Long-Term Care Problem Solving
Long-Term Care Problem Solving
Karl Steinberg (Associate Medical Director, Sharp Mission Park Medical Group) gives expert video advice on: What is a geriatric care manager?; How do I find a geriatric care manager?; How do I find long-term care for a chronically ill parent? and more...
What is a geriatric care manager?
A geriatric care manager is a person who can assist in assessing a patient and helping to determine what would be the best level of care, what kinds of services might be needed and what the best way to pay for it might be. Typically it might be somebody with some nursing experience, some social work experience and a variety of other people who have had training in gerontology or things in that general category.
What is a 'geriatric screening' for long-term care?
A geriatric screening would be a comprehensive assessment that could be done by a geriatrician, or in some instances, they have comprehensive geriatric clinics where they might see a variety of different professionals. They might see a psychologist, and a physical therapist and so on. And that would help to determine if a person needs to move to some sort of long-term care setting, or if not, how much assistance they might require in their own home, and things of that nature. So, those can be helpful.
What's the best way to approach other family members about long-term care for aging parents?
As far as talking among other family members, when you are thinking that it may be time to move your parents into some sort of supervised setting, I think just talking openly and probably doing it in an organized fashion is best. Ideas such as setting up a time for a teleconference or if you all live locally, a family meeting of some kind is the best way to do it. Even though you definitely want your parent, or parents to be part of the decision making process, I do think sometimes it is sort of like an intervention. So you want to maybe get together beforehand and just get all your ducks in a row, figure out what you need to say and maybe even what you plan to do if they don't want to go along with it. It is just depending on how unsafe you feel they are. I think it is just good to speak openly, honestly and expect a certain amount of dissent. People don't always agree and it is a very emotional and difficult decision when you are talking about putting your parents into an assisted living or, even worse, a nursing home.
What if my parent is resistant to long-term care?
I think you are going to get some resistance from you parents. They're not going to just willingly say "Oh sure! Just pack me up and send me to the nursing home." Things that you can do include, if you can remove their source of transportation if they're not safe, that is one thing you can do. I just think that at times you have to wait until something bad happens, but if you can nip that in the bud and prevent it, that is great. And exerting pressure from other people, other family members, loved ones, those things can be helpful in putting those kids of things into effect. Also, keep in mind that what you think is safe or unsafe may not actually be true, and again people are allowed to have bad judgement. You may pray that mom doe not fall and break a hip but she may have to do that and you have to recognize your powerlessness in some instances.
How do I help an aging parent if I live far away?
One of the hardest situations is when you live in one city and your aging, ailing parents live somewhere else. I know from personal experience, you can feel very helpless, you can feel guilty because you're not right on the scene when things happen and, and you feel bewildered because you just don't know what's going on with them on a day to day basis. I think obviously the best thing to do is have somebody there that you can really trust to serve as your eyes and ears. Talk to them often. Sometimes even if they aren't the kind to complain or they don't want to alarm you, you can tell certain things from talking to them. Visit your parents as often as you can and, you can do what I did, just go scoop your mom up and bring her to where you live, but you're likely to meet some resistance in those situations. But again, having a reliable family member near by is a great thing, and if you don't have that then you may want to contact the local area agency on aging or home health agency, their doctor, nowadays with the privacy laws, the HIPPA legislation, you have to sure that they clear it with the doctor to be able to discuss things with you, but keeping in contact with their physician can be something that also can be very reassuring and can also give you a little heads-up when something is brewing.