Don't "fall" victim to the flu!

It's October, and while we're enjoying the beauty of fall, we're also thinking ahead a few months and planning for flu season. If you haven't done so already, please consider the benefits of getting vaccinated for the flu. On the HealthMap Vaccine Finder, you'll find an easy-to-use searchable map of all of the locations where flu shots are currently available, with all of the detailed information you need. It also provides information about locations that offer shingles, pneumonia, and several other important vaccines.

Some important information about the 2013-2014 flu season (source: www.cdc.gov):

• Flu season generally peaks in January-February, although seasonal flu activity can run from October through May.
• The Centers for Disease Control recommends a yearly flu vaccine for everyone 6 months of age and older.
• Manufacturers project that they will produce between 135-139 million doses of influenza vaccine for the U.S. during the 2013-2014 season. This year's trivalent vaccine is made from the following three viruses:
• an A/California/7/2009 (H1N1)pdm09-like virus
• an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011



Kathleen Sebelius demonstrates
the "vampire" sneeze.

• a B/Massachusetts/2/2012-like virus.
• Epidemics of flu happen every year, and their length, timing, and severity are variable.
• Practice good health habits to stop the spread of germs: Avoid close contact with people who are sick. Stay home when you are sick. Cover your mouth and nose with a tissue when coughing or sneezing, or do so into the inside of your elbow. Wash your hands often, and use an alcohol-based hand rub when soap and water is not available. Avoid touching your eyes, nose, and mouth. Maintain good overall health, by staying physically active, managing stress, drinking plenty of water, and eating nutritious food.
• If you do get sick, there are antiviral medications to treat the flu, which may make the illness milder, help you feel better faster, and may prevent serious complications such as pneumonia.

At Elder Care Guides, we encourage all of the members of our staff to receive an annual flu vaccination, and work with our clients and their health care providers to determine which vaccination(s) are best for them.

Stay healthy!

Medication Management: The Role of the Care Manager

From ensuring medication safety and compliance, to identifying ways to keep medication costs affordable, care managers play an important role when it comes to medication management.

As health care advocates, we work closely with prescribing physicians to communicate important information such as health and functional status, known allergies, and other medications and supplements being taken. In our often fragmented health care system, the care manager can ensure that multiple health care providers are communicating, and working with the same information.

In the home, we ensure that physicians' and pharmacists' orders and special instructions are included in the care plan, providing assistance with medication set-up by the care manager or medication reminders by the in-home caregiver as needed.

And as clinicians, we can spot possible medication-related problems early, detecting potential issues and addressing them with the physician or pharmacy. Our consulting geriatric pharmacist is available to provide expert medication review, and can follow up with providers regarding recommended changes. Should new side-effects or symptoms arise, we can follow up right away, to help prevent serious medication-related problems.

Medicare's Open Enrollment period is fast approaching (October 15 - December 7), and this is another area where care managers provide an invaluable service to our clients. During this annual opportunity for Medicare enrollees to change their health plan and prescription drug coverage for 2014, care managers are available to talk with their clients and their families about their current coverage, and review their options for prescription drug coverage. When necessary, we'll work with local insurance specialists, or bring in our consulting pharmacist for recommendations. With the implementation of the Affordable Care Act and the forthcoming opening of the state's health benefit exchange, Covered California, we're prepared with the information and resources we need to support our clients in making sound decisions about their health insurance coverage.

Birthdays are good for you



This post dedicated to Mrs. M.

Having recently celebrated the 100th birthday of one of our clients, and next week celebrating my own (with a much less impressive number), I'm giving a lot of thought to these tours around the sun, hoping that I'm carrying with me through my own aging process even a fraction of the wisdom that's been passed along to me during my years of work in geriatric care management.

A few months ago, Richard Lederer, a local linguist, writer, and entertainer, posted the following on his Facebook page, in celebration of his 75th birthday. I share it with you today in the spirit of "about-to-be!"

I’m button-burstingly proud to announce today, Sunday, May 26, I turn 75 years of youth. Five years ago, I passed through the portal of my biblical threescore years and ten, and I've reached the point in my life when I have stopped lying about my age. Rather, I brag that I am so full years. I’m no longer a spring chicken; I’m a winter chicken. I’m no longer wet behind the ears; I’m dry behind the ...years. I’m no longer knee high to a grasshopper; I’m sky high above a grasshopper. I’m not a has-been. I’m an about-to-be. Yay! Yippee! Huzzah! Woo-hoo! What a ride!

Some of us try to turn back our life’s odometer. Others of us want people to know why we look this way. We admit that we have bumps and dents and scratches in our finish and the paint job is getting a little dull. And sure, the fenders are too wide to be in style and our seats are sagging. The battery no longer holds a charge, and the headlights have dimmed. The hoses are brittle, and much of the original tire tread is worn away. The transmission stays in low gear and doesn't easily shift to high. We don’t convert our fuel as efficiently as we used to, and climbing any hill is liable to cause sputtering. And whenever we sneeze or cough, our radiator seems to leak.

But you know what? We've traveled many, many miles, and some of the roads weren't paved. Wisdom and laughter are our shock absorbers. We've become classics.

And we’re not alone: Today, 518 million men and women worldwide are 65 or older, including more than one out of every eight people (13.4 percent) in the United States.

The poet Robert Browning wrote, “Grow old along with me! The best is yet to be. The last of life, for which the first was made.” While growing older is mandatory, feeling old is optional. Attitude is ageless. More than two millennia ago, the Greek playwright Sophocles wrote, “One must wait until the evening to see how splendid the day has been.” Only at sunset is the day truly golden. The later the hour of the day, the longer the shadow you cast.

Gentle Reader: You’ll never be younger again than you are right now! You may be over the hill, but that’s better than being under the hill – and it’s not till you’re going downhill that you really pick up speed! Birthdays are good for you: The more of them you have, the longer you live.

There is only one way to live a long life, and that is to age. And there is only one way to age – with a smile. If you are able to laugh at yourself, you’ll never cease to be amused. After all, you’re only old once.

Adapted from The Gift of Age (Marion Street Press)

Caring for our employees in the workplace

Ensuring workplace safety
is a unique challenge for
in-home care providers.

The pending resignation of our mayor here in San Diego has made national headlines of late. It's been the source of many jokes and some public embarrassment, but also provides an opportunity to reflect on the need to protect and care for our employees in their workplaces. The allegations being made against Bob Filner paint the picture of a manager who ran an office filled with fear, intimidation, and harassment. At Elder Care Guides, we are committed to a work environment that is safe, secure, and free of unlawful harassment or discrimination. As an employer of many clinicians and hands-on care providers who work in private homes, we face a unique challenge in ensuring that we’re providing a safe and positive work environment. The Care Manager plays a key role in assessing the home and addressing any potential safety concerns that may put either the client or the caregiver employee at risk. Clients with advanced dementia or serious mental illness occasionally exhibit difficult behaviors, and even a well-trained and experienced caregiver can benefit from the 24/7 availability of the Care Manager, to whom they can reach out for support and guidance.

Our obligations to our employees run far deeper than just providing a safe and secure workplace. We believe that employees who understand and utilize their personal strengths are fundamental to our success, and that their full engagement enhances the services we provide. When we are making a “match” between our caregiver employees and the clients that we serve, we are paying close attention to the strengths and personalities of both. It brings tremendous satisfaction to help a client find that “just right” caregiver, and it’s even more gratifying when we’ve also done the same for our employee.

The Care Management Career Path

A question that I, and many of my care manager colleagues frequently receive: "So, how did you get into this field, anyway?" Unfortunately, care management is a profession about which most of the public is still unaware, and when people learn about our critical role as advocates for disabled adults in the health and long term care systems, I usually get one of two responses: "I wish I'd known about you five years ago when I was caring for my own mother!" or "Sounds like interesting work. What kind of training does it require?"

It's a great question, with a complicated answer. Professional care managers come from a variety of backgrounds, including social work, nursing, gerontology, therapy, and psychology (among others). Professional care managers have several years of experience working with disabled adults in a supervised, clinical setting. And professional care managers are certified through one of four recognized programs.

A certified professional care manager differs from a patient advocate, a senior advisor, a patient navigator, or an elder advocate, designations without the same education, experience, or stringent certification requirements. There are many good people who care deeply about the health and well-being of our elders working in these fields, but effective advocacy through a complicated diagnosis or difficult family dynamics requires more than a kind heart, or some personal experience in caring for a member of one's own family. It requires clinical knowledge, a deep understanding of the health and long term care systems, the ability to maintain an objective perspective, and accountability to a set of professional standards and ethics.
 

Every member of Elder Care Guides'
clinical team is a member of NAPGCM:
Amy Abrams, Jean Alton, Terry Ehlke,
Cassie Farrell, Norman Hannay,
and Susan Valoff

There are many paths that one can take to becoming a professional care manager, and we work in a variety of settings, including private companies and non-profit organizations. The work is challenging and demanding, but individuals who enjoy problem-solving find it very rewarding. Membership in the National Association of Professional Geriatric Care Managers (NAPGCM) is an important first step.

If you or someone you know are interested in learning more about the profession of care management, NAPGCM will be hosting a free informational webinar on Tuesday, October 15th. 
Click here for information and to register.

Nine Years of Service (Part 3 of 3)

This month, our company celebrates nine years in business. As a founding partner of Elder Care Guides, I've enjoyed this opportunity to reflect on how far we've come, and how much we've accomplished for and with our clients. In this final post, I'll recount three more of my favorite memories from my first nine years as a part of this company:

7) Several years ago, in an effort to reconnect a frail and disabled elderly woman to a forgotten passion, one of our care managers helped a client who lived in a skilled nursing facility procure the supplies she would need to take up a unique form of painting she had mastered as a young woman. I will never forget the transformation that this client underwent, as she not only revived her old skills, but in fact taught them to her own art therapist. We arranged an art show at her facility, wherein several of her pieces were displayed and sold. I was so proud of our team, for not only providing for this client's basic care needs, but for helping her connect to this part of herself that she was able to pass along to the next generation.

8) Not long ago, a dear client whose care I had managed for many years passed away, and when I walked into the office the next morning, I was met with hugs from my colleagues, who shared funny memories of him, and joined me in my grief. I loved not only the fact that I was not expected to "be a professional" in that moment, and instead felt free to process the sadness of the personal loss, but I also loved the fact that every member of the Elder Care Guides team actually knew him. In our many years of providing care management and caregiving services for him, everyone on our staff had met him, knew his family, and understood his quirky personality. I'd often spoken of the merits of our team approach, and had never felt it more profoundly than in that moment.

9) Last year, I was elected to the Board of Directors of the National Association of Professional Geriatric Care Managers (NAPGCM), the organization that provides standards of practice and ethics for care managers, promotes certification, and provides continuing education for care managers nationwide. I'm deeply proud of Elder Care Guides' commitment to service and professional leadership with NAPGCM and in our local community.

Cheers to a great first nine! Here's to many more.

Nine Years of Service (Part 2 of 3)

This month, our company celebrates nine years in business. As a founding partner of Elder Care Guides, I've enjoyed this opportunity to reflect on how far we've come, and how much we've accomplished for and with our clients. In this series of posts, I recount nine of my favorite memories from my first nine years as a part of this company:

4) In 2007, Susan Valoff (who was then a colleague working at another local care management agency) and I co-chaired a committee that planned the annual educational conference of the Western Regional Chapter of the National Association of Professional Geriatric Care Managers (NAPGCM). To do so, we enlisted the help of several of our local care manager colleagues, providing many of us with our first opportunities to get to know one another. From this very positive experience of working together, we formed the local unit of NAPGCM, which continues to meet six times per year for professional education and collaboration. I'm deeply proud to work in an industry that is collaborative, rather than competitive, at its core. (Not to mention that just a few years later, Susan would join our team at Elder Care Guides, becoming a partner in the business and the foundation of our great clinical team.)

5) In 2008, we moved from our humble home office beginnings into a beautiful leased office space in Liberty Station. Our office in Historic Building 28 is a set of restored barracks, built when this property was the Naval Training Center (NTC). It was an area of San Diego that is full of historical importance, and personal memories for our clients (many of whom were WWII veterans), and their families.

6) Three years ago, one of our caregiver employees received the award for Outstanding Home Care Service from the California Association of Health Services at Home (CAHSAH). The award is given in Sacramento annually to an individual who is "directly involved in day-to-day care and has consistently provided outstanding service to patients in their homes." An employee of Elder Care Guides since 2004, today she continues to embody our philosophy of client-centered care.