Caring For Aging Parents

Following is some information put together by MetLife Consumer Education Center and reviewed by the National Council on Aging. It's their Life Advice® Program guide about Caring for an Aging Loved One*

*"Loved one" can describe many specific individuals in your life. For simplistic reasons, this guide uses the term broadly, and also uses forms of the pronoun "he."

Caring For Aging Parents Is Universal

When you think of family, your loved ones come to mind — a spouse, children, parents, grandparents, perhaps an aunt or uncle, or even someone special whom you consider "family." And, if you're lucky, these people are with you today, sharing in and contributing to fulfilling family life.

According to statistics, there's a good chance you will be enjoying their company for many years to come. Thanks to healthier lifestyles, advances in medicine and improved living conditions, the average life expectancy of a man today is 72, and it's 79 for a woman.

But with individuals living longer, the role of many adults has changed. Even if your aging parents are self-sufficient today, there is no guarantee their independent lifestyle and good physical health will continue. Eventually you may have the responsibility of arranging for their care. No one likes to think about the consequences of growing old, so this isn't an easy subject to bring up. But if you prepare and make plans now, you can lessen the stress and guilt during a crisis situation.

Calculate the Future

For starters, take a good look at your aging parent's financial picture. Explain that, not only do you want them to be comfortable in their retirement years, but you also want to arrange for their assets to be transferred according to their wishes upon their death. Talk with your aging parents about their intentions, and include other family members in these discussions. Be direct and honest. Tell them your concerns, listen to theirs. That way if the time ever comes when your loved one cannot participate in the decision making, you'll know you are not acting alone, but carrying out their wishes.

Following are just a few questions that may help you in this process:

Does your aging parent have a will that has been reviewed within the past three years?
Yes ___ or No ___

Do you know where to find all your parent's financial and legal papers and advisors?
Yes ___ or No ___

Do you know the approximate annual cost of maintaining your parent's current lifestyle in retirement, and do you know if they have sufficient financial resources to do so?
Yes ___ or No ___

If you are concerned about the mental or physical health of your aging parents, have you considered the use of a durable power of attorney?
Yes ___ or No ___

Living Arrangements and Care Options

When discussing who will provide continuous daily care for your aging parents, you can choose from these general categories:

Independent living.
Your parents stay in their own home or rent an apartment and provide for themselves. You oversee the situation and offer assistance and guidance when necessary.

Assisted-living community.
Your aging parents live independently in a facility that provides some additional support, such as light housekeeping or daily meals. The facility may or may not have a nursing care option available for residents who become ill.

Adult day services.
A community-based group program helps meet the needs of your aging parents through an individualized plan of care. Such programs provide a structured comprehensive program in a protective setting for a part of each day, for example, while you're at work.

Home care.
You become responsible for seeing that your aging parent's needs are met around the clock. You can move in with them or move your parents into your home, and, if necessary, either hire home health care professionals or become the sole caregiver yourself.

An intermediate care or skilled care facility, such as a nursing home.
These facilities are designed for people who need continuous, professional care at some level. Ask doctors, hospital discharge planners, social workers and friends for suggestions. You can also obtain a catalog of nursing homes from your state department of health or state agency on aging.

Discuss with your parents what might happen if you can't maintain the level of care needed for them at home. Often people dread the idea of nursing homes and hospitals, but they may become necessary. On the other hand, these options may be out of financial reach so all other options must be exhausted first. Remind your parents that the final decisions will depend largely on their health and finances at the time. Explain that you will try to carry out their preferences, but don't make promises you may not be able to keep.

Is Home Care the Answer?

If you think that home care maybe the best alternative for your aging parents, consider the following factors:

Physical and mental health.
Even if your parents are in good health now, chronic and accelerating illnesses often accompany advancing age, and their state of health may change quickly. Such changes may dictate the type and level of care needed. Can your parents manage routine chores and necessary tasks such as personal grooming, cooking, shopping, house and yard work and managing their finances? The more they can do for themselves, the greater their choices will be.

Financial Resources.
How much care will your parents be able to pay for? How complex will that care be? Will they need custodial or skilled care? Are you prepared to subsidize the expenses? You may think your aging parents have adequate financial reserves now, but those funds could be depleted if they live another 15 years or more or if they come down with a serious illness. Long-term care is expensive, whether you deliver the care or place your parents in a nursing home. Depending on where you live, home care can cost up to $35,000 a year and nursing home care can cost more than $55,000 a year.

Your own family arrangement.
If you are married, your partner's feelings about the possibility of your becoming the care provider should be considered. And don't forget your children, especially if they still live at home. If there are disagreements, counseling might be a nonthreatening way to let all family members speak their minds.

Family support.
The family unit is a major support system. Do you have family — or close friends — willing to share in the caregiving or to lend financial or moral support? If so, accept help if they offer — and don't be afraid to ask for assistance.

Community services.
If you plan to assume complete responsibility for your aging parents, be sure to check out community support services. Caretaker burnout can be avoided if you make good use of services from the beginning. To find out what's available, start with your local Area Agency on Aging or call the social services office at a local hospital.

Some possibilities:

1) Contact a local geriatric care manager with proper credentials.

2) Hire a housecleaning or yard service.

3) Find a transportation volunteer through your church or local senior service organizations to drive your parents to medical appointments or deliver groceries and prescriptions.

4) Use a meal service such as Meals on Wheels.

5) Enlist the services of a visiting nurse or a home health aide.

6) Inquire about senior center information and referral resources and adult day service facilities.

7) Contact the local chapters of associations, such as the Arthritis Foundation, the Alzheimer's Association, YMCA, American Red Cross and Veteran's Administration. They're often pipelines to the services available in your community.

8) Be good to yourself. Don't be a martyr — ask family and friends to help out. Consider joining a support group

Making the Transition

Change is difficult for everyone, especially for the elderly, who may feel they already have lost control over much of their lives. If a new living arrangement involves uprooting a loved one to another city or town, they will need a considerate and caring transition. It helps to include him in the decision. If you are caring for your parents long-distance, you may want to use the services of a geriatric care manager. For a fee, trained professionals provide a variety of services, such as helping to choose a health care facility, evaluating and monitoring care, and helping with activities of daily living.

Preparing Your Home

If you've decided care in your home is appropriate, you'll probably need to make some changes around the house. Changes can be as complex as adding another bathroom or converting a first-floor den into a bedroom or as simple as attaching a safety rail to the shower stall or having an amplified receiver installed on the telephone. Here are a few examples to get you started thinking:

1) Install a help alert system.

2) Remove clutter, sharp objects and throw rugs.

3) Install nonskid strips in showers and bathtubs.

4) Place a flashlight by the bed.

5) Install night-lights in halls and bathrooms.

6) Install railings next to all stairways and steps.

7) Set the hot water heater to a lower temperature.

8) Take a certified CPR course. In addition, you'll want to make your loved one feel welcome in your home by displaying his favorite possessions — particularly mementos and photographs — in plain sight

Read more from this article at Caring For Aging Parents at the Caremanage website

Amy Siegel, geriatric care manager and owner of Advocare, Inc. provides geriatric care management servicesin South Florida for those caring for aging parents, relatives or others. Her knowledge and skills are invaluable for anyone caring for seniors. For more information on the geriatric care management services of Advocare, Inc. visit their website at http://www.caremanage.com

Adult Children Caring For Aging Parents

Premier South Florida Geriatric Care Managers can help you care for your aging parent!

Your elderly aunt is widowed and lives alone. You’re the only family member she has to care for her. Her long-time health problems have become debilitating. You know she needs help but, because you live far away, you don’t know exactly what she needs or where to look for help. Someone suggests that you contact a geriatric care manager. What is a care manager and how can you find a good one?

A geriatric care manager (GCM) is a professional who specializes in helping older people and their families with long-term care arrangements. GCMs often have training in gerontology, social work, nursing or counseling. They also have extensive knowledge about the cost, quality and availability of services in an older person’s community. As a result, GCMs can help:

• Conduct care-planning assessments to identify problems and determine eligibility for assistance and the need for services;
• Screen, arrange and monitor in-home help or other services;
• Review financial, legal or medical issues and offer referrals to geriatric specialists to avoid future problems and conserve assets;
• Provide crisis intervention;
• Act as a liaison to families living away from the parent, making sure things are going well and alerting families to problems;
• Help move an older person to or from a retirement complex, care home or nursing home;
• Provide consumer education and advocacy; and,
• Offer counseling and support.

Choose a GCM carefully. The field of geriatric care management is relatively unregulated and many people without specialized training identify themselves as care managers, care coordinators or care advisors. Therefore, it’s wise to screen candidates to ensure that you’re working with a person qualified in this new profession.

• Ask about candidates’ training, education and background in care management and geriatrics. Ask how long they’ve been a GCM and whether they belong to the National Association of Professional Geriatric Care Managers or any other professional associations.
• A care manager’s ability to be responsive is important. Ask candidates what their average response time is to return calls from clients and their families. Have them describe their communication system: Do they use pagers, portable phones, an answering service or voice mail? Learn about their agency’s size, hours and staff composition. How are after-hours emergencies handled? What are the back-up systems for covering vacations and days off? Will you and your parent work with one GCM or several?
• Determine the scope of the GCM’s practice. Some GCMs or agencies specialize in assessments and care consultation but typically don’t follow people on an ongoing basis. An assessment is a thorough review of the client’s physical, medical and mental status, and financial resources. It serves as the basis for a comprehensive plan for the client. Other GCMs offer psychotherapy, money management, or home care. They also can act as conservators, appointed by a court to manage the financial and/or personal affairs of someone unable to manage his or her own affairs. It’s important that the GCM’s practice setting and specialties meet your needs and your parent’s.
• Investigate the GCM’s track record and reputation. Ask for letters of reference or names of previous clients you may contact. Is the GCM active in professional associations? Does the GCM perform volunteer work?

While there are no licensing requirements for GCMs, there are certification programs. Ask each candidate you interview if he or she is certified, and by whom.

Confusion about fees and billing can be a problem. Be sure you understand the GCM’s billing rates and how charges are calculated. Fees vary depending on the GCM’s work setting — private practice, public agency or private non-profit agency. Get a written service agreement that outlines the fee structure and practices.

Finally, ask GCM candidates if they subscribe to a code of ethics or are guided by professional standards of practice. Get a copy of the standards. They should deal with the right to privacy, fiduciary responsibilities, full disclosure, fostering self-determination, fees, continuing education and professional relationships. Ask how complaints are handled.

For More Information contact South Florida's premier Geriatric Care Management Team at Advocare. We provide senior care services for your loved ones in south Florida.

Nursing Home Tips from Advocare Geriatric Care Management

The Geriatric Care Management Team at Advocare work with you and your family to make any transitions for your elderly loved ones as smooth as possible. Following are some tips if you find yourself having to make the decision to choose a nursing home for a loved one.

Making the decision to put your loved one in a nursing home is hard enough, but with the current rash of stories detailing abuse of senior citizens it's almost impossible to feel safe and secure about the facility your loved one is in. But by following a few simple rules and keeping your eyes open you can reassure yourself that all will be well when you walk out that door at the end of your visit.

The first thing to do is examine the home's credentials, hopefully before anyone is admitted. Check for elevator safety certificates; fire alarm routines and various other safety-oriented goals before you even head for the nurses station. Emergency procedures should be posted clearly and easy to interpret for the reader along with various escape routes should one be blocked. Most if not all of these are required by law, so if they are not posted it's best to inquire where they are and why they aren't visible to the public.

Now that you're past the front doors, stop and take a deep breath. There should be NO odor of urine or unclean materials in the general corridors of any home. Dirty laundry should be separated from the patients quickly and efficiently, placed in the room specifically designated for that purpose. Patients should also be cleaned quickly if they have soiled themselves, and if you are smelling anything other than cleaner it's not a good sign. The scent should be clean and comfortable to yourself and your family; not an ammonia smell.

Look down at the floors and at the walls. Most homes have pictures on the walls of some sort in an attempt to make the atmosphere less threatening to their patients. If the walls are bare and the floor dirty, it's not a good sign and a breeding home for infection. The floors should be dry and clean, without pools of water anywhere other than perhaps where emergency repairs are needed - and then they should be clearly signaled and closed off from the general public and patients. Any dirt on the floors or walls should be viewed with suspicion, as it signals a problem with housekeeping.

View the nurses carefully in your first visit. If they are overworked and frantic, it's a good bet that they are understaffed and your loved one might have to wait for attention - hardly a good thing at the best of times, much less if your patient is in need of medication or physical assistance. The nursing station should be clean and tidy, with charts clearly labeled and stored appropriately; not lying about for others to see or to be misplaced. The general mood is important too - do these people like being here, or are they miserable to start with? It's a hard decision to make on a single visit, but it's a good bet that the mood of your nursing staff and the doctor on call will determine the attitude towards your loved one.

Observe the patients in the public areas. Are they clean and well-kept; hair tidy and clothing suitable? Are they left at a single table for hours with dried food on their fingers or are they cleaned up promptly and encouraged to participate in activities? It's hard to judge a home based on a few patients, especially if they also include Alzheimer sufferers in their group, but a good look at most of them will give you an idea of how much attention is paid to the average occupant.

There should be an activities board set up in a main area for the patients - check it out and see what is offered to keep their minds active. Most places offer bingo and other mental games as well as swimming and physical therapy for those patients who can participate. If there's no board, ask at the nurses station what is available for those patients who can still function normally. There's nothing worse than being forced to sit in front of the television set all day if you can still move about; or being at a loss for things to do if no one else will do them with you.

Finally, check in on how often the doctor visits and the rules regarding transportation to a local hospital if needed - along with emergency procedures and how they will react if your loved one is hurt. A regular visit from a doctor or a nurse practitioner will help make sure that adequate medical care is being given, as well as observation of any potential life-threatening disabilities.

Lastly, visit and visit often. Perform the same checks on every visit as well as monitoring your loved one's physical and mental condition. If there are any new injuries such as bedsores or bruises, inquire how it happened and how they are being treated. Most homes now document every scratch and bump to an individual to make sure that all the bases are covered in case of a lawsuit, so don't be afraid to ask how and what happened.

By staying alert and staying aware your loved one can make the transition to a nursing home with a minimum of mental or physical stress. For both of you.

If you are struggling to help an elderly loved one in the South Florida area, then you may need the assistance of a geriatric care manager. Advocare, Inc. provides South Florida Geriatric Care Managers to the area. Our clients are local and out of state family members who need help with their elderly loved one living in south Florida.

Contact us today at 954.349.3133 or email us, we can help!

Advocare Geriatric Care Management

I started Advocare Geriatric Care Management after working in medical facilities for over 20 years as an R.N. Advocare assists many families around the country in caring for their elder love ones who are down here in South Florida.

We assess an older person's living situation to ensure that their surroundings are safe, and my Registered Nurses accompany these elders to their medical appointments to ensure their complete understanding of physician’s orders. We keep in constant communication with family as we coordinate all their living and health needs. This includes the elder’s medical appointments and medical procedures, coordination and monitoring of in-home care, monitor their emotional and social well being, and if required coordinate and manage a move to assisted living or a nursing home. (only if they can no longer live safely at home.)

We do all of this in a warm, loving, caring way so that the family who might be out of town feels that their parents have the support that they need right here locally. Many adult children up North and out West tell me that our service is invaluable to their family because even if they could travel to Florida more often, they still would not know how to navigate the medical system and advocate for their parent.

This work is intensive and time consuming, but it is extremely rewarding and a community need! Please see my website @ www.caremanage.com. I would welcome the opportunity to speak with you at any point to discuss featuring Advocare, Inc in your next publication. My # is 954 349-3133 or cell 954 793-7272

South Florida Care Managers

South Florida Care Managers

The South Florida Geriatric Care Management Services of Advocare, Inc. provides south Florida care managers to the tri-county areas of Palm Beach County, Broward County and Miami-Dade County.

South Florida Care Managers provide elderly care services in the South Florida area. As part of our geriatric care management services, we accompany your loved one to doctors appointments – asking questions and getting answers to maximize the recovery, care, and long-term life benefits for your elderly family member. We take over the entire geriatric care management process – along with taking the stress and anxiety off your shoulders. And most importantly, we do this with love and compassion for your family.

Our comprehensive list of the elderly care services in south Florida that our professional South Florida Care Managers provide are:

1) Comprehensive assessment and development of a client-specific geriatric care management plan.

2) Coordination & personal accompaniment to physician and medical appointments. As RN's, our geriatric care management nurses are able to enter the exam room and confer with the doctor.

3) Support, advocacy, and liaison services between loved one, family, and all medical providers.

4) Evaluation, selection, and monitoring of all medical and in-home geriatric care services.

5) Organization & documentation of prescription medications, and instruction to client and caregivers on proper administration.

6) Communication with physicians to minimize potential drug interactions and negative side affects.

7) Crisis intervention & support.

8) Post-hospital discharge planning with home safety review & coordination of home modifications.

9) Planning / selection / coordination of alternative living options, such as assisted living or nursing homes.

10) Face to face visits with client in hospital, care facility, or at home, with ongoing phone & e-mail updates to family members.

11) Locating and interviewing caregivers in order to find the appropriate match for clients' specific needs. We assist in hiring and managing these caregivers.

12) Bilingual services available.

If you have any questions about the services our South Florida Care Managers can provide for yourself or your loved ones, please contact us today.

Phone: (954) 349-3133
e-mail: info@caremanage.com