Brandywine  - Elder Care Management, llc
 Latest Blogs:  (Updated 10/01/17)

Elder Care and Assisted Living:
Who Will Care for You?  By Penelope Wang  8/31/17

CR helps you find a residence that will keep you or a loved one safe and happy, at a price you can afford.

In 2010, Wallace Kirkpatrick, 89, was living alone in San Antonio after his wife died. A friend suggested that “Kirk,” as everyone called him, get an apartment in the assisted living facility where he also lived. Kirk soon settled into Esplanade Gardens. “He had a buddy there, and he got along with the director, so he fit in very quickly,” says his daughter, Tara, who lives nearby. Kirk was especially pleased by the dining service, which made grilled bacon-and-cheese sandwiches, one of his favorites, on request.
 
For six years Kirkpatrick was happy. But by spring 2016, when he was 95, he began to show small signs of cognitive impairment. “Once he forgot where he was going, and another time he tried to unlock the apartment next door to his by mistake,” Tara says. A newly arrived facility director insisted that the incidents meant Kirkpatrick needed more supervision than the residence could provide. That meant his family would have to move him to a facility with a memory care unit or hire additional caregivers.
 
The family was reluctant to consider changing residences. “It was too early to move him,” says Tara, 61, a speech-and-language pathologist. “My dad was still very functional and would have been surrounded by people far more impaired.” The family met with the director and agreed to hire private caregivers to keep a closer eye on Kirkpatrick.


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Emergency Room Visits: 

Many of us, unfortunately, will at some point need to visit an Emergency Room (ER). Most of you reading this will either have had a personal ER visit, or have taken a loved one to an ER. In those over age 65, falls and drug side effects commonly precipitate ER visits. According to the Centers for Disease Control and Prevention (CDC), the ER visit rate for those 65+ is over 500 per 1,000 persons, and that rate increases with age.
 
Regardless of the reason why someone heads to the ER, there are ways to make this experience as smooth and comfortable as possible. Here is a list of tips for what to bring to the ER, and what to expect once you’re there.
 
What to bring to the Hospital Emergency Room
*** Make up a ‘kit’ ahead of time
 
  • A copy of your insurance cards
  • Names and phone numbers of all your current doctors (include their specialties)
  • Names and phone numbers of close family members or others who help with your care (ex. neighbors)
  • List of current medications; including prescription, OTC (over the counter), vitamins & herbal supplements * Bring any medications you may need the first few hours in case there is a lengthy wait to be seen
  • List of your allergies
  • Copies of your recent medical test results or X-ray reports
  • Copies of legal paperwork:
    • Medical power of attorney
    • Legal power of attorney
    • Living Will / Five Wishes
  • Glasses, hearing aids (and extra batteries)
  • Sweater or light jacket
  • Notebook and Pen
  • Snacks
  • Book or something to entertain yourself
 
What to expect in an ER Visit
 
  • You’ll likely have to meet with a nurse or other ER worker to be “triaged.” This is where the staff will decide how serious your condition is and how quickly you need to be seen.
  • You’ll be asked a series of questions about what happened right before you came to the ER.
  • You will need to fill out a number of forms; including a ‘consent for treatment,’ a ‘consent for payment,’ and a HIPAA form.
  • You may be asked the same questions by a number of people.
  • You will likely wait a long time
  • If the hospital staff decides you need to spend the night, ask if you are being “admitted “ or are under “observation status.” A future blog will explain the impact of these differences.
 
With proper planning, a stay in the ER will be easier to manage. Remember, the staff is there to help. Patience, politeness and a smile can help everyone through these stressful experiences.
   

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May is National Aging Life Care Month. Each year the national Aging Life Care Association designates this month to recognize the work of Aging Life Care Managers. For this month’s blog, I’m going to answer some common questions you may have about this profession. 
 
Who are Aging Life Care Managers? 
We are professionals with advanced degrees and certification in fields related to seniors’ physical, mental and emotional health and well-being. With a client-centered approach, we assess the current situation and determine a Plan of Care to manage both current and potential future challenges. 
 
What are some terms that describe the work of Aging Life Care Managers?
Consultants, Advocates, Coaches, Mediators, Educators, Problem-solvers, Conflict-resolvers, Crisis Intervention & Medication Management professionals, Aging in Place advisors, Senior Community selection advisors
 
Why did I become an Aging Life Care Manager?
My grandmother, a very loving and special lady, lived in another state. I witnessed how difficult it was for my parents to help her as she got older. No matter how much they did to help her, they could not manage all her challenges. Since they lived far away, they did not know who the best providers were, which senior community might be the right fit for her, etc. They struggled to coordinate with her doctors, help her maintain her home, make sure she was taking her medications and eating properly. 
 
At that time, we were not aware of Aging Life Care Managers who could help us ‘navigate the maze of elder care.’ Years after she passed away I heard about this profession, decided to attend graduate school, and started my business. I wanted to assist others so they wouldn’t have to struggle to help their loved ones as we had. I’ve now been working in this field for over six years, and cannot imagine a more rewarding profession.
 
What do I like best about being an Aging Life Care Manager?
The opportunity to make a difference; to step into a crisis and help stabilize the situation, as well as plan ahead to prevent other problems from occurring. Each family’s situation is different. I’m constantly learning. 
 
What is the most valuable lesson I’ve learned from my clients?
How to handle difficulties with dignity, perseverance, and a sense of humor. My clients face significant challenges, but they rise to the challenge and I find that inspiring. 
 
For more information on the field of Aging Life Care, please visit the national Aging Life Care Association: www.aginglifecare.org
 

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ICE (In Case of Emergency) Information
 
 Make a Plan!
 Should you become incapacitated and require help, determine a plan  ahead of time.
  • Who should be contacted first? If you have a health care Power of Attorney (POA) that person should be the primary contact.
  • Is there a relative or friend you want contacted next?  Coordinate with that person ahead of time whom he or she should call and in what order.
  • Is there a family member or pet who requires in-person help? If so, make sure your primary contact knows how to line that up.
  • Keep Power of Attorney and Living Will documents in an easily accessible spot. Alert your primary contact to the location of those documents.
  • Most fire departments have free kits for emergencies that can be easily located by EMTs. Some include a form to complete that’s stored on/near the refrigerator. Others use a canister kept in the freezer. Regardless of the type, current medical conditions, medications, allergies, and copies of recent EKGs or other critical test result information will be included.

 In a safe place keep:
 1. Financial Information *** Compile a document that has login  information for all your accounts
    • Bank account and investment account names, account numbers, contact person at branch if available
    • Home and auto loan details, with contact people if available
    • Photo copies (front & back) of:
o  Insurance cards
o  Credit cards, ATM cards, store or gas charge cards,
    frequent flyer cards
o  Face page of passports
o  Drivers licenses
 2. Utility/phone/cable/internet company account numbers
 3. Compile a separate page for any work-related accounts, again with        login information
 4. Computer, tablet & mobile phone passwords
 5. EZ pass or tolltag accounts
 6. Online accounts like Facebook
 7. Contact Information
    • Family & Friends
o Home & cell phone numbers for first person to be        contacted - this should also be entered into a smart
   phone if possible under the ICE heading
o Relatives and friends who should be contacted
    • Doctors
    • Attorney
    • Accountant
    • Work contact person if applicable

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 Holiday Gift Idea 

With the holidays coming up the question arises, “what can I get my Mom/Dad/Grandpa/Aunt, etc.?” Often older loved ones have limited space and neither need nor want another item to find a place for. The situation can be further complicated by medical conditions like Parkinson’s Disease that impair dexterity, or dementia that impairs the mind’s ability to connect with a gift.
 
We truly want to find something that will show we love them and think about them. We wish we could be with them more often, and we want to find a way to make them smile.
 
On occasion I come across a gift ideal for my clients and client families. A company called WeMontage (https://wemontage.com) has such a product. It makes photo-montage “removable wallpaper.” Think of a poster with a sticky backing that can be moved from place to place and requires no hanging accessories. The process is relatively easy; choose the size of the poster and upload your photos. Check the website for pictures of several finished products.

                                Click to Watch Video   

                         

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Photos are no longer ‘trapped’ in an album that’s heavy, hard to reach, or difficult to page through. The poster can be placed within easy view and is a great conversation topic for visitors.
 
In addition to your loved one’s enjoyment seeing the pictures, is an important value for caregivers. They did not have the opportunity to know the residents when they were young, active and successful. Our elders have a lifetime of accomplishments we’re often unaware of. It can be difficult to relate to someone at a stage of life we haven’t yet reached. However, seeing that person at age 20, as a young parent, participating in a hobby, etc. is relatable. Imagine how nice it would be for your loved one to discuss her time in the high school marching band, or the cool car he used to drive.
 
Holidays can be busy and stressful. It’s terrific when we can find a gift that will be meaningful and give joy to our older loved ones. A WeMontage poster may be just that gift.


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Helping Your Aging Parents:
Are you concerned about your parents as they’re getting older and uncertain how to help them? Maybe you are unaware of what resources are available, what legal documents should be in place, or what living options are the best to consider? As an Aging Life Care Manager, I assist families struggling to find answers and plan for the future.
 
If you would like to help your aging parents, here is a checklist to get you started:
 
    Legal – In addition to having an updated will, did you know it’s important your parents have both a Durable Health Care Power of Attorney and a Financial Power of Attorney? These documents authorize you or another designated person to make decisions on your parents’ behalf if they become incapable of making sound decisions. Closely related to the power of attorney documents is a Living Will. This allows your parents to communicate their wishes regarding which treatments they would or would not want should they become incapacitated.
 
    Medical - It’s a good idea for you to have list of your parents’ current doctors, medical conditions, and a list of all their medications. Be sure vitamins and herbal supplements are included as well, since these can interact with prescription medications. Review with your parents why they were prescribed each medication, and at what time(s) each is to be taken. Be sure your parents share an updated medications list with their doctors at every appointment. It’s even wise for them to bring the actual medicines in the original containers to these appointments. A gallon-sized Ziploc bag works well for this. If your parents use plastic pill boxes, available at drug stores, to sort their medications according to time of day they are to be taken, the original containers should be kept together in the bag anyway.
 
    Housing – Ask your parents about their long-term living arrangement plans. Some are open to moving into a Continuing Care Retirement Community (CCRC) or a Personal Care (PC) or Assisted Living (AL) community. Others are adamant about remaining in their homes. Regardless of the plan, it’s important to recognize some level of assistance will be needed down the road. This conversation will help you if a parent’s ability to safely live independently becomes a concern.
 
    Transportation – As we age, our ability to drive is impacted by cataracts, arthritis and other medical conditions. Driving at night may become difficult, but that doesn’t mean your parents need to be home bound. Community-based driving services, private-duty companions, and help from friends, family & religious communities may be good options to support independence while assuring safety.
 
    Vital Information – Encourage your parents to keep a list of all investment, banking, and credit card account numbers, as well as details of mortgages/deeds/titles, medical and life insurance policies, birth certificates, marriage licenses and social security numbers. Ask your parents where this information is kept, and keep a copy if they are agreeable.
 
It’s best to have these conversations before there is a crisis. Your parents will be more willing to share their thoughts when they understand your goal is to understand and respect their wishes.
 
If you need some professional assistance to help guide you through the maze of elder care, you can visit aginglifecare.org and click on Find An Aging Life Care Expert.