You May be a Service Provider, Social or Business Contact or a Neighbor
What Do You Do When Your Friendly Relationship Crosses the Boundary to a Relationship of Concern?
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Older adults form trusting relationships yet they are a vulnerable population, especially those living alone. There are times when the responsibility of burden falls outside of family members to help, especially when there is concern about elder abuse or fraud. The Care Navigator works with individuals, businesses, local police departments and adult protective services to ensure that at risk older adults receive the appropriate assistance.
How do you know what signs to look for?
late payments (homeowner's associations)
bounced checks, frequent late or other charges (banks)
parishioners who look like they're struggling (religious institutions)
prescriptions not filled on time, an individual receiving multiple prescriptions from various physicians (pharmacist or physician)
Mention by your client that the children are interested in your client's money (financial planners, banks)
More frequent traffic accidents or insurance claims (insurance agents)
You are now helping out more than just an errand here and there (neighbors, friends)
Your client is frequently late or misses appointments. You question whether or not they should be driving. You're noticing little comments in conversations that make you wonder about the person's memory or their organizational skills (any variety of service providers including hair dressers)
You're delivering solicitation letter after solicitation letter, the recipient's home is unkempt as well as the person (postal delivery)
The Care Navigator can help by:
Evaluating executive function and ability to perform routine tasks
Providing advocacy to prevent financial or personal abuse or fraud
Providing oversight of medical, financial and legal needs related to care planning
Coordinating services to support daily activities
Educating groups and associations about how they might identify older adults at risk
When No Family Is Available
By Pamela D. Wilson, CSA, MS, BS/BA, CG, The Care Navigator
A meal site volunteer called to ask my assistance when she received a call from a woman who said she had no food and needed groceries. The volunteer provided a telephone number saying that the woman was at a neighbor's house and did not have her own telephone.
I called Mrs. Smith to ask how we might help, and to confirm she was calling from a neighbor's home. She promptly told me this was her telephone number, that she was at home and relayed her address. I asked if she had friends or family to help her and she replied no. She then went on to tell me that she was very, very hungry and needed groceries. Not knowing the real situation and having to rely on her words, I asked if I could meet with her to see what might be done.
By Pamela D. Wilson, CSA, MS, BS/BA, CG, The Care Navigator
Last week I participated in a court hearing for a client who had experienced theft. When the theft initially occurred, there was the question about proceeding to report the crime especially since the items in question were recovered. I was disturbed about this event occurring again to another vulnerable older adult and felt there was no option but to report the crime. While I had little knowledge of crime reporting or the related legal system, at the end of the journey I was glad I didn't ignore the issue. It was nearly six months from my initial call to the local police department until the final hearing.
At the hearing, I learned that this was not the person's first offense. In fact the individual was on probation from a previous offense when this theft was committed. The individual also fully intended to go back to the same line of work assuming release by the court. I was able to address the judge with a summary of events. Not only did I express concern about the vulnerability of older adults but also concern that that this individual might be allowed to work with older adults or children especially since a similar event already occurred twice.
It’s Only A “Little Memory Loss” – The Hidden Pitfalls of Doing Nothing
By Pamela D. Wilson, CSA, MS, BS/BA, CG, The Care Navigator
No one wants to say the words Alzheimer's disease or dementia so we use terms like mild cognitive impairment or moderate cognitive impairment to dance around the reality of the subject. Recently I took a client to a medical appointment. The physician performed cognitive testing with the diagnoses of "moderate cognitive impairment". There was no discussion of appropriate medications to treat the diagnosis nor was there a discussion of the consequences and future prognosis. The physician was extremely kind and compassionate. He could not have had a better bedside manner, however in my opinion he sidestepped the responsibility of telling his patient what to expect relative to progression of his memory loss.
Physicians today are limited by time and insurance reimbursements. They treat diseases and conditions but do not see the havoc that results on a day to day basis in the life of a patient diagnosed with moderate cognitive impairment.
All of my work days involve issues where I am not family but become involved because of a need for assistance. Many days the system works for my clients, others against them. Months ago I filed a Medicaid claim for a client and the final determination was given last week, however not to me directly but to the nursing home where my client resides. Due to the current state of the economy Medicaid agencies are trying to find every minute loophole not to pay or to exact penalties. In this case Medicaid tried to state that moving expenses paid to a family member were "personal care services" and thus not a reasonable payment because this type of service was done out of love and compassion for the individual and is not recompensable. This would be accurate if personal care services were provided, however moving services do not fall into this category. If you have a legitimate expense, fight the system and appeal the decision. You'll likely win.
Helping When You’re Not Family
