Geriatric Assessment and Care Plan
Are you concerned about an elderly family member or friend who has Alzheimer's or another type of dementia? Or maybe your loved one is having difficulty performing everyday tasks. Are you concerned about an elder's frequent falls or memory loss? Maybe your loved one is leaving a rehab facility and you want to be sure that services are in place by the discharge date. Whatever it is -
We can help!
Not as a replacement for family, but as an extra member on whom you can rely to advocate for you. A professional who knows how to determine needs and link you to appropriate services to make for peace of mind.
Knox Care Management offers offers a comprehensive geriatric assessment for elderly residents and disabled individuals of Knox and surrounding counties.
Our Certified Geriatric Care Manager will evaluate your loved one in their environment - in their home, assisted living, nursing home or hospital.
Our initial assessment includes:
- Pre-conference phone interview to share information about our company, review client and family goals and get preliminary details of the client's needs.
- Collection of medical information to include medical history, medications, care received to date, results of recent lab work or diagnostic tests, etc.
- Evaluation of the mental and emotional status including, the individual's memory, ability to make appropriate decisions, and care for himself/herself on a daily basis.
- Assessment of cognition including dementia.
- Evaluation of the physical function including gait, determination of mobility, ability to transfer, and continence levels.
- Determination of the elderly person's ability to manage his or her finances, to what degree and if assistance would be helpful.
- An analysis of living arrangements including the maintenance condition of house, condo or apartment and possible safety hazards or improvements that may be needed.
- A review of the client's current advanced directives.
- Referrals to Elder Law Attorneys and medical professionals for complex cases.
Recommendations / Care Plans are established to meet client needs and a family meeting, phone conference, or written summary of findings and recommendations from the assessment are reported.
- 10 Warning Signs that Help Is Needed
- Why Should I Pay for a Geriatric Assessment
- What Do You Mean When You Say "Care Plan"?
10 Warning Signs that Help Is Needed
The Eldercare Locator has produced a guide of “10 Warning Signs” to help families and older Americans determine if help is needed. Any one of the behaviors listed may or may not indicate that an action should be taken and your family member’s physician should be kept informed of physical or psychological behavior changes.
Has your family member:
1. Changed eating habits within the last year resulting in weight loss, having no appetite, or missed meals?
2. Neglected personal hygiene resulting in wearing dirty clothes, body odor, bad breath, neglected nails and teeth, sores on the skin.
3. Neglected their home so it is not as clean or sanitary as you remember growing up?
4. Exhibited inappropriate behavior by being unusually loud or quiet, paranoid, agitated, and making phone calls at all hours?Changed relationship patterns such that friends and neighbors have expressed concerns?
5. Changed relationship patterns such that friends and neighbors have expressed concerns?
6. Had physical problems such as burns or injury marks resulting from general weakness, forgetfulness, or possible misuse of alcohol or prescribed medications?
7. Decreased or stopped participating in activities that were previously important to them such as bridge or a book club, dining with friends, or attending religious services?
8. Exhibited forgetfulness resulting in unopened mail, piling newspapers, not filling their prescriptions, or missed appointments?
9. Mishandled finances such as not paying bills, losing money, paying bills twice or more, or hiding money?
10. Made unusual purchases such as buying more than one magazine subscription of the same magazine, entered an unusual amount of contests, increased usage of purchasing from television advertisement?
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Why Should I Pay for a Geriatric Assessment
An initial needs assessment is performed to identify the needs and capabilities of an elderly individual. The underlying goal of Knox Care Management is to promote dignity and respect and make a positive difference in the lives of area seniors and their families.
Over the course of 1-2 visits to your loved one's home, we can conduct a comprehensive geriatric assessment.
We report back on the strengths and weaknesses of the current situation. Looking at family resources, we can recommend options based on your loved one's preferences and budget. We can also give you a general sense of how things are likely to evolve over the next 6 months. This way you can make decisions within the context of a longer term perspective.
You or your loved one may need only an assessment and recommendations for addressing issues of concern. Many of you may need ongoing care management. You may choose to have a care manager visit periodically to monitor upcoming changes. Others may want the care manager to manage all the service needs of their loved one so they have no worries.
The certified geriatric care manager conducts the interview in the home of your loved one and it includes:
- Evaluating the physical, mental, emotional, and social needs of the elderly client.
- Assessing the physical capabilities, including mobility and ability to function in the home.
- Evaluating the mental and emotional status including the individual's memory, ability to make appropriate decisions, and care for himself/herself on a daily basis.
- Determining if the elderly person is able to manage his or her finances or needs assistance.
- Assessing cognitive brain function of Alzheimer's and other dementia patients.
- Assessing the elderly adult's interests and social support network. A support system of family and friends enhances the quality of life of aging individuals
- Conducting a home safety check to identify potential hazards
When you are facing the complex world of elder care, a professional care manager is always recommended. We can provide you with an informed evaluation, unbiased recommendations and ongoing coordination, guidance, support.
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What Do You Mean When You Say "Care Plan"?
At the end of the day the goal of Knox Care Management is to help your loved one live as independently and safely as possible.
The Individualized Care Plan is developed to address the needs identified during the assessment, and to maintain the highest level of independence and safety. You can think of it as the service and support road map and it should include specific recommendations to meet you or your loved one's medical, psychological, functional and social needs.
The Care Plan will:
- recommend specific actions to address immediate problems such as install grab bars and a shower seat in the bathroom to prevent a fall, or arranging home delivered meals if meal preparation is a problem.
- recommend strategies to monitor the client’s status such as a companion 3 days a week to supplement family visits on week-ends.
- recommend options for future or anticipated problems such as to become familiar with local assisted living communities. An important question for caregivers to consider is, “what happens when my mother’s needs change?”
Recommendations may include, but are not limited to:
- Homemaking and personal care services
- Home delivered meals
- Transportation with escort to appointments
- Adult day care
- Personal emergency response systems
- Home maintenance
- Rspite care
- Medical equipment
- Nursing or therapy through home health services
- Moving to assisted living
- Money Management and bill paying assistance
- Monitoring of medication
The Geriatric Care Manager can monitor ongoing needs and update the Plan of Care as necessary to ensure that your family members continue to receive the care they need, when they need it.
Aging can get tricky! Multiple chronic conditions can complicate decisions and family dynamics can be distracting. A care plan clearly lays out the present and future care needs based on a snapshot in time and projects the housing, financial, family dynamics, in-home care, legal, financial, spiritual, recreation, etc. decisions that may be needed in the future. It is a good method to keep you and other family members focused on the same goals.
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