For seniors — and for those with seniors in their lives…
Thanks, mjc and jerseyjack. I didn't know there was such a thing as a geriatric care manager--I thought there might be but couldn't figure out what terms to use to Google it.
I tried the NYC 311 site, but it wasn't much help. I do have a NYC area code on my work phone, so I'll try calling. Ideally, I think we'd like to keep him in the city, but it may make more sense to have him in Westchester near my brother, or in NJ near me. At his age, he has few friends left, and all but one of his siblings are gone (he's the second-youngest of six), so that doesn't matter so much, but he's lived in the city for all but 4 of his 90 years and may not take well to moving elsewhere, even nearby.
jerseyjack, he served briefly in the Navy at the end of WWII. He didn't serve in Korea or Vietnam.
mauras said:
Thanks, jerseyjack. How do we go about finding the social worker in his area (he's on the Upper West Side)?
He is a veteran (barely). His assets are limited, since he rents. He has a bit of money in investments and some money in the bank, though that's been eaten into by the cost of home care, which he's had for a couple of years. He's sometimes argumentative and can be stubborn, but he's never been physically aggressive in the least. He has limited mobility and uses a wheelchair or a walker most of the time, and he needs help with dressing, showering, etc. He goes through periods of lucidity and full awareness, but gets confused at other times, particularly if he hasn't slept well. He's also hard of hearing, which doesn't help with communication. He's prone to withdrawing into himself, but he's pretty gregarious when there are people around and usually enjoys company.
That's about all I can think of. Thanks again for any help you can offer.
You described my Mom perfectly except for being a veteran and also she owns her own home. We tried, we being my 3 siblings to respect her wishes and keep her in her own home till God calls her home. We have had live-in aides for 4 years but due to the dementia,which is progressing rapidly, we had to admit Mom into a long term care facility this past Mon. We agonized over this decision but the episodes of delirium kept getting closer and closer and the calls to come over at 2 am to calm her became unsustainable. We did our homework and toured 5 facilities.We decided on Runnells in New Providence where she had been twice before for short term PT/OT after hospitalizations.While touring we checked a few off list for different reasons but after narrowing it down we chose Runnells. Prices in all places were similar but Runnells was the only place that had a private room available and that was important to us to make the transition smoother. It was a space issue also as she was self pay and we wanted a room where we could put her lazy boy, end table,dorm size fridge and many photos.The proceeds of her house sale should pay for 2 years care and as she is now 88, I am thinking the dementia,if it keeps on worsening, will make moving her to a shared room when Medicaid kicks in something she won't be aware of. Wishful thinking maybe, but kicking the can down the road is our way dealing with this very sad time,after all ,it was the house we all grew up in and her home for the past 66 years.Caring for an elderly family member is hard work and time consuming.There were 5 adults caring for 1 person and each one was integral to the team.I can't begin to imagine how one person could handle the task but I know it happens all the time.Thanks for letting me put my thoughts on paper.
mauras said:
Thanks, mjc and jerseyjack. I didn't know there was such a thing as a geriatric care manager--I thought there might be but couldn't figure out what terms to use to Google it.
I tried the NYC 311 site, but it wasn't much help. I do have a NYC area code on my work phone, so I'll try calling. Ideally, I think we'd like to keep him in the city, but it may make more sense to have him in Westchester near my brother, or in NJ near me. At his age, he has few friends left, and all but one of his siblings are gone (he's the second-youngest of six), so that doesn't matter so much, but he's lived in the city for all but 4 of his 90 years and may not take well to moving elsewhere, even nearby.
jerseyjack, he served briefly in the Navy at the end of WWII. He didn't serve in Korea or Vietnam.
When he was in the Navy, was he in a theater of war? You don't have to decide which benefits he is qualified for. The local V.A. office will do that for you. Each N.J. county has an office or the American Legion has volunteers that have the same skills as the V.A. offices. If you can't find information, p.m. me your contact information and I will work to have an American Legion rep. contact you. I work with the state commander of Amer. Legion.
V.A. will offer the best services if he is qualified. My mom ended up in the New Jersey V.A. facility in Paramus and it was the best. If he is qualified, get the application in as quickly as possible since there is a waiting list for beds.
Regarding N.Y.C., Westchester or N.J., as his condition continues to decline, it won't matter to him if he is in the city or not. While that sounds harsh, the concern should be where he gets the best care and where you or your brother can watch out for him. For example, I visited my mother once per week. I would point out changes or concerns in her physical condition that the staff had not noticed. For some reason, she would frequently develop irritation in her left eye. This change would be forwarded to the nurse practitioner or the residence's physician for prescription. For some reason, staff did not notice these but I did.
Another example, there is a difference in the quality of activities in different facilities. Visit the facility you are considering during activity times. Are most of the residents engaged or are they sitting in their chair while the activity director is going through the motions of presenting an activity. If there is a schedule of activities, are they varied?The most extraordinary example of this was a facility in Mountainside where an activity consisted of the leader holding a microphone in her hand and singing along with the cd player while no one was paying any attention. This was supposed to be a sing-along.
do you want me to find the link to questions we suggest families use when searching out resources/facilities over here for their loved ones? I know I've posted it in another thread in this category but that would be well over 12 months ago.
There's also that national advisory service that I know some MOLers have used, is it called My Mother's Place? Help you to find a shortlist of the best places for your situation.
Some other care agencies actually have a person whose job is to help advise and smooth the transition; we now call them regional assessor which doesn't tell you anything, sorry! It's a 'linkages' role. No kickbacks involved, so purely objective based on best fit. However both your and ours are currently undergoing definition and policy changes which will impact on the decisions being made now, so I can't be much practical use.
this list of questions is based on choosing a residence in Australia, so don't follow the links!! But use the questions as conversation starters when you consider a places ( it's easy to forget something important when you're on the spot, or pressed for time. If more than one person is looking, you need objective criteria)
ACAT is another term for the assessment team; just means that the level of need has been assessed as high enough for government assistance with fees, both medical/recreational and rent. https://www.myagedcare.gov.au/considering-aged-care-home/finding-aged-care-home
My friend in NYC is willing to search for Social Service help but needs a specific street for the council member. She thinks you will get better help from the local council office.
Wow, so much good advice! Thank you all. The article that mjc posted turned out to be very helpful--it led me to the professional certification site for Geriatric Care Managers, which is what I think I was looking for all along. We're happy to pay for a consultation from someone who can refer us to nursing homes and guide us through the process. We might also try A Place for Mom--I remember reading positive things about it somewhere on MOL (possibly in this thread).
jerseyjack, I can't tell you how much I appreciate your offer of help. Contacting the council office is a great idea--the councilperson for his district is Helen Rosenthal. And Joanne, thanks for those links--they'll come in very handy when we start looking at care homes.
Forgot to say--georgieboy, I'm sorry you're going through the same thing. It's just plain awful.
Excellent article for seniors and caregivers.
NYTimes: Planning to Age in Place? Find a Contractor Now
For a year now, my husband has been staying home and receiving excellent care-- not too easy and expensive, but he is in his own home surrounded by familiar things. We supplement whatever Medicare provides with private payhome health aides. The one we use is Home Instead and all the caregivers have been excellent. Seven years ago,we moved to a one level home which meets the requirements mentioned in the article. At the time, we really didn't foresee the need -- and now we thank God we did.
Link didn't work NYT Science
This is a huge problem that the Seniors Advisory Committee will be looking into. If anyone has information regarding local resources/tips for making our homes more accessible, I would appreciate it if you could post that information here.
the Home Instead folks have wonderful resources on their websites, Joan, that are freely available to any family that needs them. These include booklets on how to make decisions on the right mix of care for your situation (regardless of where you are in the world: the material is localised); how to handle things if there are disputes in the family; suggestions for activities and different approaches to tasks for different abilities; where to find support for primary caregivers, etc.
Home Instead isn't the agency I work with, but I have close colleagues in the local branch. They're amazingly gifted professionals I'm proud to know. Last year we did the Alzheimers Memory Walk together, and their parents walked with us! (10 km, so it wasn't a slow stroll...)
a lot of info, Joan, is in the article I couldn't post! Can anyone give it a try?
Thank you so much for the link. I sent it to the Chair of the Maplewood Senior Advisory Committee and to the Coordinator for the SOMA Two Towns For All Ages Initiative. This is a topic that we will be exploring for town-wide application. Looking at existing building codes, developing a list of contractors and consultants who can help individual residents make age friendly changes to their home, and developing a pamphlet of helpful hints in making these adjustments to the home are some of the approaches now under consideration. Please PM if any of you would be interested in working on this.
Keep the ideas coming!
as a caretaker I can vouch for how tough it is. A labor of love for my husband of almost 63 years with, thankfully, no dementia.
What I find has helped me are friends, new and old, family visits, and the necessary addition of home health caregivers. There is no mention of them in the article. The benefits of a couple of afternoons of aides is it provides extra care and socialization for him and help for me with chores- and the opportunity to get out of the house.
Online shopping makes being housebound tolerable!
Caregiving Is Hard Enough. Isolation Can Make It Unbearable.
https://www.nytimes.com/2017/08/04/health/caregiving-alzheimers-isolation.html
https://www.nytimes.com/2017/08/11/opinion/sunday/vaccinations-elderly.html
Baby boomers, caretakers, and seniors should take note
https://t.co/HdPxvGksXF?ssr=true
Vital info to have going into the hospital. We were caught up in the rabbit's hole last year.
https://www.nytimes.com/2017/10/25/style/the-future-of-nostalgia.html?ref=todayspaper
The reality of life and its baggage. Whenever and wherever homes are decimated by storms, fire or earthquakes, the survivors often bemoan the loss of “things” forever gone.
Watchful advice for treating seniors with skin problems...
https://www.nytimes.com/2017/11/20/health/dermatology-skin-cancer.html?ref=todayspaper
good read to start off another year...
Another good read for anyone with balance issues..
https://www.nytimes.com/2018/01/02/world/europe/netherlands-falling-elderly.html
mtierney, I'm sorry you're asking about this, but hope your experience with it will be as good as our family's was (outside NJ, though, so no practical guidance).
Wish I were closer so I could help. 
Sending all the positive vibes and hugs we can, hoping it helps a little to know others are praying for calm, compassion, skill and peace - and a healthy sense of humour if and when appropriate, when reminiscing.
mtekierney said:
Thanks!
Despite having lost their main office and hospital beds due to a hospital merger............Hospice of Central
Pennsylvania allowed my Uncle the dignity of staying in his own home and departing this earth from there
They visited several times a week to comfort,to shower and administer their wonderful services to him
For 10 weeks they were there.............there are angels among us
The last few days, as the end neared they furnished us with more appropriate pain killers. They were
on call 24 hours a day and more than once we made a late night call to them for help
A Hospice nurse was present when he left us. She was qualified to make the death declaration
They furnished us walkers and again at the very end a hospital bed
Their services are covered by Medicare
They are the light we need at a very dark time
thanks, Author. Had the initial interview yesterday and I was pretty overwhelmed. I was assured that we could leave the program at any point. I guess I cannot get my head around the basic premise of “comfort care”. Only certainty I have is knowing that he would not want to be hospitalized again! We are in Ocean County now.
Most of what I have heard about home hospice care is reassuring. Aim is to make the patient's last days as easy and pain free as possible. The prospect of needing this, or even having it recommended, is very emotional and extremely overwhelming. Be grateful that your husband's condition allows you this alternative. In our case, home hospice care was not an option unfortunately. I wish it had been.
You will need to reach out to friends and/or family and talk over your feelings now and as events progress. Reaching out here can help too. Please don't hesitate to ask for emotional support or a friendly ear. Feel free to send me a PM if you want to take this off-line.
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NYC has a 311 information line but it seems to work only from phones with NYC area codes. Possibly a website for NYC.Gov
I will ask my friends from Central Park for information.
The veteran question is most important... did he serve during the Korean or VN war in those countries?
There are "spend down" of asset requirements before you are able to get him placed somewhere in Medicaid. If you place him in a facility, make sure they have provision for Medicaid beds.
If his assets are limited (do you have a general idea of value) I doubt you will be able to save any of it.
Another question, do you want him in a place in the city where friends and you might visit or do you want him in N.j. where costs are likely lower and you can also tend to him?