This is the story of Norma and her mother Betty. Betty is 85 years old and lives in a little town on the side of an unnamed mountain in rural Virgina. She lives alone and her closest neighbor is two miles away. That neighbor is her daughter Norma. Norma takes care of her mother 24/7 and can’t seem to hold down a full-time job due to her caregiving responsibilities. If you ask Norma, she is fine with this because her mother is the most important thing in her life.

We received a call from Norma to ask if there was any resources they could turn to help with her mothers care in her rural area. She also wanted to talk with someone about selling the house and moving her mother in with her as well as executing a power of attorney document. How did she find the people to give her advice on this when she lived in such a remote area of the county?

Luckily, we had a solution for her. Like so many other health care companies in the United State, we had begun embracing technology to help market and provide information to our clients. Our newest technological offering was a tele-consultation option that would put Norma in front of our staff of geriatric case, managers, social workers, and legal, real estate and financial partners.

Via Skype video and phones, we met with Norma and her mother one icy day in late December when all roads were impassable up into the mountains where they lived. We discussed her mother’s health and the issues that Norma was having with taking care of her mother. We suggested home health and personal care agencies in the area that would be able to come take the burden off of her as a caregiver. We discussed future nursing home placement and the quality homes in that area of the country. Our legal team gave Norma advice on power of attorney issues and how to get a document executed. This was done all while they sat around a roaring fire at their home and we sat drinking Starbucks three states away.

Does technology solve all caregiver issues. No, not in the least. It can’t provide direct observation of the client and the caregiver situation. We can’t give her proven advice on the quality of nursing homes in the area, only what we can find from research online. What our tele-consultation product did offer Norma and her mother was peace of mind in knowing that they could access professional that could give them advice and point them in the right direction.

If you would like more information on how technology is helping seniors, please see our website at www.eldercarelifesolutions.com/tele-consult.

 In today’s blog we have pulled a section from our website to address  some questions from our clients as well as questions we have received via email. We hope some of these answer your questions regarding our services and what to expect.

Q. What exactly is a geriatric care manager?  -Liz, Chattanooga

I’ve been under the impression and for years that minorities are more apt to bring an elderly or disabled loved one into their home as opposed to putting them in a nursing home or some kind of facility. In fact, I worked in a nursing home for a few years while in my twenties.

It appears that most minorities have a real sense of “family, values and sticking together” and they tend to want to take care of their elders out of respect. Now I’m not saying whites don’t. This may also have to do with the costs associated (residential facilities vs. in home care) and quite possibly new laws and legislation in play for Medicare and Medicaid recipients.

Stumbling across an article from the Science Blog yesterday, I read that in the last decade, minorities have poured into nursing homes at a time when whites have left in even greater numbers. This data is according to Brown University suggests a racial disparity in elder care options in the United States. This analysis was found in the journal of Health Affairs dated July 7, 2011.

This study suggests that elderly blacks, Hispanics, and Asians are gaining greater access to nursing home care. But the growing proportion of minorities in nursing homes is coming about partly because they do not have the same access to more desirable forms of care as wealthier whites do, said the study’s lead author Zhanlian Feng.

“Seemingly, we are closing the gap in terms of minority access to nursing home beds, but I don’t think that is something to celebrate,” Feng said. “They are really the last resort. Most elders would rather stay in their homes, or some place like home, but not a nursing home unless they have to.” (Ask any senior citizen and they’re more than likely going to tell you this. My Mom to this day, continues to try and make me promise that I will not put her in a nursing home).

This new analysis shows that between 1999 and 2008 the nation’s nursing home population shrank by 6.1 percent to just over 1.2 million people. In that time period the number of whites in nursing homes decreased by 10.2 percent nationwide, while the number of blacks rose 10.8 percent, the number of Hispanics rose by 54.9 percent and the number of Asians rose by 54.1 percent. The study also looked at nursing home population changes in the top 10 metropolitan areas for each minority.

Prior research has shown that the nursing homes in predominately minority areas are often of lower quality and are more likely to close, while assisted living facilities are more likely to be built in areas where residents have high incomes. The result, reflected in the figures in the new Health Affairs paper, is a disparity that plays out not only economically and geographically, but also racially.

Most care alternatives are not equally available, accessible, or affordable to everybody, certainly not to many minority elders.

As policymakers look to “ re-balance” elder care from nursing homes to other forms of care, for instance with shifts in Medicaid funding to support home and community-based services, they should account for these disparities, Feng said. As it is, whites are clearly more likely to be using more desirable alternatives; more concerted efforts may be required to promote minority elders’ use of them too, he said.

One way Feng and his co-authors have quantified the disparity in eldercare is by grouping metropolitan areas into quartiles based on the proportion of whites, blacks, Hispanics or Asians 65 or older in each area. They found that the representation of blacks, Hispanics and Asians in nursing homes increased as their share of elderly in the total population increased. This did not hold for whites, who did not appear to be obliged to choose nursing homes as they age.

In New York, a top 10 metropolitan area for blacks, Hispanics and Asians, nursing home residents from these groups increased 22 percent, 84 percent and 40 percent, respectively. With different rates in different cities, the challenge facing policymakers is not only national, but also local.

In the end, it would be a fabulous world if we all could choose where we wanted to spend the remainder of our days, but somehow – that isn’t reality. Siblings, children, family members, government, and our money or lack of it,  all play a part in end of life care.

Source: In addition to Feng, the paper’s other authors at Brown University are Mary Fennell, professor of sociology; Denise Tyler, gerontology researcher; Melissa Clark, associate professor of community health; and Vincent Mor, the Florence Pirce Grant Professor of Health Services, Policy, and Practice.

The National Institute on Aging supported the research.

About the Author:

Susan Avello is Vice President and Partner of Aging Info USA  based in Chicago,IL. Aging Info USA directly supports employee caregivers, HR and Executive Management by implementing creative approaches in education, resources and training in regard to eldercare and family caregiving and work/life challenges. She is the author of two books as well as The Working Caregiver and HR Virtual Cafe blogs. You can connect with her on Twitter @susanavello.

Below are several ways that a GCM can assist your family members:

Adjustment- there are times when a family cannot be with the senior during their times of transition into the assisted living . A care manager can assist with paperwork, moving in furniture and personal belongings, acclimating the senior to the activities and the ALF and meeting new residents.

Medical Coordination-when a senior has multiple appointments with many different medical specialties, the care manager can help coordinate these visits, arrange transportation, and attend on behalf of the family members. Once the visit is complete they can report any findings back to the family and the assisted living staff. More importantly, if the senior is transferred to the emergency room, the care manager can be there immediately to assist the family and facility.

Delivery of Supplies-oftentimes, the facility will rely on family members to provide certain items that they do not, such as incontinence supplies, over the counter medications and personal beauty items. The care manager can assist the family to provide these supplies when needed and coordinate delivery with the facility.

Assessment-many times a care manager will be called on by the assisted living staff to perform a complete geriatric assessment of the senior to decide if they are suitable for assisted living or need further placement in a nursing home. With increased Medicare regulations, this is becoming more and more common.

A care manager can be a valuable asset to the family and the assisted living staff when a new resident arrives. Not only can they help the family adjust the care and culture of the facility, but they can also give the family peace of mind in knowing that someone is looking out for their parents when they are not able to.

Blount County Elderwatch members receive proclamation for WEAAD from Blount County Mayor Ed Mitchell

What do patients want from Family Medicine? An MD they TRUST & who feels part of family

Wow! If that doesn’t make you stop for a second, I don’t know what will. In order to be a good family medicine physician, you have to treat patients like family! The question was then asked about doing this in an industry environment that is so limited. How does one accomplish this? Well, during the discussion I added my own two cents worth. I told this group of professionals that they needed to look at working with outside resources, namely a geriatric care manager!

What could we as geriatric care managers do for family physicians? We could monitor their patients in the home. Make sure they get to their appointments and ensure that information is passed on to the family of the elderly client. Work with the office and nursing staff to ensure that the patient keep up with medications and insurance benefits. We could be the eyes and ears of the families when they live out-of-state. In essence, we can be an extension of the family medicine practitioner and keep everyone headed in the right direction.

As someone so eloquently put it tonight, we could be the hub in the wheel of medical care for the family, making not only the job of the caregiver easier, but also the physician.

• Five areas to look at when touring a nursing home
• What is the ideal time for a visit
• Where to find the nursing homes federal “grade”
• What questions to ask and who to ask them to
• Where to get additional assistance in your nursing home search

Wont you consider joining us? Please sign up at http://bit.ly/f8Ecwe

However maybe our company can offer some advice on how to make your caregiving role a little easier. Over the next couple of days I will give several tips that will not only enhance but make your life more bearable as you take care of your loved ones needs:

• Be Prepared
• Inform your employer
• Find someone to confide in
• Take care of yourself first
• Know your limits

The first item of business is to make sure you have a plan before the crisis happens. Like the old Boy Scout motto, be prepared before you have to run yourself ragged. Get in touch with local resources such as the Office on Aging, hospitals and your local churches to see what type of assistance they may offer you and the person you are caring for. Make sure you have all the material resources in place whether it be food in the house or a shower chair for your mother that just home from the hospital following hip surgery. Have caregiver roles established beforehand. Know before the crisis how long you will devote to your role and who will be there to give you assistance and provide coverage when you need a break. 

 Next time, will discuss how to inform your employer and several tips that can ensure you have a job when you return.

I get this type of call all the time on my office phone here at Eldercare Life Solutions. Children start to notice that mom just doesn’t “sound right” on the phone, so the they make a visit home and find that she is not taking care of herself, not taking her medications and find that the dog has not been outside in two weeks. When they call, they are often in a panic. Is it time for a nursing home? An assisted living? What direction should they go?

That is one of the advantages of hiring a senior care management firm. We can make the transition from home or hospital to a facility so much easier on both the family and the elderly relative. How do we do this?

• Research of clients preferences on distance from a nursing home.
• Research of quality nursing homes based on survey data, staffing and food service inspection scores
• Taking the family on a tour of the nursing home
• Suggesting that they go visit again-after hours.
• Assisting with paperwork for admission to the nursing home
• Assisting with Medicaid and insurance issues and applications.

The most important piece of advice that I can give any family searching for a nursing home for their loved one is to research them fully. Be prepared before the time comes so that you can make an educated decision and not a split second one. A senior care management firm such as our can help you prepare before the time comes. When there is a crisis it will be managed my easier because a lot of the decisions have already been make.

For more information on our services and how to plan for nursing home or assisted living placement beforehand, visit us at www.eldercarelifesolutions.com.