Geriatric Care Management

Care-planning assessments to identify needs, problems and strengths

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.

 

(Return to top)

Counseling Services

Knox Care Management's certified geriatric care manager is an experienced counselor with over 25 years of experience. She understands that the elderly can experience grief differently than other adults, and because loneliness usually intensifies when older people lose a loved one, grief counseling for the elderly focuses on helping individuals overcome feelings of sadness and depression.

 

According to a model explaining the stages of grief by Dr. Elisabeth Kubler-Ross, denial, anger, bargaining, depression and acceptance are common stages of grief. 

 

Grief counseling teaches individuals coping strategies for the difficult moments, such as holidays, birthdays, anniversaries and other special times the person shared with the deceased. Although everyone copes with grief differently, grief counseling can help to identify unhealthy coping mechanisms.

 

Life transition work is about grieving and celebrating what is past and honoring what lies ahead.

(Return to top)

Communication with Medical Professionals

If you sometimes feel overwhelmed by the medical system, you are not alone! It can be daunting for anyone. Our experienced staff can serve as your medical advocates. We help you clarify your questions, and make sure you get answers.

 

We accompany your loved one to their appointments. We lobby for the type of care your loved one wishes to receive. Because we understand the system, we can go to bat for you. This liberates your time and energy to provide the love and support that only a family member can give.

 

(Return to top)

Communication with Families

Families are kept apprised of their loved ones’ on-going progress through emails and/or monthly telephone contact. Of course family members may call anytime with questions and concerns.

(Return to top)

Periodic Check-Ins

We can be your eyes and ears. Things can change quickly in the aging process. By checking in periodically, we can let you know whether your loved one is still able to live safely at home.

 

As elder care professionals, we know the problems that commonly arise, and the most cost-effective solutions. Perhaps there are some mobility issues that are making life more difficult than it needs to be. There may be a simple device that could remedy the situation. Maybe your loved one is starting to have memory problems and needs help with paying the bills, or balancing the checkbook. Perhaps he or she needs a bit more oversight in terms of taking medications as directed. Through periodic check-ins, you receive peace of mind knowing the current situation remains the wisest choice.

 

This service may be helpful when a caregiver needs to go out of town or for long distance caregivers. We can provide feedback via email or phone as to the conditions found and any needs noted.

 

A daily or weekly telephone call can provide a helpful "check in" from a caring supporter. We can also help with reminders to take medicine or keep appointments

 

(Return to top)

Medication Set Up & Monitoring

Medication mismanagement is prevalent among the elderly and the consequences can be profound. It can lead to preventable health decline, hospitalization and sometimes even death.

 

Our staff (RN) can provide weekly, monthly, or as needed assistance with setting up medication dispensers, verification of medication compliance, review of medications with physicians, help with re-fills.

 

(Return to top)

Money Management

Are you concerned about your parents or another relative’s ability to pay bills, balance a checkbook and manage day to day purchases without assistance? Are they at risk for scams or credit problems due to functional limitations? Have they changed lifelong habits in how they manage their money? Do they show poor judgment in regard to their finances?

 

When managing finances or paperwork becomes too confusing or unmanageable, we can assist with Money Management. Our support includes:

 

• Bill-paying, including calls to payees regarding incorrect bills and preparation of checks for clients to sign.

• Balancing checkbooks and maintaining organization of bank records.

• Preparing and delivering bank deposits.

• Organizing tax documents and other paperwork.

• Negotiating with creditors.

• Deciphering medical insurance papers and verifying proper processing of claims.

• General organization assistance.

• Providing referrals to legal, tax, and investment professionals.

 

(Return to top)

Falls Risk & Home Safety Assessment

Our Care Manager can assess your loved one's risk for falls and make recommendations on how to prevent them. Preventing falls will help seniors to remain independent and age successfully; goals that persons of all ages and their caregivers want to achieve.

 

Kim Goetze is a personal trainer.  She is certified through the National Academy of Sports Medicine, the Arthritus Foundation and the Aquatic Exercise Association. Her programs include functional training for balance (fall prevention), agility, strength, flexibility, Yoga, Pilates and Thai Chi.

 

A study in the February 2010 issue of the journal Injury Prevention reveals that, between 2000 and 2006, falls-related deaths in American elderly have increased by a staggering 42 percent. For decades, falls have also been associated with other devastating consequences, like severe injuries and permanent disability.

 

Falls occur every year in about one in three individuals aged 65 or over–a figure that increases to two in three for those who already had a fall. The injuries caused by a fall are often severe and may result in long-term disability or even premature mortality.

 

One of the greatest fears among older persons is the fear of falling. Fear of falling leads to lost confidence and increased inactivity. Irrational fear? Quite the opposite, as falling is a primary catalyst for hospital admissions among seniors.

 

Consider the following startling statistics:

1. Falls are responsible for 40% of nursing home admissionsFalls cause
2. 70% of accidental deaths in people over 75 years of age
3. One in three older adults living at home experiences a fall requiring medical care
4. Injuries from falls results in direct medical costs of $70 billion each year
5. Indirect cost and human costs of falls impact individuals, caregivers, families, and businesses

 

Falls are caused by internal as well as external factors. 

 

Internal factors such as:

• slowed reflexes
• balance disorders
• weakness
• muscle tightness
• reduced flexibility
• cognitive impairments
• low blood pressure 
• visual deficits

Controllable external factors include:

• medications
• poor lighting
• cluttered living spaces
• lack of handrails
• unstable chairs
• rugs

These are just some of the factors that can lead to a devastating fall. The good news is that most falls can be prevented. The first step is an assessment of the risk that your loved one has for experiencing a debilitating fall.

 

(Return to top)

Disaster Planning

Having a personal disaster plan gives elderly or disabled individuals a feeling of control over their situation. Our Care Manager can assist with making a plan for your loved one for any type of disaster.

 

Knox Care Management suggests that you take time now to think about your daily routine – the foods you eat, the medications you take, the people you rely on, and so forth.

 

Think about the ways in which these items might change if a disaster knocked out your power, and you couldn’t leave your home. How would they be affected if you had to leave your home due to a disaster?

 

Ask yourself:

 

• What kind of disaster could affect us?

• Where would we stay?

• What would we eat and drink?

• How would we communicate, get information, deal with medical emergencies, acquire supplies, and replace our belongings and medications

 

Once you have developed your plan, discuss it with everyone involved, and make sure they have copies as well. Make sure this list gets any updates or changes to your plan.

 

Planning should include dependable transportation options, evacuation routes, and knowledge of nearby medical facilities. A special kit containing extra batteries, copies of prescriptions, one week of medications and backups of important medical devices should also be prepared in case the individual in question is isolated from medical facilities for an extended period of time.

(Return to top)

Arranging & Monitoring In-Home Care

It may be that your loved one is no longer able to live safely alone. Having someone come by twice a week to cook a few meals and do some light housekeeping may be all that is needed. Or, it could be that your loved one requires more constant attention.

He or she may not need the services of a nurse. But the daily presence of a kind caregiver can assure he or she is eating regularly, taking baths, and taking medications as directed. You can choose part time or full time assistance.

We can do the background checks and handle all the taxes and scheduling. You rest easily knowing your loved one is in good hands with caring and consistent help.

(Return to top)

Medicaid and Insurance Assistance

Maneuvering through the maze of insurance, Medicare, and Medicaid issues can be more than overwhelming even for the most knowledgeable person.

Financial resources used to fund medical care include, personal health insurance, long-term care insurance, private funds, Medicaid, Medicare, and possibly Veterans benefits.

Healthcare and Long-term care insurance

 

Even for the person who has prepared well for his/her elder years with sufficient health insurance and long-term care insurance, understanding the policy and filing claims can be frustrating. Our care manager can help you to understand your rights and help to communicate and file claims with the insurance companies.

 

Medicaid Qualification

 

In Tennessee there are a number of different Medicaid programs. If certain eligibility requirements are met, Medicaid virtually absorbs the entire cost of nursing home care that exceeds the resident's income.

 

Medicare and Long-Term Care

 

Medicare and Medicare supplemental insurance do not cover long-term care. Under very limited circumstances, they may cover a few weeks in a nursing home. We can help you look at other options should assisted living or nursing home care become necessary.

 

(Return to top)

Placement & Relocation Services

We understand that most seniors want to stay in their own homes for as long as possible and our services are designed to help them do just that. Sometimes, however, moving becomes the best option. 

 

If your loved one needs more assistance than can safely or affordably be provided at home, we are happy to make suggestions based on his or her needs, and on family finances.  We understand the broad range of services available in the elder care continuum and can recommend local facilities most likely to result in a good fit and positive transition.

 

We take pride in maintaining up-to-date information on all facilities in our area.  We can accompany you on tours and ask all the right questions so you are making an informed decision.  Your Care Manager will help you every step of the way.

(Return to top)

Wellness Program

Services offered by Kim Goetze, Personal Trainer, includes but not limited to:

 

• an initial consultation

• a fitness assessment

• the design of an appropriate program using the Optimal Performance Training model

 

These programs are individualized to meet the specific needs of clients and include training for improved

 

• flexibility

• cardio

• respiratory

• balance

• core musculature

• resistance

• nutrition

 

Programs include functional training for balance (fall prevention), agility, strength, flexibility, Yoga, Pilates and Thai Chi. Ms. Goetze is also certified through the National Academy of Sports Medicine, the Arthritis Foundation, and the Aquatic Exercise Association.

 

(Return to top)

Testimonials

Written by Sandy Cropper (adult child of one of Nancy’s clients) – November 1, 2012

 

Nancy recently provided services to my Mom during a time of transition and great health challenges.  I am the oldest of six adult children, three of whom live out of town and three who live in the same town as our mother.

 

Mom experienced a second hospitalization within months of the first and we needed professional support to guide us during Mom’s recovery at the Rehab hospital and also to advocate for her care.  Previously, we tried to do this ourselves and found miscommunications between doctors, hospitals and other providers that caused Mom more problems.

 

Nancy exceeded our expectations in guiding and monitoring Mom’s care to ensure she got what she needed.  This was not easy since Mom has multiple health issues.  Nancy’s expertise and clear communication skills helped us all understand better what was going on and what our options were.

 

There were difficult decisions to make which included letting go of Mom’s independent care living apartment.  Nancy was very good at keeping all of us informed and diplomatically presented pros and cons of the decisions we had to make.  There was disagreements among all of us siblings, but Nancy helped us support one another for Mom’s sake. One unexpected benefit of working with Nancy is that we (siblings) have learned to communicate better with one another!

 

Nancy demonstrates professionalism, a high level of competence in her profession and caring.  It is a great combination! I was also impressed with her responsiveness whenever we sent email questions to her.  She responded quickly and sometimes in the evenings or weekends.

 

I highly recommend Nancy as a Geriatric Care Manager. 

 

__________________________________________________________________

 

Nancy has been, quite literally, a lifesaver.  My brother and I both live out of town and our uncooperative, Alzheimer’s afflicted mother was unwilling to take any assistance from anyone.  Nancy was able to come into her life in a way that was ingratiating and non-threatening.  My mother now has sufficient care, still able to be in her home, and we have a trusted ally to help us handle all the issues that come up for mom.  I don’t know what we would have done without Nancy!

 

(Return to top)