 | Doug Stark
is president of ComfortCare Homes, Inc. ComfortCare provides long-term care for the memory impaired at all levels of care and function in elegant, single-family residential homes. Born out of the Stark family's experience with Alzheimer's they have grown to 25 homes with 8 in Wichita and 17 in Nebraska and Virginia. A native of Wichita, Doug attended Wichita public schools and the University of Kansas. He served for 12 years as a Big Brother and has been a member of Wichita Rotary for 19 years. He is board member and Treasurer of Kansas Health Ethics. Doug can be contacted through his office at 7701 E. Kellogg, Suite #490, 67207, by calling (316) 685-3322, or by sending an e-mail to comfortcarehomes@aol.com |
Senior Living
2004-03-01 14:01:00
What to do when they don’t recognize the risk
: Who should the family call first for assistance? ANSWER: It depends. Typically the best place to start is with the doctor, particularly if the relationship is strong and over a number of years. Again, a geriatric care manager is also a great first step because although you will spend a little money for the expertise and service, they can assess the entire physical as well as psycho-social situation for the older adult and make objective recommendations. The assessment takes place in the person's home so that the living environment is evaluated also. The nice thing about this approach is that the geriatric care manager can offer objective opinions outside that of the family relationship that the older adult might be more inclined to accept. You may find that unless you are dealing with an obvious danger such as driving skills that put your loved-one and others at risk, you may be forced to take it slow. You may have to implement some limited services to begin with in order to give the older adult time to adjust to the help. Racing to implement major changes can overwhelm and be very counterproductive.It is very important that someone has a Power of Attorney for Health Care Decisions or a Living Will that gives a trusted family member or friend the authority to step in and make decisions that will meet with the wishes of the older adult, or at least are in their best interest should the need arise. And so there is no mistake, there are Power of Attorney documents that are limited to conducting business transactions on behalf of an individual that have nothing to do with healthcare decisions. You need to make sure your POA (many times referred to as a Durable Power of Attorney or DPOA) covers healthcare decisions, and of course it needs to be signed, witnessed and notarized when the individual is of sound mind and is mentally/emotionally prepared to. Waiting until the older adult is feeling threatened of loosing their independence or worse yet, develops a disease that leaves them cognitively impaired and incapable of entering into a DPOA agreement can be a real mess as you then are many times forced to go through the court system to accomplish the task. &nb
ANSWER: This is often heard from caregivers, "Mom is becoming more frail. What do I do?" There is typically not a dramatic single event that signals the shift from daughter/son to caregiver. It is a process. Some older adults resist the need for services and help. As you begin the process, here are some suggestions:• Sharing your concerns with the older relative.• Involving the rest of family (strength in numbers).• Getting advice from the Department on Aging, Senior Services or organizations like the Alzheimer's Association to help you develop an understanding between "normal" aging vs. not normal or disease related aging. • Contacting a geriatric care manager (sometimes it is easier for an outsider to discuss these sensitive issues with the older adult). A care manager will assess the risks faced by the older adult. The care manager will look at: A) available social supports; B) self-care ability; C) physical condition and a potential need to get a doctor's opinion and/or assessment; D) emotional/ mental/cognitive impairment, etc.• If the older adult is thinking cognitively (is sound of mind) you should listen to their preferences. It will help if the older adult feels he/she is being listened to. You may want to suggest help for a "limited time" to help the older adult get used to the idea of assistance.• Talk to the older adult's doctor. Most people are predisposed to listen to their doctors advice. Many times it carries more authority than the opinion of family members.• As a caregiver, you may have to take things slower than you would prefer as many times you will face resistance to change as a result of feeling that independence is being removed. QUESTION: Who should the family call first for assistance? ANSWER: It depends. Typically the best place to start is with the doctor, particularly if the relationship is strong and over a number of years. Again, a geriatric care manager is also a great first step because although you will spend a little money for the expertise and service, they can assess the entire physical as well as psycho-social situation for the older adult and make objective recommendations. The assessment takes place in the person's home so that the living environment is evaluated also. The nice thing about this approach is that the geriatric care manager can offer objective opinions outside that of the family relationship that the older adult might be more inclined to accept. You may find that unless you are dealing with an obvious danger such as driving skills that put your loved-one and others at risk, you may be forced to take it slow. You may have to implement some limited services to begin with in order to give the older adult time to adjust to the help. Racing to implement major changes can overwhelm and be very counterproductive.It is very important that someone has a Power of Attorney for Health Care Decisions or a Living Will that gives a trusted family member or friend the authority to step in and make decisions that will meet with the wishes of the older adult, or at least are in their best interest should the need arise. And so there is no mistake, there are Power of Attorney documents that are limited to conducting business transactions on behalf of an individual that have nothing to do with healthcare decisions. You need to make sure your POA (many times referred to as a Durable Power of Attorney or DPOA) covers healthcare decisions, and of course it needs to be signed, witnessed and notarized when the individual is of sound mind and is mentally/emotionally prepared to. Waiting until the older adult is feeling threatened of loosing their independence or worse yet, develops a disease that leaves them cognitively impaired and incapable of entering into a DPOA agreement can be a real mess as you then are many times forced to go through the court system to accomplish the task. QUESTION: Tell me about hospital discharge procedures and appropriate questions to ask hospital social service staff. ANSWER: Hospitals must develop a "safe discharge" plan. The discharge planner should determine the older adult's needs after he/she leaves the hospital. Who is the caregiver? Can he/she transfer independently? Who will get the meals? Do you have transportation to get to the pharmacy, doctor? Do you have running water, heat? Do you want additional services? Hospital social workers do a great job but they are limited because they do not work in the home. They must rely on the information given to them by the older adult or the family/friend agent. They do not have time to verify support systems that might help in the transition. vvv Doug Stark is president of ComfortCare Homes, Inc. ComfortCare provides long-term care for the memory impaired at all levels of care and function in elegant, single-family residential homes. Born out of the Stark family's experience with Alzheimer's they have grown to 25 homes with 8 in Wichita and 17 in Nebraska and Virginia. A native of Wichita, Doug attended Wichita public schools and the University of Kansas. He served for 12 years as a Big Brother and has been a member of Wichita Rotary for 19 years. Doug can be contacted through his office at 7701 E. Kellogg, Suite #490, 67207, by calling (316) 685-3322, or by sending an e-mail to comfortcarehomes@aol.comBy Doug Stark
