2010 August

Choosing Home Care for a Loved One?

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss on August 31, 2010

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

Do you choose a company by reputation or what the costs will be? Perhaps the most important qualifier for you is that the company is located close to your parent. If you choose the one with the lowest rate, is that what you get in quality? It certainly could be! There is an old phrase, “you get what you pay for”. I can’t say that is always the truth but, there is some truth to it.

Do you see value in paying more for one company over another? Are you willing to pay more for caregivers that are trained and supervised? Does a company with guidelines and high ethical standards meet your standards for care? Is length of time in business important to you? I would look for a company in business at least 5 years (be sure the wrinkles are out of the company). You should ask who owns a company and know what motivated them to build this type of business – it might give you an idea on company values. Value is determined by the buyer not the company. However, a good reputation should be perceived as “value” – it means the company has a track record and works at excellence.

Inquire about general liability insurance, bonding if necessary, employee taxes, workman’s compensation insurance and also ask about employee benefits. Companies that care about the caregivers they hire, who pay for vacation/sick leave and health insurance, tend to acquire better employees and have higher retention levels than those who don’t, but charge less.

If the first or even the second person a company sends to you is not a match in personality, (the skill needs should have been made by the agency) don’t give up. It is important to tell the agency you need someone who is more talkative, or someone who cooks what your mom likes – be specific on what will increase the quality of your loved one’s life.

In our agency, we usually say you didn’t marry the first person you dated (or at least most of us didn’t), so we can’t expect the first person to be the perfect match – but we will work with the client and the family to find the person that best matches – perfection is rarely possible.

Look at value and not just price when hiring a home care or companion agency for your parent. Give your loved one’s security and peace of mind by finding skilled oversight and good care.

Mother is in the Emergency Room and I’m a 1000 miles away!

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, Relationships on August 20, 2010

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

Watch the video blog: http://www.youtube.com/watch?v=KbOpD9U-jNw

What do you do when you hear that your mother has been hospitalized and you know she has dementia, even though it has not been diagnosed because your father wasn’t ready to hear the truth? Now, Dad is gone, and you have a situation than can go from bad to worse in a matter of hours.

You need to find an advocate or someone who can be with her and help with the questions in order to get an accurate diagnosis and the correct treatment. Often, without an advocate, patients with early stage dementia, are seen in the ER and sent home because they are socially appropriate and the hospital has no way of knowing what their base line was prior to the most recent trip to the ER.

God forbid they give her new instructions or a new medication and send her home. With impaired memory, things can easily change again and not for the good.

The best action is to find a friend or family member than can be with her in the ER, giving correct history, so good medical decisions can be made. If you can’t find a family member, try to locate a Professional Geriatric Care Manager who might not know the entire history, but can advocate for her to be evaluated while in the hospital and follow her when she goes home, setting up systems that will help with the confusion around new medical routines and/or medications.

We all need advocates when we are sick – so when you have an aging family member in the hospital and you can’t be there it is imperative that you have someone to see that they get the treatment they need to return to their prior functioning levels, if possible.

Finding Home Care for Someone with Alzheimer’s Disease

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, End of Life, Relationships on August 17, 2010

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

Not everyone can care for an individual who has memory impairment and doesn’t reside in the same reality as the rest of us due to cognitive changes brought on by an organic dementia.

Even family members who have been to classes and seem to understand the process, get caught up in the old relationship. They forget that it takes patience and real professional skills plus a kind heart to care for someone who is impaired by a progressive illness such as Alzheimer’s disease.

Below are five questions to ask an agency before you employ their caregivers:

1) What type of dementia specific training do you provide for your caregivers? Also, how do you test for these skills?

2) How often do they attend continuing education courses?

3) How much dementia experience did they have before working at your company and how many years have they been with this company?

4) Who provides the supervision? What are their supervisor’s qualifications? You want to hear that they have at least 4-5 years experience with dementia and the minimum of at least a BA degree in a field related to Nursing, Social work, Family Counseling, or Gerontology. Certified Geriatric Care Managers should be your preference.

5) Is there someone skilled to help with behavioral challenges 24/7? What are the skills and education of the people who are on call?

Even the most skilled care professional needs to have support, coaching and help in being creative when a problem arises. A team approach and creative techniques are best when behaviors become challenging.

Even the most challenging individuals with a dementia can stay at home with the right kind of care, loving caregivers, 24/7 professional backup and creative thinking!

Role Models in the News & Aging

Posted in Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss on August 13, 2010

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

We can look to women like Lena Horn or Betty White and admire them for their talents and gifts. We can also be encouraged by their spirit and, I would guess, their” fight” to be seen and respected for not just their talents, but who they were as women.

Who were they? They were women of talent but, more than just their God given talents of music and comedy. They were merely like many of us, struggling to find a place for ourselves in this life. Some of us give up the challenges and accept a more simple life – sometimes with great contentment and other times wishing we took risks and nurtured our talents. We all have unique gifts – some of us just never had the chance or opportunity to bring them to fruition.

I have had the great honor to speak with many seniors in their later lives. Those who age positively are the ones who have overcome challenges and those who have taken risks to accomplish something that was dear to their hearts and true to their beliefs and values. These women and men who are content in later life have accepted challenges and losses as part of the journey and don’t blame anyone or themselves for any back sliding, failures or disappointments.

Are you taking risks knowing that some of your goals might not be accomplished while trying to find roles that increase your integrity as well as give meaning to your life? When you are 88, what will you say about your life, looking back and looking forward?

As long as we are in this life, we have opportunities to grow and expand our integrity – with sometimes the smallest of gestures.

Watch the video blog: http://www.youtube.com/user/sjrichar3#p/u/0/gJkRAJMEY1o

My Marriage vs. Parent Care

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, Relationships on August 10, 2010

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

Is your marriage at risk because you have only time for your parents’ needs? Are you still trying to get mom’s approval at the risk of losing your marriage? Are you using your parents care needs as a distraction for working on your relationship?

If you answered “yes” to any of these questions, it is time to see a therapist who is also a Geriatric Care Manager. I don’t say this for self-interest, but because I have a passion for finding balance and quality of life for all individuals.

Your parents do need care, but you don’t have to be the only one providing it – and if you think you do, all the more reason to talk this over with a skilled professional. Getting an objective professional to help you see what it is your are doing with your precious time, love and energy could be the difference from having a quality life and being overly stressed and ending up with a stress related illness. This Professional Geriatric Care Manager can also give you some local resources to share the care with you.

Loving another means we need to have boundaries, set limits and always find some time for self-care. The biggest mistake those who are caring for an aging parent make is “over-caring”. The opposite of “over-caring” is not under caring – it is “balanced caring”. Which means you will need to say “no” in order to provide time for others in your family such as a spouse or a grandchild, or maybe the job you might lose if you don’t find ways to share the care.

Eldercare & Caregiving in the U.S.

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, End of Life, Future Trends, Relationships on August 5, 2010

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

Watch the video blog: http://www.youtube.com/watch?v=Y-Bt4HWZRsI

More and more of us are caring for our aging family members at the same time as working, caring for adult children and wondering if we can ever retire. Some of us are even retiring early and reducing our possible pensions and social security benefits to care for a family member.

According to AARP there are an estimated 44.4 million caregivers in the United States, on average that provide 21 hours of care per week. The average length of caregiving is 4.3 years, according to AARP, but in my professional experience most families I work with spend 8 to 10 years providing some element of care. One issue the studies don’t reflect is, once a family member has moved to skilled nursing or assisted living, the care might not be direct but it continues with medical appointments, advocacy and emotional support. So this journey can be as long as 20 years!

The AARP study said the most frequently unmet need of caregivers are finding time for one self, managing emotional and physical stress, balancing work and family responsibilities.

That is one of the reasons that Eldercare Services provides free support groups for family members in both our San Francisco and Walnut Creek offices. Check out our schedule on our “Classes and Support Groups” page on the website. http://eldercareanswers.com/answers-and-news/classes-and-support-groups.php

Don’t try to do this alone – get the support you need.

The Donut Hole

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, Elder Abuse and Fraud, End of Life, Health Care Reform, Relationships on August 3, 2010

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

Two of my client’s families have told me this week that their parent has reached the “donut hole,” that place in the Medicare D (drug plan) where they will need to cover all the costs of prescriptions until they reach an even higher level and then Medicare will cover most of the costs.

The question I pose to all of you is: doesn’t the term “donut hole” conjure up one of two visions – something good to eat or thin air? Should it be called Medicare D “Pay Some – Pay All – Pay a Little” plan?

Let’s get creative and change the name of the “donut hole”. Can we give these little treats back to the donut shops!

Maybe we should call the Medicare D gap in paying for prescriptions the “Black Hole” or the “No Pay Zone”.