Geriatric Care Manager—>Aging Life Care Professional

WHAT IS AN AGING LIFE CARE PROFESSIONAL?

An Aging Life Care Professional, also known as a geriatric care manager, is a health and human services specialist who acts as a guide and advocate for families who are caring for older relatives or disabled adults. The Aging Life Care Professional is educated and experienced in any of several fields related to aging life care / care management, including, but not limited to nursing, gerontology, social work, or psychology, with a specialized focus on issues related to aging and elder care.

The Aging Life Care Professional assists clients in attaining their maximum functional potential. The individual’s independence is encouraged, while safety and security concerns are also addressed. Aging Life Care Professionals are able to address a broad range of issues related to the well-being of their client. They also have extensive knowledge about the costs, quality, and availability of resources in their communities.

Aging Life Care Professionals become the “coach” and families or clients the “team captain,” giving families the time to focus on relationships rather than the stress. In Raleigh, Durham, and surrounding area, contact Raleigh Geriatric Care Management, an Aging Life Care member.


Leave a comment

Filed under adult children of aging parents, Adult day care, aging drivers, Aging In Place, aging life care association, aging life care professional, alcohol and seniors, Alzheimer's Disease, anxiety and the elderly, assessments, bathing and seniors, care giving, care planning, caregiver burnout, caregiving, caregiving and the holidays, dementia, Depression and the elderly, driving retirement, elder care raleigh nc, elder nutrition, eldercare, employee stress, family meetings, Geriatric Care Management, Having a conversation, humor, laughter in caregiving, Long Term Care Insurancee, long term care planning, medication reminders, moving in with family, NC, Nursing Homes, nursing homes and assisted living, paying for home care, Power of Attorney, Raleigh, respite, Sandwich Generation, senior care, senior driving, Seniors and driving, sibling relationships, support groups, travel with seniors

The Sandwich Generation

By Kathleen Bogolea, MS

Since the adoption of the National Family Caregiver Support Program in late 2000, there have been numerous news articles and points of interests written about the family caregiver and their many different roles within the family and the community. Roughly, it is estimated that American families provide 80 to 90 percent of all in-home long term care services for their aging family members, disabled adult children and other loved ones.  These services may include assistance with activities of daily living (ADL’s), medical services coordination, medical supervision, administration of medications and assistance with financial, legal, spiritual and emotional concerns.  These services are priceless and the family caregivers that provide them often go unrecognized and over utilized which can lead to great stress for the family caregiver.  In contrast, if these same services were to be provided by our national health care system, it would be estimated at approximately 250 billion dollars per year.

Recently, and of particular interest, there is a new buzz around a subset of caregivers known as the  “Sandwich Generation”.  These are caregivers who find themselves squeezed in between caring for younger loved ones such as children, and their elder parents or other elder family members.  While the Sandwich Generation is not a new form of family caregiving, these caregivers are receiving a long overdue peaking of interest within American society.

Currently, the typical American Sandwich Generation Caregiver is in her mid-forties, married, employed and cares for her family and an elderly parent, usually her mother. With this said, it is important to note that there are more and more men that find themselves in a caregiving role and even squeezed in between the generations.  It is also important to note that there is an ever-growing segment of family and sandwich generation caregivers that live in rural communities. Unlike caregivers living in urban and industrial areas, rural caregivers may find themselves removed from readily available and professionally organized supportive services and care networks.  They may also find themselves not only carrying the normal burdens that are associated with providing care for a loved one, but also they may be faced with challenges such as geographic barriers to resources and isolation from other caregivers, family members or informal supports.  This lack of service availability, care networks, and isolation from other caregivers and family members can add to caregiver stress, burnout, and depression. 

The demanding role of being a caregiver spreads across all racial, gender, age and ethnic boundaries.  Some of the common stressors that affect both urban and rural sandwich generation caregivers are:

  • How do I split my time between my children/family and my elder loved one?

  • How much of my time is too much time in each caregiving role?

  • How do you find the time for my marriage?

  • How do you find the time for myself?

  • How do I keep the generational peace between my kids and my elder loved one?

  • How do I find the resources that I need for my self and my loved one?

  • How do I combat my feelings of isolation?

  • Guilt, Guilt and more Guilt for not having enough time to accomplish all that “should” be doing. 

To counter act some of these stressors, here are some caregiver tips that may help sandwich generation caregivers along the way:

Hold A Family Meeting
At this meeting, discuss the many different caregiving tasks that need to be accomplished each day or week.  Set a task list for family members to complete each day/week.  Set mutual expectations of how the many tasks of caregiving will be accomplished.  Caregiving is often a one-person show but it does not need to be if you have family support.  The family meeting also allows for family members to participate and share in the valuable gift of caregiving and this can be very rewarding.

Communication
Encourage children and elders to communicate with one another.  During the family meeting, make sure that all family members have a chance to talk about their thoughts and feelings.

Ask For Assistance
Make a point of picking up the telephone and spending time calling resources such as your local Area Agency on Aging, a hospital social worker, a physician or church. The Internet can also be a wonder resource finding tool.  Never be afraid to ask for assistance when you need to, you may be surprised at who has been waiting to help you.

Take Time To Care For Yourself
Too often I meet caregivers who are run down and even sick because they have not taken time to care for themselves.  Sure, no one can take care of your loved ones as well as you do but you must care for yourself if you want to continue to care for your loved one.  This is not an act of selfishness, it is actually an act of great giving.

Take time every day to “check-in” with yourself, even if it is only 10 minutes.  This should be your protected time.  Enjoy this time by reading, listening to music, exercising or whatever you like to do.

  • Remember to laugh at the funny things in life.

  • Take time to be “in” your marriage.

  • Listen to your body. If your body is telling you to slow down, or that something is not right, seek medical advice.  Too often we do not listen to our bodies no matter how loudly they may be talking to us.

Every caregiver and caregiving situation is unique but there are always common factors which bridge these situations and caregivers together.  It is easy to become lost in the caregiving that you are providing but remember that support can come from many different sources and in many different ways.  For those of you who are squeezed in the sandwich generation please know that you are not alone and that assistance is often only a telephone call or internet site away. 

Raleigh Geriatric Care Management, Aging Life Care Association Member. 

Leave a comment

Filed under adult children of aging parents, aging life care association, Alzheimer's Disease, elder care raleigh nc, eldercare, family meetings, Geriatric Care Management, Having a conversation, Sandwich Generation, senior care

Are You the Middle of a Triple Decker Sandwich?

Kathy Birkett, Senior Care Corner

Many baby boomers have grown to think of themselves as part of what has been termed the “sandwich generation”, caring for their aging parents or grandparents and their children at the same time. Calling that simply a sandwich overlooks a very important part of the equation, unfortunately the same part many boomers overlook — yourself.

Sharing information about the Triple Decker Sandwich Generation is an attempt to get boomer caregivers to realize the portion of the sandwich in the middle needs care as well. So often we find family caregivers putting their own needs on hold to address the sometime overwhelming needs of their children and senior loved ones.

No one in the multiple layers of the sandwich benefit when a caregiver ignores her or his own needs to focus totally on the needs of others. For some reason, though, we have been taught to feel like we’re being selfish when we think of ourselves. Just the opposite is true however.  When we take time to take care of ourselves, we put ourselves in a better position to give our best to others.

What happens when you shove your needs aside for too long? There are many reports of stress related disease and depression among boomer caregivers. Certainly being the middle “deck” of the sandwich can contribute to that. Focusing on the health care needs of others but ignoring your own can have serious consequences, especially for those entering a time in their lives where medical visits should be growing more – rather than less – frequent.

Being a Caregiver to Yourself

Taking care of that middle deck of the sandwich doesn’t mean simply looking after yourself, but those aspects of your life that are also necessary to your well being.

  • caring for a relationship with a spouse, partner or friends who help complete your life
  • putting appropriate focus on the job that provides the income needed to support the other aspects of your life (and hopefully some fulfillment)
  • hobbies, sports or other activities that let you get away from the rest of your life for a while
  • anything other aspect of your life that is important to you and allows you to decompress

The first step in caring for the middle deck of your family sandwich is to recognize that you and your needs are important and need to be met. Take some time for yourself and think about those needs putting plans in place to address them, just as you do to meet the needs of your children and senior loved ones for whom you care.

How do you care for yourself and your needs when it already feels like there are too few hours in each day? Can you substitute technology for some of the effort you put in already? There are a growing numbers of devices and programs that bright people have developed to meet the needs of people like you. There might just be an app for that!

In order to fully care for yourself to care for your family, you have to give yourself permission to put yourself in the sandwich instead of on the side of the plate. Some days will be harder than others to find time for your needs, but don’t give up. You will feel stronger when you have met your needs and be more able to be a loving and competent caregiver to the rest of the sandwich layers in your life.

Leave a comment

Filed under adult children of aging parents, Adult day care, aging drivers, Aging In Place, alcohol and seniors, Alzheimer's Disease, anxiety and the elderly, assessments, care giving, care planning, caregiver burnout, caregiving, dementia, Depression and the elderly, elder care raleigh nc, employee stress, family meetings, Geriatric Care Management, Having a conversation, long term care planning, moving in with family, NC, paying for home care, Raleigh, respite, Sandwich Generation, senior care, sibling relationships, support groups

Caregiver Burnout

By Dr. M. Ross Seligson

Being able to cope with the strains and stresses of being a Caregiver is part of the art of Caregiving In order to remain healthy so that we can continue to be Caregivers, we must be able to see our own limitations and learn to care for ourselves as well as others.

It is important for all of us to make the effort to recognize the signs of burnout, In order to do this we must be honest and willing to hear feedback from those around us. This is especially important for those caring for family or friends. Too often Caregivers who are not closely associated with the healthcare profession get overlooked and lost in the commotion of medical emergencies and procedures. Otherwise close friends begin to grow distant, and eventually the Caregiver is alone without a support structure. We must allow those who do care for us, who are interested enough to say something, to tell us about our behavior, a noticed decrease in energy or mood changes.

Burnout isn’t like a cold. You don’t always notice it when you are in its clutches. Very much like Post Traumatic Stress Syndrome, the symptoms of burnout can begin surfacing months after a traumatic episode. The following are symptoms we might notice in ourselves, or others might say they see in us. Think about what is being said, and consider the possibility of burnout.

  • Feelings of depression.
  • A sense of ongoing and constant fatigue.
  • Decreasing interest in work.
  • Decrease in work production.
  • Withdrawal from social contacts.
  • Increase in use of stimulants and alcohol.
  • Increasing fear of death.
  • Change in eating patterns.
  • Feelings of helplessness.

Strategies to ward off or cope with burnout are important. To counteract burnout, the following specific strategies are recommended

  • Participate in a support network.
  • Consult with professionals to explore burnout issues.
  • Attend a support group to receive feedback and coping strategies.
  • Vary the focus of caregiving responsibilities if possible (rotate responsibilities with family members).
  • Exercise daily and maintain a healthy diet.
  • Establish “quiet time” for meditation.
  • Get a weekly massage
  • Stay involved in hobbies.

By acknowledging the reality that being a Caregiver is filled with stress and anxiety, and understanding the potential for burnout, Caregivers can be forewarned and guard against this debilitating condition. As much as it is said, it can still not be said too often, the best way to be an effective Caregiver is to take care of yourself.

Leave a comment

Filed under adult children of aging parents, Adult day care, aging drivers, Aging In Place, alcohol and seniors, Alzheimer's Disease, anxiety and the elderly, assessments, bathing and seniors, care giving, care planning, caregiver burnout, caregiving, caregiving and the holidays, dementia, Depression and the elderly, elder care raleigh nc, employee stress, family meetings, Geriatric Care Management, Having a conversation, laughter in caregiving, long term care planning, moving in with family, NC, Raleigh, respite, Sandwich Generation, senior care, sibling relationships, support groups

Coping with Depression: Signs You Might be in Trouble

When caregivers take on the responsibility of caring for a loved one, we expect our lives to change. What is unexpected, and often goes unnoticed, is the forfeiting of our own well-being in order to become a primary caregiver.

Ask yourself the following questions. If you answer, “Yes,” to any of them, you need assistance. Support groups, your loved one’s social worker, your physician, counseling or therapeutic centers and a number of other community resources can help you in providing greater balance between your caregiving responsibilities and your well-being.

  • Have you stopped communicating with friends you had before you became a caregiver?

  • Do you lack time to participate in activities that make you feel good?

  • Is your caregiving role negatively affecting your personal relationships?

  • Have you failed to have a check-up lately or find you do not follow the doctor’s recommendation for you own health?

  • Does your loved one need, but not have, a monitoring device?

  • Has your loved one become abusive towards you?

  • Have you noticed you are becoming verbally, physically or emotionally abusive to your loved one?

  • Are you drinking or taking drugs to cope with stress or distress?

  • Has your sleeping pattern changed since becoming a caregiver?

  • Do you feel you are not getting enough sleep?

  • Do you refuse to let others assist you, or give your respite, for fear something will happen if you leave you loved one in another’s care?

caregiver.com

Leave a comment

Filed under Uncategorized

Depression in the Elderly

By Estee Bienstock, R.N.

Depression affects more than 20 percent of our elderly population, aged 65 and older (U.S. Department of Health and Human Services, 2009). For many, depression presents initially late in life. Depression in older persons is closely associated with illness or injury and can cause great suffering for the individual and the family.

Feeling down from time to time, due to life struggles, is normal. Depression, on the other hand, is a REAL medical condition in which a person has feelings of sadness, loss of motivation, and lack of self-confidence. The feelings of hopelessness and helplessness prevent one from enjoying everyday life and affects overall daily functioning. There is a loss of interest, even in one’s family, friends, work or social activities. Depression is often described as “living in a black hole.” Getting through the day can be overwhelming.

There are many reasons why our treasured elderly family members experience depression. These include:

  • Loss of a close family member (spouse) or friend
  • Chronic pain or illness
  • Difficulty with mobilization
  • Frustration with memory loss
  • Difficulty adapting to life changes (i.e., moving residence)
  • Reaction to an illness
  • Side effects of medication

Depression varies from person to person and the symptoms are varied. Women have a greater risk of depression than men. Women tend to have feelings of guilt. Deprivation of sleep is frequently a problem. Women tend to either lose weight or gain weight. When men suffer from depression, they often see it as a sign of weakness. They tend to be more aggressive, angry, violent and reckless. Men have a higher suicide rate. (U.S. Department of Health and Human Services, 2009)

Other symptoms people may have when suffering from depression include:

  • Loss of interest in activities of daily living such as social interactions, work, family gatherings
  • Pessimism
  • Disturbed sleep patterns
  • Irritability, agitation, and restlessness; loss of energy, feelings of fatigue
  • Self loathing, feelings of worthlessness; frequent crying
  • Decreased concentration, difficulty focusing, unable to make decisions,
    memory loss
  • Headaches, gastrointestinal disturbances, muscle aches, and weakness
  • Abnormal thoughts about death

Depression can be difficult to identify in the elderly and is often untreated because many people think that depression symptoms are a normal part of aging or a natural reaction to chronic illness, loss, or dramatic changes in social transition. Contrary to popular belief, depression is not part of the normal aging process. Many elderly people and their families do not recognize the symptoms of depression, are not aware that it is a medical illness, and are not familiar with treatments. It is natural to feel grief in the face of major life changes, such as leaving a home of many years or losing a loved one. Sadness and anguish, natural responses to major life changes, are normal, temporary reactions to the inevitable losses and hardships of life. However, depression is a medical disorder that continues for prolonged periods. Depression requires professional treatment to reduce the intensity and duration of the condition.

Deteriorating health, a sense of isolation and hopelessness, and difficulty adjusting to new life circumstances often combine to create untenable living situations for the elderly. Suicide in our elderly population far exceeds the general population as a whole.

Fortunately, the treatment prognosis for depression is good. Once diagnosed, 80 percent of clinically depressed individuals can be effectively treated. Medication is effective for a majority of people with depression and the elderly respond the same way. (Adams et al, 2007) Medications can be combined with supportive psychotherapy or cognitive behavioral therapy to improve effectiveness. Psychosocial treatment plays an essential role in the care of older patients who lack social support or lack coping skills to deal with their life situations.

Suggestions for activities for skill building with the elderly patient with depression include:

  • Utilize music as a distraction from worries and an assist for relaxation; try it as a sleep aid before bedtime
  • Organize interactions with pets as a relief from loneliness; ask friends or neighbors to visit with their pets regularly
  • As a focus for new growth, assist the patient with nurturing a seedling
  • Select readings as a stimulant for conversations about feelings
  • Encourage reminiscence and sharing of recollections for posterity to increase feelings of self-worth

Caregiver skills that are important to nurturing our elderly patients with depression include:

  • LISTEN
  • Be patient
  • Acknowledge the sadness
  • Resist giving advice, but hone your listening skills
  • Do not pass judgment
  • Promote realistic expectations

Deteriorating health and advancing age present problems for the patient and their loved ones. Issues associated with depression can lead to family conflicts, even more isolation, financial strain, abuse of drugs or alcohol, and thoughts of suicide. Depression, left untreated, prevents elderly loved ones from enjoying life as they have in the past.

A strong support system is often helpful to both the caregiver and the senior person’s well being. Find sources of help for caregiver tasks. Contact family, friends, neighbors, church/synagogue, workplace, Area Agency on Aging or other organizations. Keep looking!

Family physicians can have a significant impact on the health and well-being of the elderly and their caregivers. Family physicians can educate caregivers on behavioral management techniques and coping strategies. By providing the holistic approach to care for patients and caregivers, family physicians can help prepare families for the many phases of this challenging role and allow the patients to feel safe with their dignity left intact.

Raleigh Geriatric Care Management, www.rgcmgmt.com

Leave a comment

Filed under Uncategorized

Is it Elder Abuse?

By Hilary Wright

Abuse isn’t happening just to toddlers and young children, but is becoming more common among the senior citizens in this country. Unable to take care of themselves, they must rely on a professional or family caregiver to help them from day to day. If you have a loved one who must depend on care from someone other than yourself, you may want to know the tell-tale signs of the many forms of abuse that they may be afflicted with. 

Sometimes, an elder may report an incident of physical abuse; however, they often won’t, so you’ll need to look for other behavioral and emotional signs, like depression or withdrawal from family and friends, changes in behavior, i.e., mood swings or appearing frightened and teary eyed. Sometimes, the abusers themselves will give clues to possible abuse by their refusal to take the elder to the doctor when needed, by not allowing family and friends to see the abused person alone, by giving explanations which are found to be inconsistent with the abuse symptoms.  They may have bite marks and scratches themselves, from an elder fighting back.

Signs of physical abuse:

  • Cuts, lacerations, welt marks (a possible sign of using restraints)

  • Burn marks from cigarettes

  • Malnutrition or dehydration

  • Hair loss from someone grabbing/pulling hair

  • Sores on the body, open wounds

  • Weight gain or weight loss

  • Poor skin conditions

  • Unexplained injuries, such as fractures and breaks

  • Bruises, scratches, bite marks, finger prints

  • Frequent trips to the emergency room

  • Black eyes, broken fingernails

  • Over or under medicated

As much as people don’t want to think about it, sexual abuse does occur among the elderly. It’s considered sexual abuse when something happens either without their consent or when an elderly person is incapable of making such a decision on their own. Physical signs of sexual abuse may include:

  • Bruises around the breast or genital area

  • Cuts or lacerations around the breast or genital area

  • Clothes with blood stains or tear marks

  • Soreness around breast, genital, or anal areas

  • Difficulty with walking or sitting

Some older people may report sexual assault, while others may withdraw from family and friends, flinch at certain quick movements, or be frightened by the opposite gender. The abuser will usually have a story that will not match the physical or emotional evidence noted by family members, and they will generally not allow family or friends into the home or to be around the abused person alone.

Not all abuse can be seen with the naked eye. There’s also emotional and psychological abuse that occurs when a person is demeaning and dehumanizing to another person. Psychological and emotional abuse can also make someone withdraw into depression or even deny that anything bad is actually taking place. You may catch the abuser talking down to the person, calling them hurtful names, and begin to withdraw the elder from visiting with family and friends.

Behavioral signs of psychological abuse:

  • Continuously emotionally upset or disturbed

  • Nervous behavior and a repetition to their actions

  • Negative attitude

  • Agitation or anger

  • Rocking back and forth, sucking their thumb, or even biting (themselves or others)

Financial abuse occurs when a caregiver takes advantage of an elderly person financially, either through stealing money, lying about how much the elder needs for certain care, or cashing the elder’s checks without permission.

Signs of financial abuse:

  • Caregiver withholds money from the elder

  • Checks are cashed without permission of the elder

  • Personal belongings begin to disappear

  • Power of Attorney begins to be misused

  • Caregiver isn’t actually providing the services that are needed

  • Elders aren’t taken to the doctor when needed

  • You notice unusual items being charged on a credit card

  • You notice the elderly person requesting a transfer of assets or funds

  • There’s sudden and abrupt changes in a will

  • They are not aware of where all their money has gone

  • Suddenly, they are unable to pay their bills

  • They are unable to buy clothes, food, and other necessities

  • You notice withdrawals of a lot of money at the same time or within the same week

Another form of abuse is neglect and abandonment, occurring when an elderly person isn’t being cared for properly, like not being fed, bathed, or properly medicated.  Ignoring an elder is also considered a form of neglect and abandonment, because the caregiver refuses to give them any sort of care. The signs of neglect and abandonment can sometimes be noticed with a simple inspection of a loved one, where you may see things like untreated sores or bed sores, malnutrition and/or dehydration, unsanitary living conditions, or dirty bed linens and clothes. You may also notice a strong odor coming from a loved one, due to the lack of continual hygiene, or obvious weight loss or weight gain. Sometimes an elder will actually begin begging you for food, or tell you they have some medical or dental need that hasn’t been tended to.

Although it’s no excuse, caregiver abuse, either by a family member or by a professional, often occurs due to caregiver burnout, caregiver stress, substance abuse, emotional and mental issues of their own, economic conditions or living arrangements. This doesn’t mean that all caregivers are abusers, because very few are; but it’s better to be informed and educated for the safety of your loved one. If it’s a family member who is a caregiver for someone disabled or elderly, you can take some preventative measures in order to prevent it from occurring, or to at least notice it at the very earliest stages. Educate yourself on the signs and symptoms of caregiver stress; make sure the caregiver is receiving help from others, so they don’t have to do everything on their own, which can quickly lead to caregiver burnout; and investigate other living arrangements, in order to take an elderly loved one out of a toxic, ultimately unsafe environment. Elderly people don’t have to be a target for others, especially by those who are supposed to care for them. Older people can also take some important steps on their own in order to make sure they remain safe from abuse of all kinds:

  • Don’t live with a family member who is or has been abusive in the past.

  • Speak to friends often, especially when you feel as though you are being taken advantage of.

  • Review your will. If changes are made, be sure it is because you want them to take place, not because of pressure from family members.

  • Have friends and/or neighbors visit you often.

  • Seek legal advice when making decisions.

  • Have your Social Security or pension check deposited directly into your account.

  • Speak directly to your attorney first before signing a Power of Attorney.

  • Don’t sign anything until you’ve read it. If you have difficulty understanding the legal terms, make sure to seek out an attorney and have them explain it to you.

Leave a comment

Filed under Uncategorized