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Excerpts from The Post and Courier
November 24, 2003
The Le Catos like to watch the boats at the City Marina from their sunroom.
Joanne Osbon, director of home health services at Care for Life, visits Maurine and John Le Cato once a week to discuss and organize their medications.
Maurine and John Le Cato take in the view of the City Marina from their sunroom. Joanne Osbon discusses one of John Le Cato's medications with him. John and Maurine Le Cato knew there would come a time when they would need help getting through the day. The Le Catos have no children and thought they would have to leave their private home for some other living arrangement when that time came. But that hasn't happened, John Le Cato says.
While the Le Catos are in their mid-80s and no longer can manage many aspects of their lives, they aren't about to move into an assisted-living facility or nursing home. Like many seniors, they have found a more satisfying solution. It's one that has been around for about 15 years and allows them to remain in their home at the Ashley House and be as independent as possible, for as long as possible.
They have hired a geriatric care management agency.
"Neither one of us ever learned to drive a car," Maurine Le Cato says. "We were dependent on public transportation, but the little bus that used to take us was discontinued by CARTA. Taxis are hopeless. Sometimes they come and sometimes they don't. We needed someone to get us to doctors' appointments and to the grocery store and things like that."
They hired Care For Life, one of three care-management agencies in the Charleston area, for transportation, but found they enjoy some of the agency's other services as well. "When we got started with Care For Life, they wanted to do things to make life easier for us," she says. Maurine Le Cato says that if she doesn't get the dishes or some other chore done, the helper from Care for Life will. She says the helper always knows exactly what to do and how they want it done.
"I don't know what we ever did before," she says.
Geriatric care is an option that experts say is particularly well- suited for seniors whose close relatives live in other states and are not available to monitor them. For them, geriatric care management is a way to maintain their quality of life.
"Any one of five reasons -- nutrition, medication, safety, hygiene and home maintenance -- or unaddressed medical problems, can cause an older person to fail in the home," says Mary Peters, a former hospital administrator and president of Care For Life.
Agency staff members who assist the elderly are trained to look for clues as to how well seniors are continuing to function, Peters says. Changes are noted and discussed with family members and health care providers.
The structure of the agencies varies, but the services they perform are similar. They begin with an assessment of a senior's physical and mental health, social life, home environment, general ability to function and coping techniques.
The agencies also develop care plans based on the assessment; screen household help; review financial, legal and medical issues; perform crisis intervention; act as liaisons with long-distance relatives; find assisted-living and nursing homes when the time is right; provide consumer education; and offer counseling and support.
"During the initial consultation, the nurse takes information on their medications, problems, doctors, telephone numbers, family telephone numbers, even where will they be going should we have a hurricane," Peters says.
EXPANDING FIELD
The Tucson-based National Association of Professional Geriatric Care Managers, founded in 1986, has 1,700 members. Experts give several reasons for the success of the relatively new specialty.
Seniors are living longer and want to stay in their homes as long as possible. Adult children who would be expected to help manage their parents' lives often reside out of state. Changes in Medicare and private insurance have made it harder to qualify for hospitalization. Those same changes have caused hospital stays to become shorter and the elderly to spend more time at home, in need of assistance.
AVAILABLE SERVICES
Seniors sometimes have problems preparing meals and getting to the grocery store, Peters says. So about 30 percent of the elderly don't get sufficient nutrition. Poor nutrition can cause problems including anemia, dehydration and weakness.
Seniors may say they have problems with their teeth, and after talking with them, it's clear they have been eating poorly for years and lack the nutrition necessary for healthy teeth.
Elderly people who live alone often overuse or underuse medications, Peters says. Sometimes, spouses take the other spouse's medication because they are convinced it's better for them. Or they may take several medications for the same diagnosis. "A person might have a dish or container and have all of these meds jumbled up together, and they won't remember what they have taken and maybe they'll take a few extra," Peters says. "We have a nurse who goes by weekly and puts their medication in a medicine tray. She also communicates with the pharmacist and the doctors about things like side effects."
Unrecognized medical problems also cause the elderly to need help, Peters says. Sometimes the thing that is bothering them at home is not what is bothering them when they get to the doctor's office. Or they have multiple problems and cannot remember which one is most prominent. Geriatric care managers are responsible for ensuring that even little problems are taken care of, because they can become big problems later on.
Another concern is falls and complications from falls, Peters says. Magazines, electrical cords and rugs can pose hazards for older people trying to get around their homes. Combined with changes in vision, sensations and hearing and a slower reaction time, it is easy for seniors to lose their balance.
"Accidents are the fifth leading cause of death in older adults, with falls constituting two thirds of those accidents," Peters says.
Hygiene also can be a problem for the elderly, especially when something traumatic, such as the death of a spouse, has occurred, Peters says. An older person who loses a spouse also may lose the motivation for many things. Those who live alone are less likely to keep to a schedule of dressing, bathing and grooming.
Geriatric care managers also can help with the transition to an assisted-living facility or nursing home when the time is right and continue to visit the senior at the facility and report to the family.
Reproduced with permission of the copyright owner. Further reproduction or distribution is prohibited without permission.
November 24, 2003
The Le Catos like to watch the boats at the City Marina from their sunroom.
Joanne Osbon, director of home health services at Care for Life, visits Maurine and John Le Cato once a week to discuss and organize their medications.
Maurine and John Le Cato take in the view of the City Marina from their sunroom. Joanne Osbon discusses one of John Le Cato's medications with him. John and Maurine Le Cato knew there would come a time when they would need help getting through the day. The Le Catos have no children and thought they would have to leave their private home for some other living arrangement when that time came. But that hasn't happened, John Le Cato says.
While the Le Catos are in their mid-80s and no longer can manage many aspects of their lives, they aren't about to move into an assisted-living facility or nursing home. Like many seniors, they have found a more satisfying solution. It's one that has been around for about 15 years and allows them to remain in their home at the Ashley House and be as independent as possible, for as long as possible.
They have hired a geriatric care management agency.
"Neither one of us ever learned to drive a car," Maurine Le Cato says. "We were dependent on public transportation, but the little bus that used to take us was discontinued by CARTA. Taxis are hopeless. Sometimes they come and sometimes they don't. We needed someone to get us to doctors' appointments and to the grocery store and things like that."
They hired Care For Life, one of three care-management agencies in the Charleston area, for transportation, but found they enjoy some of the agency's other services as well. "When we got started with Care For Life, they wanted to do things to make life easier for us," she says. Maurine Le Cato says that if she doesn't get the dishes or some other chore done, the helper from Care for Life will. She says the helper always knows exactly what to do and how they want it done.
"I don't know what we ever did before," she says.
Geriatric care is an option that experts say is particularly well- suited for seniors whose close relatives live in other states and are not available to monitor them. For them, geriatric care management is a way to maintain their quality of life.
"Any one of five reasons -- nutrition, medication, safety, hygiene and home maintenance -- or unaddressed medical problems, can cause an older person to fail in the home," says Mary Peters, a former hospital administrator and president of Care For Life.
Agency staff members who assist the elderly are trained to look for clues as to how well seniors are continuing to function, Peters says. Changes are noted and discussed with family members and health care providers.
The structure of the agencies varies, but the services they perform are similar. They begin with an assessment of a senior's physical and mental health, social life, home environment, general ability to function and coping techniques.
The agencies also develop care plans based on the assessment; screen household help; review financial, legal and medical issues; perform crisis intervention; act as liaisons with long-distance relatives; find assisted-living and nursing homes when the time is right; provide consumer education; and offer counseling and support.
"During the initial consultation, the nurse takes information on their medications, problems, doctors, telephone numbers, family telephone numbers, even where will they be going should we have a hurricane," Peters says.
EXPANDING FIELD
The Tucson-based National Association of Professional Geriatric Care Managers, founded in 1986, has 1,700 members. Experts give several reasons for the success of the relatively new specialty.
Seniors are living longer and want to stay in their homes as long as possible. Adult children who would be expected to help manage their parents' lives often reside out of state. Changes in Medicare and private insurance have made it harder to qualify for hospitalization. Those same changes have caused hospital stays to become shorter and the elderly to spend more time at home, in need of assistance.
AVAILABLE SERVICES
Seniors sometimes have problems preparing meals and getting to the grocery store, Peters says. So about 30 percent of the elderly don't get sufficient nutrition. Poor nutrition can cause problems including anemia, dehydration and weakness.
Seniors may say they have problems with their teeth, and after talking with them, it's clear they have been eating poorly for years and lack the nutrition necessary for healthy teeth.
Elderly people who live alone often overuse or underuse medications, Peters says. Sometimes, spouses take the other spouse's medication because they are convinced it's better for them. Or they may take several medications for the same diagnosis. "A person might have a dish or container and have all of these meds jumbled up together, and they won't remember what they have taken and maybe they'll take a few extra," Peters says. "We have a nurse who goes by weekly and puts their medication in a medicine tray. She also communicates with the pharmacist and the doctors about things like side effects."
Unrecognized medical problems also cause the elderly to need help, Peters says. Sometimes the thing that is bothering them at home is not what is bothering them when they get to the doctor's office. Or they have multiple problems and cannot remember which one is most prominent. Geriatric care managers are responsible for ensuring that even little problems are taken care of, because they can become big problems later on.
Another concern is falls and complications from falls, Peters says. Magazines, electrical cords and rugs can pose hazards for older people trying to get around their homes. Combined with changes in vision, sensations and hearing and a slower reaction time, it is easy for seniors to lose their balance.
"Accidents are the fifth leading cause of death in older adults, with falls constituting two thirds of those accidents," Peters says.
Hygiene also can be a problem for the elderly, especially when something traumatic, such as the death of a spouse, has occurred, Peters says. An older person who loses a spouse also may lose the motivation for many things. Those who live alone are less likely to keep to a schedule of dressing, bathing and grooming.
Geriatric care managers also can help with the transition to an assisted-living facility or nursing home when the time is right and continue to visit the senior at the facility and report to the family.
Reproduced with permission of the copyright owner. Further reproduction or distribution is prohibited without permission.