CONTRIBUTED BY: GRETCHEN NAPIER - LIFELINKS CEO
We complete the solution.
This article completes a series of articles titled "Why can't caregiving be simple?" To read the entire series, click here.
Below we will walk you through the examples you read about within the series and how an Aging Life Care™ Team with years of experience, knowledge and expertise in care management and advocacy can help others in the same situations that the families in the examples faced.
The Aging Experience for Families
The aging experience for most families begins gradually and the family begins to notice little changes, little concerns along the way. Usually the aging adult is insistent that it's no big deal and they are just having a temporary problem. Usually, adult children are busy with their own lives and don’t want to upset mom or dad, so things perk along until an event occurs, causing more concern or even bringing the family to a crisis moment during an emergency. It could be a car accident, or a fall, or a medical event like a stroke or heart attack. Generally speaking, the family may have been considering new options, but this is the tipping point when action needs to be taken. Ideally, a comprehensive look at the full picture is the best approach (considering both aging parents if a married couple is involved, finances, religious or cultural preferences, long term expectations, pets, dietary needs and preferences, realities of diagnoses, safety of current home, medications, etc.). But this is overwhelming. And most families assume whatever has caused this crisis is the primary problem to be addressed. They are wrong. This approach sets the family up to fight one crisis after another. Kind of like plugging a hole in a dam with your finger.
No human lives in a vacuum, and elderly adults systems are more acutely intertwined than at any other time in life. If a 40 year old doesn’t eat healthy, they will gain weight over time, but on a day to day basis, they continue functioning at the same capacity. Something as simple as dehydration in an aging adult can upset eletrolytes cause mental confusion and extreme lethargy within days. A urinary tract infection in a middle-aged adult is simply uncomfortable, but the psychotic side effects it can have in an elderly person can be frightening. So a comprehensive look at all systems, is the best way to get ahead of future crises and get the whole family moving in the same direction toward agreed upon goals.
LifeLinks completes the Assisted Living Solution
The very best independent and assisted living communities, do an excellent job and providing services within their building in a congregate setting. Meals in the dining room with a variety of choices, medications at a scheduled time that accommodates timing needs of 40+ other residents, activities popular with enough residents for a reasonable turn out, scheduled transportation (i.e.grocery on Tuesdays, doctors on Wednesdays, Wal-Mart on Thursdays, etc.) are all done well in the best communities. Between a private apartment, meals and activities, a great balance is provided between privacy and socialization. But if your loved one needs help advocating for herself at a doctor’s appointment or remembering what was said there, the assisted living facility can’t help. Or if your loved one has behaviors that aren’t conducive to groups (messy eating, toileting challenges, inappropriate outbursts) then they are likely to be isolated in that private apartment.
In the first part of our series, Why Just Moving to Assisted Living Doesn’t Always Work, Jim needed a community with an “onsite” nurse, not an “available” nurse. A LifeLinks Aging Life Care Professional™ could have helped the family identify that need, as well as the communities who provide it. Instead his family came to us after he had already moved back home and we joined their team to coordinate the right balance of services so he could remain at home until the end of his life.
Margaret just adored the salesperson, and her promises, at the community she chose for her husband, but had no way to evaluate the true quality of care provided there. Additionally, she lacked confidence to follow her own instincts when things didn’t seem right. Our Aging Life Care Professionals™ spend many hours each week working with the staff at retirement communities and long term care facilities all over town. We know who is really good with residents in early stages of dementia and who is better in later stages. We know who provides the best nursing care for medically frail residents and who is better at providing interesting programming for more active and cognitively engaged residents. So we would have helped Margaret look behind the curtain and choose the best community for her husband. Instead, she came to us after the move when the community didn’t seem to be meeting his needs. As part of the care team, we worked with her and the community to provide training to their staff about the specific needs of Margaret’s husband and we supported her efforts to take care of herself and set appropriate boundaries with the facility. We helped her check in on him to ensure quality care continued to be provided and worked with the community team anytime things got off track. They were thankful for more ideas and for someone else to provide the one-on-one, problem solving attention to this family. Everyone benefited when Margaret’s husband was able to remain living at this community for a many years, getting all of his needs met.
Elizabeth was the out-of-town daughter who struggled to know what was happening medically with her mom, since her mom couldn’t remember what happened at the doctor’s appointments and couldn’t remember to tell the doctor important things. Eventually, Elizabeth was scheduling her visits so she could attend the appointments. After engaging LifeLinks, one of our Aging Life Care Professionals™ attended every appointment to ensure the right issues were brought to the doctor’s attention and Elizabeth promptly received a written report after every appointment that was so detailed, she “felt like I was there!” When Elizabeth’s mom stopped attending activities at the community, we helper her hire a companion to take her mom on outings at Cheekwood, walking around the mall and getting treats like her favorite, Christie Cookie.
LifeLinks completes the Caregiver at Home Solution
The downside to low unemployment numbers, is that it makes it really hard to find good people to do difficult, low paying jobs. Like caregiving. When jobs were really hard to come by, it was easier to find hardworking people willing to do a great, caring job. Now that people can always find a job at a restaurant or driving for Uber or Lyft, there are fewer good people available for the often physically and demanding job of caregiving. What is left are often people with no caregiving or life experience, people who can’t get or stay employed at higher paying and/or less difficult jobs, people who want to prey on the vulnerability of aging adults.
In the series, our blog titled; Why just hiring one good caregiver doesn’t always work, Michelle needed reliable and competent caregivers to take care of her husband with Parkinson’s Disease while she took a much needed, and well deserved vacation. Unfortunately, that is hard to find. With the increased support from their LifeLinks’ Aging Life Care Professional™, we could have called the caregiver an hour before his shift was supposed to start to be sure he was awake and planning to show up. We could have called 30 minutes before the shift, to be sure he was on his way. And then we could have confirmed at medication time that the caregiver was present and medications had been given. At any step along the way if the caregiver wasn’t available or it seemed like he wouldn’t show up on time or at all, we could have gotten another caregiver on the way from the agency, rather than starting that process when it was already past time for the shift to start and the medication to be given. Unfortunately, Michelle did not hire LifeLinks and resigned herself to staying home and providing all of her husband’s care herself.
Dan had two incomplete problems with the caregiver solution. When new caregivers showed up, he had to retrain them to the specifics of his mom and their household. A LifeLinks’ Aging Life Care Professional™ could have worked with the caregiving agency to notify us whenever a new caregiver was assigned, so that we could meet them at the client’s home to review all the details. Dan’s other problem was a manipulative caregiver, trying to work the system to her advantage. Because she’d been working the system for many years and this was Dan’s first experience with it, he mistook her earnestness for trustworthiness and it cost him money and time while he sought out the longer term solution. Once LifeLinks’ got involved, we helped him find a reputable agency and partnered with Dan and the agency to hold caregivers accountable.
Scott is a busy attorney and dedicated son, but there are not enough hours in his day to handle all the problems that seem to continually arise with the caregivers for his mom. The LifeLinks’ Aging Life Care Professional™ has been a real sanity saver, by taking over all of those details. Anytime there is a change to the care plan, the Aging Life Care Professional™ personally meets with and talks to every caregiver on the team to be sure they understand how to implement it and answer any of their questions. If a specific technique is needed, she involves the LifeLinks’ nurse or physical therapist for training. In emergency situations when the caregiver unexpectedly doesn’t show up, the LifeLinks’ Aging Life Care Professional™ even stays with his mom until someone arrives. Now Scott can focus on his work, knowing his mom is taken care of, and when he visits with her, they reminisce and look through old picture albums, instead of him running around “putting out fires.”
LifeLinks completes the Medication/Doctor Solution
Primary care physicians are excellent generalists. When you have a heart problem, though, you need to see a cardiologist. Everyone pretty much agrees on this, and most doctors easily make that referral. When it comes to managing dementia, Parkinson’s Disease, and difficult to manage behaviors, a specialist such as a geriatric psychiatrist or movement disorders neurologist may be a better fit. But due to the stigma related to mental health many doctors are reluctant to make these referrals or unaware they exist and families can also be afraid to see this kind of specialist. LifeLinks’ Aging Life Care Professionals™ work with many of these specialists and can help your family understand when and why their expertise is warranted. These specialists excel at the tricky process of identifying the right medication.
During the process and even once the most effective medication is determined, there are many more factors influencing the mood, pain level and behavior of your aging loved one. Our LifeLinks’ Aging Life Care Professionals™ evaluate the full support system, make recommendations and help you implement the right level of stimulation, information about creating the right environment and training for the best way to approach care with your loved one.
Creating a system of care for your aging loved one is like putting together a jigsaw puzzle.
Each of the pieces provide little meaning on their own, but together make the whole picture. Someone who has worked the puzzle hundreds of times is always going to do it faster than a first timer. An Aging Life Care Professional™, like those on the team at LifeLinks, can help you organize all the pieces of your puzzle into a clearer picture.
*Fictitious names are used to protect the privacy of our clients
This blog post is an introduction to a series titled: WHY CAN"T CAREGIVING BE SIMPLE? To read the series from the beginning, start here.
ABOUT THE AUTHOR
GRETCHEN NAPIER - CEO