The graph below shows the number of episodes per Medicare beneficiary per year.  You will see that the average number of hospitalizations is 1.2 per year.  The Villa Home Care population served by Geriatric Care Mangers in 2011 had a hospitalization rate of 0.5% – a difference of 58%.  Emergency room visits decreased by 91% from the general Medicare population.

When one considers quality of life as well as costs,  keeping our older family members out of the medical care system is a given.  Partnering with a Geriatric Care Manager positively impacts that goal.

For a complimentary consultation with a Geriatric Care Manager, contact us at 602-957-9300 or visit our website at www.villahomecare.com.

Studies show that almost 1/5^th of Medicare patients who had been discharged from a hospital were rehospitalized within 30 days, and 34% were rehospitalized within 90 days.  Also 50% of those were rehospitalized within 30 days had no physician follow-up following their discharge.  Hospitals are beginning to be held accountable financially for those Medicare patients we used to call “frequent flyers” – those individuals we got to know on a first-name basis.  These are people that came in on a fairly often basis.  It will soon be in the health care institution’s best interest to keep those folks out of the Emergency Room and out of their in-patient beds.  Plus it is certainly in the client’s best interest to stay out of those setting.  It is absolutely no fun to be hospitalized!

Geriatric Care Managers are in a great position to assist in this endeavor.  Care Managers can make certain that new prescriptions get filled (and taken).  Medications are reconciled and discrepancies addressed before that client gets into trouble.  We can get the client to their physician for that follow-up appointment.  Having a Care Manager involved can mean that symptoms are dealt with early – before the client is in a crisis situation that necessitates an Emergency Room visit.  Care Managers can advocate for clients in various care settings, such as rehab centers, assisted living communities, or home.  Providing education about the intricacies of the health care system can be invaluable for both the client and his/her family.  Care Managers also coordinate care and promote communication among multiple health care providers, such as the primary care physician and specialists, the home health agency or hospice program, the pharmacy and the long term care insurance company, among others.

It is also understood that if a client has any deficits in his/her activities of daily living (ADL’s) or instrumental activities of daily living (IADL’s), they are more likely to be rehospitalized.  This is where a caregiver may come into play.  Helping that individual with medication reminders, preparing nutritious meals, guarding against falls all serve to lessen the chance of hospitalization.

Bob Dylan has the message right.  Times are changing, and it might be time to consider having a Geriatric Care Manager on board.

For more information about services from  Villa Home Care, please call us at 602-957-9300 or visit our website at www.villahomecare.com.

Our advocacy is demonstrated in many ways. When a 90 year-old client was hospitalized for a possible stroke, the Villa Care Manager was by his side, making certain that his out-of-state children were kept updated on his condition.  She also was able to avoid unnecessary delays for her client by communicating with the Emergency Department physicians and other personnel. The Care Manager arrived armed with a current medication list, a list of current health conditions, and physician information, as well as emergency contacts – all quite helpful when diagnosing this new problem.

Attending physician appointments can be another form of advocacy for our clients and their families.  When my mother-in-law saw her doctor, we rarely heard any factual outcome of that visit.  Mom didn’t want to worry us, but actually that was more worrisome for us than getting the real story.  So, with permission, the Care Manager is able to communicate with the client’s children, allaying their anxiety.

Advocacy efforts can take place in the client’s home, also.  Conflict among family members is common (yes, really) – especially when it relates to the best action to take for Mom’s well-being.  The Care Manager can be an active participant in family conferences with a very objective view-point, always looking at what outcome is in that client’s best interest.

Each and every day, Villa Home Care’s Care Managers are involved in advocacy activities, on behalf of our clients.

For a complimentary consultation with a Geriatric Care Manager, contact us at 602-957-9300 or visit our website at www.villahomecare.com.

Villa Home Care is pleased to once again offer our “Gift of Tuesdays” to families.  Memories are created when the older adult is paired with a Villa Caregiver or Care Manager.  We have taken folks on the Dolly Steamboat on Saguaro Lake, to the English Rose Tea Room, to Gammage Auditorium for a musical, and more.  There are so many opportunities to cater to an individual’s unique interest.

Villa Staff will take care of all of the arrangements for the outing.  Just tell us where and when and we will do the rest.

For more information on the “Gift of Tuesdays” program, please contact us at 602-957-9300.

Click on the link below to play the audio clip:
Karen Jeselun returns on KXXT Radio Phoenix

Most of the adult children we speak with are experiencing one of more of the above emotions as they are trying to address the needs and concerns of their aging parents.  It seems to all boil down to the same issue… WHY WON’T THEY ACCEPT HELP?

The reasons are complex and often difficult for families to sift through.  But the following are the most common statements of resistance that we hear:

1. “I have to save my money for you!”
2. “I don’t want to become dependent on anyone!”
3. “It would be more trouble to have to ‘get ready’ to have someone come into my home.”
4. “If this doesn’t work out, would I have to leave my home?
5. “I lived through WWII where we had to ‘make do’.  I can take care of myself!”

No wonder we adult children are frustrated, anxious, frightened and uncertain.  How can we more effectively cope with our parents when we know they need assistance?

First of all, having a heart-to-heart conversation may be beneficial.  Helping that loved one recognize the burden that their refusal of outside help is placing on you and your relationship with them often paves the way for more open communication.  The adult child can again assume the role of child and enjoy quality time with their parent, instead of being the main caregiver.

Another strategy that is often effective is a “trial run” with a caregiver.  When my mother-in-law and father-in-law returned to their winter home in Mesa, my husband and I “insisted” that they have a caregiver once weekly for a few hours as a “trial”.  “Let’s just see how it goes”, we told them.  The day my father-in-law died, he thanked my husband for the help he had in their home.  “That was the best gift we could have ever received”.

Sometimes having an outsider, such as a Geriatric Care Manager, come in can make all of the difference.  Even if a Care Manager makes exactly the same recommendations the son or daughter does, it may be more readily accepted.

Lastly, know that you are not alone.  Most baby boomer-aged persons are dealing with these very issues.  It really does help to talk with your friends and neighbors, just for the moral support.  Many communities and churches offer support groups, as well as resources to consider.

The National Association of Professional Geriatric Care Managers (caremanger.org) is a wonderful resource to locate a Care Manager in any part of the country.
For a complimentary consultation in the Phoenix area by a Villa Home Care Geriatric Care Manager, please contact us at 602-957-9300 or visit our website at www.villahomecare.com.

Last month, you were introduced to Maria.  Just to recap, Maria, 84 years old, was struggling in many areas of her life, and her three out of state children panicked, wondering how to best help their Mom.  They involved a Care Manager in her situation. In August, we reviewed five roles for the Geriatric Care Manager:  Assessment, Care Planning/Coordination, Physician Coordination, Medication Management and Crisis Response.  This month we will continue with the remaining five reasons to partner with a Geriatric Care Manager.

Reason #6 Transition planning. Transitioning from hospital to home, or from rehabilitation center to home, can sometimes be a precarious experience, especially related to medications. About half of adults experience a medication error after hospital discharge.  When Maria was preparing for her discharge from her rehab center, the Geriatric Care Manager (GCM) noted that she was prescribed a new blood pressure medication, and her instructions for home stated “Continue all medications as previously”.  Since she was already on a medication at home to lower her blood pressure, adding a second medication may have caused serious problems.  When asked for clarification, her physician concurred that she only needed to be taking one medication.

Reason #7 Recommendations in housing.  Is Maria able to be at home?  Does she need some type of assisted living?  Memory care?  Maria’s Care Manager really felt she would be safe at home at this time with the support of a daily caregiver for a few hours.

The 8th Reason to involve a GCM can be a local presence for check-ins. This service is invaluable for those adult children who don’t live nearby.  A monthly or bimonthly professional set of eyes looking in on Maria can really bring peace of mind.  Maria’s children could breathe more easily knowing that they would be notified of any problems – as well as a solution!

Reason #9 is a GCM can act as an extension of the family in a professional role.  Maria’s son recently said “you become me”.  And that is so true.  But as I told her son, we are really better than you, as we don’t bring years of relationships (good or bad) to the situation.   Care Managers are very objective and can truly advocate for the best decisions for the client.

Reason #10 is that we all need help.   Navigating the aging process is not easy.  Often we face crises without any kind of time to prepare. It is OK to ask for help.

The National Association of Professional Geriatric Care Managers (caremanger.org) is a wonderful resource to locate a Care Manager in any part of the country.
For a complimentary consultation in the Phoenix area by a Villa Home Care Geriatric Care Manager, please contact us at 602-957-9300.

Her children were scared to death – the son made call to the family attorney asking for help.  “What can we do?”  This trusted adviser contacted a Villa Home Care Geriatric Care Manager.

Reason #1) Assessment –With the goal of preserving Maria’s dignity, independence and resources, the Geriatric Care Manager met with Maria.  She found a very lonely lady with definite memory loss, mismanagement of medication, poor nutrition, at risk for falls, and, of course, driving problems.  While in the home, the mailman showed up with stacks of envelopes from her mailbox.  The Care Manager went through the mail with Maria and found two photo radar tickets and a cancellation from her LTC policy for no payment of premiums.  An assessment was also completed of Maria’s financial status, including a review of her Long Term Care Policy, qualification for VA benefits, and eligibility for the State Medicaid program.

Based on the above findings, the Geriatric Care Manager completed an individualized “stay-at-home” plan with recommendations for a caregiver for three hours daily to help with personal grooming, meal preparation, medication reminders, transportation, and socialization, as well as ongoing services from a Geriatric Care Management to set up her medications monthly, and accompany her to MD appointments – communicating updates with Maria’s children.

Reason #2) Care Planning/Coordination with others – Geriatric Care Managers are a resource for families.  Referrals are frequently made to Hospice, Medicare Home Health services, home physician services, assisted living communities, Meals on Wheels, transportation services, or even dog walking.  A Geriatric Care Manager can figure it out!

Reason #3) Coordination of Care with physicians- As Maria was declining, she would tell her children following her MD appointments that “all was fine – don’t worry about me”.  She was also not able to provide her physicians a real picture of her status.  The Care Manager was able to share with the doctor what really was transpiring, and again communicate with the family.  Maria had 5 specialists as well as a primary physician.  Unfortunately each of those physicians were concerned with just a piece of her health care – the Care Manager served as the central link to coordinate each plan, functioning as the central repository.

Medication Management is Reason #4)-  Maria had 8 prescription medications.  Two were for high blood pressure, two were for memory, one was for depression and two other medications to aid in digestion.  The Care Manager had serious concerns if she was 1) taking at all, taking as ordered (doubtful) or 2) double or triple dosing.  A system was set up in Maria’s home using an automated medication dispensing system that alerted the Care Manager if she did not take her meds on time.

Reason #5) Crisis Response- Families have someone to call in the middle of the night or on Sunday afternoon when they receive that panicked call from an older adult or that daughter out of state.  It happens.  It happened when Maria fell in her backyard. Villa’s Geriatric Care Manager met Maria in the hospital Emergency Room and learned the Maria had fractured her hip.  She arranged for a caregiver to stay with Maria until her son could arrive, and surgery was over.

(To Be Continued)

For a complimentary consultation by a Villa Home Care Geriatric Care Manager, please contact us at 602-957-9300.

My 92 year old father, a World War II veteran, is an active participant in the American Legion Honor Guard.  I was able to observe a military funeral and listened to my Dad’s bugle sound out Taps into the still evening air – revering the service and sacrifices the deceased veteran made for our country.  What a moving experience for his family, and for all of us in attendance.  I am so very proud that Dad has made this commitment for over 60 years now, and plans to continue for as long as he is able.  I know that there are veterans all over our country who are still giving of themselves in so many ways.

I have two challenges for all of us this July.  First of all, thank a veteran!  It doesn’t matter if they are 22 or 92.  They are protecting us, our families, and our country.

And secondly, help us spread the word about the Veteran’s Administration Aide and Attendant Care Program.  This provides financial assistance to qualifying veterans and/or their spouses for caregiving services. We find that many, many veterans and their families are not aware of this program.  This financial support may make the difference in their “independence”.  It could mean staying at home instead of relocating.

So as our sparklers die out, and the hot dogs and watermelon are eaten, reach out and say “thanks” to those military veterans who serve us so well.

For more information about the Aide and Attendant Care Benefit and other home care services, please contact Villa Home Care at 602-957-9300 and request a complimentary consultation from one of our Care Managers.

*35% of all hospital admissions for older adults is related to medication mismanagement?

*125,000 older adults die each year (or 342 each day) due to medication related problems.

*The average older adult takes 8.8 medications?

Medication Management for any of us can be perplexing; however, older adults bring their own set of issues to the equation.

Very often medications are not taken as prescribed due to adverse effects.  Lasix, a diuretic or “water pill” often prescribed for Congestive Heart Failure, may be skipped because a person decides since they have an appointment or an outing, and they don’t want to have to use a bathroom enroute.

Cost can frequently impact compliance.  When a prescription for 30 days costs over $300, many of us would take pause.  Being on a limited income, as so many older adults are, just means that sometimes these difficult decisions have to be made.   With cost being a concern this also means that discontinued medications may not be discarded, but “saved” in case it is needed again.

Generic vs. brand names can be quite confusing.  Using the Lasix example noted above, many medicine cupboards include both Lasix and the generic form, Furosemide.  When both bottles say “Take one daily”, that is exactly what is done – leading to serious consequences.

One last extenuating factor concerns multiple physicians prescribing medications.  One of our Villa Home Care clients saw 4 Specialists, as well as his Primary Care Physician.  All of these physicians were prescribing various medications for him.

What’s the answer?

Having a medication management “system” in place can promote compliance.  That system can take many forms.  We have all seen the plastic medication boxes that many pharmacies sell that are labeled with the day of the week and the time of day.  These plastic boxes work quite well for many folks, and they are very inexpensive.  Medications can be placed in the appropriate sections for a week, or even a month.  It is easy to see if medications are left behind.

If an individual likes to “rearrange” the medications in the plastic boxes, then this is not the solution.  However, there are more sophisticated medication systems available that are locked, and only dispense the medications needed for that dosing time.  These kinds of devices can also notify a designated individual when the medications are not removed from the devise, so that a phone call can be placed as a reminder.

Villa Home Care offers a Pharmacist Review of medications.  The services of a pharmacist are available to our clients to review that lengthy list of medications.  Being specially trained in the geriatric field, the pharmacist can look for correct doses, consolidation of doses, duplications, potential side effects, and even the appropriateness of the drug itself.

Lastly, having a Geriatric Care Manager present at all of the physician appointments can greatly promote coordination of prescriptions.

For more information on Medication Management services, contact Villa Home Care at 602-957-9300 or www.villahomecare.com.