you’re promoted - alzheimer's disease and dementia ... · you’re promoted: caregiver to...
TRANSCRIPT
You’re Promoted:Caregiver to Care Manager
Robert Miller, LMSW, CDP, Operator
Vice President of Company Development
DISCLAIMER:
I DO NOT have all the answer. I wish I did!
But I have touched most of the areas we are talking about today… both personally and professionally.
5.4More than million people are living with Alzheimer’s disease
By 2050, the number of people age 65 and older with Alzheimer’s disease may rise as high as 16 million.
http://www.alz.org/facts/overview.asp
Facts about Alzheimer’s
47.5%Nearly half of people aged 85 and older,will have the disease
For those that think this is just an old person’s disease,200,000 people under the age of 65 have Alzheimer’s.
http://www.alz.org/facts/overview.asp
Facts about Alzheimer’s
60%More than of family caregivers report high levels of stress due
to prolonged caregiving…
and 35% of caregivers report that their health has gotten worse due to care responsibilities.
http://www.alz.org/facts/overview.asp
Facts about Alzheimer’s
There is a difference between “caring” and “doing”.Numerous gerontological research studies report that family members provide nearly 82 percent of the necessary care for an elder family member. Oftentimes there is one primary caregiver…
UCSF/Human Resources: Elderly Caregiving: Choices, Challenges, and Resources for the Family
You can care, BUT have a plan
You cannot plan for everything, but a plan helps make sure that both Care-Receiver and Care-Giver get their different needs met.
UCSF/Human Resources: Elderly Caregiving: Choices, Challenges, and Resources for the Family
The TRUTH
Most family Care-givers are not prepared or practiced for all the responsibilities in caring for someone aging and/or ill.
Defining Care-Giving
Providing unpaid assistance for the physical and emotional needs of another person.
• Caregivers provide a wide range of services:• Errand Running
• Medication Management
• Physical Care… assistance with dressing, bathing, incontinence, transfers
• Transportation
• Bill paying and business management
• Food prep
• Etc… http://www.alz.org
Robert Miller, LMSW, CDP, AHCA
As well as… CNA/CMA… PT/OT… PhD… CPA… M.Div… CFO… CEO… CIO (Technology)… CPHT (Medications)…
Defining Care-Giver
Caregivers can also be considered primary or secondary.
• PRIMARY: The person(s) who has the main responsibility for care-giving.
• SECONDARY: Often supporting the primary caregiver.• Other family
• Friends
• Church
• Neighbors
University of Missouri, Challenges and Choices: Elderly Caregiving. http://extension.missouri.edu/p/GH6657
Who is a Caregiver…
• A Caregiver can be anyone:
• Who has it been usually?• Female spouse or daughter
• “The typical caregiver is 57 years old, female, married and employed outside the home.”
• “She can expect to spend as many years caring for a parent as for her children.”
• “There is also a good chance that she will be a caregiver to more than one person during her lifetime.”
University of Missouri, Challenges and Choices: Elderly Caregiving. http://extension.missouri.edu/p/GH6657
History of the Caregiver…
• In the past, the unmarried daughter was expected to provide care for an aging parent.
• We went from being Hometown communities to a Transient Society. Children moved away from home to the “big city.”• BUT Kids are coming home…
Rewards
• Although care-giving can be challenging, it is important to recognize that it also has its rewards.• Feeling of giving back to a loved one.
• Feeling of purpose and that the Caregiver is needed.
• Strengthen relationships with the care-receiver.
• Can appreciate one’s own life more.
• Can help a Caregiver feel good about themselves.
Caregiver stress fact sheet / womenshealth.gov
The other emotions of care-giving
• The 7 other Emotions of caregiving:• Guilt
• Resentment
• Anger
• Worry
• Loneliness
• Grief
• Defensiveness
Carring.com. https://www.caring.com/articles/7-deadly-emotions-of-caregiving
Objectives 2:
1. Understand the emotional weight in the role of caregiving and decision making.
2. Understand the use of applied Case Management techniques in a purposeful way for family caregivers in shifting roles.
Defining CaSe Manager
Professional definition: A health care professional, typically a nurse or social worker, who arranges, monitors, or coordinates long-term care services
Google web definition
Defining CARE Manager
My definition: A Committed Caregiver who coordinates care services, manages a care team and advocates for the special needs of someone they are caring for.
Robert Miller, LMSW, CDP
Who is on the care team?
• Doctor (PCP or primary care practitioner)
• Secondary CareGivers
• The Lawyer
• The Accountant
• The Bank Manager
• Home Health, Hopsice or other service providers
Who else is on the care team?
• Family
• Church
• Neighbors
• The guy the mows the yard
• Your Friends
• Whomever you TRUST
CareGiverDon’t Get Stuck in the BoxPrimary
Secondary
CareGivers
Home Health
Physician
Accountant
Private Care
Estate Planner
CareGiver Care ManagerPROMOTIONPrimary
THE TEAM
Physician
Secondary Caregivers
Estate Planner
AccountantHome Health
Private Care
It’s a mindset
Care Manager
And there is no less love!
THE TEAM
Physician
Secondary Caregivers
Estate Planner
AccountantHome Health
Private Care
DISCLAIMER:
Keep in mind that cognitive ability of the care-receiver must be considered regarding some of the information provided today.
• Understands care-receiver is still responsible for good choices or bad
The Care Manager:
• Feels responsible and often guilty
The Caregiver:
Which do you want to be?
• Guilt is one of the number one feeling we deal with in caregiving.• It can Motivate or Manipulate.• Cue the “Please and thank you story.”
• Understands limitations and boundaries while still committing to care-giving
The Care Manager:The Caregiver:
Which do you want to be?
• Important to understand the difference between NEEDS and WANTS… as well as how to set priorities.
• Cue the “I have a check that needs to go to the bank story.”
• Feels obligated and even trapped by compounding responsibilities
• Understands it is the best person for the job, family or otherwise
The Care Manager:The Caregiver:
Which do you want to be?
• Need to understand how relationship with the Care-Receiver is effected by personal history, limitations, abilities, etc.
• It takes a strong person to admit if you cannot care for someone and why.
• Feels it is “family business”
• Understands it takes a team to get the job done
The Care Manager:The Caregiver:
Which do you want to be?
• Know how to ask for help. Today’s Care-Receivers are complex. It requires managing fiscal responsibilities, as well as psych/social/emotional/physiological needs.
• No one is an expert in all these areas.
• Feels it is their burden alone
• Makes a plan and communicates it to the team
The Care Manager:The Caregiver:
Which do you want to be?
• Treat it like a business. To be successful, you have to have a Care Plan. • Put in on paper / Make a schedule / Create a check list / Delegate. • Then inspect what you expect!
• Takes the task call-by-call, feeling the stress of a growing need for help
• Takes a day off
The Care Manager:The Caregiver:
Which do you want to be?
• If something happens to “you” the patient/Residents looses their most important advocate.
• Cue the “I think we should not call this weekend story.”
• Eventually sacrifices personal needs to such an extent they are exhausted and/or ill
Objectives 3:
1. Understand the emotional weight in the role of caregiving and decision making.
2. Understand the use of applied Case Management techniques in a purposeful way for family caregivers in shifting roles.
3. Learn about various community resources and tools to manage the care of a loved one in their own home or care home setting.
Tools & Tasks…
• Make a monthly CALENDAR and everyone takes their piece• This helps everyone commit to the task of care
• Not every family member has the same time and resources to offer. IT IS NOT A COMPETITION.
• Hire services to fill in the gaps
• Tap into volunteer services
• Use the calendar to communicate expectations
Tools & Tasks…
• Create a MEDICAL RESUME• Have important information collected in one place and easy to grab-n-go
• Make sure everyone knows were information is kept
• Make sure you have affairs in order• Advance Directives and wishes written out
Tools & Tasks…
• Create a COMMUNICATION SYSTEM• Organize how people will get information and stay updated
Tools & Tasks…
• Communication System:• Communication Book
• Email or phone chain
• Facebook / Other Apps• Consider Privacy issues
• Family (Business) meeting schedule• Time for major decisions
• Best if you have one point person who is responsible to disseminate information to the team
Tools & Tasks…
• Technology is a double-edged sword. • Make sure to use what makes sense in organizing and connecting the team.
• Don’t get caught up in the latest gadget… but what works for you.
• KEEP IT SIMPLE
Bibliography:
“Caring” vs “Doing” - UCSF/Human Resources: Elderly Caregiving: Choices, Challenges, and Resources for the Family.
Dementia Stats - http://www.alz.org/facts/overview.asp
Defining Care-Giver - University of Missouri, Challenges and Choices: Elderly Caregiving. http://extension.missouri.edu/p/GH6657
Caregiving Rewards - Caregiver stress fact sheet / womenshealth.gov
7 Deadly Emotions of Caregiving - Carring.com. https://www.caring.com/articles/7-deadly-emotions-of-caregiving