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

Watch this video blog: http://www.youtube.com/watch?v=uvSyldkV_cQ

I taught a class that I teach often this past week and heard from many participants in the class:  “I’ve been doing it all wrong”; “I wish I took this class 2 years ago”; “I struggle trying to make my mother understand what I am saying, for me and not her, and it always ended up in an argument that I didn’t win”!

If you have a family member with an illness such as Alzheimer’s Disease, Lewy Body Dementia or “Frontotemporal Dementia” – please, please take a class and get yourself to a support group.

Having to change the way you have communicated to someone you have had a 50+ year relationship with is a challenge.  It takes some new skills and the reinforcement from others in the same boat as you to make changes in your style of communicating.

A new way of communicating can reduce anxiety for you and your family member.  It can mean all the difference in the quality of your relationship and greatly affect the individual with memory loss’s sense of self-esteem.

Eldercare Services provides classes in our office monthly and either me or one of our Geriatric Care Managers are also teaching in the community – we are not alone – other professionals are giving these classes all over the country.  Do your homework – find a class and improve the quality of your life and the life of the person you love who has a memory loss illness.

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/geriatric-care-managers/ http://eldercareanswers.com/blog/2010/07/geriatric-care-managers/#comments Fri, 16 Jul 2010 17:10:52 +0000 Linda Fodrini-Johnson http://eldercareanswers.com/blog/?p=391

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

Watch the video blog: Geriatric Care Managers

We are often asked about the background of our professional staff and I can proudly say they are all Certified as Care Managers, (CMC).  This means they have been tested and have passed an exam that says they have the knowledge to guide families with aging issues.  In order to take this test, you must have had at least 2 years of supervised care management experience and met the educational requirements.

Some professionals come to this type of work through different professional paths, such as nursing, social work, counseling, gerontology or related fields.   At Eldercare Services, we require at least 2 years in the field of elder care or senior services, but in reality, all the professional geriatric care managers on our staff currently exceed 10 years.

When families work with our agency, they not only get the care manager for their family member, but they get the experiences and wisdom of all 20 care managers.  This collective wisdom is what makes our delivery of care management attractive to families. They love the idea of knowing if their care manager is away, they have the resources of the other 19 who will know the needs and desires of their parent through our 24/7 client information system.

We are dedicated to the profession of care management and stay attuned to the latest changes in care and entitlements to older adults through on-going professional education. 

Currently, I am the President of The National Association of Professional Geriatric Care Managers (NAPGCM), an organization of 2000 professionals across the nation.  We can help you move a parent to the Bay Area or help you move your mom to your location if it is the value and desire of your family.   Six of our professional staff members are enrolled as members of NAPGCM.

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

View the video blog: Guilt and Parent Caregiving

Recently in talking with a caregiver who takes care of her mother, father and mother-in-law, the ever present “guilt work” came into the conversation.

“Why”, said the daughter, “do I never feel like I do enough or do the right thing”?  Well, it is more complicated than this simple answer but, the answer is, you just can’t fix it! 

The majority of us have a tendency to want to make something or someone better, to make those who are hurting or suffering from progressive illness, like a dementia, fell better or be less anxious.  A parent can have an uncanny way of making us feel like we didn’t stay long enough or get just the right fix to whatever the problem was that engaged us in the interaction.  This is often not so much because you have a controlling parent but because of the parent’s anxiety, fear or loneliness.

It is hard to know what the pull is but, if you leave feeling guilty it is often because you can’t truly make the internal feeling that they have go away, no matter what your skills, education, experience or love are.  Those who are successful at balancing caregiving with self-care know they can’t fix all problems.  What you can do is be “present” when you are with your parent.  Express your love and admit you don’t have all the answers.  Do your best knowing you can’t fix everything!

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

A daughter I was working with called and asked how to get her mother to agree to go to a doctor appointment for a flu shot.  Her mom has dementia of the Alzheimer’s variety and is starting to become paranoid.   The daughter has spent the past 65 years reasoning with her mother, a retired attorney.   She was having difficulty not giving her mother all the details about upcoming events, as she had done her entire life. 

I had to tell her that the days of reasoning were over.  She need now only tell her mother a limited amount of information.  Over communication and details justifying an action only make those who are losing the ability to process information more paranoid or angry. 

Instead, I told her to just tell her mother she was coming to take her for an outing and lunch.   First, they “dropped in” at the doctor’s office. Her mother recognized it when she got there – but did not remember when the daughter tried to explain to her before. She successfully got her flu shot and a brief medical evaluation. 

Immediately after the visit the daughter took her mother to lunch with no mention of the medical stop.  Mom commented on what a wonderful time she had and the daughter called to thank me for the advice and the reduction of stress she was had been feeling.

View the video blog on this topic:  Dementia and Appointments

Professional Geriatric Care Manager Supervisor Eileen Zagelow, BA, CMC

How often I have heard from a family member that their mother is in the hospital and seems so confused! 

Patients who were functioning fairly well at home often seem unaware, forgetful or anxious when in the hospital. Sometimes there are reports of combative or agitated behavior; or concerns that a patient can no longer function in their current living situation.  Disorientation, unusual behaviors and the inability to follow directions are words that break families’ hearts and cause them enormous stress.

It is important to remember that even for slightly confused seniors being out of their regular environment and structure can be overly stimulating. When that is added to their current illness, treatment and a parade of strange people popping in and out of their room all day, confusion can rise dramatically.

Dementia has many faces. Alzheimer’s disease, vascular disease, medication related confusion and oxygen issues are just a few of these faces. When a person suffering from dementia finds themselves chemically altered, physically displaced and surrounded by unfamiliar faces it is “normal” for them to experience an exponential increase in confusion. 

When concerns arise about whether Mother or Dad can return home, it is very important to know that this is not a desirable time to make a placement decision.  Often times once seniors have been medically treated for their illness and return to the familiarity of their home they can recoup a level of function befitting their living environment, not necessarily back to their previous level, but possibly enough to manage. Indeed, the familiar environment itself can often help in stabilizing seniors.  This happened with my own father who had COPD.  The doctor said that although he would like to keep my father in the hospital a bit longer, he could see that his confusion and agitation were getting worse.  He thought Dad would improve more rapidly in his comfort zone – home.  And he did!

There are occasions when a temporary stay at a skilled nursing facility might be part of the “return to home” care plan and other times when bringing in live-in or hourly caregivers may be appropriate until the patient has an opportunity to stabilize. 

Fortunately, Geriatric Care Managers are highly skilled in navigating these waters. Their knowledge, empathy and organizational abilities can clarify options and assist families and patients in attaining the best solution for the senior.

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

I have a wonderful company to lead and we always refer to ourselves as the “team”.  No matter what you do or what your job description is, you work for a common goal. In our case, it is quality of life for elders and peace for families.  We acknowledge that the journey of aging can be stressful and very hard for individuals and families to seek help.  We all think we should be able to do anything alone – forgetting we can’t excel at all elements of life – we just can’t be objective when it concerns someone we love.  We turn to doctors, lawyers, accountants, and we should also turn to those who have expertise in any area we find challenge or dilemma.

One of the values for families using Eldercare Services Professional Care Managers in the San Francisco Bay Area is that we resource each other when looking to solve a problem or find an appropriate resource/service for a client.  This means that the “collective wisdom” of 20 very experienced, well prepared and certified care managers is sourced for every challenge the family faces.  This is the reason many families choose our company over others who may have limited professional expertise.

Adding a Geriatric Care Manager to your family’s team gives them the ability to use objective eyes to see with clarity what they can’t because of past history, unrealistic expectations and sometimes just denial.   The professional Care Manager will help the family see, in their own time, what they need to see, will guide them in the options available, help them with challenging decisions and act as an advocate when or if needed.  They are the “quarterback” on your family’s team – making calls that will meet the goal of winning, when it comes to peace, during a crisis or challenging decision.

Sometimes a family only needs a map on how to get from base to base and other times they need a coach, a trainer and a shoulder to lean on when the process is tough. Teams need leadership but the leader should always take into consideration the value and goals of the client. That is what we do on our team at Eldercare.  We make recommendations based on past history, client values and existing resources.  The client (older adult) is our primary focus; however, the entire family is always in the broader picture.