The elderly present a unique set of challenges. Conditions can change quickly if potential dangers are not identified or ignored. As we age our systems can break down with little or no warning, especially when plagued with chronic illnesses, multiple medications, frailty, memory issues, recent falls, and other age related conditions. It can be challenging and stressful working with these individuals especially for the ill-informed or inexperienced. Judgement can be compromised during a state of urgency when calmer, experienced objectivity can make reasonable assessments and suggest practical suggestions to reduce anxiety and resolve issues before they become a crisis or result in needless hours spent in emergency rooms.
The Evaluation is the most important first step towards identifying immediate problems and documenting the current status of the client. This extensive report addresses not only the current concerns, but also areas of weakness and vulnerability which could represent ongoing challenges as conditions change. It will become the foundation for managing all aspects of the aging client’s life and living situation.
Coordinate and facilitate recommendations outlined in the Plan of Care as required and agreed upon by the client or legal advocate. Immediate problems are addressed promptly and a longer-term care plan is discussed. Regular communication becomes a critical part of the management process since the condition of the client is always subject to change.
A one-time consult may be indicated if there is adequate care management by the family but one particular issue presents a challenge that requires investigation, evaluation, coordination and facilitation. The scope of the consult is determined in advance and additional hours dedicated to facilitation of recommendations will become ongoing care management.
Geriatric Care Managers are not attorneys and do not offer legal advice. However, simple forms can be prepared, reviewed with all parties, and signing can be facilitated by the care manager in the comfort of the client’s home.
As conditions change it may be necessary for the aging client to move into a residence that can provide additional assistance. There are a variety of options to consider. The Geriatric Care Manager can help the family understand the range of options and help decide what is best for the client.
Death is a natural part of life and when irreversible physical or cognitive changes occur and prolonging life unnecessarily becomes detrimental to quality of life, it becomes the responsibility of the loved one’s trusted agent to honor the wishes outlined in the Advance Directive which may include considering palliative or hospice care.