementia several years ago. There are many types of dementia, and no cure. Recently, it has become apparent that Ms. S. is having even more difficulty with her motor skills. It has been just over a year since she moved into the Assisted Living Facility’s Memory Unit. She has done remarkably well, but at this point, now that she is wheelchair bound, it is difficult to take her out for routine check ups with her Geriatrician.

As her Geriatric Care Manager, and her advocate, I decided to call her doctor and ask if he would be willing to visit her at the Assisted Living Facility. He happily agreed and will see Ms. S next week. He was glad that, instead of Ms. S. being assigned to the facility’s physician, we are able to continue the longstanding, trusting, wonderful relationship that they have built.

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 Ramsey or Ridgewood Office to schedule a consultation.

201-587-5283.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ  07446

45 N. Broad St., Suite 503, Ridgewood, NJ  07450

A Week in the Life of a Geriatric Care Manager

This week was our follow-up visit with Ms. B’s primary care physician. Last week she had noted that her heart rate was faster than it should be and blood work, urine sample, chest x-ray and EKG were normal. We were so grateful that an infection was ruled out and that her heart rate returned to baseline during the appointment with the doctor. This week, her doctor wanted to make sure that her vital signs remained stable. I reviewed with the doctor that Ms. B is feeling well, eating well, sleeping well and taking her medications correctly. The doctor took her vital signs and ran another EKG just to make sure that the heart rate and rhythm were normal. Ms. B passed with flying colors!

As her Geriatric Care Manger, my weekly assessments and medication management are essential tools which assist me to determine the course of action before a serious medical condition develops.

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 Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ  07446

45 N. Broad St., Suite 503, Ridgewood, NJ  07450

A Week in the Life of a Geriatric Care Manager

Each week I have the pleasure of visiting Ms. B. As her Geriatric Care Manager and Registered Nurse, I am well versed in her medical issues and needs. During my weekly visits I take her vital signs, perform a physical assessment and also set up her weekly medication reminders.

This past week, although Ms. B said that she felt well, I noticed that her heart rate was elevated. I quickly checked her for signs of dehydration and made sure that she was taking her medications correctly. At 90 years old and with Dementia, her caregivers play a crucial role in her care and well-being. I reviewed my concerns with her home health aide and asked if there had been any changes to Ms. B’s level of confusion. I stayed with Ms. B as I called her primary care physician. I reviewed my findings with him and asked that we bring her to the office immediately. We both agreed that a visit to the emergency room was unnecessary at this point, as Ms. B was not in distress and did not have any complaints of shortness of breath, dizziness, chest pain or weakness and a trip to the hospital could add unnecessary stress.

We arrived at the doctor’s office a few minutes later. We were taken in immediately and blood and urine samples were obtained. A chest x-ray was done as well as an EKG. Within a short while, an infection was ruled out and the heart rate was back to normal.

We were all so grateful that Ms. B’s physician assessed her so quickly. Ms. B remains stable but we have a follow-up appointment with her physician in one week to ensure that she remain healthy.

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 Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ  07446

45 N. Broad St., Suite 503, Ridgewood, NJ  07450

A Week in the Life of the Geriatric Care Manager

Happy New Year!  It’s hard not to think of ways to make 2012 a better year. The first thought that comes to my mind is that I will exercise more as a way to stay in shape and reap the many physical benefits. But when I recently read an article called “Refresh Your Mind,” memory expert Gary Small, MD said if there was one single change that you could do to make a difference to keep your mind sharp as you age it would be moderate physical exercise.  He states that when your heart is really pumping you deliver more nutrients and oxygen to your brain, and that the body secretes protective chemicals during physical activity which are thought to spark the growth of neurons.

Dr. Small also explains that mental exercise is also important and that even driving home via a new route can help. He states that once a task has become repetitive the brainwork involved becomes more rote which means there’s less neural activity going on.

He also talks about a study done in Finland in 2009 that found that subjects who drank 3 to 5 cups of coffee a day has 65% lower risk of dementia and Alzheimer’s. But too much coffee makes it hard to sleep and sleep is important for brain health. Moderation is the key.

When asked if he thought a single change could make a difference, Dr. Small felt that according to his data, if everyone in the United States adopted one additional healthy lifestyle habit, the number of expected Alzheimer’s cases would be reduced by a million in the next five years.

On that note, I’m off to the Gym (via a new route of course)!

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 Ramsey or Ridgewood Office to schedule a consultation.   201-587-5283.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ  07446

45 N. Broad St., Suite 503, Ridgewood, NJ  07450

A Week in the Life of A Geriatric Care Manager

When one of my client’s sons asked me to accompany his father to his post op visit I thought it was a great idea, even though my 93 year old client didn’t feel it was necessary!

After any surgical procedure, there can be medication changes, wound care instructions even dietary changes and follow up testing may need to be scheduled.

With his complex medical history, medication regimen and hearing loss, my client was relieved that I was with him while the doctor went over a multitude of changes in his medications, as well instructions to care for his incisions. I asked pertinent questions and relayed the information to my client in the doctor’s presence to alleviate any confusion. I took good notes and simplified the instructions.  Using his calendar, we both developed an easy to understand timeline to stay organized day by day.

As the saying goes, “just take it one day at a time”… I know those very words have helped me when life seems overwhelming and disorganized.

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 Ramsey or Ridgewood Office 201-587-5283 to schedule a consultation.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ  07446

45 N. Broad St., Suite 503, Ridgewood, NJ  07450

A Week in the Life of a Geriatric Care Manager

With winter approaching, I wanted to make some recommendations for Ms. A. We have come to know that her mood drastically improves when she is able to go outside. Even if it’s only standing on her terrace for a few minutes looking at the sky and taking some deep breaths, Ms. A always feels that her spirits are lifted when she gets fresh air.

When she mentioned dreading the winter weather, I started to read up on seasonal affective disorder, also known as SAD. It is described as episodes of depression that usually occur at certain times of the year. It primarily affects women and mostly during the winter months. Symptoms are usually the same as depression. There is no real test for SAD. It’s important to see your physician for a physical exam and blood tests to rule out other disorders that are similar to SAD. Just as with other types of depression, antidepressant medication and talk therapy can be very effective. Other ways to treat SAD are to make sure that taking walks and exercise are being done during daylight hours. Keep active socially even if it takes a lot of effort.

Light therapy can also be used. This is a very bright florescent light that mimics the sun. Your doctor would need to give you instructions on how to use a light box for light therapy. Typically you sit in front of the light box for 30 min. each morning to mimic the sunrise .

People who’ve had repeated seasonal affective disorder should talk to their mental health care provider about prevention measures. Starting treatment in the fall or early winter before the symptoms begin may be helpful.

I had a good conversation today with Ms. A. and her caregivers.  We are all on board with the commitment to spend time outdoors each day as long as the weather permits.  They will encourage her to exercise daily as well as socialize even if socializing means just a simple phone call to a friend.

“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.”

A Week in the Life of a Geriatric Care Manager

When Mr. T found out he needed to have a procedure at his local hospital, he immediately called me for assistance.  He was completely overwhelmed with the details. He didn’t know when or how he would get to and from the hospital. He didn’t understand his preoperative instructions; he was confused about how long it would take to heal and wondered why he wouldn’t be able to drive for a few weeks.

Because I am Mr. T’s Geriatric Care Manager, I was able to advocate on his behalf.  I spoke to his physician who would be performing the procedure, I learned all I could about pre and post op care. I arranged for the hospital’s transportation service to pick him up at his house and reassured him that I would be there to bring him home and review his discharge instructions.  Because Mr. T lives alone, his doctor and I spoke about the need for overnight supervision just to ensure Mr. T would have help should he need it.  With Mr. T on board, I contacted a Home Health Care Agency and set up a certified home health aide to stay with him from 8:00pm until 8:00am.

I am pleased to say that the procedure went well and Mr. T is getting stronger every day.

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.

A Week in the Life of a Geriatric Care Manager

With Thanksgiving on most of our minds this week, we at Distinctive Care are communicating with our client’s families to ensure that their aging parents will not be alone for the holidays.

When I spoke to Ms. S’s daughter, she asked for assistance in bringing her mom home for Thanksgiving.  As Ms. S’s geriatric care manager, I was well versed in the care she would require for this wonderful outing.  Since she resides in an assisted living facility in Bergen County, I worked with the staff to coordinate what would be necessary to meet Ms. S’s needs.

Since Ms. S did not have to travel far to be with her family, we hired an ambulette with trained personnel as the transportation for the big day.  They were informed that Ms. S is confined to a wheelchair and would need to be lifted up the several stairs into her son’s home.  Because she does require assistance with eating and toileting, we hired a certified home health aide to spend the day with her.  Because medications will need to be given throughout the day, the pills will be organized, written out and explained to the family and the aide.

We are all thrilled and thankful to make this day possible for Ms. S and her children.

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.