Long Term Care Planning: Community-Based Care Settings

We were invited to write a series of brief articles for the monthly newsletter of our friends at MDK Insurance Services, describing the continuum of long term care, and how to navigate oneself through it. You can sign up for the newsletter on their website, and each month we provide a copy of the article here as well. Please share the information with someone you know who is thinking ahead about how to plan for (and pay for) their own or a loved one's long term care.

Volume VI: Community-based care settings

Previous installments of this series have described the resources available to those planning for care at home, and the goal of this issue is to describe the basic options for community-based long term care. Those who choose to move out of a private home and into a "senior living" setting do so for a variety of reasons. For some, it is a financial decision, while for others it is a lifestyle choice - freedom from the day-to-day responsibilities of managing a household, or the opportunity to interact socially with more people on a daily basis.

Independent Living communities are also sometimes referred to as "retirement communities." Some amenities such as communal dining, light housekeeping, transportation services, and planned activities may be available, but no personal care is provided. In these communities, residents must usually be able to ambulate independently.

Residential Care refers to a range of different housing providers that are licensed (in California by the Department of Social Services' Community Care Licensing division) to provide assistance with activities of daily living such as bathing, dressing, and medication management. A Board and Care home is a small residence (usually a single family home) with between six and twelve residents and a small staff of attendants. An Assisted Living facility is a larger community that usually offers several different levels of care and more supportive services.

Skilled Nursing Facilities are sometimes referred to as "nursing homes." They are licensed (in California by the Department of Public Health) to provide skilled nursing and supportive services for those who require assistance with most - or all - of the activities of daily living.

Next month we'll explore some additional specialty community-based residential services that are available, and then we will move on to a discussion of fees and funding sources for each level of care.

Are Your Employees Orange?

We have spoken earlier about the great research done by Chester Elton and Adrian Gostick in The Carrot Principle, a book about employee engagement and the effects of recognition in the workplace. The authors have done it again, this time in The Orange Revolution, which discusses teamwork. The book encompasses what makes a great team, and how an "orange" team, or one with a high sense of unity in a common goal, achieves breakthrough, positive results.

Teams exist in almost every organization, in every arena. The elder care industry is no exception, especially when you consider geriatric care management, and the team it takes to care for an elder in their home. Elton and Gostick found that once an initial level of basic competence is met, there are 5 key factors every team needs in order to achieve "orange" status and be effective:

• Goal Setting (knowing where the team is going)
• Communication (wise use of your voice and ears)
• Trust (believing in others and being trustworthy)
• Accountability (doing what you say you will do)
• Recognition (appreciating others' strengths and contributions)

A geriatric care manager and an organization that employs caregivers to the elderly has a key responsibility to ensure their employees are humming the same tune when it comes to those five factors. Supervisors who set clear goals, encourage and provide detailed communication, build trust, hold team members accountable, and recognize great work will undoubtedly have an engaged team environment built around the client.

Since October brings us lots of orange in pumpkins, Halloween, and harvest colors, I encourage you to survey your employees and client care teams to see if they are engaged and orange, too.

Age of Champions

It's time for another Elder Care Guides movie suggestion! "Age of Champions" is an uplifting story of a group of athletes—a 100-year-old tennis champion, 86-year-old pole vaulter, and a team of basketball grandmothers all chasing gold at the National Senior Games. The film captures the triumphant spirit of these competitors as they tackle the challenges of aging with grace, humor, and optimism. Win or lose, they inspire us to follow our dreams and find purpose at any stage of life.

"Age of Champions" is showing at the San Diego Film Festival this Saturday, October 1st at 12:30pm at the downtown Gaslamp Theatre. Buy your tickets now, and discover how you can build on your strengths, find your purpose, and become a champion too.

Long Term Care Planning: Bridging Home and Community

We were invited to write a series of brief articles for the monthly newsletter of our friends at MDK Insurance Services, describing the continuum of long term care, and how to navigate oneself through it. You can sign up for the newsletter on their website, and each month we provide a copy of the article here as well. Please share the information with someone you know who is thinking ahead about how to plan for (and pay for) their own or a loved one's long term care.

Volume V: Bridging Home and Community

In previous issues, we’ve outlined the resources that are available when planning for the care at home of a disabled elder. It’s important to remember that those who lose connections with friends, community organizations and social groups, or who fail to build new connections and participate in engaging activities are at risk of social isolation, known to negatively impact physical and mental health. Fortunately there are community-based programs available to help those living at home with physical or cognitive impairments to remain socially connected, physically active, and mentally stimulated well into their old age.

Adult day health care programs are licensed centers that provide medical services and a variety of therapies, social services, and stimulating activities, as well as meals for the participants, who usually attend the program between 4-8 hours per day, several days per week. Adult social day care provides a similar structure, but does not offer skilled medical services and emphasizes socially, physically, and intellectually stimulating activity. Senior centers are neighborhood-based facilities that offer an array of social and educational opportunities, often offered on a drop-in basis. Many provide exercise programs and nutritious meals for participants on the days that they attend. For those who are no longer driving, it is essential to plan for transportation alternatives, to ensure access to all of the types of services that have been described. To find transportation and other resources in your community, contact your local Area Agency on Aging, or log on to the national Eldercare Locator: www.eldercare.gov.

The above resources can supplement a care plan that provides safety and support at home while keeping the elder connected and engaged. Next month, we’ll discuss the different levels of community care that are available for those who are considering making a move from a private home.

Making the Move - "Home Sweet Home"

Recently, at the request of some family members, I recommended some long term care facilities to a couple of my clients. The moves, when they happened, were as different as my clients but in both cases I found some similarities.

No matter how careful you are, when discussing the move, there is always the point when the client states that "this is just going to be a temporary move" or something to that effect.

This is when your diplomatic best needs to shine. Without lying or promising something that won't or can't happen, you need to encourage your loved one to focus on some positive advantages of the move. Point out the lovely accommodations, the proximity of their room to the library or the dining room. Escort them around the grounds in order to familiarize them with all that it has to offer.

Socialization is going to happen, make the best of it by making sure the Admissions Director has a good understanding of your loved one's interests, capabilities and personality.

Make sure when you visit that you are friendly to the other residents. This goes a long way in helping your mom or dad adjust and provides some common talking points when you're not around. It also can help a lonely fellow resident a chance for a personal connection.

Facility apartments and rooms are not "home". Like most anything else, they need to take on the personality of the resident in order to be comfortable and one's own "safe have" in this unfamiliar community. So make it as homey has possible from the start! Put pictures on the walls, add family photographs around the apartment, place a special quilt on the bed, provide a good reading lamp and a comfortable chair or two. Having a chair for a guest is pretty important. Really, no one finds sitting on a bed very comfortable and your mom or dad will be more likely to invite someone to sit down for a visit if they can offer a place to actually sit!

Give your parents time to adjust to their new home. You making daily visits really doesn't help in that adjustment. They need to learn how things happen within their new community and who they can turn to. Developing rapport with the staff is crucial for a comfortable transition and a happy resident.

Change is always difficult but with thoughtful planning the adjustment to one's new "home" can effectively be made and the new resident will feel that they are truly "Home Sweet Home".

Caregiving Comes from the Heart

Elder Care Guides' Human Resources Director Elizabeth Reynolds was recently interviewed on Business Networking Radio. In the interview, Elizabeth touched on some of the characteristics of a great professional caregiver, and the career path for graduates of programs like Newbridge College's Medical Assistant program. In addition to training and professional experience, Elizabeth has an eye for identifying candidates with relevant personal experience providing care to a disabled loved one, and the less-tangibile "heart" qualities that are essential to the services that we provide.

To download an mp3 of the interview (air date 7/20/11), please click here.

For information about opportunities for professional caregivers at Elder Care Guides, please visit the "Career Opportunities" page on our website.

Long Term Care Planning: Bringing in a Professional

We were invited to write a series of brief articles for the monthly newsletter of our friends at MDK Insurance Services, describing the continuum of long term care, and how to navigate oneself through it. You can sign up for the newsletter on their website, and each month we provide a copy of the article here as well. Please share the information with someone you know who is thinking ahead about how to plan for (and pay for) their own or a loved one's long term care.

Volume IV: Bringing in a Professional

This month we continue to outline the array of options for those planning for the care of an aging or disabled loved one at home. In addition to hands-on assistance with the activities of daily living, various professional supports are available to help families navigate the maze of long term care and manage complex caregiving situations, including fiduciaries and geriatric care managers.

Professional fiduciaries are licensed individuals who serve by court appointment as guardians, conservators, or personal representatives of an estate. They may also be designated by an individual to serve as trustee, representative payee, or agent under powers of attorney. If a disabled person is no longer able to manage their finances or health care decision-making, and no family members are available or appropriate to assume this role, a fiduciary may be brought in to undertake these essential functions.

Geriatric care managers are certified specialists trained in nursing, gerontology, social work, or psychology, with expertise in issues related to aging and elder care. Services include in-home assessments and care planning, arranging and monitoring care services, 24-hour availability for assistance during emergencies, liaising with long-distance family members, and health care advocacy. For many families and professionals caring for a person with chronic physical or cognitive disabilities, a professional geriatric care manager serves as an experienced guide and resource.

For more information, visit http://www.pfac-pro.org/, or http://www.caremanager.org/.

We've now covered some basics for planning for care at home, and next month we'll explore community-based resources that can serve as a bridge between home and facility.