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.

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!

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.

]]> http://eldercareanswers.com/blog/2010/08/eldercare-caregiving-in-the-u-s/feed/ 0 http://eldercareanswers.com/blog/2010/07/assisted-living-%e2%80%93-is-it-your-future/ http://eldercareanswers.com/blog/2010/07/assisted-living-%e2%80%93-is-it-your-future/#comments Tue, 27 Jul 2010 17:08:07 +0000 Eileen Zagelow http://eldercareanswers.com/blog/?p=409

Professional Geriatric Care Manager Supervisor Eileen Zagelow, BA, CMC

Yes, no, maybe?  This prospect dances out there in the breeze every so often.  We get glimpses of it occasionally then seemingly effortlessly the thought drifts to another day. This might be a decision you could be making for yourself or, even more dauntingly, for someone else.

The idea of giving up our home, whether it is a flat in the city or a sprawling abode in the country, can be an extremely emotional one.  It is a decision many people never make for themselves actually.  Philosophical as we may be about planning, “doing” often proves difficult!  There are so many factors that play into planning around “needing to move”.  Physical function, age, location, assets, desires, family and friends are all part of the mosaic!  And that doesn’t include the “where to move” or “should I move” pieces!

Working as a Geriatric Care Manager for many years has taught me that this is a decision that is best made with professional insight and advice. Intimate knowledge of facilities and the types of care appropriate for an individual’s need and style is critical.   Comparative costs can be overwhelming.  Moving or remaining at home is a question all its own! A Geriatric Care Manager can be most helpful in such a situation.

Consultations for immediate placement consideration usually involve a nominal fee, if any.  Consultation for the “what ifs” is very affordable and easily worth the cost of professional counsel.

I encourage anyone looking down the road, whether you are organizing your trust or sharing your desires with your children, to call a Geriatric Care Manager for advice.  For those in the throes of a crisis, whether it be for yourself or someone you care about, please consider this advice and consult with a professional before you make a move.  Your decision to do so could be extremely cost effective both financially and emotionally.

Being an informed consumer is always important and certainly that is the case here. There are many inviting options available, whether one stays at home or transitions to a new home, that can enhance the senior years and allow for the full life we each deserve. Guidance can only help!

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

Watch the video blog: http://www.youtube.com/watch?v=oltA6PVmEXo

Often families come to the conclusion that it’s a safety risk for their frail elder family member to stay at home yet 24/7 in-home care is not affordable.  The question arises: What is best for Mom or Dad?

Remember to think of future needs as you make a decision for the needs of today.  If your parent has a progressive illness, be certain that the retirement community you choose can meet the changing needs of your parent and know what the costs of that support might be.

It is helpful to have a skilled objective professional work with you and your family.  I highly recommend that you hire someone who will be your advocate in assessing Mom.  This will give you an environment that will enhance your senior family member’s life and give you all peace of mind.

This activity will usually be about 3 or 4 hours of professional geriatric care management time.  And many care managers will arrange for you to get a discount on your first months rent – so in the end you wind up getting more back than you paid for in advice and direction.  Be sure that the care manager you have hired is certified as a care manager and a member or part of a team that are members of the National Association of Professional Geriatric Care Managers.

A professional who does not receive a “kick back” for the referral is going to refer you to a home or community they are familiar with and help you look at all the variables before making this important decision.

]]> http://eldercareanswers.com/blog/2010/07/finding-senior-housing-for-aging-parents/feed/ 0 http://eldercareanswers.com/blog/2010/07/dementia-changes-in-abilities-grief/ http://eldercareanswers.com/blog/2010/07/dementia-changes-in-abilities-grief/#comments Tue, 20 Jul 2010 16:51:04 +0000 Linda Fodrini-Johnson http://eldercareanswers.com/blog/?p=396

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

When a parent or spouse can no longer do what they did yesterday, it becomes another transition for the primary caregiver and for the extended family.

These transitions catch us off guard and an overwhelming sense of loss and grief is experienced by the primary care provider.  The caregiver often does not label this as a grief process, but it is about loss – however slow – it still has the power to stop us in our tracks.

If you are caring for someone with a progressive dementia, such as Alzheimer’s Disease, you probably have had a similar experience.  I think of a story of a spouse who called me one day in tears and said, “Linda, I thought I had accepted this disease and today my wife could not remember how to get toothpaste out of the tube.   I could not even help her.  I just had to go into the other room and cry.”

And that is what we need to do with this type of pain – express it, find someone with whom to discuss it and move on.   What this gentleman said to me a few weeks later is, “I just put the tooth paste on the brush and then she knows what to do and soon I’ll probably have to help her brush as well.  And when that happens I’ll probably have those same feelings all over again.  But, today we are enjoying our backyard and watching the birds at the feeders with great pleasure.”

If you can learn to let go of your feelings, express them, find a coping mechanism, so as to preserve the dignity of the person with the dementia it will be easier to move on to what you can enjoy together and make this a less painful journey.

Being in  the moment is all each of us has.  However, we feel pain at little losses as well as big ones and it is important to do the grief work and not let it eat at your inner soul.

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

Watch this video blog: Research Shows Family Caregivers Want More Education on Caregiving

The National Alliance for Caregiving in collaboration with AARP did an extensive report on “Caregiving in the U.S. 2009”.  The report shows that the increase for information and formal caregiver training has increased over the past 5 years. 

What family caregivers want is more information and education on, is care recipient safety at home, easy activities to do with the person they are caring for, as well as how to choose a home care agency, assisted living facility or nursing home.  A large portion wanted information on one subject and since the report showed an increase in those caring for someone with Alzheimer’s disease – that is one of those areas we just can’t give families enough information and guidance.

It was interesting to me that families looked to the doctor for ideas on education and in our area very few physicians are aware of what is available in the community unless they were connected to a senior service of a local hospital.  They also looked to their caregiving provider for information – however, not all home care agencies have skilled professionals to provide caregiver specific education.

Another surprising finding is caregivers expressed less desire for information about finding time for themselves.  I am not sure how to interpret this – I would like to say that they all find time for self-care or at least more know of the importance of caring for oneself while caring for another.  I hope it isn’t that they are overly focused on caregiving and have not thought about their own needed self-care.

See our website for the classes and support groups we have scheduled in our offices and in the community.  We believe information is empowering.

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

When a family member is diagnosed with Alzheimer’s, often little is given to the patient or the family as they all are entering a very long journey of feelings of anger, disbelief, grief, depression, fear and concern.

It would be my ideal that each family who must experience this disease is given a coach to help them find joy and peace on this path that can be filled with potholes.  The professional could help families review and update legal tools that will be needed for decisions in the future, help them look at all the options for the future and help them plan for the costs as well – enlightening them to entitlements and benefits.

The coach would get to know the family on an intimate level and know what types of interventions would work well for the patient and each family member.  How we approach a challenge will vary from person to person and from family to family – we are all unique.

When the families have the trust in one single person or a small group of people to guide them on this journey, they truly can be freed to live and find joy in the moment.

Often professional Geriatric Care Managers are experienced at Alzheimer’s family coaching and, with just one visit a month, can give families the life line then need to find peace of mind and quality of life despite having to traverse a disease that steals minds.  At Eldercare Services, we have been guiding families in this manner for many years.

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

View this video blog: Memory Loss and Aging Parents

When one parent is exhibiting signs of memory loss the other parent can often cover up for the spouse who is losing the ability to care for themselves.   Adult children are often surprised when they hear about a diagnosis they never saw, sometimes because of denial and at other times because the well parent was doing such a good job of making excuses or covering for the ill parent. 

Often this is because of the well parent’s denial and fear of facing the truth of the pending loss.  Other times both parents might be experiencing a dementia and they need each other to maintain their independence.  It is fascinating for me as a professional, to see how we humans struggle to stay independent for fear of losing control.  Are we not really all interdependent?  Don’t we depend on others to produce our food, manufacture our clothing, build structures, secure our financial resources etc?  Would it not be a better world if we were all much more comfortable with the phrase “inter-dependence” instead of struggling to hold onto “independence” even to our own detriment?

Often adult children have a difficult time seeing the dementia for some of the same fears around loss and grief.  It is not easy to experience the loss of a parent in a way that robs them of self and leaves an empty shell of what was a beloved, intelligent being.  Rest assured that love can be experienced and expressed into the later stages of dementia and we can all learn the importance of just being in the moment – because truly that is all there really is.

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

There are so many websites leading in different directions, each touting they are the premier, largest, biggest, best option for aging parent home care, assisted living or even financial planning and legal advice.

Where does a family turn?  How do families know they are getting someone who is working on behalf of them, with the central goal being quality of life based on client values?

The best way is to ask questions.  The venture capital company that has just hit on baby boomer aging might be able to gather some health and human service experts – but do they know mom’s community or your community?   It isn’t just expertise that you want guiding your choices, it is knowledge on ALL the local resources, knowledge of benefits, aging, care choices and most of all understanding the emotional toll this can bring to everyone in a family.

So, what questions do you ask?  I think these are the most important ones:

1)      How long has this company been in my community?  Are they local or do they just have a national database?

2)      How long have their “experts” been with the company?

3)      Are these experts credentialed and certified by a creditable process (not a 30 hour course)?  Do they have a license – if so, do they have years in the field doing aging or elder care work?

4)      Do they take referral fees from outside agencies, facilities or professionals?   If it is a “free” service you can assume so, if it’s not a non-profit or government agency, someone pays.

5)      Is this person going to help you make a decision and help you see the pro and cons of each decision as it affects your family members?

6)      If you are looking for an Elder Law Attorney, Financial Planner or Geriatric Care Manager, do they belong to a National Association that has standards for membership and certification?

Asking questions will lead you to where you will get the best guidance.