I am thinking of looking for a geriatric care manager. I've read they can be helpful in assessing situations and providing insight for elder care decisions and objective conversations with family members. I currently moved home to help my parents with my mother's health issues and vascular dementia. My father is her primary care but forgetful and not always on top of things like her meds and whether or not she ate lunch. They are in their 80s. I work full time, have just about 12 hour days with a long commute, and have reached a burn out often just trying to keep their house clean and yard in shape although my dad pays a guy to cut the grass. I understand they are elderly, but they basically sit around all day and watch TV. My dad does grocery shopping and my mother still does laundry if he asks her to. She is at the point where she won't shower, etc. I've tried to talk to my dad about this and he says he doesn't want to upset her. He doesn't want to put my mother in a home, and I don't either especially at this point, but I've hit bottom a few times and have told him that that's where she is headed if he doesn't realize it.
My mother has also always been stubborn and has gotten really grumpy, almost nasty in the last month. She's also recently gone on an anti-seizure med and I'm not sure if that's contributing to it. Sadly her "normal" personality is very sweet and caring. She can sometimes still be that way but mostly complains now and I can't always be ok with it. I try not to take it personally but after working all day and sitting in 1 1/2 or rush hour traffic b/c I need to be out where they live, I have no patience. I keep telling myself it could be worse and it will but I need some help so thought about a geriatric care manager to get started. Are they really worth it?
Also I have found through experience that care managers should not work for the same care agency that is providing care for someone. It is a conflict of interest. As a home care nurse and care manager myself I have been put in this position and what happens is it removes a lot of the power a care manager has because first they are an employee. I'll give you an example. I had a man who needed 24 hour care and a wife with early stages of dementia. They had three daughters involved but all out of state so I was handling everything. We had an aide on that was available overnight and the office was thrilled to have the case well staffed, or so they thought. Truth I came to find out was he had another job all day, came to that house at night, showered and went to sleep!!! The wife reported this to me and I reported as well and was waiting on a replacement that never came. They blew off the wife's complaints saying she has dementia despite my support and continued to send this most disrepectful man who called himself a caregiver to this vulnerable home and my hands were completely tied. If I was on that case privately I would have fired that agency in a hot minute and had another one in there. It made me sick, and I now I have my own company so I will never be in that position again. Nursing is a constant battle between advocating for our patients and being a good employee. They do not go hand in hand, ever. I highly recommend hiring a private care manager.
Believe me these agencies know this too, and are happy to provide a "free" care manager. BEWARE.
It's also important to get a good personality fit. Interview at least three.
What about Independent or Assisted Living? Tell Dad you know he doesn’t want to put Mom in a home, but you know he wants to do the best for her, and you want the best for him as well. Be honest with him and tell him you will help out when you can, but that you feel awful you can’t be there are often as you like. It’s just too much.
Your other option might be a home health aid but Seniors (like me) often see this as an invasion of their private space and don’t want to accept in-home help. In that case, a GCM would be able to determine their needs and arrange for help.
Good luck. Let us know what you decide.
With regard to your mother's irritability, it may be a side effect of her medication or the inconsistent amount in her system. My father was placed on anti-seizure medication and developed a volatile temper. He was switched to a different medication that he tolerated better. There are about 10 different ones to choose from, they all might cause one side effect or another, they are usually meant to be taken at exact intervals to maintain a therapeutic level in the body (12 hours apart in my dad's case), and it takes some trial and error to adjust the dosage to prevent the seizures but minimize the side effects like sleepiness, dizziness, etc. This should be brought to her doctor's attention asap.
With regard to placement, I actually think it's inevitable, but we all struggle with the idea of it. To give you the other perspective, my upbeat aunt said of her new facility that she finally felt safe because there was always someone available to help her. She also noted that the friendships may be short, but at least there are friends. When I placed my dad, who had only me for company, he suddenly had other people, including residents and their family members, to engage with, as well as more activities and interests to pursue. I put him in a board and care with 5 other people in a residential home. Sometimes couples reside there together. There are different housing options for seniors and different price points to consider. Best to you.
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