Caring for elders – and their caregivers

While 4 a.m. trips to the ER are not everyday occurrences in the life of a geriatric care manager, they are also never off the table in my role as a certified senior adviser, Aging Life Care Association (ALCA) manager and chief care manager of New Rochelle-based Concierge Healthcare Consulting, writes WAG elder columnist Abbe Udochi.

“She was found on the floor and says that she cannot move her arm.  We called 911 and they are taking her to the ER.”   

That was the message a nursing home manager left me at 3:48 a.m. on a Saturday morning in May, waking me from a sound sleep.  A 70-year-old resident had fallen out of bed and injured her arm. The woman was a client of mine at Concierge Healthcare Consulting (CHC), the geriatric care management practice I founded in my hometown of New Rochelle.  

I knew the client to be a fall risk and prone to serious injury, including to the brain. I alerted the client’s family and called the emergency room with information on her pending arrival, health history, medications and medical device implant before leaving for the ER.  

For three hours at the hospital, I gathered facts, talked to doctors and nurses about the woman’s health history and stressed the need to have all her medications on hand in case of an extended stay. I made sure that my client was comfortable and masked and waited with her for X-ray results, keeping her spirits up by sharing amusing stories about our history together. I also texted, called and emailed regular updates to her family and nursing home.  Fortunately, the woman was able to return to the nursing home by 10 a.m. with her sprained arm in a sling and without any fractures or head injuries. 

While 4 a.m. trips to the ER are not everyday occurrences in the life of a geriatric care manager, they are also never off the table in my role as a certified senior adviser, Aging Life Care Association (ALCA) manager and chief care manager of CHC. It’s a role I’ve embraced in my personal as well as professional life. I’ve been at the forefront of the public health insurance industry since 1996, from Albany to New York City to Washington, D.C. But I also have a lot in common with my clients. I, too, was a family caregiver — twice in my life, first for my uncle and then for my father. I know firsthand how difficult and stressful the role of caregiver can be. My goal is to make caregiving easier for my clients than it was for me. 

My first client told me that knowing whom to go to and when is a strong suit of mine. And I have followed that suit in a number of ways as families of elderly loved ones or solo agers handling their own life situations engage CHC to manage a variety of needs. We help our clients through health crises as well as develop and implement advanced plans for care. We support families and seniors making decisions on all issues — medical, mental health, housing, finance, insurance, legal. Our service encompasses something as seemingly minor as accompanying a senior to doctor appointments — which isn’t at all routine when the patient has hearing, cognitive or mobility issues — to mediating disagreements among family members. Sometimes our service simply gives relatives a break or relieves a solo ager who feels overwhelmed by all the life decisions that need to be made. 

A specialty that sets CHC apart is its focus on a clientele representing all races and ethnicities, people with a wide range of financial resources and family configurations. It’s a specialty that’s been reinforced by my life in culturally diverse New Rochelle, where I am active in my church, and a supportive Girl Scout mom.  

My 30-plus years of experience as a senior health-care executive and professional advocate for health care for multifaceted communities has taught me that providing the right care in the right place at the right time in a sensitive manner makes a huge difference in having a successful health outcome.  

Many families of elderly people and solo agers are unaware that geriatric care management exists — until the resource is much needed. Families and individuals frequently learn about geriatric care managers (GCMs) from a friend who has had experience working with a professional or through a reference from an attorney, accountant, financial planner, home-care agency, insurance agency or even a medical practitioner.  

Some approach care management while in crisis and others do so before a crisis strikes.  But it is never too early or too late to engage a care manager. Over the years, I’ve helped a 93-year-old Yonkers widow relocate from a condominium that was no longer affordable to an assisted-living facility in her beloved hometown. I aided a New Jersey woman as she helped her 81-year-old sister-in-law — suffering from aphasia, or the inability to communicate, after surgery for cancerous brain tumors — to resettle in her native Colombia. And I was the “boots on the ground” for a divorced attorney raising a teenage son in rural Alaska and trying to navigate her father’s various health challenges in Manhattan, a continent away.

Unfortunately, he died in rehab. 

The end of her father’s life was “an intense and essential time,” she told me, adding that she appreciated having me in her corner for the last few months of her father’s life. “I believe he was better off for it.”        

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The Eight Knowledge Areas of Aging Life Care

According to the Aging Life Care Association (ALCA), a national trade association of approximately 2,000 care managers, there are eight knowledge areas of Aging Life Care within the holistic, client-centered approach used by geriatric care managers, also known as Aging Life Care Professionals:   

  • Providing advocacy for the elderly in health, personal care and community settings;
  • Offering crisis intervention for sudden changes in health status, accidents or unexpected hospitalizations;
  • Assisting communication with providers and interpreting health, long-term care and disability insurance;
  • Helping analyze and estimate the financial aspects of eldercare;
  • Sorting through senior living and housing options;
  • Providing information about the legal aspects of eldercare and making attorney referrals;
  • Navigating challenging family dynamics; and
  • Referring to local resources to support the elderly and their family caregivers.
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