These are real stories from my geriatric care management work, but names have been changed to protect privacy.
Eight years ago, Belle’s daughter Jane and her husband moved to Africa for a military assignment and they expected to be out of the country for three years. After another three year reassignment, they settled in another state with a plan to eventually move Belle to their home. Jane hired Geri-Options eight years ago to take her mother to appointments, oversee and monitor her care and assess her on-going needs. Belle is ambulatory and communicative but has multiple health issues including a valve replacement, requiring a pacemaker, GERD, hypertension, and mild cognitive issues. She is on blood thinners and needs regular blood testing. She has also had hospitalizations.Read More
Belle lives alone and independently in a low-income retirement center apartment. She is able to perform activities of daily living and prepare meals. She has low income and resources. Belle does not drive.
The geriatric care manager assisted in many areas:
- Driving and accompanying Belle to her medical appointments to clarify needs and orders.
- Arranging a free medication dispensing machine when the pillbox became difficult to manage; Belle takes 23 different medications and a nurse assists in ordering and filling the machine.
- Assisting with completing yearly applications for Medicaid, Food Stamps, and housekeeping help.
- Belle loves her soap operas and her cat, and has a couple of friends in her community—but she spends a good deal of time alone. Referring Belle to Stepping Stones, an activity and socialization program for persons with dementia, has been very beneficial. She has made new friends.
- Taking her shopping when the retirement complex bus cannot, and helping her select new glasses or purchase items she needs.
- Taking and staying with her several hours in the emergency room after a fall in which she sustained a broken nose.
- Taking her to routine and pre-op testing.
- Locating another primary care physician when her usual doctor closed her practice.
- Advocating for her when there were issues with her provider or service delivery.
The care manager is in constant contact with Belle’s daughter via email and telephone regarding needs, the on-going assessment of functional and cognitive changes, and the need for community resources. The daughter includes her mother in the Christmas holidays and Belle enjoys the opportunity to be with her 4-year-old grandson when her daughter visits.
In July of 2009, Geri-Options was contacted by the local probate court regarding an individual who lived in a small community outside of Denton. Lillie was an 82-year-old retired teacher, a widow with no children, who lived alone.
Her niece had filed to become her guardian due to a recent diagnosis of dementia and some possible exploitation of her aunt in her local community. Her niece lived in Austin and would not be able to visit and check on her as often as she would like, and was looking for a service that could help ensure her aunt was getting all the services she needed.
Although she had the diagnosis of dementia, Lillie otherwise appeared healthy. She had been a heavy smoker when she was younger but she had stopped smoking several years ago. She enjoyed a glass of wine in the evening with friends and had a small support system in her local community. She typically ate one meal a day in a local restaurant with friends, though it was unknown at that time how many other daily meals she ate or the amount. She was still driving, but her family was concerned about her safety and the safety of others. She was financially comfortable living off her pension and a small family trust. She initially started with an in-home caregiver for four hours a day to ensure she received two meals a day. In time, the home care increased, and by the time of her death, she had 24-hour care in her home. The family wanted her to remain in her home as long as possible. She died in her home with hospice care following hospitalization for respiratory complications.Read More
The geriatric care manager assisted in many areas:
- Monitoring the services provided by a local caregiver agency.
- Recommending when their services should increase and when a specific caregiver was not providing adequate services.
- Accompanying Lillie to her medical appointments to clarify her needs.
- Purchasing and delivering items determined by her caregivers that would help them provide better services (i.e. bedside toilet, shower chair).
- Purchasing personal and household items that might be needed (i.e. shoes, bras, cushions for her patio furniture, seasonal covers for her outside faucets).
- Hiring repairmen/servicemen to make repairs and changes to her home (i.e. grab bars in the bathrooms, bug/termite treatment, carpet cleaning and replacement).
- Staying with her and her caregiver for several hours when she had to go to the ER for treatment of illnesses and injuries.
- Picking up medications needed from local pharmacies.
- Meeting Lillie and her caregivers for lunch.
- Communicating with her accountant and guardian to communicate any needs.
- Addressing concerns of caregivers during home visits and by telephone.
The geriatric care manager kept the niece/guardian informed as to Lillie’s care by telephone and email. When the niece would visit her aunt, the GCM would also meet with her to give her any updates and discuss future care plans for her aunt. Lillie had a wonderful sense of humor, never tired of “teaching” and socializing with those around her.