The Professional Geriatric Care Manager’s Blog

A Week in the Life of a Geriatric Care Manager in Bergen County, NJ

May is National High Blood Pressure Education Month.

High blood pressure (also known as hypertension) usually has no symptoms so it is important to know your blood pressure numbers even when you’re feeling fine. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps blood. If this pressure rises and stays high, over time it can damage the body in many ways.

Approximately one in three adults in the United States has high blood pressure. Untreated, high blood pressure can damage the heart, blood vessels, kidneys and other parts of your body which can lead to heart attack, heart failure, stroke and kidney failure.

High blood pressure is classified as:

• Normal blood pressure: less than 120/80
• Prehypertension: 120-139/80-89
• Hypertension: greater than 140/90
• Stage 1 Hypertension:140-159/90-99
• Stage 2 Hypertension: 160 or greater/100 or greater

Anyone with blood pressure readings greater than 120/80 should be encouraged to make lifestyle modifications.

• Quit smoking.
• Lose weight if overweight.
• Eat a healthy diet to include more fruits, vegetables and less saturated fat.
• Reduce your sodium intake.
• Exercise regularly, at least 30 minutes a day, several times a week.
• Limit alcohol to two drinks a day for men and one drink a day for women.
• Find healthy ways to de-stress such as yoga or caring for a pet.
• Medication may also be necessary to treat high blood pressure. There are several types of drugs available as well as combination medications to treat hypertension.
• Know your blood pressure numbers. Keep a blood pressure diary. Talk to your doctor about what you can do to maintain your normal blood pressure or what steps you can take to lower it.
• Take charge of leading a healthier life; your heart will thank you.

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.

A Week in the Life of a Geriatric Care Manager in Bergen County, NJ

Last week I wrote about the assessment I performed on Mr. P. Newly diagnosed with stage 2 Alzheimer’s disease, his wife and their son did not know where to turn.

I met with Mr. P’s son to review my findings and reassure him that I could help him implement a plan to ensure his dad remains safely at home.

With wonderful doctors already in place, including his Geriatrician, Neurologist and Neuropsychologist, as well as the support and information they had already received from the Alzheimer’s Association, I went to work reviewing the care plan I had developed.

Mr. P’s son agreed that we needed to interview and place a certified home health aide with his dad as soon as possible to assist with bathing and dressing. We talked about supporting his mom and allowing her to be a wife and not a caregiver for her husband.

Just as important was to follow my recommendations to ensure that the house is safe. A full, detailed list was provided with resources to help make the necessary changes.

I provided information to access Veteran’s Administration benefits, long term care insurance, advanced directive, durable power of attorney and contact information for attorneys specializing in elder law.

I included several recommendations, should the need arise, for future placement in a facility that has accommodations for people with memory impairment.

With the care plan in his hand, and a sigh of relief, Mr. P’s son thanked me. He was prepared and looking forward to reviewing my recommendations with his parents.

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.

A Week in the Life of a Geriatric Care Manager in Bergen County, NJ

When I meet a new family, I can almost feel the tension between the family members dissipate as I explain what Geriatric Care Management is and how I can provide support to the family.

A new diagnosis of Alzheimer’s disease or other type of Dementia can leave the person’s spouse or adult children not knowing where to begin and where to turn for guidance.

As a Geriatric Care Manager and Registered Nurse, after speaking with Mr. P.’s son at length, I schedule an assessment in Mr. P’s home as the first step to ensure that he was in a safe situation.

During the assessment, I spent time with the client, and his spouse to learn more about Mr. P the person. With his wife filling in the blanks, it was wonderful to listen to the story of his life.

With trust building between us, I could then assess his mental status using the SLUMS (St. Louis University Mental Status) exam as a cognitive screening tool as well as the Geriatric Depression scale to assess for any signs of depression.

I performed a thorough home safety evaluation, reviewed his medications and checked for any expired medications.

I took his vital signs and inquired if he was in any pain.

I observed as he walked and transferred from a chair to his walker.

I spent several wonderful hours with Mr. P and his wife. They were appreciative of the detailed information that I was obtaining. I explained to them that I would be putting together a plan of care to assist them to remain in their home safely.

I informed Mr. P’s son that I completed my assessment and would meet with him in a few days to review the care plan that I would begin writing.

He thanked me and said he is feeling a sense of relief already!

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.

A Week in the Life of a Geriatric Care Manager in Bergen County, NJ

The adjustment period for Ms. S. is going well! Whenever there is a change in the environment with someone suffering from dementia, a decline can take place. The move from the Assisted Living Facility where she resided for just over a year to a long term care facility has gone smoothly.

Her daughter, her Geriatrician and I as her geriatric care manager, gathered with the director of nursing to assess Ms. S. We were all pleasantly surprised at how well she adjusted to her new home.

From the activities director learning about her likes and dislikes, the director of therapies inquiring what exercises can be started, the head nurse communicating with her long time Geriatrician to the dietician making sure Mrs. S. has all her favorite desserts, the transition has gone well.

I will continue to see Ms. S and follow up on her progress on a weekly basis. I will communicate with her children and provide peace of mind to them as I have done in the past. Maintaining communication with all the departments at Ms. S’s long term care facility helps to continue to ensure she is receiving all the benefits of her new surroundings.

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, New Jersey

Today was a one-month follow-up visit with Ms. S and her geriatrician.  As her geriatric care manager, I visit her weekly. I have noticed the changes in Ms. S over the past year, and with her geriatrician seeing her monthly, we are both making sure she is receiving the best care possible.

Over a year ago, Ms. S moved in to an assisted living facility. Over the course of this past year, multiple mini strokes have left her without the ability to speak, and dementia has required an increase in the level of care that she had originally needed. Wanting to keep her in the same facility, her family agreed to let me assist them in hiring a private caregiver who was put into place to ensure she would receive the additional care required.

Today, with me, Ms. S’s family, the head nurse and her geriatrician, we all came to the conclusion that it is time to transfer her to a long term care facility. This decision came about because of safety concerns. Right sided paralysis is making it too difficult to shower and transfer her safely.  A long term care facility can provide the skilled nursing care as well as special equipment that are needed when someone can no longer bear their own weight.

New onset of difficulty in swallowing poses a significant risk for choking. Feeding tube placement will need to be discussed with the family after they carefully review Ms. S’s living will.

The transfer will take place within one week. I will continue to support Ms. S and her family. Change is never easy and I am honored to be a part of this next chapter in Ms. S’s 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 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 in Bergen County New Jersey

As Mr. T’s geriatric care manager, on my bi weekly visits, we always seem to talk about food.

Whether he’s asking me to go out for pancakes or stop at the local Italian bakery to buy me a treat, I find myself enjoying his passion for food.

Tall and lean at 93 years of age, living independently, paying his own bills, driving, and preparing his own meals, I asked Mr. T what his diet has consisted of for most of his life. He laughed and answered “pasta, pasta, pasta!”

I told him I found that hard to believe, with all the negative talk about eating too many carbohydrates! He thought about it again and decided maybe it has something to do with the salad, olive oil, tomatoes and red wine that always accompany his pasta dinner.

I also learned that many years ago he was in the food industry. He prepared specialty salads and sold them to large grocery chains.

I shared with him a list of anti-aging foods that I had recently read about:

• Leafy green vegetables
• Onions
• Tomatoes
• Grape fruit
• Apples
• Blueberries
• Cranberries

His comment on my food list, “I hope you didn’t work too hard on that because all you had to do was ask me!”

I agree and I will continue to inquire about how to live healthfully and free of dementia from my 93 year old mentor.

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 Manger in Bergen County, NJ

Finding a personal trainer that not only specializes in geriatrics, but makes house calls and has experience in dementia would seem like a tall order but at Distinctive Care, we strive to meet all the needs of our clients.

Ms. A is thrilled with her new personal trainer and her workout regimen designed to help minimize falls.  At any age, muscle strength can be improved to help ward off frailty which can lead to falls.

Building muscle has many benefits. It boosts your metabolism, burns fat and most importantly for Ms. A, it can actually help to reduce arthritis pain when strong muscles help support and protect your joints. And because building muscle promotes weight loss, there will be a reduction of pressure on the joints themselves.

Weight bearing exercise can also keep your mind sharp as blood flow improves to the brain.

Building muscle doesn’t require a gym membership but proper guidance by a personal trainer can be an invaluable way to get started.

Ms. A and her caregivers are being educated weekly by her personal trainer. Not only are her muscles getting stronger but her sense of pride and accomplishment are immeasurable.

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, New Jersey

I recently read a great article about ways to easily improve your mood. Whether you’re a gloomy teenager, a middle-aged mommy, or an octogenarian, the winter months can certainly dampen your spirits.

As a geriatric care manager it is important for me to consistently monitor my clients’ moods. This week, while visiting Mr. T on a dark gloomy rainy day we started to talk about simple ways to boost our moods.

I shared with him a few tips that I recently read for mood improvement:

• Flipping through old photos of your family or pictures from your favorite vacation.
• Volunteering boosts happiness because it increases empathy and makes you appreciate all the good in your own life.
• A gratitude journal can help you reflect on a daily basis how well things went for you that day.
• Listening to music or losing yourself in a novel.
• Exercising outdoors whenever possible.
• Religious services or meditation.
• Singing in the shower.

We also agreed we could add pet therapy, the companionship of friends and family and a good night’s sleep to our list!

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

Success! Last week I wrote about Ms. A. She is 95 years of age with mild dementia and a recent diagnosis of depression. Her family was reluctant to agree with Ms. A’s geriatrician on starting an antidepressant. They were concerned that she was already on too much medication to treat her hypertension.

I am so happy to report that all who surround Ms. A, including her certified home health aides, her children, her geriatrician and I, all agree that after several weeks on the antidepressant, Ms. A is smiling more and showing less agitated and frustrated behavior. Where she would snap at the aides when they tried to assist her, she is now calmer and more appreciative of the help they provide.  She engages in conversation more with family and started to laugh and smile again.

Because fatigue can be a common side effect of many medications, Ms. A’s geriatrician decided to see how well she could sleep at night without the prescription sleep medication she has been on for several years. She was hopeful that it was no longer necessary.

Ms. A’s doctor was right! She has been sleeping well at night and waking up in the morning rested and ready to take on the 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 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

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