Assessment and Planning-Key to Eldercare
Evelyn’s children became concerned when she began calling frequently and asking the same questions over and over. As with many families no one was certain how to determine what was going on with mom. She seemed fine when they visited and it was easier to ignore some of the “red flags” than to deal with them. Evelyn insisted she was fine and her children accepted that at face value and allowed her to remain independent. That’s what she wanted and she said she was managing OK on her own. Evelyn decided to go out one day and rake leaves. She was later found wandering in the dark several miles from her home.
This is a common scenario today. In our practice it frequently happens that only in a crisis situation does the family seek assistance. It’s not that they don’t care-- it is a combination of role reversal, taking care and in many cases charge of a parent, and the ability to be firm and make difficult decisions when a loved one is unable to do that for themselves. A parent may have lived in the same house for 50 years and the idea of moving or having someone stay with them is unthinkable. Families do not know where to turn for assistance often going to the parents’ primary care doctor for advice and leaving with a prescription but no real assistance in planning for the future.
It is important that someone who is exhibiting physical or cognitive changes is properly assessed and plans for their current and future care needs be put in place. This often involves a team of professionals working together to make sure that the plan meets the individuals needs from a functional, cognitive and financial perspective. The team may consist of a geriatrician, care manager, social worker and elder care attorney. Each specializes in the needs of the elderly and is experienced in all aspects of long term planning.
An assessment should include all aspects of an individual. How well do they function in the home including watching them walk, get in and out of the shower, do the stairs? A mental status screen is helpful to get a baseline of cognitive status but should be taken a step further. Ask what they would do if they smelled smoke, saw a waste paper basket on fire or if a stranger came to the door. Unlike memory issues, these questions assess judgment and safety awareness. It is often these questions that will help families to recognize a problem that needs attention.
Activity of daily living (toileting, bathing, dressing, hygiene) should be looked at and you should examine how the individual is able to care for themselves. How are medications managed? Meals? Laundry?
The team works together with the family to determine based on all the information what feasible options are for each individual. They will offer recommendations and assist in making the needed referrals.
Evelyn was lucky. She was found unhurt and her family worked with me to find a safe and appropriate plan of care. She is doing well and her family can spend quality time with her. The crisis was averted in time but could have been avoided with education and planning.
CzepigaDalyDillman is one of the few Connecticut law firms to have a Geriatric Care Manager on its staff. We care not just about our clients’ “legal health” but also have a concern for their safety, dignity, and independence. That is why we hired Linda Worden. Linda has the training and expertise to make sure all of a client’s health and safety needs are appropriately addressed. Linda G. Worden has over 25 years of experience in geriatric services. She is a member of the National Association of Professional Geriatric Care Managers and the Connecticut Association for Home Care. She has served on the Connecticut Home Care Board of Directors and Visiting Nurses Association of New England Board of Directors; and she is a member of the Advisory Council for Senior Resources Area Agency on Aging and the Middlesex County Elderly Services Committee. Linda is a Registered Nurse and has a Master’s in Public Health and is a Clinical Instructor at University of Connecticut School of Medicine and past Clinical Instructor in the School of Nursing.