Archive for the 'Interviews With Health Care Professionals' Category

Popular Senior Care Authors, Carol Bradely Bursack

Tuesday, December 18th, 2007

carol-bradley-bursack.jpg Part II of the CareGrade interview with Carol Bradely Bursack

 

What is the biggest complaint you hear about finding care?

Seeking care for a loved one can be a confusing and frustrating experience. People do not know how to get the appropriate information and do not know their options. Dealing with insurance, Medicare and Medicaid can seem like a full-time job, and my result in not obtaining all the benefits that are available. Getting advice from people who have or are confronting the same issues can be helpful. Another good option is to hire

a qualified professional geriatric care manager, if one is available in your area. They can be found at www.caremanager.org. This can be especially helpful if your loved one lives out of town..

What advice do you have for our readers?

If you decide to put a loved one into a nursing home or assisted living facility, do not feel guilty about it. You are not giving up or abandoning them. You are still the caregiver, but are now getting the extra help that can benefit both of you.

If you ask most seniors where they want to be, they will almost always tell you they would prefer to stay at home. While most people are very comfortable in their homes, it may not be the best place for them. The bathrooms may be upstairs, or the house in need of repair. Unfortunately, many people still think of nursing homes and assisted living facilities as cold, uncaring institutions. This may be true of some, but today many homes offer personalized care in a comfortable, homey environment.

When considering a facility for your loved one, the most important thing to look for is how well the staff treats each other and the residents. In her book, “Old Age in a New Age: The Promise of Transformative Nursing Homes”, Beth Baker discusses the need for management to treat certified nurses aides (cna’s) with the respect they deserve. A staff is well- treated will, in turn, treat the residents well. Before deciding on a facility, visit it all times of the day and night. Observe how nurses treat cna’s, and how cna’s treat each other and the rest of the staff. That is the best clue as to how the residents will be treated.

What resources would you recommend for caregivers?

Go to websites such as mindingourelders.com, caregrade.com, alzheimers.org, Healthcentral.com, and Eldercare.gov. Eldercare.gov has the eldercare locator, a useful tool for people looking for help. Just be aware that the services found on this site have not been screened.

How do you think the internet will affect caregivers in the future?

I think the internet is great and is going to continue growing. Helpful information is available 24/7, with a growing number of quality sites, chat groups and forums. However, caregivers are very vulnerable and need to be wary of what they read and with whom they communicate. That said, the internet is a great resource that can help caregivers lose that feeling of isolation and let them know there is hope.

Carol Bradley Bursack is a columnist, speaker, blogger and author of “Minding our Elders:Caregivers Share their Personal Stories.” Her blogs can be found at www.mindingoureldersblogs.com and www.healthcentral.com/alzheimers

CareGrade interviews Carol Bradley Bursack about her book “Minding Our Elders”

Wednesday, December 12th, 2007

 

minding-our-elders-cover.jpg This is the first of a three part installment

CG: What inspired you to write your book Minding Our Elders?

CBB: I had been a caregiver for seven elders over the span of two decades, and I began to feel very isolated. In speaking with other caregivers, I realized that they also were feeling isolated. I was a writer by profession and always felt that I learned the most through stories. I began writing stories about my own experiences as a caregiver and in telling people about it, realized that they also wanted to have their stories told. The book is really a compilation of stories from many different caregivers, each with their own unique circumstances. I think that because there are so many different people other than myself involved with the stories, it touches a much broader audience. Most people can relate to one story or another.

The goal of the book and my blog is to help caregivers feel that they are not alone. The book has been described as a portable support group and my blog allows for feedback and has chat groups. Friends may offer sympathy, but they cannot truly understand unless they have been in the same situation. But by communicating with others who are dealing with the same issues, caregivers can help themselves and feel less isolated.

When I was caring for my elders, there were no internet chat or support groups through which I could communicate with other caregivers, and I felt very isolated. The computer has opened a whole new world of possibilities. We all know how difficult holidays can be, so I find it most gratifying when people tell me that with my help they were able to make it through.

Carol Bradley Bursack is a columnist, speaker, blogger and author of “Minding our Elders:Caregivers Share their Personal Stories.” Her blogs can be found at www.mindingoureldersblogs.com and www.healthcentral.com/alzheimers

Assisted Living - What Care Managers Look for

Wednesday, November 21st, 2007

A Professional Care Managers View

In our ongoing series of interviews, CareGrade.com spoke with professional care manager Michele Tyson C.M.C. to find out what a professional care manager looks for in assisted living facilities.

CG - What do you, as a care manager; look for in an assisted living facility?

MT – Quality of care is my major concern. I want to know if there is a nurse available, is the placed staffed by home health aides, what are the staffing ratios.

I also look to see what levels of service are available. Do they offer special services such as secured dementia unit or dementia programs? Do they offer a higher level of care or is this a facility for higher functioning people only.

Lastly, I look to see where the facility is located. Is it close to major hospitals, doctors and shopping? Is it on a busy road or a quieter location?

CG - What problems do you most often encounter?

MT – The most common problems I see are when people are not happy with the food, or when there are care issues.

CG - What questions should a family ask when speaking with an agency and trying to make a choice?

MT - Is there a registered nurse available 24 hours per day?

How are medications handled?

What services are included in monthly fee and what additional costs do they need to be aware of?

What activities and programs are available?

Is transportation available, especially for doctors’ appointments?

Are special diets accommodated for?

CG - How long does it usually take for a person to move into a facility?

MT - If a bed is available, they should be able to get in within 24-72 hours as long as the physicals are completed and the other issues such as preparing to move are all taken care of. While a family can definitely make all the arrangement for moving into a facility by themselves, a geriatric care manager could make it easier and speed things up.

CG - What are the most difficult people to find assisted living for?

MT - Finding a facility with a secured dementia unit can be tough. There is often a waiting list for these. The other big challenge I see is finding a bed for a person with limited resources.

CG – Is there any other advice you would give a family looking for assisted living?

MT - Look early; don’t wait until there is a crisis situation where placement is absolutely necessary.

Schedule appointments to visit with several communities.

Ask if you can stay for lunch or dinner. Most communities will accommodate that without a problem

What to Look For When Choosing Home Health Care

Friday, November 2nd, 2007

 

A Care Manager’s View of Home Care

 

CareGrade.com did an interview with professional care manager Liz Salston, LSW to find out what a professional care manager looks for in a home care agency.

 

CG -What do you, as a care manager, look for in a home care agency?

LS - I look for an agency that offers a comprehensive service, not just companionship. I want the client to be able to have medication assistance and hands on care from a home health aide should they need it. I also look for supervision from an RN.

 

Other things I look for include having consistency in terms of coverage, and a good relationship with the care manager, which includes feed back and quick responses to phone calls. Lastly, I want to see that an agency does a good job of screening the home and the client’s needs in order to help make the right match with a caregiver.

 

CG - What problems do you most often encounter?

LS - I have had some issues with the professionalism of agencies when communicating information about their clients. On a broader scale, making good matches between the client and caregiver is a big problem. Agencies often fall short when taking all of the facts about a client in to account. They need to look at more than just the physical condition and consider things such as the client’s interests, quirks and personality. They also need to consider the caregiver’s needs. For example, an agency should be careful not to send a person with allergies into a house with pets they are allergic to.

 

Response time when filling cases, especially for call outs and emergency fill-ins tends to be another problem. An agency should be staffed well enough that it does not have gaps in coverage.

 

CG - What questions should a family ask when speaking with an agency and trying to make a choice?

LS - People searching for care should ask the agency…

What happens if it is not a good match?

How quickly can you make a change if it is needed?

Do you have enough coverage if a person calls out?

.

CG - How long does it usually take to get service started?

LS - A good agency should be able to get a new case started within 48 hours. Sometimes they have to start with a temp until they can secure more permanent placement.

 

CG - What are the most difficult cases to fill?

LS – I find cases that are short term, less than two weeks, can be a challenge to get filled. It takes just as much work and costs the agency just as much to staff one of these cases as it does for a long term case. The agencies are just not as motivated. What they fail to recognize is that is that short term placements often result in long term cases over time. Agencies need to take this possibility into account.

 

Other cases I find hard to get staffed are when there is a racial bias. Unfortunately it is out there. I attempt to teach my clients and their families’ lessons in tolerance and acceptance when engaging home care services. Clients need to understand that the majority of workers in this field come from minority groups and that their priority should be the quality of care provided. Personal biases need to be put aside and relationship building will occur over time if given a chance.

 

 

Liz Salston is a social worker with 22 years of experience in the field of services for older adults. She has served as Director of Recreation and Social Services at the Martin and Edith Stein Assisted Living Residence and as a social worker at the Central New Jersey Jewish Home for the Aged in Somerset. She has run several socialization and respite groups at the Jewish Family Service of Southern Middlesex County and has worked as a social worker in HUD senior housing.

Liz holds dual Bachelor of Arts degrees in Sociology and Judaic Studies, a Master of Social Work, as well as a Master of Arts in Contemporary Jewish History.

 

She is a licensed social worker in the state of New Jersey, a member of the National Association of Professional Geriatric Care Managers, Inc., and the National Association of Social Workers.

 

You may reach Liz at www.salstoneldercare.com (732) 238-1775

What to Look for in Assisted Living

Friday, October 26th, 2007

A Professional Care Managers View

CareGrade.com did an interview with professional care manager Liz Salston, LSW to find out what a professional care manager looks for in assisted living facilities.

CG - What do you, as a care manager, look for in an assisted living facility?

LS - The first thing I look for is to see if it is truly a homey environment. This is not an institution these people are moving into, it is a new home. While being homey is important, the facility must also be well run and have a kind staff. I look for a place that all employees, from housekeeping all the way up to the director, will drop whatever they are doing to help a resident with whatever their needs are

Other things I look for include

An environment that is protective for people who are memory impaired. I like to see that the higher functioning people are able to come out and socialize with the rest of the resident, as long as there is staff supervision.

The facility has nursing supervision 24 hours per day

Transportation to doctors and outside recreation is provided.

There is an affordable tier system of care level.

The survey.

Lastly, I like a facility that either has a separate skilled section of its own or a relationship with a skilled facility. I want to know that if a person requires the skilled care for a short term stay, that they will be transitioned back to their home in the assisted living facility once they are better.

CG - What problems do you most often encounter?

LS - I really don’t see many problems with the facilities I use.

CG - What questions should a family ask when speaking with an agency and trying to make a choice?

LS - Will staff engage their parents?

Will they push the residents to go to activities or encourage them to participate?

Do the residents each get lifeline pendants in case of emergency?

How does staff help settle a person into their new surrounding?

Is their any type of support group separate from resident council?

CG - How long does it usually take for a person to move into a facility?

LS - If there is no waiting list, a person should be able to move in within a week. It definitely saves time and speeds everything up when a family works with a good care manager. We have already done all the homework and know what facilities would be best for each individual.

CG - What are the most difficult people to find assisted living for?

LS - Individuals with behavior problems and psychiatric conditions or people who are agitated tend to be the most difficult to find the appropriate accommodations. Another group are those that have problems making the adjustment to a new place to live.

Liz Salston is a social worker with 22 years of experience in the field of services for older adults. She has served as Director of Recreation and Social Services at the Martin and Edith Stein Assisted Living Residence and as a social worker at the Central New Jersey Jewish Home for the Aged in Somerset. She has run several socialization and respite groups at the Jewish Family Service of Southern Middlesex County and has worked as a social worker in HUD senior housing.

Liz holds dual Bachelor of Arts degrees in Sociology and Judaic Studies, a Master of Social Work, as well as a Master of Arts in Contemporary Jewish History.

She is a licensed social worker in the state of New Jersey, a member of the National Association of Professional Geriatric Care Managers, Inc., and the National Association of Social Workers.

You may reach Liz at www.salstoneldercare.com (732) 238-1775

A care manager’s view of assisted living with Mark Zilberman

Tuesday, October 16th, 2007

CareGrade.com did an interview with professional care manager Mark Zilberman, LCSW to find out what a professional care manager looks for in assisted living facilities.

 

CG What do you, as a care manager, look for in an assisted living facility?

MK I like to see what my immediate reaction to the place is. How are the aesthetics? Is the place comfortable? Do I feel good there?

Then I look to see what services are offered, in particular, what is included in the base fee. One of the biggest problems I encounter when trying to compare one place against the other is figuring out what is included and what is extra. Some places seem like they cost more, but when you really compare apples to apples, you see that they are offering a lot more services in the base price. Other places are more ala carte.

 

I also check to see what happens when a person runs out of money. Is the facility set up to work with them when that happens? Some facilities are accepting Medicaid, but sadly most places do not.

 

When possible, I check to see what other people say about the facility. I look for input from people who have had actual experience. A service like CareGrade can be helpful with something like that.

 

I also look to see what staff they have available. Do they have a social worker and nurse? What days and hours are they available? Does a doctor come in to see patients and how often do they come? Do they have transportation available?

 

As a care manager, I also look for facilities that work with me and include me in the patient care process. I like to form an alliance and work with them to help bring about the best results.

 

CG What problems do you most often encounter?

MK The biggest complaint I hear about from people is assisted living facilities is the food.

 

CG How long does it usually take for a person to move into a facility?

MK That depends on a lot of factors. If a person needs to pack up their belongings, sell their home, fill out the paperwork, get financing settled and a host of other circumstances it can take a several weeks or longer. People who work with care managers such as myself tend to move in much faster, as I am experienced in helping them with all of the things they need to do. It goes much faster and easier when a professional is there to help.

 

CG What are the most difficult people to find assisted living for?

MK I think that one of the more challenging things is when a person is borderline between a nursing home and assisted living. I try and work with the facility to see what the best place for the person would be.

 

Mark Zilberman, LCSW, has been working in geriatric care management for almost seven years. He brings diverse experience to the field, having worked and studied in the specializations of substance abuse, mental health, developmental disabilities, and homelessness. As Founder of NorthStar Care and Guidance, he and his organization are called upon to manage a spectrum of issues for families. Zilberman was previously affiliated with SeniorBridge, Inc., Beth Israel Medical Center, and The Floating Hospital.

He received his MSW from SUNY at Stony Brook. A licensed clinical social worker in NY and NJ, Zilberman holds credentials in substance abuse counseling from both states. Mark is a member of the National Association of Geriatric Care Management.

You may reach Zilberman at www.NorthStarCare.net, 888-288-6152

Interview With Care Manager Mark Zilberman about Home Health Care

Thursday, October 11th, 2007

A care managers view of home care

 

CareGrade.com did an interview with professional care manager Mark Zilberman, LCSW to find out what a professional care manager looks for in a home care agency.

 

CG What do you, as a care manager, look for in a home care agency?

MZ As a care manager, the main thing I look for is service. The caregivers don’t seem to be very different from one agency to another except that certain registries pay better and can attract a slightly higher caliber of person. What does differ is the service I receive. I look for an agency that will work with me, be responsive to my requests and questions. I also look for how well an agency handles problems when they occur. Can they fill in with replacements quickly and can they solve the problems when they come up?

 

CG What problems do you most often encounter?

MZ The biggest problem I find is that the aide who is sent to a case is not well matched to the client in need of care. When an agency makes a good match, the cases work out much better. Unfortunately, many agencies are very busy and do not have a huge selection of people to try and make the perfect match. They do their best but have to work with who they have available at that particular time. Often, the need for a home attendant is initiated during a crisis. Therefore, the agencies must act quickly.

 

CG What differences do you see between agencies?

MZ The main distinction I find is agency or registry. The agency employs workers directly while the registry uses independent contractors who work for the client. I tend to lean towards the agency model. I find that there can be advantages with registries, such as lower costs, but the family needs to understand potential problems. I explain how they work and let the family decide which way they want to go.

 

CG What questions should a family ask when speaking with an agency and trying to make a choice?

MZ Families should ask about after hours coverage, how quickly does the agency get back to them, do they offer medication management, how often is billing done and what the costs are to name just a few.

CG How long does it usually take to get service started?

MZ I have found that is usually takes just a few days to get service started. Companies that use my assessment as a professional care manager are able to get the case started faster than companies who need to do their own.

 

CG What are the most difficult cases to fill?

MZ Filling a case for a person who smokes tends to be harder to staff. Many caregivers just do not want to sit in a smoky room all day. Cases involving mental illness and behavioral issues can also be a challenge.

 

CG What role would a care manager play if a family is looking for an agency?

MZ Family’s will probably get better service working with a care manager that has relationships with an agency or agencies. There’s a familiarity with staff that can really help. Obviously, an agency or registry has a greater need to serve a care manager as that CM can be or is a conduit to many other cases.


Mark Zilberman, LCSW, has been working in geriatric care management for almost six years. He brings diverse experience to the field, having worked and studied in the specializations of substance abuse, mental health, developmental disabilities, and homelessness. As Founder of NorthStar Care and Guidance, he and his organization are called upon to manage a spectrum of issues for families. Zilberman was previously affiliated with SeniorBridge, Inc., Beth Israel Medical Center, and The Floating Hospital.
He received his MSW from SUNY at Stony Brook. A licensed clinical social worker in NY and NJ, Zilberman holds credentials in substance abuse counseling from both states. Mark is a member of the National Association of Geriatric Care Management.

You may reach Zilberman at www.NorthStarCare.net, 888-288-6152

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