It's a small caregiving world

Have you ever felt like synchronicity was at work in your life? I found a little bit of synchronicity today. As I have mentioned in blogs past I spend 1 afternoon a week at the Center for Memory and Aging neurology practice in Poway, CA. My job there is geriatric care manager/ clinical social worker and I see the patients and their families after they receive a diagnosis. I help them cope with the news and provide community resources such as the new caregiver support group I am starting over at Sunshine Care Assisted living homes across the street. Well, anyway Adrienne from Sunshine Care came by and said, "Kathy you need to contact Melanie, the social worker next door at the Poway Health Care Center". SO I call Melanie and it turns out she is not only my neighbor for work but also lives in Scripps Ranch. She has been reading about the Scripps Ranch Elder Care Alliance for the past few months and even recommended another colleague to come to one of our meetings. I then shared with her the story of Fran the Age @ Home client (and my Scripps Ranch neighbor) I took care of for over a year. Fran had also been a resident of The Poway Health Care Center for a time. We now have an appointment to meet in person later this month. I will also tell her about the Center for memory and Aging and the good work being done right next door. It sure is turning out to be a small caregiving world.

Tax time and care management

I finally went to my tax guy today. I know, I know it is getting late and not much time left until that famous April 15 deadline. The good news is he praised me for being so organized and keeping sound records. The bad news is of course I owe, I owe, so off to work I go. As it turns out care management has proven to be somewhat recession proof. People continue to age. Older adults prefer to remain in their own homes, now more than ever. Top 5 reasons for aging @ home
1) Decreased home values discourages selling the 'family nest egg'
2) Moving to retirement community is costly when you add up all the monthly fees and services
3) National movement to bring services into communities: 'virtual assisted living' services
4) Independence equals living in your own home
5) Friends and family nearby

Funniest line yet: The tax guy said my job is like tax season for him, only year round.

On being a "surrogate daughter"

In the past few weeks several of my clients have referred to me as their "surrogate daughter". Their real daughters have echoed this sentiment by calling me their "surrogate sister". I can't tell you how honored I am to claim that title. To me it connotes trust, responsibility and love all key ingredients in caring for an aging parent. My job is to assist adult children in the care of their aging parents when their work, family or long distance prevents them from being there. So not only do I perform neccesary tasks, I do it with compassion and care. You see my 'job' is more than that. It is a calling. This is what I do, but more important this is who I am.

Hospice care

What an eventful day. My client just graduated off hospice care. She was on for about six weeks, coming home with a failure to thrive diagnosis. With the loving care of her family and the round the clock caregivers she has gained weight, is sleeping better, her heart disease is stable and she has fully recovered from a stroke. In other words she is ALIVE! I have been in this business a long time and have placed many many people on end of life palliative care, but this is a first and it feels great.

Elder Care San Diego

My own experience-not good

Last week I had to have a dental implant. I have been going to the same oral surgeon for years and had several procedures which led up to this major one. Since this was after all surgery I had my daughter Nora drive me and I went pretty much empty handed. When I go there I discovered that of course I needed my credit card to pay for the $3300 plus surgery ( no insurance doesn't cover it). However I was stunned with the office worker said, to me, no credit card no surgery. So I asked Nora to return home for my pruse and credit card, thinking that cleared up any problem. Well no it didn't. You can not have the surgery until you have paid for it." After all this is a business. Come again? I thought it was a doctors office. We will not operate on you you until your daughter returns with the credit card. Excuse me you are holding my surgery up? I asked to speak to the office manager. Another office worker came out and told me she had spoken to the office manager and yes indeed this is the office policy, Not only that but how could I possibly come for surgery not prepared to pay for it? ( I don't know maybe I was thinking of the titanium screw going into my jaw and being laid up all weekend on Vicodin?)
Again I asked to speak to the office manager and they called her on the phone after conferring with each other: what should we do? (Should we let this irresponsible person talk to our manager?) I think the crowning insult was when I asked to speak to the doctor and they said, "He has nothing to do with it". Well the manager gave her permission for me to go forward with my surgery, my daughter brought the credit card and all ended well. One last note: I over heard them scedhuling a patient for surgery telling the person about no eating before hand, get there 15 minutes ahead of schedule etc, but no mention to bring payment in full.

Hiring professional caregivers

Hiring professional caregivers can be an overwhelming task for adult children of aging parents. Most of the time you only have a list of companies given by the hospital discharge planner. Not only that but you need the caregivers yesterday! Your parent wants to go home and usually her doctor wants her to go to a nursing home. Mom will say anything to get out of the hospital, including agreeing to caregivers. You start calling names on the list and whoever costs the least and gets out there the quickest wins the job. It may not matter anyway because mom's plan is to fire the caregivers after a day or so anyway. So you have done all that work, gone through all that stress for basically nothing. And the icing on the cake is mom still needs help so she doesn't repeat the trip to the hospital. Guess who is left holding the caregiving bag? That's right, you.

If this sounds familiar write me and tell me your caregiving stories.

Helping a Senior Move

This week I helped a 79 year old client move. As a geriatric care manager I know that what can seem straight forward and easy to accomplish for a younger person is incredibly difficult for the elderly. In this case I supervised Mrs. M in finding a senior community to move to and hired the movers and packers. The movers are Help U Move and have a fine reputation for working with seniors. Their office number is 760 721 4357.
Mrs. M recently lost her driver's license due to a dementia diagnosis. Any move can be stressful but when you have a mild to moderate case of dementia the stress and forgetfulness combine to cause a huge amount of confusion, so I became, as she likes to say, "her memory". I also became her driver and we shuttled about town doing the things that need to be done for a move. One important thing is I made sure she got some breakfast and lunch the day we packed. I also supervised her taking her medicine so that would not get lost in the shuffle. She is now safely in a senior community where she already knows many of the residents. The senior center is across the street and the library is up the road. I will continue to visit with her regularly as I have done for the past two years.

"Yes we can!"

Our new president has asked us to give back to our community, to volunteer and help one another in any way we can. We had our first meeting for the Scripps Ranch Elder Care Alliance last night. More that 30 people came to my house to talk about this important subject. I brought out the kitchen, dining room and folding chairs. People were sitting on the floor and on the stairs. We went around the room and introduced ourselves and told why we wanted to help launch this initiative. We had spirited discussions about transportation, in home services, community resources and how to go about building our coalition. We set up a volunteer committee as all agreed this is the place to start. Our next meeting is Thursday February 26, 2009. Yes we can!

Aging in place in Scripps Ranch

I am fielding daily calls from volunteers wishing to join the Elder Care Alliance here in Scripps Ranch. Just as I suspected this is an unmet need which once posted is bring out both care providers and elders wishing to know how to access in home services. I have identified transportation, in home care services and home safety issues as top priorities. We will need a census of the number of elders in our community of 32,000. It is exciting and I can't wait to get started.

Dancing With Doris

I love my clients dearly. Yesterday I met with Doris (name changed to protect confidentiality) a 89 year old with some memory impairment. Doris was telling me about the New Year's Eve party she attended at her retirement community. She lamented the lack of dancing partners. "When I was a girl I went to an all girl's school and we thought nothing of dancing with each other. At this party they had a lovely big band yet all the women sat around and only the couples danced." So right then I jumped up and grabbed her hands and we spontaneously started to dance. She was humming the Charleston and showed me a couple of moves. We danced together on the tile floor of the kitchen for a couple of beautiful minutes.
How great is that? From now on I will incorporate dancing with Doris into every home visit we have.

movie looks at aging through unique lense

Just returned for seeing the movie The Curious Case of Benjamin Button. What a life affirming movie. This movie radiates love and honors the elderly no matter how old they are!! This is key to the plot which is about a boy who is born old and as he grows he ages in reverse. Love is presnt throughout the movie, love between Benjamin and his adopted mother who runs an "old folks" home. Love between the elders living in the home and Benjamin, who grows up loving and losing those very residents. Caring is another huge part of the story. Being cared for, later taking careof and once more needing care. One funny line said is" We all begin and end in diapers". Please go see this movie and enjoy those you love at any age.

elderly coupled committed murder/suicide

I am so sad to read this story in today's UT. A 90 year old man shot and killed his 88 year old wife them killed himself. Apparantly he decided they had both reached the end of their "productive' lives. No note was found and no surviving family members were listed. So many questions come to mind. What was their health status? Did the wife have Alzheimer's disease? Perhaps their home was being forclosed. One thing for sure, He was feeling helpless and hopeless about their situation. What can our community do to reach out to aging people in dire straights? Please write and share your thoughts.
Kathy R

Age @ Home on Internetvoicesradio.com

Last night I had my 15 minutes of fame on internetvoicesradio.com I used a prepared script but quickly deviated in order to respond to Lillian Cauldwell, the moderator's questions. I love answering questions, something I do as a big part of my job, and Lillian asked questions in order to learn what a care manager is and also general questions about aging. Quickly, I own Age @ Home Elder Care Management a company that provides licensed experts and reliable resources to elders facing physical and cognitive challenges. One common question is does Medicare pay for care management? No Medicare does not pay for ongoing care management nor caregivers. Medicare is reserved for acute short term health issues and hospitalization. Care management is a fee for service just like your attorney. Another common question is what is a durable power of attorney? DPOA is for healthcare and or finances and is a legal document that names a person to act on your behalf when you are incapacitated, usually a spouse or adult child. If anybody out there would like to ask other questions about this field please post a comment.

Happy New Year from Age @ Home Elder Care Management

Happy New Year. I have been under the weather this holiday season but feeling much better now. 2009 is poised to be a fantastic year. My work at the Center for Memory and Aging starts immediately ( my Medicare status is now good). I just started 2 new cases with my company Age @ Home Elder Care Management, and my dear hubby Gary surprised me with a getaway weekend to Cabo San Lucas as a Christmas present. All these good things have come to me by virtue of hardwork and being open to receiving from the universe. Tonight at 7:00pm I have a 15 minute time slot on http://internetvoicesradio.com I will be talking about Age @ Home Elder Care Management. My best to everyone out there in bloggerland.
Kathy R