​By Lory Smeltzer, BA, MPH, CMC

Does this sound a bit familiar?

A call came into my office from a woman “Sara” who lives in New Jersey. She expressed concerns about her elderly mother “Dee” who resides at home in Florida. Dee had a recent fall with no major injuries and her short-term memory is getting worse. Dee heard about a caregiver who helps others in her neighborhood, so she hired her on privately for 5 hours every day. The caregiver helps Dee with bathing, meal prep, medication reminders, and transportation to doctor’s appointments. Sara was told by the neighbor next door that the caregiver has not been showing up for some shifts and has left early for most of her shifts, leaving Dee to fend for herself.

Sara is the oldest of 3 and although she has never been emotionally close to her mother, she was appointed a few years ago by Dee to be her Durable Power of Attorney and Health Care Surrogate, so she wants to make sure Dee is well taken care of. Sara’s siblings have never agreed with Sara’s decision to keep Dee at home and they bring that up to Sara every chance they get. They thought Dee should have moved into assisted living years ago. Now Sara is questioning her decision-making judgement.

Search and Seek

Sara needed professional advice. Someone who deals with these situations and family dynamics often and knows how to find the right solutions. Sara found my Aging Life Care Management agency, Advanced Senior Solutions, after speaking with several other professionals involved with Dee. She spoke with Dee’s doctor, financial planner, and pastor. Sara then called Dee’s estate planning attorney, who gave her my agency’s information. When Sara called me, it was clear how distraught she was. She has been trying to manage mom’s care from a distance along with holding down a full-time job and raising 2 young children. Sara asked me what she should do; abide by her mother’s wishes to stay at home or move her into assisted living. She had never heard of the profession of Aging Life Care Management and did not know how we can help.

Best Kept Secret

I explained to Sara that this profession was founded 35 years ago by a group of social workers in New York who worked for hospitals and nursing centers. We come from healthcare and mental health backgrounds such as Case Management, Social Work, Counseling, Psychology, Public Health and Nursing, are degreed and/or certified, and are members of the Aging Life Care Association where we have to abide by a strict Standards of Practice and Code of Ethics along with continuing education. Not all “Care Managers” are Aging Life Care Professionals so families must do their due diligence when considering hiring one.

How We Can Help – Let Me Count the Ways

An Aging Life Care Professional offers various services to help families like Sara’s by assessing Dee’s needs, identifying areas of concern (or potential concern), creating an individualized plan of care, making appropriate recommendations, coordinating services, and then overseeing the care. We assess medical, psychosocial, functional, safety/environment, legal, financial, and end of life / spiritual needs. We work as a team with Dee’s financial planner, attorney, physician, and home care providers. Once we get the appropriate mix of reputable services in place, we will visit Dee on regular oversight of care visits and tweak her care plan according to Dee’s changes in level of care. We can attend doctor’s appointments, ask the right questions, take accurate notes, and then send a progress report to Sara so she is kept abreast of our involvement. When the time comes and Dee can no longer manage at home either due to safety or financial constraints, we can begin the difficult conversation with Dee and the family in considering moving her into a more appropriate alternative living environment. Most importantly, we can oversee Dee’s care in assisted living, skilled nursing, or rehab centers, and even in hospitals. Because we are paid for privately (not by insurance), we can advocate for Dee across all settings, making sure all healthcare providers are communicating effectively and planning for Dee’s safe discharge. Most importantly, we are Sara’s unbiased professional advisor, so Sara is confident that she is making the best decisions on behalf of Dee, which also keeps her siblings off her back.

So, What Happened to Dee?

In summary, Sara signed on for our Life Care Management services and Dee was assigned to one of our Nurse Care Managers. After completing a comprehensive assessment of Dee, the Nurse found her to be exhibiting signs of a Urinary Tract Infection which manifests in falling and an increase of confusion and forgetfulness. Dee was also malnourished and not taking her medications as prescribed. With authorization from Sara and Dee, the Nurse Care Manager requested the doctor to write orders for a urinalysis (positive for UTI), arranged for Medicare Home Health Care (Physical and Occupational Therapy), brought in private pay home care through a reputable agency, a shower chair and walker, and oversight of care visits by her Nurse Care Manager to attend doctor’s appointments, manage her medications, monitor her overall well-being, and be available for emergencies 24/7. Dee is still thriving at home today, which gives Sara and her siblings a tremendous amount of peace.

For more information, contact Lory Smeltzer at Info@advsrs.com or 727-443-2273

CAREGIVERS YOU ARE NOT ALONE