Wednesday, January 22, 2014

When and Why to Intervene with Aging Parents

 One of the biggest frustrations I have as a geriatric care manager is the tragedy of guiding adult children through a crisis with their aging parent(s) that takes its toll in stress, time away from work and family, and last minute travel expense that in retrospect was entirely avoidable. 

Every year 98% of our referrals come to us crisis. Often we are not called until the family has attempted to find solutions through word of mouth, or internet searches, and trial and error—and realized too late there was more error than trial. Some of those errors can be costly. 

Some typical scenarios: 

  • A burned out caregiving spouse gets seriously ill or dies from the chronic stress and neglect of her own mental and physical health needs for years, leaving behind a spouse immediately in need of placement or 24 hour care at home.
  • The widow living on her own, her kids all live out of town. They come to see her once or twice a year and believe mom is “just fine” as she always tells them on the telephone. Her son flies in for a weekend and finds she’s lost 30 or more pounds, she and the house are a mess, the car has huge dents, there’s a pile of unopened mail, she has not taken her medications in months. He has to leave by Tuesday or will lose a major deal.
  • The couple with major health problems who know they need to move and want to move to a better living situation than their three level home in a crime ridden neighborhood, but are trapped by “overwhelmed inertia”—there is so much to be done that they do nothing. By the time they feel “ready” to move they are too frail to be eligible for the independent living places they desire.
  • The sibling concerned about the exploitation of her parents by her unemployed sibling who is living in their basement and off of their money while neglecting their care and household.
  • The couple who were perfectly fine until…. 

And so it goes. The phone rings and the sounds of angst fill my ears. I want to help, need to help, but who has legal authority to engage services? Who has financial authority to access the parents’ funds or is willing to pay for services? Who even knows what they have and where it is? Arguments ensue between siblings over what should be done, how it should be done, and who will do it—the one thing they can agree upon is that none of them have the time, experience, or patience! If only they had called sooner.

When is the best time to call a geriatric care manager? 
The best time is when you don’t think one is necessary! At that time we use our knowledge and experience as nurses and social workers to evaluate the elders’ mental and physical health, finances, home environment, and support system in order to create a plan and gather a team of experts such as elder law attorneys, home health care and companion service providers, financial advisers, and senior move specialists to maintain what is working well, fix what is not, improve what we can, and prepare for future. Taking a proactive, rather than reactive approach saves thousands for both the elders and their children. In fact, the tax deductible expense of geriatric care management services are usually recouped by the savings—often several to a hundred fold!

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