Monday, January 26, 2009

Photo by David Webber

Care Managers, Working with the Aging Family, by Cathy Jo Cress

Ms. Cress presents us with papers written by both her and her colleagues in care management that address the current realities faced by the aging family, for example:

Navigating Families Through the Hospital to Home
Helping Aging Families Communicate with a Physician
Working with Long-Distance Families
Family Meetings and the Aging Family
Working with Couples
Dying, Grief , and Burial in the Aging Family

The target audience is other care managers but I think this book can also be useful to families trying to get a handle on their situation. The clear, concise text provides much needed vocabulary and concepts that relate to elder care. It would be useful for the long-distance caregiver and anyone trying to organize care. Just as many of us see our homes becoming mini-nursing homes, many of us will need to be geriatric care managers for our loved ones. This book is a great resource---well worth the investment.

Wednesday, January 21, 2009

The Caregiving Map

Our consultant to all things WEB, Sherry Knecht, suggested the What I’m Reading Now section. This makes sense since I read a lot. However as I started listing what I was reading, I realized how it might seem to be all over the map. In a way it is. Because caregiving in general, and geriatric care in particular, covers a big map:

Illness and/or geriatric issues and concerns
Caregiving issues and concerns
Management challenges and strategies

When people are faced with a new set of responsibilities it is very normal to reason---this is similar to something I’ve done before, therefore I can do this.

Here is my problem with this reasoning. The situations may only be similar on the surface. A deeper look will reveal major differences which, if unaddressed, will cause serious problems down the line.

For example, one comment I hear quite a lot from women: I raised x number of children---I can take care of my mother. Often there is a specific body language/posture---the jaw sets, the chin comes up and the arms are folded---the captain at the prow of the family ship. While I applaud the women’s commitment to family care needs and am glad they are on the job, I worry that their equating caring-for-children with caring-for-Mother will spell trouble.

In my experience, caring-for-Mother is to caring-for-children as
---cooking at home is to running a restaurant or
---starting a business is to buying a business that is 80+ years old and the founder is still the CEO!

More about this later.

Friday, January 16, 2009

My Stroke of Insight, A Brain Scientist’s Personal Journey, by Jill Bolte Taylor, PhD

How often do we hear the words “So and So had a stroke.” We wonder---how bad? Paralysis? Speech impediments? But most of us don’t know exactly what a stroke is or how one occurs or even where? Dr. Bolton, a neuro-anatomist (brain scientist) has written this book to answer these questions. More importantly she gives us a first-person account of her own experience with stroke at 37(!).

I appreciated her chapters called “Simple Science” and “Hemispheric Asymetries” in which she gives us all a short course on the brain and the origin/impact of strokes. She also provides two practical checklists:

Ten Assessment Questions to determine capabilities such as the ability to perceive three dimensions, a sense of time, ability to think linearly, etc.
Forty Things I Needed the Most which range from the need for respect, clear speech, lots of sleep, a team of professionals and loved ones. She asks that we “trust that my brain can always continue to learn.”

The book is easy to read. I think it is a must for anyone who is dealing with someone who has suffered a stroke---professional or not. What stroke sufferers need most is patience and time---often in short supply.

Thursday, January 15, 2009

10,000 Hours

What do the Beatles, Bill Gates, Mozart and Peggy Flynn have in common?

I just finished reading Malcolm Gladwell’s Outliers, The Story of Success.

The dictionary definition of outlier is “something that is situated away from or classed differently from a main or related body.” (pg. 3) The book jacket describes outliers as “those people whose achievements fall outside normal expectations.”

Caregivers are outliers. We fit both the definition and description. The main or related body is the medical system that sets normal expectations for care delivery. Caregivers’ achievements definitely fall outside those normal expectations.

No wonder we feel invisible much of the time!

I have often felt like an outsider (more tolerated than welcome) in doctors’ offices and during home hospice visits. Caregivers are often made to feel like an outsider in many subtle and not so subtle ways---hard on the self-esteem and especially the morale.

From now on I intend to see myself as an outlier.

What has all this to do with the Beatles et al? The author makes that point that hard work is one of the major factors in success---practice, practice, practice---whether it is Bill Gates at the computer, the Beatles performing in Hamburg for hours each day, or Mozart composing for years---10,000 hours devoted to perfecting one’s skill.

It dawned on me that my caregiving work, especially in the HIV epidemic in San Francisco (1990-2004), gave me the opportunity to put in those 10,000 hours. Practice. Practice. Practice.

According to Mr. Gladwell “success follows a predictable course. It is not the brightest who succeed…Nor is success simply the sum of the decisions and efforts we make on our own behalf. It is, rather, a gift. Outliers are those who have been given opportunities---and who have had the strength and presence of mind to seize them.” (pg. 267)

I am so grateful to everyone who gave me the opportunity to care for them!

Monday, January 5, 2009

Some Warning Signs of Telemarketer Fraud”

While news reports about the Madoff scandal could be heard in the background, I was going though some old files and found this gem from a course on financial elder abuse. It is important to remember that it is not only elders who are vulnerable. Hard times can make us all wishful thinkers. Unfortunately the current economic climate makes individuals both more likely to engage in fraud and to be susceptible to fraud.

1.You’ve “won a prize” or “a prize has been reserved for you.”

2.You’ve been “selected to receive” a special offer.

3.You must “act immediately” or lose your chance for a special offer.

4.You must spend money to “reserve your free gift” or “pay for shipping for your gift.”

5.You’re promised “fantastic financial returns” or “risk-free investing.”

6.You’re told that a “legal loophole allows people in the know” to profit from a “one-time-only situation.”

7.You’re asked for your credit card number and expiration date “to make sure you are a credit card holder.”

8.You’re asked for your Social Security number or personal financial information, such as your bank account number.

9.You’re asked to donate to an agency that sounds like a well-known charity, such as “American Cancer Center” (instead of the American Cancer Society).

10.You’re asked to give to an organization you don’t know, but that sounds like it’s linked to a public agency, like the “Police Support Center.”