How Can I Help When I Am So Far Away?
Emily Opal lived in the outskirts of Georgia. She was original from Northern California but, moved away thirty years prior to follow the humidity and southern hospitality. With her move, she left behind her mother, father, and younger brother. Emily did keep in touch with her family and visited at least once a year. On her last visit to California, Emily noticed a decline in her mother’s health. Her mother had recently been diagnosed with dementia and was not sleeping well at night. Her Dad had been the primary caregiver and it was clear he was worn out. Emily sat down with her father because she was worried about his health as well. He stated he was fine and not once complained of needing help with his wife. He felt that this was his duty as a husband to stay by his wife’s side and to never ask for help.
Emily was concerned about her father, so she decided to stay two weeks in her parents’ home to provide some help. During this time, she observed her father ignore calls from his friends, cancel his scheduled outings, and no longer was reading the morning newspaper. To Emily, it appeared her father was no longer participating in the activities he enjoyed. For example, he used to meet the “guys” for coffee every Thursday morning. He had dropped this routine and became frustrated when Emily asked why he wasn’t going. He also became angry at his wife and would have regular outbursts. Emily witnessed her mother leaving the water on and forgetting to close the front door after she let the cat in. Her father appeared to be on edge monitoring his wife throughout the day. Emily even noticed her mom didn’t shower at all while she was there. When she tried to encourage her mom in the shower, she refused. When she spoke with her father about the issue, he stated that his wife had stopped showering and he no longer was able to encourage her to bathe.
Nearing the end of her two week stay, Emily decided she needed to sit down with her Dad to discuss getting some help for mom so that he could have some time for himself. Her Dad cried and admitted he needed help. Living across the country, Emily often felt that she was helpless regarding her parents. Living so far away, she couldn’t stop by and bring dinner or take mom to the doctor. Her brother lived in California but had three kids and didn’t visit his parents very often, as he was extremely busy. After an emotional conversation, Emily’s dad agreed to some help. Now she had to figure out where to find an agency that was trustworthy and experienced, as well as able to communicate with her living out of state.
Emily returned home; however, her quest to find help for her parents had not ceased. After work one night she began searching the internet for assistance. Unfortunately, Emily had been out of California so long, she no longer had the contacts she had in the past. Her first hit on assistance for older adults was the Aging Life Care Association. This association is a team of professionals focused on “aging well.” “Aging Life Care™, also known as geriatric care management, is a holistic, client-centered approach to caring for older adults or others facing ongoing health challenges. Working with families, the expertise of Aging Life Care Professionals provides the answers at a time of uncertainty. Their guidance leads families to the actions and decisions that ensure quality care and an optimal life for those they love, thus reducing worry, stress and time off of work for family caregivers through:
- Assessment and monitoring
- Planning and problem-solving
- Education and advocacy
- Family caregiver coaching (ALCA, 2018)
Emily began to wonder, what is an Aging Life Care Manager and can just anyone call themselves a care manager? Emily soon found out that the term “care manager” is used frequently, and at times, by those who are not credentialed nor qualified. According to the Aging Life Care Association, “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 are members of the Aging Life Care Association™ (ALCA) and differ from Patient Advocates, Senior Advisors, Senior Navigators, and Elder Advocates. ALCA members must meet stringent education, experience, and certification requirements of the organization, and all members are required to adhere to a strict Code of Ethics and Standards of Practice” (ALCA, 2018).
Emily was thrilled to be able to locate a credentialed Care Manager in her parents area. She learned that an Aging Life Care Professional could assist her parents in many ways, to include:
- Initial home/hospital/facility visit with client, family, and staff.
- Plan of care based on psychosocial needs assessment, client’s needs/wishes, family input and care mgr. recommendations.
- Support, coordinate and advocate for clients as the client’s needs evolve and change.
- Arrange, accompany, and monitor medical visits.
- Monitor home/facility visits as required to assure client safety, satisfaction, and care.
- Written reports for physicians, POA, client attorney, family, and facility as requested.
- Verbal and/or electronic communication with physicians, client attorney, POA and family as needed.
- Arrange and facilitate client/family/staff meeting(s) as requested.
- Money management to include: pay client bills, balance checkbook, sort through mail with explanations to client and referrals to financial planner/attorney as indicated.
- Re-assessment of client needs, review and update care plan in place.
- Explain and make recommendations for community resources.
- Review LTC Insurance policies with client/family & assist in filing a claim for long-term care services.
After all her research, Emily contacted a local Care Management company to see how they could provide assistance to her parents. The Care Manager listened to her story and provided guidance and resources that were extremely beneficial. Emily was pretty amazed that she could do all of this across the United States. That night, she talked to her Dad on the phone and discussed options for assistance. Her father called the Care Manager the next day to set up an appointment. Emily was thrilled.
The Care Manager met with Emily’s parents and discussed both short and long term goals. Both desired to stay at home, so home care was discussed to give dad a break. Dad had some concerns about bringing someone into the home, so the care manager provided key tips on how to choose the best in-home care. These tips included the following questions:
Company: Ask: How long has the company been in business? Are they licensed and bonded? What experience does the owner have in this field? Are the caregivers employees of the company? If “No”, you assume the employer role. It’s critical to have someone who is honest, dependable, and trained to provide the care as well as an experienced, management team.
Services: Ask: What types of services does the agency offer? What can I expect the care providers to do? Is there regular training on site by expert trainers? Who supervises the employees on the job? Is there after hours support? Ask specifically whether there are credentialed Care Managers on staff to provide support and guidance to the provider employees.
Employee Staffing & Supervision: Ask: How can you be assured of good care and the person’s needs are met? What steps do they take to screen their employees? Who supervises the employees at the home? The company should have a professional, i.e., a credentialed care manager to make initial and monitoring visits to assure the care is appropriate.
Cost: Ask: Are fees clearly defined? Can I or my family member afford the costs? Will long term care insurance pay for home care? A professional company will clearly define the costs. Be concerned if the agency states no contract to sign. A signed agreement protects you!
Insurance & Liability: Ask: Does the company carry the necessary insurance? Will the company cover the employee if he/she is driving a client? Who is responsible if the employee is injured on the job? It is critical to ensure that the home care company utilizes care providers who are insured & bonded with sufficient coverage to protect the client/family.
After the vetting process, Emily’s Dad found the right agency and the caregivers started the following week. It was an adjustment process; however, Mom and her caregiver became fast friends. Her caregiver was even able to get her in the shower! A huge accomplishment. They also go to lunch together, do some household chores, and reminisce about days past. When questions came up about insurance policies, medical appointments, medications, and resources the Certified Care Manager was there to help. Emily’s parents finally had a team, which was such a gift.
As the care progressed, Emily’s Dad started leaving the house and meeting his friends to golf and go out to lunch. Now when she talks on the phone with her Dad he sounds more relaxed and is so thankful for his supportive team. When Emily talks with her Mom, she sounds happy and more fulfilled. For a daughter living half way around the country, this is all she could have asked for. She knows her parents are living their best lives and have the local support that they needed.
For more information on Certified Care Managers, please visit the Aging Life Care Association at www.aginglifecare.org. To find an Certified Care Manager in your area, visit the website and click “find an aging life care expert.”
Michelle Howard, R.N. is a Care Manager with Elder Options, Inc. Michelle’s passion for Care Management comes from the enjoyment she receives when working with the public and assisting the members of our community.