AGING CARE MANAGEMENT™ SERVICES
Assessment and Aging Care Planning
To build a truly comprehensive Aging Quality of Care Plan™, you first have to understand the senior. That's why every Aging Care Management™ engagement at Aging Care Planning Solutions starts with a comprehensive assessment.
WHY WE START HERE
Understanding the whole senior, not just the immediate need.
A comprehensive assessment identifies not only physical and functional needs, but also preferences, priorities, social and emotional challenges, and risk factors. Our Aging Care Managers™ (or Geriatric Care Managers) have extensive experience assessing care needs, and are trained to gather this information with compassion, respect, and discretion.
As a family member, it's likely that you cannot be as thorough or as objective when planning for care. After all, we all view things through the lens of our own history and experience. In most cases, families become involved in elder care only after a critical event, such as a fall or a new medical diagnosis. As a result, you may find yourself in a reactive mode, unable to be as thoughtful as you'd like to be in your decision making.
Having a professional Aging Care Manager conduct an assessment and develop an Aging Quality of Care Plan™ helps you regain perspective, and helps provide the best possible care for your elderly loved one.
DEFINING THE PROCESS
What is Aging Care Planning?
Aging Care Planning, or elder care planning, refers to a three part process. Based on the initial assessment, the resulting Aging Quality of Care Plan becomes an agreement between the senior and everyone involved about how to enhance quality of life and reduce the risks of living at home.
01
Identify
Identifying the issues that negatively impact an individual's life.
02
Prioritize
Prioritizing the outcomes the senior and family most want to see.
03
Determine
Determining the interventions, services, and resources needed to reach those goals.
Seniors and their family caregivers benefit from having an Aging Quality of Care Plan because it serves as a road map, keeping everyone focused on the interventions that require attention. Planning for elder care is an ongoing process, and the plan needs to be updated and managed as real time, real life changes occur.
Beyond serving as a yardstick for progress, an Aging Quality of Care Plan is an essential tool to have on hand in the event of a crisis or medical emergency. It outlines, in writing, what kind of care the individual wants, which is especially helpful if a loved one is no longer able to articulate their own wishes due to a medical condition or cognitive decline. It enables family members to make decisions consistent with their loved one's preferences and values.
THE CORNERSTONE
The biopsychosocial assessment.
A biopsychosocial assessment is the cornerstone of Aging Care Planning. Its goal is to understand the whole person: not just physical or medical needs, but emotional, psychological, social, and even spiritual needs as well.
A biopsychosocial assessment is typically conducted by a credentialed social worker, nurse, psychologist, gerontologist, certified senior advisor, or another professional who specializes in working with geriatric clients. It usually takes one to three hours and may be conducted across one or more sessions, most often in the senior's residence, though a hospital, a family member's home, or the practitioner's office can also work.
During the evaluation, the Aging Care Manager asks questions across several areas:
Presenting Issues
Why does the senior need help now?
Social Support
Past and present support systems.
Medical History
Current information that is relevant to their care.
Emotional Wellbeing
Mood, affect, losses, and changes.
Medications
A full picture of what is currently prescribed.
Risk Factors
Isolation, home safety, falls, nutrition, driving, caregiver burnout, and more.
Functional Abilities
Current ADLs and IADLs.
Because it covers such a wide range of physical and emotional territory, a biopsychosocial assessment results in an understanding of the whole person, which in turn allows interventions to be chosen based on facts, not assumptions.
THREE LENSES, ONE PERSON
Biological, psychological, and social.
Aging Care Planning, or elder care planning, refers to a three part process. Based on the initial assessment, the resulting Aging Quality of Care Plan becomes an agreement between the senior and everyone involved about how to enhance quality of life and reduce the risks of living at home.
BIOLOGICAL
Medical and physical status
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Medical diagnoses and conditions
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Medications
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Sleep habits
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Nutrition and digestion, weight gain or loss
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Hearing and vision
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Toileting
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Skin condition
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Ambulation and walking
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Pain and respiratory issues
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Swelling of extremities
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Management of ADLs and IADLs
PSYCHOLOGICAL
Emotional wellbeing
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Feelings and moods
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Appetite and sleep habits
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Recent changes
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Energy level
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Thoughts of suicide
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Anxieties
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Coping mechanisms, past and present
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Pleasurable activities and hobbies
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History of mental health concerns, personal or family
SOCIAL
Connection and purpose
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Past activities, hobbies, and careers
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Significant people in their life
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Valuable lessons learned
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What gives them pleasure
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Ways to adapt past interests into present day activities
Bill Thomas, MD, founder of the Eden Alternative, identified three plagues affecting older adults: boredom, loneliness, and helplessness. The cure for boredom is meaningful, purposeful activity. The cure for loneliness is companionship and social engagement. And the cure for helplessness comes from opportunities to participate, give back, and reciprocate. Our Aging Care Managers build plans around all three.
"Why do you need an Aging Life Care Specialist? Because family comes first."
-PATTI URBAN
THE DELIVERABLE
The Aging Quality of Care Plan.
Most people understand the value of meeting with a financial planner to build a plan tied to their goals, or an estate planning attorney to protect what matters. An Aging Quality of Care Plan is a similar kind of tool. It communicates how and where a senior wants to live, what matters to them, and how care should be handled, so that it is always administered in a way that honors their wishes.
Questions an Aging Quality of Care Plan may help answer:
If I should require care, who will provide it?
Where should my family turn for guidance and support?
How will my care be financed?
Who will make decisions about financial, living, and health care matters?
Where are my essential documents stored?
What is important to me in selecting the right care provider?
Where do I want to be living?
Who will handle paying the bills?
How do I want to spend my time?
Who do I want to spend my time with?
What are my regular routines?
What are my medications?
Who will provide transportation?
What kind of activities do I enjoy?
If my family can't see eye to eye, who will have final authority?