You’re Promoted:Caregiver to Care Manager

Robert Miller, LMSW, CDP, Operator

Vice President of Company Development

DISCLAIMER:

I DO NOT have all the answer. I wish I did!

But I have touched most of the areas we are talking about today… both personally and professionally.

Objectives 1:

1. Understand the emotional weight in the role of caregiving and decision making.

5.4More than million people are living with Alzheimer’s disease

By 2050, the number of people age 65 and older with Alzheimer’s disease may rise as high as 16 million.

http://www.alz.org/facts/overview.asp

Facts about Alzheimer’s

47.5%Nearly half of people aged 85 and older,will have the disease

For those that think this is just an old person’s disease,200,000 people under the age of 65 have Alzheimer’s.

http://www.alz.org/facts/overview.asp

Facts about Alzheimer’s

60%More than of family caregivers report high levels of stress due

to prolonged caregiving…

and 35% of caregivers report that their health has gotten worse due to care responsibilities.

http://www.alz.org/facts/overview.asp

Facts about Alzheimer’s

There is a difference between “caring” and “doing”.Numerous gerontological research studies report that family members provide nearly 82 percent of the necessary care for an elder family member. Oftentimes there is one primary caregiver…

UCSF/Human Resources: Elderly Caregiving: Choices, Challenges, and Resources for the Family

You can care, BUT have a plan

You cannot plan for everything, but a plan helps make sure that both Care-Receiver and Care-Giver get their different needs met.

UCSF/Human Resources: Elderly Caregiving: Choices, Challenges, and Resources for the Family

The TRUTH

Most family Care-givers are not prepared or practiced for all the responsibilities in caring for someone aging and/or ill.

Do you know WHO you are caring for?

Your History…

Gma

Nothing taught me more than becoming a Care-giver…

DorothyGma

Defining Care-Giving

Providing unpaid assistance for the physical and emotional needs of another person.

• Caregivers provide a wide range of services:• Errand Running

• Medication Management

• Physical Care… assistance with dressing, bathing, incontinence, transfers

• Transportation

• Bill paying and business management

• Food prep

• Etc… http://www.alz.org

Robert Miller, LMSW, CDP, AHCA

As well as… CNA/CMA… PT/OT… PhD… CPA… M.Div… CFO… CEO… CIO (Technology)… CPHT (Medications)…

Defining Care-Receiver

Care-Receiver is…

the person

the patient

the family member…

…receiving care.

Defining Care-Giver

Caregivers can also be considered primary or secondary.

• PRIMARY: The person(s) who has the main responsibility for care-giving.

• SECONDARY: Often supporting the primary caregiver.• Other family

• Friends

• Church

• Neighbors

University of Missouri, Challenges and Choices: Elderly Caregiving. http://extension.missouri.edu/p/GH6657

Who is a Caregiver…

• A Caregiver can be anyone:• Spouse

• Child

• Friend

• Neighbor

Who is a Caregiver…

• A Caregiver can be anyone:

• Who has it been usually?• Female spouse or daughter

• “The typical caregiver is 57 years old, female, married and employed outside the home.”

• “She can expect to spend as many years caring for a parent as for her children.”

• “There is also a good chance that she will be a caregiver to more than one person during her lifetime.”

University of Missouri, Challenges and Choices: Elderly Caregiving. http://extension.missouri.edu/p/GH6657

History of the Caregiver…

• In the past, the unmarried daughter was expected to provide care for an aging parent.

• We went from being Hometown communities to a Transient Society. Children moved away from home to the “big city.”• BUT Kids are coming home…

Rewards

• Although care-giving can be challenging, it is important to recognize that it also has its rewards.• Feeling of giving back to a loved one.

• Feeling of purpose and that the Caregiver is needed.

• Strengthen relationships with the care-receiver.

• Can appreciate one’s own life more.

• Can help a Caregiver feel good about themselves.

Caregiver stress fact sheet / womenshealth.gov

Weekend Adventures

The other emotions of care-giving

• The 7 other Emotions of caregiving:• Guilt

• Resentment

• Anger

• Worry

• Loneliness

• Grief

• Defensiveness

Carring.com. https://www.caring.com/articles/7-deadly-emotions-of-caregiving

Objectives 2:

1. Understand the emotional weight in the role of caregiving and decision making.

2. Understand the use of applied Case Management techniques in a purposeful way for family caregivers in shifting roles.

Defining CaSe Manager

Professional definition: A health care professional, typically a nurse or social worker, who arranges, monitors, or coordinates long-term care services

Google web definition

Defining CARE Manager

My definition: A Committed Caregiver who coordinates care services, manages a care team and advocates for the special needs of someone they are caring for.

Robert Miller, LMSW, CDP

There is no “I” in TEAM

Who is on your team?

Who is on the care team?

• Doctor (PCP or primary care practitioner)

• Secondary CareGivers

• The Lawyer

• The Accountant

• The Bank Manager

• Home Health, Hopsice or other service providers

Who else is on the care team?

• Family

• Church

• Neighbors

• The guy the mows the yard

• Your Friends

• Whomever you TRUST

CareGiverDon’t Get Stuck in the BoxPrimary

Secondary

CareGivers

Home Health

Physician

Accountant

Private Care

Estate Planner

CareGiver Care ManagerPROMOTIONPrimary

THE TEAM

Physician

Secondary Caregivers

Estate Planner

AccountantHome Health

Private Care

It’s a mindset

Care Manager

And there is no less love!

THE TEAM

Physician

Secondary Caregivers

Estate Planner

AccountantHome Health

Private Care

DISCLAIMER:

Keep in mind that cognitive ability of the care-receiver must be considered regarding some of the information provided today.

COMPARISONS

Let’s think about the shift in mindset

Is this you?

• Understands care-receiver is still responsible for good choices or bad

The Care Manager:

• Feels responsible and often guilty

The Caregiver:

Which do you want to be?

• Guilt is one of the number one feeling we deal with in caregiving.• It can Motivate or Manipulate.• Cue the “Please and thank you story.”

• Understands limitations and boundaries while still committing to care-giving

The Care Manager:The Caregiver:

Which do you want to be?

• Important to understand the difference between NEEDS and WANTS… as well as how to set priorities.

• Cue the “I have a check that needs to go to the bank story.”

• Feels obligated and even trapped by compounding responsibilities

• Understands it is the best person for the job, family or otherwise

The Care Manager:The Caregiver:

Which do you want to be?

• Need to understand how relationship with the Care-Receiver is effected by personal history, limitations, abilities, etc.

• It takes a strong person to admit if you cannot care for someone and why.

• Feels it is “family business”

• Understands it takes a team to get the job done

The Care Manager:The Caregiver:

Which do you want to be?

• Know how to ask for help. Today’s Care-Receivers are complex. It requires managing fiscal responsibilities, as well as psych/social/emotional/physiological needs.

• No one is an expert in all these areas.

• Feels it is their burden alone

• Makes a plan and communicates it to the team

The Care Manager:The Caregiver:

Which do you want to be?

• Treat it like a business. To be successful, you have to have a Care Plan. • Put in on paper / Make a schedule / Create a check list / Delegate. • Then inspect what you expect!

• Takes the task call-by-call, feeling the stress of a growing need for help

• Takes a day off

The Care Manager:The Caregiver:

Which do you want to be?

• If something happens to “you” the patient/Residents looses their most important advocate.

• Cue the “I think we should not call this weekend story.”

• Eventually sacrifices personal needs to such an extent they are exhausted and/or ill

AND BREATH!

Pay Attention to What Your Body is Telling You…

Objectives 3:

1. Understand the emotional weight in the role of caregiving and decision making.

2. Understand the use of applied Case Management techniques in a purposeful way for family caregivers in shifting roles.

3. Learn about various community resources and tools to manage the care of a loved one in their own home or care home setting.

TOOLS to MANAGETreat it Like a Business

Tools & Tasks…

• Make a monthly CALENDAR and everyone takes their piece• This helps everyone commit to the task of care

• Not every family member has the same time and resources to offer. IT IS NOT A COMPETITION.

• Hire services to fill in the gaps

• Tap into volunteer services

• Use the calendar to communicate expectations

Tools & Tasks…

• Create a MEDICAL RESUME• Have important information collected in one place and easy to grab-n-go

• Make sure everyone knows were information is kept

• Make sure you have affairs in order• Advance Directives and wishes written out

Tools & Tasks…

• Create a COMMUNICATION SYSTEM• Organize how people will get information and stay updated

Tools & Tasks…

• Communication System:• Communication Book

• Email or phone chain

• Facebook / Other Apps• Consider Privacy issues

• Family (Business) meeting schedule• Time for major decisions

• Best if you have one point person who is responsible to disseminate information to the team

Tools & Tasks…

• Technology is a double-edged sword. • Make sure to use what makes sense in organizing and connecting the team.

• Don’t get caught up in the latest gadget… but what works for you.

• KEEP IT SIMPLE

DISCLAIMER:

These are not recommendations… but examples.

There are A LOT of apps for every pharmacy and company you can imagine.

There are apps that help monitor and document a wide variety of care details that can be helpful.

I like the way this app tracks the team.

This is great for keeping track of multiple people a caregiver is helping.

Success for THEMIs Success for YOU!

Help them remain (or feel) a part of their life

Bibliography:

“Caring” vs “Doing” - UCSF/Human Resources: Elderly Caregiving: Choices, Challenges, and Resources for the Family.

Dementia Stats - http://www.alz.org/facts/overview.asp

Defining Care-Giver - University of Missouri, Challenges and Choices: Elderly Caregiving. http://extension.missouri.edu/p/GH6657

Caregiving Rewards - Caregiver stress fact sheet / womenshealth.gov

7 Deadly Emotions of Caregiving - Carring.com. https://www.caring.com/articles/7-deadly-emotions-of-caregiving

Thank You!

Questions