Crisis Managed the Windward Way

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By Heather Arsenault, Aging Life Care Manager

Since I began working at Windward Life Care® as an Aging Life Care® Manager, I’ve gained a deep appreciation for the great work our team of care managers and home care aides performs every day to ease our clients through the joys and challenges of their later years. Of the many services we offer, one of the most valuable is accompanying our clients during their hospital and emergency room stays. I was reminded how essential a care manager’s role as a patient advocate can be during a client’s recent emergency room visit.

Our client “Mary” had fallen in the courtyard of her memory care facility. The staff found her on the pavement and called her primary Windward Aging Life Care Manager, Terry, and then had her taken to the closest hospital’s ER. Mary was complaining of knee and shoulder pain. Luckily, Mary was ushered into a “real room” at the hospital quickly, having been transported by ambulance.

At Windward, we have a system where every client has a back-up care manager in addition to their primary care manager. Since Mary’s care manager Terry was occupied with another client situation, and because I was her back-up and thus familiar with Mary’s situation, I rushed to the hospital to meet Mary at the ER—and I’m so glad I did. As good as the care at this hospital is, there are some things that a knowledgeable advocate can do for a client/patient in these situations that few others can. This is particularly true when the older person has dementia.

I first introduced myself to the nurse and told her I would be assisting Mary per her and her family’s request. I was able to provide important background information about Mary particularly regarding her memory issues and medications. The hospital then kept me informed regarding all testing: a CT scan (due to Mary being on a blood thinner) to check for bleeding, and X-rays of her shoulder and knee.

Mary asked questions that I was able to address when hospital staff was unavailable. She was very cold, and more than once, I had to ask the nurse for another blanket to keep Mary warm. Mary also repeatedly asked why her arm was constricted. I explained that it was the automatic blood pressure cuff doing this. When she needed her knee and foot rubbed, I was able to take care of that. And when she had to urinate (more than once), I was able to get the nurse, and they assisted her with the bedpan.

If Mary had been alone, she couldn’t have reached out to them herself; she wouldn’t have known what to do. Even though she had been a nurse herself, her memory was too impaired to allow her to advocate for herself. Several times she asked me where we were, and she had no recollection of the fall. While she was resting, I continued to ask the nurse when the doctor would be in to give us the results. I was also able to reach Mary’s daughter and update her on Mary’s condition, which she appreciated, and she was able to talk to Mary herself.

The emergency room can be a chaotic place, and this can be upsetting to older adults. At one point, a woman in her 30s, being held in the hospital for a psychiatric evaluation, was screaming obscenities and crying for over 45 minutes. Her room was near Mary’s, so Mary kept questioning what was wrong with the woman. She asked me, “Can you go help her?” I reassured her that the staff was helping her, though the situation was still upsetting to Mary.

The doctor finally arrived at 8:00pm (three hours after Mary had entered the ER). He said all tests, including the CT scan, came back negative. Mary tested positive for a urinary tract infection and dehydration, so they started her on antibiotics and fluids. Once she was stable, they were going to make sure she could stand up, and then they would transport her back to the memory care community.

Mary returned back home that evening. My final text to Mary’s daughter to update her on everything was at about 9:45pm. She thanked me for going to the hospital to help her mother on such short notice and especially appreciated someone being with her. We agreed that Windward would provide a caregiver to furnish one-on-one care for Mary the next day, to give her some additional support and attention.

When I left the hospital ER that night, there were at least 50 people waiting to be seen, including several older people by themselves. I am grateful that Windward staff can accompany our clients during these stressful hospital visits, providing advocacy, comfort to the client, and peace of mind to their families. It is an invaluable service we provide.

 

Windward Life Care’s interdisciplinary team of Aging Life Care® Managers has certification and professional training in a number of areas related to healthy aging, including nursing, geriatric care management, and social work. If you would like us to create a personalized plan for yourself or someone you care about, please contact us at (619) 450-4300 or [email protected].

*Out of respect of our clients’ privacy, some names have been altered.

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Emergency Preparedness Tips for Home and Family

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Wildfires are spreading through much of the state of California, with some families facing the need to evacuate their homes. Regardless of your proximity to the fires, it is important to put together a proactive emergency preparedness plan. Not only will you be ready to keep yourself and your family safe, but you can also watch out for elderly clients and neighbors who might need assistance in an emergency situation.

Emergency Preparedness Tips to Follow

Since September is National Preparedness Month, we wanted to suggest few things that can be done in your home. Follow these tips so that you are ready if a wildfire or other emergency affects your area:

  • San Diego Emergency Phone App: The city of San Diego has a free emergency app that can be used for notifications. You will receive text message notifications and instructions when there are emergency alerts in the area.
  • Phone Charge: Communication is important in an emergency. You should always keep your cell phone charged and have the charger on hand.
  • List of Essentials: Are there any essentials that need to be grabbed on your way out the door in the event of an evacuation? Have this list handy so that you don’t overlook anything critical like medications, medical equipment, and important papers.
  • Evacuation Routes: What is the best way to escape the area? Have a map of the local evacuation routes. Knowing multiple paths out of the neighborhood can be important if the emergency is blocking your normal roads.
  • Bring the Pets: Animals are a part of the family, so don’t forget to bring your dog or cat along. Be sure to have food as well as a crate or leash. Most of the emergency shelters in San Diego are pet-friendly.

Family Caregivers and Emergency Planning

While it is important to follow the general tips listed above, don’t overlook the importance of personalized preparedness when caring for someone with health challenges. It can be helpful to have copies of that person’s medication list and care plan,  as well as enough medication to get through the critical hours of the emergency.  The Alzheimer’s Association has prepared these helpful preparedness tips for caregivers of older adults with dementia. These suggestions can be used for people with other medical concerns as well.

If you need assistance in preparing for an emergency, such as wildfires or earthquakes, then Windward Life Care is here to help you find the right resources. Contact us to learn more about the services that are available.

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Quality Care and Support for LGBTQ Aging Adults

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In honor of Pride in San Diego this month, we’d like to discuss a topic of concern in the community: providing the support that is needed for aging LGBTQ adults. It is estimated that the population of LGBTQ adults in America over the age of 65 will double by 2030, reaching a level of more than 3 million people across the country. As the older LGBTQ population grows, there are unique challenges that need to be addressed so that our society is prepared to support the needs of full diversity in the aging population:

  • Caregiving and Decision Making: Unfortunately, many LGBTQ partners and their families of choice aren’t recognized by the law, which means that family members don’t have access to medical leave to take care of a sick partner. Additionally, in the absence of a health care advance directive, decision-making can be limited to immediate family members. This can negatively affect the partner’s ability to care for their loved one.
  • Health Care: Nationally, up to 80% of long-term care for aging adults is provided by family members and relatives. LGBTQ elders, however, don’t always have close family members to lean on for assistance. As a result, they need to rely on the services of hospital, assisted living, and home care professionals who may have little or no training in working with LGBTQ older adults. In addition, paying for professional care is more costly than receiving care from family members.
  • Cultural Competency of Care Providers: Even if the person has access to health care, about 20% of LGBTQ people avoid medical care because they are afraid of discrimination. Overcoming these cultural barriers is essential so that everyone feels comfortable seeking medical care when needed.
  • Health Disparities: Overall, LGBTQ individuals have lower rates of health insurance coverage. Health problems might occur and persist because of disparities in health care access, an HIV/AIDS diagnosis, and/or other chronic physical or mental health conditions. These disparities need to be corrected so that LGBTQ older adults have access to the health care services they need.
  • Housing Discrimination: It is common for older LGBTQ couples to be victimized by discrimination when looking for rental or senior housing options. Many individuals feel they need to re-closet themselves in senior housing to avoid the discriminating treatment from staff.

Everyone deserves to receive quality care and support during all stages in life. If you are in need of services, or if you know a friend or family member who needs help, then reach out to our team at Windward Life Care. With our membership in the Greater San Diego LGBT Health & Wellness Referral Network, we can help you with advance care planning; healthcare advocacy; and finding the appropriate resources in the area to support your needs.

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Summer Heat Safety for Older Adults

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The heat can be uncomfortable for people of all ages, but older adults are prone to heat stress, which can be a dangerous situation if left untreated. As a result, seniors can experience several heat-related health problems when the weather warms up outside.

Whether you are caring for your own health or you are a caregiver for another adult, it is important that you are proactive to stay safe in the heat.

Why Older Adults are at Risk

Why is the risk higher for older adults? Often, seniors have medical conditions that affect the body’s ability to regulate temperature. Some chronic conditions can change the body’s response to heat.

Certain medications might have an impact on how the body sweats. For example, diuretics can increase the risk of dehydration due to water loss. Heart disease impacts the blood circulation, which makes it harder for the body to dissipate the heat.

Older adults’ sense of thirst also diminishes with the aging process. Feeling less thirsty, combined with some seniors’ difficulties with incontinence, can lead many people to avoid drinking water and other fluids. This increases their chances of becoming dehydrated which can lead to hospitalization.

Prevention is Important

Don’t wait for symptoms to occur before taking action against the heat. Being proactive is the best solution to prevent health complications:

  • Stay in an air-conditioned area as much as possible during the day.
  • Increase water consumption. Drink consistently throughout the day instead of waiting until you are thirsty.
  • Wear clothing that is loose-fitting and light in color.
  • If you are feeling warm, take a cool bath or shower to lower your body temperature.
  • Minimize physical activities, especially when you are spending time outside.
  • Use window coverings to keep the heat of the sun out of the room.
  • Turn on the air conditioner, even if it increases the utility bills; or, go to a public library, indoor mall or San Diego County-sponsored “Cool Zone.”
  • Avoid caffeine and alcohol which can increase the risk of dehydration.

If you have an aging neighbor or family member, then it is smart to check in regularly to make sure they are staying cool. In the situation where the power is lost, it is essential to offer assistance to help the person get to a cooler place.

When to See a Doctor

Certain symptoms might indicate that it is necessary to see a doctor: strong or rapid pulse, feeling faint, confusion, increase in body temperature, or dry, flushed skin.

Whether you have questions about heat-related symptoms or you need assistance with other medical concerns, Windward Life Care is here to assist. We can help you find the right resources to match your needs. Call to learn about the services that we provide.

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Aging Life Care Manager Helps “Bill” to Age Well

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Windward’s Aging Life Care Managers help clients to make positive life changes that result in better health and quality of life. Here is one example of a client, “Bill,” whom Care Manager Heather Arsenault has had the honor to work with for the past year and a half.

Bill was referred to Windward Life Care® by his estate planning attorney. Bill has required help most of his life due to the effects of a brain aneurysm he suffered as a teenager. After a lengthy recovery, Bill was able to go back to school and graduated in the mid-1960’s. He worked on and off, including several years as a cashier at a local convenience store. Bill is now 73. He has a heart of gold and loves a good conversation.

One of the challenges Bill has faced in his life is social isolation. To help with companionship and incorporating meaningful activity into Bill’s life, Heather introduced a home care aide, Zahrina. With the dependable structure that a daily home care aide provides, Bill now fills his days with activities that further his physical and mental health and bring joy to his life.

Each morning Bill and Zahrina play Windward Life Care’s “Memory Match Game” with cards that have personal photos of people, pets, and places in his life. Other activities they enjoy are: going to Padres games, walking at Seaport Village, walking at Spanish Landing, and eating out. Bill has a personal trainer and a therapist who both come to the house weekly. Heather also worked with Bill’s Power of Attorney to get him started in swim therapy classes this summer. As a teenager, Bill was an avid swimmer so he was excited to return to this favorite pastime.

Aging Life Care® Manager Heather Arsenault visits Bill monthly at his home, or out at one of Bill’s favorite restaurants.  Heather has weekly contact with Zahrina to share information and ideas for helping Bill. Heather determined that Bill would benefit from safety upgrades at his home. She arranged for a company to initiate bathroom improvements, upgrade flooring, and remove floor rugs to make his environment safer.

Heather has also facilitated Bill’s visits with his health care providers to ensure that his chronic conditions are well-managed and that crises are averted.

Bill’s consistent routine including in-home caregivers, engaging activities, and taking steps toward a healthy lifestyle have led to an “aging well” story.

 

Windward Life Care’s interdisciplinary team of Aging Life Care® Managers has certification and professional training in a number of areas related to healthy aging, including nursing, geriatric care management, and social work. If you would like us to create a personalized plan for yourself or someone you care about, please contact us at (619) 450-4300 or [email protected] lifecare.com.

*Out of respect of our clients’ privacy, some names have been altered. 

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