Olga Brunner joins Obama Project on Healthcare Reform

For Immediate Release

Boca Raton, Dec. 29, 2008.  Olga Brunner, Founder and President of A Good Daughter Geriatric Care Management in Boca Raton, was invited to attend the first Boca Raton community meeting of the Obama-Biden Transition Project on Healthcare Reform.  The community discussion was presented as an apolitical discussion and was held at the Spanish River Library in Boca Raton on Sunday, Dec 28, 2008.  Moderator of the discussion,  Diane Gold, a Boca Raton disease prevention advocate organized the group which consisted of community leaders and interested senior citizens in the Boca Raton community.  Among the attendees were Dr. Robert Gordon, founder and head of the American Healthcare Association, Ryan Cuff, representative of the insurance industry, interior decorator Barbara Courtney, and a U.S. citizen participating via speakerphone from France.  Attendees were invited as a result of participation in the recent on-line discussion at www.change.gov the Obama-Biden Transition team website. 

 

Our U.S. health care system is flawed and fails to deliver affordable, high-quality health care to all Americans.  Our system faces three interrelated problems which are: modernizing health care information systems; expanding healthcare coverage to all Americans; and prevention and public health.  President-elect Obama presented a framework for health reform to achieve these three goals.  The Boca Raton community participants were presented with a series of seven questions from the Transition project on Health Care reform to discuss openly as members of the South Florida community which they serve.  A final question from the moderator read:  If you had one thing to change in our present healthcare system, what would that be?  Among the interesting solutions presented were:  more transparency; separation of health care providers from pharmaceutical and insurance industries; direct negotiations without insurers; government funding for home health care; trim the fat of incompetence and beurocracy; insurance for all; self advocacy and responsibility; reforming lifestyles for health; universal healthcare with universal standards; preventing pharmaceutical companies from tracking doctor prescriptions written to their patients; government funding for preventative care and optimization instead of disease concentration.  A survey was completed by each participant to be presented to the Obama Transition Team on healthcare reform.  The moderator will draft our group's discussion submissions to the Transition Team along with a group photo taken at this historic meeting.  

For more information, contact Olga Brunner, MS, CMC, health care advocate for Southeast Florida's elderly community and President of A Good Daughter Elder Care Management in Boca Raton.  Website:  http://www.AGoodDaughter.com    

Brunner's contact information:  olga@agooddaughter.com

Interesting Link between Alzheimer's and Diabetes

Blood Sugar Loss May Trigger Alzheimer's : From press wires today in the Journal, "Neuron"

LONDON (Reuters) - A slow, chronic reduction of blood sugar to the brain could trigger some forms of Alzheimer's disease, U.S. researchers said on Wednesday.

The study of human and mice brains suggests a reduction of blood flow deprives energy to the brain, setting off a process that ultimately produces the sticky clumps of protein researchers believe is a cause of the disease, they said.

The finding could lead to strategies such as exercise, reducing cholesterol and managing blood pressure to keep Alzheimer's at bay, Robert Vassar and colleagues at Northwestern University's Feinberg School of Medicine in Chicago reported.

"This finding is significant because it suggests that improving blood flow to the brain might be an effective therapeutic approach to prevent or treat Alzheimer's," Vassar, who led the study, said in a statement.

"If people start early enough, maybe they can dodge the bullet."

Alzheimer's disease is incurable and is the most common form of dementia among older people. It affects the regions of the brain involving thought, memory and language.

While the most advanced drugs have focused on removing clumps of beta amyloid protein that forms plaques in the brain, researchers also are looking at therapies to address the toxic tangles caused by an abnormal build-up of the protein tau.

Vassar and colleagues analyzed human and mice brains to discover that a protein called elF2alpha is altered when the brain does not get enough energy. This boosts production of an enzyme that in turn flips a switch to produce the sticky protein clumps.

The finding published in the journal Neuron could lead to drugs designed to block the elF2alpha production that begins the formation of the protein clumps, also known as amyloid plaques, Vassar added.

"What we are talking about is a slow, insidious process over many years," he said. "It's so mild (people) don't even notice it, but it has an effect over time because it's producing a chronic reduction in the blood flow."

How to Prepare a Parent Before Moving to Assisted Living?

New posting below:  This article came from Ryan Malone's "Inside Assisted Living" posted Dec. 27, 2008.....

A reader asked:  I  would like to hear more about activities that can be done with my mom while she is in my home awaiting the transition to assisted living.  I found a wonderful facility for my mom for Feb. 1. I interviewed the activity director and she was very helpful.  Here are some of the suggestions from the Activity Director:    Start preparing her for the transition by shopping for items that she may want to put in her new home.  If the new community has outings, participate in one of them and bring your mom there to have lunch with the other residents.  Try to involve your mom in all the community entertainment before her arrival.  While at your home, work on a scrapbook together of memorable photos and occasions that she will be able to bring with her.  This is always comforting to bring a little piece of family with her on the day of the move.  The waiting period can cause anxiety, so it will be important to keep her engaged during her time at home.  You want to avoid a situation where she can sit and mull over the move.  If she is interested in crafts, bead stringing or other projects are always good ideas. Making simple recipes or baking cookies for her ” new friends” will help her connect in her new community as well. In short, I would visit there often and start the transition process before she physically moves in.  If you care to comment, please let us hear your suggestions below:  

olga@agooddaughter.com

Do You Know What to do Before a Hospital Discharge?

If you are confined to bed, your hospital team (or case manager) will assess your ability to move about and position yourself for maximum comfort and to prevent skin breakdown. They will decide whether you need a trapeze to help raise yourself in bed and will examine your ability to transfer in and out of bed, either to a wheelchair or to an ordinary chair.

Walking

If you are able to be up, your hospital team (or case manager) will evaluate your ability to "ambulate" (walk) to the bathroom, and to other parts of the house. If you need help to move about, your hospital support team will show your family how to support your weight while you are walking and getting out of bed, so as to avoid injury. Perhaps you can walk independently with the use of a "walker," a "three-pointed" or ordinary cane, braces, or other specialized equipment.

It is very important that your equipment be the right size and configuration, and that it be adjusted specially for your needs. You must be sure to speak up at any time if your equipment is no longer satisfactory. When using braces, pay particular attention to your skin in the areas where braces fit. Point out any blisters or areas of redness. If you find that your shoulders, arms or legs get very tired during walking, it may be that your appliances, cane or crutches are not in proper adjustment, or that you may need some additional exercises.

Toileting 

Bowel and Bladder should be re-evaluated in light of your home set-up. Are you able to walk to the bathroom independently or with the use of aids? Is the toilet situated so that you can safely and easily use it? Equipment may be needed to adapt the height or accessibility of your toilet. A raised toilet seat, arm rests or grab bars can be easily added if needed. If you cannot get to the bathroom, a bedside commode can be provided. Arrangements can be made for privacy and cleanliness.  Urinary incontinence is sometimes a problem after certain kinds of strokes or surgical procedures. If your situation requires the use of a catheter of any type, your nurse will show you how to use and care for it. If incontinence products are needed, purchasing those ahead of time is important.

Bathing

An assessment of your ability to shower or bathe and proper equipment needed is important. If sponge baths are preferred, decide whether the bed or bathroom would be more practical and energy-saving. Have the nurse or (case manager) show your caregiver how to bathe you most efficiently, simply, and with the least discomfort. Bed and sponge baths should be comfortable and relaxing.

Transportation

Transportation may be a concern, particularly if you will have therapy or doctor appointments. If you have private insurance, check to see whether it covers ambulance or alternative transportation. Ask your hospital discharge planner or case manager if there are local transportation resources available. Some free transportation may be available. 

Home Health

Home Health Agencies are available in most communities and will provide skilled services on an intermittent basis and paid for by Medicare. The services of professionals who make up your home health team (e.g., registered nurses, social workers, and physical, occupational, and speech therapists) are prescribed by your physician. Your hospital discharge planner or case manager will help arrange for home health services if needed.   

If you are a long distance family member looking for a professional geriatric care management team for your loved one, please call A Good Daughter Elder Care Management in Boca Raton, Florida.  See us on the web at:  http://www.agooddaughter.com or call:  800-963-3877.  olga@agooddaughter.com 

New for 2009 - Understanding Social Media 101

New posting below:

OK, so we're getting closer to 2009.  You've called everyone you know to wish them happy holidays and you've emailed everyone on your contact list.  What else can you do?  Funny you should ask.  The following guide will give you tips on how to make the most of your networking efforts going forward in the new year.  And that includes networking around the globe.  I recently discovered another Olga Brunner in Spain on Facebook.  Before starting make sure you read and comply with terms and conditions of each community.  Here we go:  

1.  Blog.  What is a blog?  A blog is a web site that provides text, photo and/or video content in chronological order.  If you have a blog, it may be hosted freely as part of a larger blogging community like Blogger, Tumblr, Typepad, Box, Blogspot, or WordPress.com  What to do?  Write blog posts that link to your web page.  To set up your own free blog, go to one of the blogging communities noted above and follow the step-by-step instructions to set up your own blog.  

2.  Podcast.  What is a podcast?  Podcasts are digital audio recordings of a broadcast or similarly recorded program, made available on the Internet for downloading to a personal audio player (like an iPod).  What to do:  If you're a podcaster, don't forget to tell your audience about your web page.  If you'd like to learn how to create your own podcast, go here, for step-by-step instructions:  http://www.podcasting-tools.com/how-to-podcast.htm

3.  Vodcasts.  What is a vodcast?  Vodcasts are digital video webcasts created by any user, usually hosted in an online video sharing community like: Blip.tv, Brightcove, Dailymotion, Youtube, Vimeo or Viddler.com  What to do?  Use your vodcasts to explain your ideas, while directing people to your URL/page.

4.  Social Networks.  Microblogging social networks are a growing online segment of people who are part of a community like Twitter, Jaiku or Pownce.  The microblog platform is a way to share details of your life or what you are doing in between the times that you sit down to write blog posts or emails to friends and contacts.  You might tell your friends what you are making for dinner or the name of a new book you are reading, by sending short, 140-charachter messages via the web.  On twitter, these short messages are nicknamed "tweets".  

5.  Online or Mobile Social Networks:  Communities that connect people with friends or new contacts online or via mobile devices.  Examples of these are Facebook, Imeem, Linkedin, Myspace, Plaxo and Twitter. What to do?  List and share your URL on your social network profile pages in communities like Facebook & Myspace.  

6.  Social Bookmarking sites?  Sites such as Furl, Del.icio.us, Google Bookmarks, Ma.gnolia, Reddit, StumbleUpon are communities of people who save links or "bookmark" things they want to read/do/reference online at another time, and see what other community members are bookmarking/interested in.  So, set up an account, save, share and tag your URL.  

7.  Other online communities?  Communities are formed to connect people with common interests, hobbies, or provide information.  There are millions of 'em.  

8.  Status Updates?  Instant message services such as AIM, Facebook, Google Talk, iChat, MSN messenger or Yahoo messenger.  People who work online have been known to stay in touch with friends from work using these.

9.  What are web and mobile chat platforms?  Mobile chat platforms like Seesmic or Qik or live stream, similar to videoconferencing but from your webcam, laptop camera or even cameraphone.  Visit their home pages for step-by-step instructions to start your own online video conversation stream.    

Credit for the above information given to:  www.ideablob.com/about/social_media  

Good luck out there.  Please feel free to comment.  Hope it was helpful.  Get a marketing plan for 2009 and go for it!  Social networking is the way to go in 2009, even if you're a baby boomer.  

olga@agooddaughter.com

Bill Paying for Client With Dementia

New posting below:  From time to time on the geriatric care management list-serve we share different viewpoints on issues that may improve how we serve our clients.  Following is a post from a care manager in North Florida (Toni Nelson-Huff) on the subject of care managers and bill paying for clients with dementia.  

"Many older and frail clients need assistance with bill paying, but may find it cost prohibitive at a standard GCM rate if you pay the old fashioned way with handwritten checks from the clients checkbook.  I agree that becoming a signer on a client's account is not a good idea.  It may make things easier for your accountant, but it opens you up to a lot of risk.  (As an aside, I really think that your accountant should be someone who can give you sound risk management advice, and I'm not sure the suggestion to become a signer on a client's account qualified as that.)

I did bill payment through an escrow account for many years.  If you use a program such as QuickBooks and have a system set up, it goes very quickly.  Paying several bills a month took less than a quarter hour for multiple bills, and seldom was more than an hour even if research had to be done on a bill.  Clients make a deposit into the account, (which is entirely separate from paying our invoice) and those funds are used to pay bills.  The original bill and proof of payment are filed away and at year end, or sooner if they prefer, are provided to the client.  Each month they receive a printout of the bills paid and the amounts.  This does require having someone with some bookkeeping skills.

Another option is using s service such as PayTrust. www.paytrust.com  It is a very comprehensive bill paying service that provides many ways to pay bills, and many different built in reporting formats.  You would still need to set up an escrow account, but save the steps of receiving the bills, writing checks, mailing them.  

Either way, the important issue is to make sure not to co-mingle your business money and the clients escrow money. I know one agency director who opened escrow accounts in a separate bank from the business account to make it harder to mistakenly make a deposit the wrong place.  Bill payment service requires a lot of checks and balances in order to protect you and the client. Have a clear policy statement of what you will and will not do, and procedures for how you will carry out your policy. Make sure the client, or their responsible party, agrees in writing to your bill payment policy.  I would also check your insurance policy to see if it is covered. Some do cover bill payment, but no forms of investments or money management activity."  

In our care management practice, this issue came up when a dementia client who was still able to pay bills before going to the hospital, became unable to pay 24 hour a day caregivers while in the hospital.  In this case, her daughter left blank checks that could be prepared and signed by the client as soon as she was able to resume bill paying for herself.  Please feel free to leave your comments below.  olga@agooddaughter.com

Do You Really Know Why Someone Takes A Turn for the Worse?

New posting below:

Last night I received a call from a visiting daughter when paramedics were called, stating her mother fell and had a possible hip fracture.  A few hours later when it seemed apparent my client was going to be admitted to the hospital, and with the daughter's flight schedled to leave tomorrow, I urged her to get a private caregiver for her mom.  I understand the terrible expenses associated with a private caregiver at a bedside when hospitals are supposed to provide this care.  However, I've already experienced how night shift nursing staff have different priorities than day shift. Having been on the inside of the business working midnight shift as an assistant administrator, I observed firsthand what goes on at night and the reasons why some staff prefer to work at night. They do so because they're away from the watchful eye of supervisors and family members.  Things go wrong.  

Case in point, a few months ago an 80 y.o. female client was hospitalized with bowel obstruction.  I instantly got her a private aide at night, mostly because staff tends to be short at night and for her own comfort because of dementia.  The aide called at 2:00 am telling me she had taken a turn for the worse, and her cardiologist/ internist left specific orders for her to be transferred to ICU with Levaquin drip.  The charge nurse on her floor however, decided to send the patient to the telemetry floor and not the ICU because "this will make us look bad", not knowing the aide was privately paid by the family and was not hospital staff.  I got to the hospital just as the patient was sent to the wrong floor and the exchange was taking place between the two charge nurses.  The nurse in telemetry was refusing the patient because they couldn't administer the "drip" as her doctor ordered.  I walked into this nightmare just as all this yelling back and forward ensued.  

When it became apparent my client's vitals were deteriorating, I pulled out my cellphone and went to call her doctor telling him of the nurses' refusal to follow orders.  An effort to pull nurses off the ICU floor and administer care on this telemetry floor was further delayed by who knows what!  

Eventually, the doctor calleded back, the administrator was notified, the patient was transfered to ICU (although valuable time was wasted by the hospital's inefficiency) and the patient expired. Had it not been for our private aide, we would never have known why.  A word to the wise, when you have a parent in a hospital or rehab facility, allow the funds for private duty care.  It could make a big difference in your parent's outcome.   I welcome your comments.  

olga@agooddaughter.com

CLEANING HOUSE

New posting below: Recently I was asked by an adult child who lives in a foreign country and has a dad in our service area to "Clean House" with respect to the caregivers assigned to her dad's care.  It seemed her father had become quite disturbed by one of his caregiver's recent behaviors but was afraid of change because he was very dependent on her.  The daughter could see that dad was often worried that his caregiver would get mad at him since she carries grudges for years.  I provided the daughter with our usual explanation about preparing our comprehensive assessment, explained how we could resolve her dad's situation, and sent her our free report via email which we make available to new families.  The daughter responded with her goals which were: 

1. Get a picture of what is involved with his care so that this info can be transferred to any new people who come on the job  2.  Ascertain whether you think his case is one for which you could find a good live-in person and relief people  3. And concern for our fee to do the assessment and any consequent charges because her dad was running out of money and he would soon have to go into long term care as a result.  

 The Medicaid laws here in Florida (and in the rest of the country) have become more stringent for admission.  Just because an elder runs out of money does not qualify for admission.  I would therefore, have to provide a pretty comprehensive analysis of his medical, mental, legal, financial, environmental and social aspects in order to see if down the line there is enough to qualify him for a long term care admission.  

Now for our assessment: Our staff nurse and I conduct this assessment together and generally spend 3 hours doing so. Beyond that we take the information back to the office and work an additional 3 hours preparing the plan of care and entering data into our database.  Actually, our fee is the least expensive in Southeast Florida for a certified professional care manager (I've checked).  What I refer to as a “free home evaluation” is basically a Meet and Greet to evaluate the dynamics of the case and to see if we would be the best fit for the client.  This is usually done when an adult child is in town and we are all meeting one another for the first time.  A GCM assessment is completely different.   

In the past we have chosen to accept new clients without this assessment and have found this first of all not to be the best way to start a case for the client's best interest. Our training takes us far beyond what a family member would expect and as care managers we have a trained eye to look for things in our assessment that in the long run would prove beneficial to the client.  When we have taken a new client without this assessment, we sort through the bits and pieces as we go along and in the long run this "piece-meal" approach is far most costly to the family.  

Our nurse starts with checking the client's vital signs.  We then look at medications, diagnoses, hospitalizations, surgical history; get information on every medical person the client sees; put together a key contact list of all family members, friends, neighbors, and significant persons in their lives; obtain copies of the legal documents; find out if they've made end of life arrangements and document where and with whom; find out who the attorney is and who the financial advisor is; determine the client's assets, expenses; and income; look at their functional ability; look at the safety features of his home; look at what activities the elder participates in for a meaningful social life and find out if he obtains religious services and where.  In addition we perform a geriatric depression assessment as well as an exam for cognitive status.  After the assessment is complete, we prepare a plan of care with all of our recommendations including:  concerns; goals; action plan and present a written document that is beneficial to family as well as medical providers.  We stand by starting a case with this assessment-it's the best way to advocate for this client.  When you look at it is not such a costly expenditure for 2 medical professionals conducting this in the home without inconveniencing the client.  

In addition we provide all of our clients a complimentary Grab-n-Go Emergency Folder with all of their vital information in one neat, attractive folder which fits on the client's refrigerator.  In South Florida EMS personnel are used to going to the refrigerator for vital information.  We keep this information fresh and updated consistently.  This folder is also a handy tool to take to a doctor's office at the time of an appointment instead of carrying "pill bottles" as we often see in doctor's offices when clients go with their aides.  If you agree or disagree or just wish to comment, please select the comments link (below).  olga@agooddaughter.com   If looking for a competent care management assessment, please go to the web: http://www.AGoodDaughter.com

Adjusting to A Retirement Community

New posting below:  I recently received a letter from a client's son stating that his father had complained recently about his living situation stating he wanted to buy a small house.  He complained about the food, the other residents, the neighborhood, the expense, etc.  The son stated that it was hard to fully understand what his dad's displeasure is related to, but thought it's more related to being old and less independent than it is to anything specific about his retirement community.  Since seniors with cognitive impairments may not handle the strange surroundings, a new schedule, and all the new people very well we both are a ware that a move to his own home is out of the question.   Do you have a parent threatening to move out of a safe retirement community?  Share your comments below.  Be sure to look for our own comments in this particular situation.  olga@agooddaughter.com

Alzheimer's and Sundowning in the Independent elder

New posting below: 80 year old female has 4 adult children who live long distance and grandchildren in town. She  is starting to have behaviors associated with sundownerʼs syndrome which goes hand in hand with Alzheimerʼs type dementia.  She has been treated for AD this past year and lives alone with a part-time aide who visits in the afternoons and prepares lunch and dinner, and takes her to a senior center for activities. Currently, she wants to be up at night and wants to spend the day sleeping.  Client just told her daytime aide to leave because she wanted to sleep all day today so we are starting to see a pattern.  I had a long conversation with her psychiatrist whom she sees for depression and he suggests that it may be time that the family start either looking for a retirement facility or get her a live-in aide.  Doctor states she is unable to take stronger sleep aids because she lives alone and may be a fall risk.  She needs to get up, groom, dress, eat meals, take medications, go to stimulating activities during the day so that she can have restful sleep at night.  Problem is her family takes her out when they're in town and keep her out till late so she misses her sleep and night medications.  This is not working for her anymore.  The family needs to be aware that she has a progressive disorder and her life needs consistency.  Disturbing her body clock, flying her all over the country to visit family, has negative effects on her cognition, increases her depression, and causes confusion.  Missing her night meds and her mild sedative, isn't good.  As care managers, we've  put in place great measures to give her life more consistency which is what she needs.  Her disease is progressing and family needs to be aware of the confusion caused by all this inconsistent behavior on their part.  I have urged them to follow a simple plan of action with her to no avail.  Here's the question: How to get them interested in her best interest and to stop overstimulating her at night due to their own feelings of guilt? I welcome your comments. Please leave your post below at the comments link. olga@agooddaughter.com

 

Shingles - The Importance of R and R

New posting below: To other Geriatric Care Managers:

Having had a recent bout of shingles myself and looking at a new vulnerability, I see the value of rest and relaxation, not working from 6:00 am to 10PM, unplugging from the Blackberry every now and then, and relying on staff to have greater responsibility in terms of client management. This morning I allowed myself to sleep-in until 8AM, something I never do.  I allowed time for coffee and did some meditation before checking the blackberry for our most recent emails, and you know what, my world did not collapse because I took time for me.  In speaking with a client's daughter just a few minutes ago, I was reminded that I need to allow my body to heal completely so there is no relapse.  As she reminded me, our nurse is completely competent to take over while I work from home.  So, here goes Olga, don't feel guilty, take your antioxident juice and vitamins, drink water, and practice what you preach to others so that you can return to work soon well rested, less grouchy, and able to do what you do best.  Shingles is not a disease of the aged, it can happen to anyone who had chickenpox as a child and is in a highly stressful situation.  With the current economic climate's effect on small businesses, we are all feeling the pinch so do as I say and do, take time to relax, meditate, sleep in if you have to, work from home when you can, exercise to stay strong, and take time to laugh!  (the best medicine of all).  Any comments? 

Move Management for Seniors

New posting below: I can't tell you how many clients I work with that manage to remain stress free all throughout the entire buying or selling process of their homes (which must also fall in the "top 10 most stressful things to do" list), but then turn into frazzled monsters when moving day comes around. Common sense tips, like keeping your medicines, wallet, cell phone, etc. available (and unpacked) before you move, and creating a map of what goes where (and then labeling the "what" so you know "where" it'll go when it gets there) are some great ideas for making a stressful day less hectic. For senior moves in North Broward and Palm Beach counties I usually recommend a senior move manager when downsizing from a large home into a retirement community. When interviewing senior move managers be very careful that they fully estimate the job and not underbid the others by leaving key areas of the home off the estimate. I have had nightmares with a vendor who did just that. Any additional comments? Post them below....
olga@agooddaughter.com

Reverse Mortgages in the new Economy

New posting below: When looking at ALFs with our clients we kept hearing from the facility marketing people who explained they weren't at full occupancy because the new customers couldn't sell their homes. In this market they can't sell their homes so they don't have enough money to pay entrance fees or monthly carrying charges. A real problem for many, but we are always surprised at how no one ever mentions a reverse mortgage as a tool to get around that. Although your financial adviser or banker could explain in more detail, the idea is that the bank will give you monthly installments on the value of your house, plus interest. At least you would have enough for monthly carrying charges. In the end, unless you pay it back, the bank will own your house. I wonder if the bank will give you payments in larger increments than monthly. Anybody know? Do reverse mortgages work only when you continue to reside in that home?
olga@agooddaughter.com

Driver Evaluations and Seniors

New posting below: An 82 y.o. female lives independently, still drives, cooks, visits friends, shops, pays bills, dresses self, does own laundry, plays cards, etc. Had a major motor vehicle accident last year, suffering loss of consciousness and amnesia. Still does not remember how the accident occured. Driver's test one week post accident warned she should limit driving to her immediate vicinity but did not restrict license. Just had another MVA and does not want a repeat driver's eval. How would you convince her that this is in her own best interest? Contact: olga@agooddaughter.com

Aging and Alcoholism

What are the options regarding an 83 year old individual who should not live alone due to the 'infirmities of aging' such as sensory loss, no transportation, fall risk, alcohol abuse, refusal of outside help, and adamantly refuses to consider an Assisted Living Facility?

Doctors in conjunction with a professional geriatric care manager can delve into the various problems that underlie certain behaviors. Getting a senior citizen sleeping well, eating well, taking medications which are needed can go a long way to a happy well-adjusted life. First of all I would recommend a psychiatrist that specializes in substance abuse. I would then look into Home Health care from a State Licensed Medicare Agency who can come in and organize the medications then make daily visits to ensure compliance. Does he have an internist in whom he trusts? The internist can write an order for home health. This is paid by Medicare. Having someone work on his addictive behavior combined with daily visits from a home health team can go a long way to his road to recovery. If interested in a professional care manager to perform a comprehensive assessment go to http://www.agooddaughter.com/ Care to be the first to comment? Please click on 0 comments link (below)