As we think about the recent holiday visit with our families, we often come away with unsettled feelings that everything may not be well. When we are in another town, our concern escalates as we reflect that the aging of our loved ones is becoming visibly noticeable. So noticeable that we no longer may be at ease. We want assurance that everything is under control, that those we love are able to manage their daily chores and manage the household needs and care for themselves. We need the comfort of making certain that our loved ones’ circumstances are stable – from many perspectives. Perhaps the comfort of an on-site right-hand that can make an uncertain situation in our loved ones’ homes newly safe and secure.

At that point of time, panic sets in and we must take action and look for local professional assistance. Usually we need guidance to find qualified services and experienced people to evaluate your loved ones in their home and coordinate any needed care.

An RN (Registered Nurse) Geriatric Care Manager can be the answer. The Care Manager will begin with a home visit and a lengthy needs assessment. An RN Geriatric Care Manager will collect all the needed medical records in order to clarify any problems. An experienced professional knows what to look for and can make recommendations that assist the family in making decisions with their loved ones that will be helpful and reassuring.
The Geriatric Care Manager can do all of the following activities in order to bring peace of mind to those who are far away from family as physical changes may require even small shifts in life as we know it.
1. Assessment
2. Care planning
3. Care implementation
4. Home management
5. Client/family education
6. Liaison with physicians
7. Crisis management
8. Advocacy
9. Medication management
10. Plan for socialization
11. Placement services
12. Benefit assessment and planning
13. Communication systems with families and other professionals

If we can help provide assistance that will give you peace of mind, knowing that your loved ones have some extra care at hand, call us at 410-823-3153 for a free 30 minute consultation.

I WANT TO SHARE WITH YOU INFORMATION ABOUT ONE OF OUR GERIATRIC CARE MANAGERS.  She is Mary Schenning and works part-time for us.  Mary has a quiet calming way about herself. Her understanding of human behavior comes from many years of working with patients both in the hospital setting and outpatient. She is perceptive, quickly analyzing the problem bring all of her expertise to produce solutions both for the client and the family. When we discuss our work I often think that I would like to be nurtured by Mary back to a state of wellness.

Ivory House Health Services are Geriatric Care Managers and Certified Nursing Assistants working together to allow seniors to live more safely in the comfort of their own homes. If not possible to remain at home, our staff is knowledgeable about the many options for varied assisted living facilities that are available in the Baltimore area.  For more information about our Geriatric Care Managers and In Home Care in Maryland you can contact Ivory House Health Services or call 1-800-704-3536.

Caring for persons with dementia can be a demanding task. It requires time and energy.  Even care sprinkled with lots of love can be extremely wearing and difficult.  It is essential that as a caregiver you take care of yourself.

Recognizing the signs of stress in yourself or someone you care about is the first step in taking action. Finding ways to reduce the stress helps to lessen the long-term emotional and physical toll of care giving. Research has shown that caregivers suffer many health issues when they don’t take care of themselves or allow persons to help them.

There are things you can build into your daily life to help maintain your health and well being.

1. Learn about the disease process and giving care.
2. Be realistic about the disease.
3. Be honest to yourself and what your expectations for your care giving will be.
4. Accept the difficult feelings you may be experiencing.
5. Share your feelings with others and do not feel upset about how you do feel.
6. Look for the good things in your life
7. Remember your preventative wellness routine
8. Look around every corner for humor.
9. Get help, support and practical help.
10. Make plans for the future.

Remember the Geriatric Care Managers can be very helpful.

11.  Be sure to give yourself relief time daily and a day off per week.
12.  Hire help when necessary.

Life Can Be Easier, We Promise

Aging Process

Normal aging occurs in everyone. Some signs associated with normal aging are as follows:

• Decrease in vision
• Decrease in hearing
• Decrease in the function of the heart
• lungs and kidneys
• Increase in the time it takes to remember

Changes that require immediate attention.

Inability to perform activities of daily living such as:

• Bathing
• Dressing
• Toileting
• Ambulation
• Shopping
• Laundry
• Feeding Self
• Food Preparation
• Use of telephone
• Housekeeping
• Transportation
• Ability to handle finances Responsibility for own medication

Weight loss

Loss of appetite leads to weight loss which may be due to any of the following:

• Medications
• Memory loss or Dementia Depression
• Chronic medical problems

This inability to perform these tasks may indicate underlying physical or psychological problems. A thorough evaluation is necessary. These problems did not occur overnight and may require more than one intervention. Geriatric care managers are available to perform an evaluation to determine the type of interventions necessary.

Common Diseases That May Cause Disabilities and Death in Older Adults.

• Heart Disease
• High blood pressure
• Pneumonia
• Flu
• Lung Problems
• Cancer
• Urinary tract infections
• Memory loss or Dementia
• Depression

Chronic Problems That Require Attention

Medical Problems

We must not think of chronic illnesses such as heart disease, high blood pressure as normal when people age. Geriatric care managers can assist you in monitoring these problems so that your loved one can have the best quality life possible.

Memory Loss

This is one of the most difficult problems faced by seniors. Memory loss usually manifests itself gradually. You or your loved one may not recognize that there is a problem or may deny it exists.

Early signs of memory loss may include forgetting dates, not eating, not bathing. It may manifest itself in the inability to handle finances and making excuses not to participate in social events due to poor memory.

The causes of memory loss are many. Memory loss may be due to depression, medications, stroke, dementia, Alzheimer’s disease and nutritional deficiencies. It is very important to a have a thorough evaluation to determine the cause to help you and your loved one determine the present and future care that will be needed.

Depression In The Elderly

Depression is a common illness of the elderly. There can be multiple events that can trigger depression such as death, and the loss of independence due to chronic illnesses. Signs of depression are irritability, anxiety, sadness, loss of appetite, social withdrawal and difficulty sleeping. Depression in the elderly is treatable.

Adult Children as Caregivers

Adult Children must recognize how difficult it is to take over the role of caregiver. Much resistance may be met especially if your loved one does not recognize there is a problem. There are health care professionals such as geriatric care managers who are available to help you in all these areas. It is up to you to make use of their skills to alleviate stress by getting the help you need.

When it comes to family communications, it’s never too late to improve. Even families with long histories of not communicating very well…or at all…can learn to share their views and ideas for meeting the senior care needs their loved ones. We often hear about the importance of  “letting go” and when our loved ones are in their golden years its crucial to put family issues to the side and face the reality of the challenges ahead for both senior citizens and the family members who may become responsible for informed decision making and elder care planning.

If your family is communications-challenged, try these simple rules:Learn to tell…and to accept…the truth.

• The varnish is less important than the woodwork it covers.
• Think of family communications as an opportunity for personal and family growth.
• Put your issues and concerns out on the table for discussion. Do others see the situation the way you do? Be open to give and take, but try to move in the direction of a consensus about what the senior care needs and opportunities really are.
• Be inclusive. Draw out what each family member is thinking and feeling, including the senior or seniors for whom you are trying to support.
• Stick with it. Reaching a consensus usually takes some work. Be willing to give it the time and effort it requires.
• Be open to both asking for and accepting help. The whole idea is to not “go it alone.”
• Share the load. Make sure there is basic fairness going on in terms of the financial, time, and emotional costs of the family’s overall care efforts.
• Know when to say “no.” If the “fairness” message is not getting through, or if you are simply stretched beyond your capacity, it may be a time to say “no.”

John is a 79 year old gentleman who had suffered for many years with diabetes, depression and congestive heart failure. When Ivory House became involved, it was because John had been hospitalized due to a heart problem. While in the hospital, the geriatric care manager from Ivory House was called to do an assessment of John’s problems and develop a plan of care for his discharge to home.

While John was still in the hospital, the care manager helped him prepare and write questions for the doctor concerning his condition and prognosis.  She also reviewed John’s chart and spoke with the physician regarding the plans for John’s discharge.

During one hospital visit by the care manager, John was complaining that it was late in the afternoon and he had not had a bath.  The care manager (a nurse) bathed John and changed his bed so that he would feel refreshed.

Assisted Living Care

When John went home from the hospital, the care manager arranged for an aide to assist him with his daily bath.  In addition, the care manager served as a liaison to coordinate care with the skilled nursing, occupational, and physical therapy services which were provided through Medicare.  He lived in a communal assisted living setting so his meals, laundry and other necessities were handled by the community staff.  Because John was anxious about medication management, the care manager prepared his medications in a weekly medication box.

The care manager visited John on a twice weekly basis and more often if the need arose.

She routinely evaluated him for cardiac problems, calling his cardiologist when she had questions about his cardiac status. The care manager also took John to all his physician appointments and assisted John in understanding changes in his condition and medications. The cardiologist gave the care manager permission to increase John’s diuretic for his congestive heart failure based on her observations and within certain dosage limitations. She instituted a plan of care for John to follow concerning his cardiac and diabetes status. John called the care manager when he was not feeling well and she would visit his home to assess him.

Liaison Between Patients and Doctors

Due to John’s serious chronic cardiac illness, the care manager’s assessment would sometimes indicate that John needed to go to the emergency room.  When this happened, she took him there and would stay with him to serve as a liaison to the emergency room physicians and nurses. If he needed to be admitted, she would assist him in answering the questions of the admitting physician and nurse.  The care manager would then visit him daily while he was in the hospital.

Eventually John required a facility that was able to provide a higher level of care. The care manager completed all the necessary paper work and wrote a transfer summary, including all the care she had provided for John.  In addition, she assisted him in the packing of his belongings.

John was most appreciative of all the work the care manager had done for him and John’s quality of life was greatly enhanced by the relationship he had with his care manager.  He continued to keep in touch with her until his death last year.

Hiring the right Geriatric Care Manager is not an easy decision.  You will rely on this person to make sure the care of your loved one is managed in a way that helps them get the most out of life while monitoring their safety and physical health.  Therefore, hiring someone without knowing what to ask them in advance is risky business.  Arm yourself with as much knowledge regarding elder care as you can and keep the following in mind when looking for Geriatric Care Management.

Sometimes dealing with the elder care issues of our parents can be overwhelming. Decisions about assisted living, nursing homes and/or long term care can literally rip families apart.  Seniors are sometimes resistant to change and may not even realize the circumstances surrounding their situations.  Siblings may not agree on the proper course of care and financial disagreements among family member are common.  It may be best to have a third party well versed in caring for the elderly to help families choose and administrate elder care programs.

Here is a list of 10 reasons you may need a Geriatric Care Manager

Paul is an 86 year old man who was in a nursing home and wanted to go home.  His only living relatives were cousins who lived in the South. When Paul was able to be discharged, his cousins were referred to Ivory House by the staff of the nursing home. A geriatric care manager went to the nursing home to meet Paul and complete a needs assessment.  She felt that Ivory House would be able to care for Paul in his own home.  In preparation for discharge, the care manager made arrangements for aides to care for Paul while he was still in the nursing home. This provided a period of adjustment for Paul to begin to know the individual aides who would care for him in his home.

Paul lived in a very large home three story stone home.  Inside were various antiques he had collected through the years.  When the care manager first entered the home she noticed the paintings, some with calligraphy, which hung on all the walls. She thought some well known artist had painted them.  Paul’s cousin told her that Paul had done all the paintings and calligraphy but, due to his poor eyesight, could no longer create such detailed art.

The care manager worked closely with the cousin who was Paul’s power of attorney in getting the home cleaned and ready for Paul. A bedroom was created in the former dining room, a hospital bed was ordered along with all the other supplies that were needed. Since Paul slept during the night, the care manager arranged for a live in aide who could also sleep at night. The care manager and cousin turned the sitting room into a room for the aide.

Paul had many chronic illnesses, which included: chronic obstructive pulmonary disease, poor circulation in the legs, and osteoporosis.  His poor circulation and gait problems made walking impossible, so Paul used a wheelchair.  Prior to discharge from the nursing home, the care manager made arrangements for groceries to be delivered to Paul’s home and established a delivery system for both medications and medical supplies. Collaborating with the nursing home social worker, she arranged for physical and occupational therapy services in the home.  She also contacted a physician and podiatrist who were able to make home visits.   Through her resources at Ivory House, blood work and chest x-rays could were done at the home when needed.

When it was time for Paul to be discharged from the nursing home, he was determined to be incompetent.  His care manager arranged for an elder-law attorney to assist Paul in setting up a Power of Attorney to manage his financial and healthcare decisions.  Once discharged, Paul was very happy to be home. He immediately began listening to the radio and to his record collection. He loved classical music and would talk with his care manager about what was happening in the world.  After several months in his own environment, Paul’s health and mental state improved so much that his physician felt he was competent to manage his own affairs.

The care manager visited Paul weekly to assess his medications, medical supply needs and medical condition.  She reviewed Paul’s plan of care with him and the nursing aide.

Plumbing and heating problems with Paul’s home were handled by the care manager. Due to cost of heating the home, taxes and utilities it was decided that it would be more cost efficient for Paul to move to an apartment.  He agreed with this move and the care manager visited various apartments.  She found a lovely two bedroom apartment for Paul, which overlooked a rose garden. The care manager made all the arrangements for the move which included: deciding with the client what furniture and paintings he wanted to take to the apartment, cleaning the oriental rugs he was taking, arranging for the placement of his furniture and making arrangements for his paintings to be hung in the apartment. She assisted Paul’s power of attorney in the sale of his antiques, the cleaning of his home and getting it ready for the move.

During the years Ivory House cared for Paul he was never hospitalized. After several years, his power of attorney felt it was necessary to move Paul to an assisted living facility. The staff from Ivory House visited Paul often after his move.  They sent him cards and celebrated his 94^th birthday with a cake and gifts.  Approximately six months after his admission to the assisted living facility, Paul died.  Paul had a great life once he came home from the nursing home and he enjoyed being home with his belongings, both in his home and his apartment.

In honoring seniors this month of May, we are giving to the first 300 older adults to respond to our website an 8×11 magnetic writing board for the refigerator. We hope that you will take this opportunity to give us your name, address and brief story that you would like printed on our web site.  We will send you the board FREE for your use.

Again, may you find more blessed days and stories to share with your families.

8x11 Magnetic Writing Board

Please enter your information below to receive your FREE magenetic memo Pad.

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