geriatric care manager

When it Pays to Hire a Pro – CBS News Interview

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Dementia and Memory Loss, Relationships on April 12, 2011

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

I came across an interview on CBS News with Donna Rosato from Money Magazine that stresses the importance of hiring a professional when it comes to making important decisions about your aging loved one’s affairs. She stresses that with a small investment, there is a potential to save a lot of money. In my experience as a Geriatric Care Manager, I have found many benefits for my clients that ultimately increased their monthly income substantially. We professionals are well versed in knowing what resources are able to get our client’s what they are rightfully entitled to.

In addition, a Geriatric professional will ease the worries and stress and has the expertise to know what the most efficient avenues are in order to obtain the highest quality of life for the elder and concerned family member.

Other professionals are mentioned in the interview as well. All in all, it is important information for all of us to know, regardless of our age or situation…

To watch the video, click here.

My Husband Has Alzheimer’s

Posted in Blog, Uncategorized on January 28, 2011

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

Watch the video blog by clicking here.

“I feel so alone and even though I attend a support group, the feelings of loss, anger and love make my head spin.”

“It is hard for me to articulate my feelings of confusion and it seems like a betrayal to the man I have loved so deeply for over 50 years.”

Being a spouse, wife or husband of someone with a dementia is a trial, not just a journey. The well spouse often feels guilty for their honest feelings – this journey of love and care needs a “professional” guide. It would be a gift to both the well spouse and the person in need of care to consult with a Professional Geriatric Care Manager at least once a month or every 6 weeks.

The well spouse needs to be affirmed, re-directed at times and given permission for self-care. Because, without “self-care”, well spouses can end up in the cardiac or stroke unit of their local hospital and then who cares for that “beloved” husband or wife?

The dementia journey can be 10-20 years. It can be a time of love and moments of joy if the well spouse can find balance and ways in which to affirm themselves. This takes some coaching and guidance often by a professional very aware of dementia behaviors and the interventions to use for each situation.

It also means that well spouses have to share the care with other family members (and ask for specific help), community programs and caregivers trained in dementia care (often these come from agencies with excellent training programs).

All of our caregivers are given training and are exposed to the family journey of “dementia” care. Be sure when you do hire an agency they can tell you they have provided this training and they provide 24/7 assistance with any behavioral issue.

Be a real loving spouse – take care of yourself and check in with a professional to be sure you don’t get off track!

Choosing Skilled Nursing

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, Relationships on January 18, 2011

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

“Help – Mom’s diabetes is out of control, she can’t manage it and we can’t be there for her. Her memory is failing and it looks to us she is losing weight.” “Dad should be on oxygen and now they are talking about a gastric feeding tube because of his Parkinson’s disease.”

Older Adults who have complex medical issues that can’t be managed by themselves or their family need another level of care. Quite often this is “skilled nursing” because no other level of care can provide the medical attention they need on a 24/7 basis.

Not everyone will need “skilled nursing” care and I highly recommend that families work with a Professional, Certified Geriatric Care Manager before making this decision – for options that might have been overlooked.

If the care manager, the family physician and the family think it is time to look for a skilled nursing facility it is best to start back with that Professional Care Manager who has experience with all the skilled care communities in the location you want your family member. The reason I say to start with this person is, because they know all the facilities and their strengths and weaknesses. One might be better with dementia, diabetes or stroke patients than the other. Some will take Medicaid/Medi-Cal when resources are limited and others will not. Some excel at physical therapy and others are not as strong in that service. So, the answer is: choose the right facility for the needs of the client, not necessarily how it looks or how close it is to you (even though that is important).

You will want to check on-line evaluations of the skilled nursing facilities as provided on the Medicare website or in Northern California the California Advocates for Nursing Home Reform site (www.canhr.org). You could also call your local Ombudsman Office for this information and a list of facilities in your area (800-510-2020 in California).

When you visit, you will want to look for the calendar of activities, the menu and have a tour. If possible, chat with residents. You don’t want to see a lot of residents lined up outside the nurse’s station. You’ll want to see people in their rooms engaged in activities that interest them or in group activities. Inquire about bringing in some personal favorites such as a favorite chair or other piece of furniture and, can the beloved cat or dog visit?

If this is to be the “home” of your family member, you want all the family to visit. Look for rooms where you could gather as a family. And, would your 6year-old grandson be ok visiting Great Grandma in this environment? Believe it or not the opinion of a 6year-old can be great information.

So – if possible have a Geriatric Care Manager help you with the decision and if not, ask that 6year-old to give you their opinion. Out of the mouths of babes often comes the most honest truth.

Geriatric Care Managers – Saving Families Money

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, End of Life, home care, Relationships on January 7, 2011

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

Watch the video on YouTube by clicking here.

Families at a distance, families in conflict, families with resistant elders and families at a loss for options for their frail or confused elder often can save hundreds or thousands of dollars using the expertise of a Professional Geriatric Care Manager (one who is certified).

If you are living across the country and have to take time off work and fly on short notice across the country, it could cost you thousands of dollars as opposed to spending a few hundred dollars on a local expert to assess your aging parent and give you direction, counsel, coaching and advice before you fly across the country.

When families are in conflict on what is best for mom or dad it can mean one or many are taking time off of work without pay to care for a parent that might be better served by a local program, an entitlement or skilled caregivers. It can also mean that the energy in arguing with siblings is causing you stress and adding to your own health care costs. The neutral, Geriatric Care Manager, won’t take sides but make recommendations based on the needs of the aging parent.

Not knowing local, State or National benefits costs families thousands of dollars. One client of mine, after a one-hour of consultation, left my office with the knowledge of a benefit that brought $22,800, in one year, to her parents who live across the country. That more than paid for the one hour she paid me.

Get professional help if only for a 2-hour family meeting or a 1-hour consultation. Thinking you can do it alone on the internet can lead you to a good sales pitch but poor information that isn’t client centered and all about what they are selling!

Lots of Help at No Cost!

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, home care, Relationships on November 16, 2010

Professional Geriatric Care Manager Supervisor Eileen Zagelow, BA, CMC

As a Geriatric Care Manager, I am constantly impressed with the many things family caregivers do to help themselves help someone else. One thing that really tops the list in terms of bang for your buck in my opinion is attending a support group. Please keep reading!

Support groups are usually free and family caregivers who attend them seem to “hear” things differently. What is it that keeps some people away from support groups? I think some level of fear or misunderstanding and just plain being too tired to do one more thing.

Fear of what? Fear of being judged, fear of being bored, fear of being subject to lots of crying and wondering how does sharing with others help me?

These groups are the foxholes of caregiving. You will find camaraderie, someone with knowledge you may not have, someone who understands what you are going through in a common situation in time. In addition, you will hear first hand information regarding resources – who, where and why they might be helpful. This comes from other people who are also on the front lines of the struggle. In addition to receiving a huge amount of help you will also feel empathy and heartfelt sympathy for what you and the person you are caring for are going through. Interestingly, this often happens with a minimal amount of cathartic tears, although tissue boxes are kept at the ready!

If you decide to stick your toe in this pool, commit to giving yourself three meetings before deciding if its for you or not. As in most relationships in life, it can take time to meld into a comfort zone with others. If you continue to try, you will feel informed, lighter and just a bit more energetic.

One final thought – there are very specialized support groups. Some are disease specific such as ALS, Alzheimer’s disease and Parkinson’s disease for example. Others are more encompassing – caring for a spouse or an aging parent. To find out more about groups in your area, feel free to call our office at (866) 760-1808 or check the resource chapter of our website. Local hospitals and the Alzheimer’s Association are also good resources.

Fielding the Perfect Team – Who to Include and When to Do It!

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

Professional Geriatric Care Manager Supervisor Eileen Zagelow, BA, CMC

“I wish I had met you 3 years ago!” This comment makes me smile when I think of the lovely gentleman who said it to me when he first became my client. Fortunately, I was able to work side by side with him for several years, assisting him in the care of his wife and his own adjustment to the changes she experienced. Later we separated out his needs and preferences for his quality of life. This was a very rewarding relationship indeed – for each of us.

During my 17 years at Eldercare this wistful sentiment has presented itself often – people wishing they had connected with a geriatric care manager earlier in their journey. Frequently I am asked for a handbook that prepares one for the eventualities in caring for a person entrusted to them, or perhaps one that helps them prepare for their own unforeseen needs. Surely there are books and articles some of which are very helpful. However, just as one financial how-to book cannot prepare one for all aspects of investing, one how-to book cannot prepare a person for advocacy and navigation in the retirement and healthcare arena.

The fact is that appropriate questions rarely present themselves until after the crisis – this is unfortunate, but true. Having the perfect professional team in place can help avoid crises, minimize risks and foster a plan of action for the short-term as well as the long-term.

This team should include a financial planner; a legal advisor and a certified geriatric care manager. Financial projection is obviously a must; however, what you are planning for may be less clear. Legally, a consultation with an attorney versed in elder law can be strategically important. Benefits often need to be looked into, particularly when couples have shared assets. Also, clarifying legal documents can minimize future problems.

A geriatric care manager is an invaluable member of this team. Their expertise assists in many ways – providing an inside look at living transitions, navigating the healthcare system, working with families to find solutions both internal and external, providing dementia education where needed and advocacy whenever there is a need.

Getting this team in place before it is needed is the best time to do it, but whenever you do it, having your perfect team will allow for greater freedom from worry financially, emotionally, and physically.

Who is the Expert in Aging Care Choices?

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, Elder Abuse and Fraud on June 29, 2010

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.

Dementia and Communication

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss on June 11, 2010

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

It is important in communicating with someone who has Alzheimer’s or a related dementia, to know the words they have always used for a room like the toilet – did they say “powder room”, “bathroom”, ”can” or another?

If your family member is going into a care center, retirement community or dementia care facility and they spoke a language other than English as a child – be sure to communicate this information to caretakers because, as the disease progresses, also do language skills. The word they used in English might be gone, but the word they learned for “bathroom” as a child remains. Language loss will affect both the receptive and expressive language skills.

So, if their most recent language is their second language, give the caretakers a list of important words in the language of origin and a way to pronounce each for communication that is important like: bathroom, bedtime, mealtime, come, stop, go, yes, no.

Loving comes without language and it is our hope that all who care for those who have lost the ability to communicate with language will continue to care with love.

Watch Linda’s Video Blog Dementia and Communication!

Applying for Medi-Cal or Medicaid Benefits for a Spouse or Aging Parents

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss on May 21, 2010

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

It is true that couples don’t have to spend every last dollar in order to have the cost of skilled nursing covered by governmental benefits. Remember, Medicare does not cover the cost of custodial care in a skilled nursing facility. Medicare only covers short periods of time for rehab after surgery, an accident or other covered pre-admission conditions.

In many states, there are benefits that allow spouses to quality for governmental support of long term care costs in a skilled nursing facility. There are many exempt assets and in California, the well spouse, can keep up to $109,560 (2009) and still qualify to have his or her spouse in a Medi-Cal covered skilled nursing facility.

The spouse receiving these benefits, may need to cover some of the costs with his or her retirement benefits. This will differ from couple to couple and allowances are made if the spouse who stays at home needs more income for their health and wellness.

It can be confusing to understand what is accepted and what counts towards the total allowed for the well spouse. Consulting with a Certified Geriatric Care Manager for an hour or two is all you will need. If you have to move assets in order to qualify, we recommend that you consult an Elder Law Attorney who is a member of The National Association of Elder Law Attorney’s (NAELA.org).

Learn all you can about your benefits. Sit down with someone skilled in helping you make long term decisions, such as a Professional Geriatric Care Manager. Knowing about your benefits doesn’t need to be hard.

Mom Needs Care and Siblings are in Disagreement

Posted in adult children, Age Related Issues, Alzheimer's, Blog, Care Management, Caregiving, Dementia and Memory Loss, End of Life on April 30, 2010

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

Often we hear from families, that need services for a parent, that their brother or sister doesn’t think mom needs anything or they feel she needs 10 times the care she really needs to stay safe and well. This conflict can sometimes delay an intervention that would benefit all family members.

It is hard to accept that a parent is in need of an intervention due to cognitive decline that might impair judgment and safety. It is also hard to insist that a parent needs help who is physically frail but resists having help. Often this resistance stems from the unfounded idea that accepting care might be a signal that the family might try to move them from their beloved home. Having a consultation with a professional Geriatric Care Manager or attending a class for “family caregivers” often allows all the family to hear the same information and make more informed decisions.

Finding the right balance of services for mom, that allows her to retain her dignity but keeps her safe, should be the goal of meetings with geriatric professionals. Mom’s values will have to be considered in any major decision in order to preserve quality of life. It is important that families choose to work with someone who is certified as a care manager and a member of the National Association of Professional Geriatric Care Managers.

Making pre-mature and not well thought out decisions can cause great stress to families – know your options, know the costs and look for solutions that respect the dignity and values of the older person.