Going Home Again
Jack Perkins is a feisty, independent-minded, and solitary 85-year-old man who, after a fall and many complications, had been living in various area nursing homes for more than seven years. One day he decided he wanted to go back home. A widower with no children, Jack felt a longing for his house, his neighbors, and the street where he lived. And, remarkably, he still owned the home even though it had been standing empty all those years. Jack’s desire became focused after he had resumed paying his bills himself after an argument with his bill payer and realized what it was costing him to live in a nursing home.
Many nursing home residents would like to go home but few have both the financial and physical ability to actually make that return journey. Although Jack was determined, no one really believed that it would be possible for him to return to the community after being in a nursing home for so long. And Jack had no concept of how logistically difficult it would be to accomplish his wish. He kept saying that all he needed was a telephone and a flashlight, even though he was wheelchair-bound and his house had nine steps up from the street to the front door and two stories above that.
How We Helped
The chaplain at the nursing home had made a strong connection with Jack and wanted him to succeed so he referred him to Joanne, a Care Manager from Your Elder Experts.
At first Jack was suspicious and sent Joanne away. Three months later, he called her back to meet. Over the time they worked together, Jack and Joanne developed a trusting relationship that allowed Jack to accept some help. Joanne worked with home modification contractors to make the house wheelchair accessible and to allow all of Jack’s living to be on one level. She carefully screened home health aides until she found two who could accommodate Jack’s temperament and challenging personality. Jack now refers to his weekday aide as an “angel on earth.”
Joanne also arranged for a physician to make home visits to ensure that Jack’s medications are monitored. While not quite managing with just a telephone and a flashlight, Jack looks healthier than he has in years and is living in the house where he was born with six hours of home care a day and an emergency call system. Jack is still frail but with the help of his own Elder Expert he is living life in his own home as he wished.
An Elder Law Attorney
Daniel Stevens, an elder law attorney, had accepted a case that was supposed to be simple: create a will, a health care proxy, and a durable power of attorney for an 82-year-old man. In talking with the man, Mr. Stevens realized the older adult seemed unable to handle his finances or make decisions. He visited the man at home, where he lived alone, and noticed peeling wallpaper, leaks, and unkempt rooms. Mr. Stevens learned that the man’s out-of-town family had patched together help with cleaning and laundry services and had arranged for visiting nurse services after he had sustained a fall. However, it was not enough.
How We Helped
Mr. Stevens suggested a consultation with a Care Manager at Your Elder Experts. The Care Manager arranged for aging life neuro-psych testing to assess the man's mental status. His memory problems were not as severe as the attorney had feared.
But the older adult did need additional services to continue living safely alone in his home. Your Elder Experts arranged a variety of services from scheduling rides to doctors’ visits and monitoring his medications to finding workers to make repairs around his house.
Working with Mr. Stevens’ client, Your Elder Experts also kept in touch with the man’s family to assure them he was receiving excellent care.
An Elder Living Alone
Sylvia, an 85-year old hoarder, was living alone in her apartment. Her husband Saul, the love of her life, was in a nursing home for long-term care because of many medical complications. She needed help with filling out the Medicaid paperwork for her husband's nursing home. They had no children and seemingly no other relatives involved in their lives.
How We Helped
Friends recommended that Sylvia call Your Elder Experts. Karen, Sylvia's Care Manager, referred her to an elder law attorney to do some estate planning. The attorney discovered that there was money to pay for her husband’s long-term care and for other care for Sylvia. In addition, he found a distant nephew was willing to become involved.
With the nephew as the power of attorney and Karen collaborating on decision-making, Karen helped Sylvia sort through her possessions, move to a nearby assisted living facility, grieve when her husband died, and arrange for appropriate medical follow-up for a cancerous ulcer on her leg.
Care Managers from Your Elder Experts continued to work with Sylvia, accompanying her to doctors’ appointments as her medical conditions fluctuated and eventually worsened and bonding with her around decision-making at the end of her life. Her spirit touched all who came in contact with her and, with the help of Your Elder Experts, her last years were filled with both caring friends and professionals.
A Daughter's Dilemma
Dr. Joanne Williams, a medical researcher in Greater Boston, had a busy schedule and two adolescent children. Her parents lived a two-hour drive away in the town where Joanne grew up. Her father had been the town doctor and her mother was socially active. But now her parents seemed unable to manage their house or their lives independently.
Joanne’s brother in California ordered groceries for his parents online and had them delivered. They also arranged for a gardener/handyman to help with the upkeep of the house. But it was not enough. Joanne’s mother was becoming more disoriented and anxious, calling Joanne five times a day for small reassurances or to repeat something they had discussed half an hour earlier. Her father’s arthritis was more and more painful and he likely needed a hip replacement, which Joanne knew would be disruptive and catastrophic. She was driving home to care for them weekly and neglecting her and her children’s lives.
Even though it broke her heart to think of moving her parents from their home, Joanne realized it had to happen. The rural town where they lived had few options for the kind of medical care and support they needed. Finances were a concern, as the money would have to last to care for both parents or for the surviving spouse when one of her parents died.
How We Helped
Joanne drew a circle on the map of her town and only considered the two senior housing options within a half mile of her house. A colleague suggested that she speak with Your Elder Experts before bringing her reluctant parents to look at the two options. The Care Manager met with Joanne and her parents at her home in the evening to accommodate Joanne’s work schedule. She was able to assess Joanne’s parents’ frailty and get a sense of their finances. She then suggested two more appropriate senior housing options, still close by to Joanne but with low-income programs so the couple would not have to move if their money ran out.
Joanne and the Care Manager also strategized how to show the assisted living facilities to the parents considering their frailty and the emotionality of the decision for everyone. Surprisingly, her parents agreed to a one-month respite stay at a facility that was less than a mile from where she worked. Their adjustment has been relatively smooth and the phone calls have ceased. Joanne is able to check in on her parents every day if she wishes and had the time to take her older son to look at colleges. Her parents attended her daughter’s chorus concert at the middle school and the family is looking forward to being together for Thanksgiving. Her parents are strongly considering making the move a permanent one.
Dealing with Dementia
Mr. and Mrs. Marks, a loving couple, had been living in their own home. He was 85 years old and she was 75. He had been a successful chemical engineer and she was a gifted artist and gallery owner and the homemaker for the family. Their two children lived out of state. Mrs. Marks was diagnosed with early dementia. Although still driving, she was having difficulty managing their home and organizing and structuring her day. Her husband also needed respite.
How We Helped
Their children contacted Your Elder Experts and a Care Manager arranged for some companion services to help with the household tasks and to bring some respite for Mr. Marks. As the dementia progressed, the care manager helped the family talk with Mrs. Marks about giving up driving and then helped the couple find an appropriate assisted-living facility. When the dementia progressed, Mrs. Marks moved to the dementia floor of the facility while Mr. Marks remained on the traditional side. This allowed the couple to still share their lives with care appropriate to each individual’s needs. Mr. and Mrs. Marks’ children rely on the Care Manager from Your Elder Experts to handle the day to day managing of their parents’ care and as an additional expert resource when there is a crisis.
A Physician's Concern
Mr. Michael Fisher had untreated mid-stage Alzheimer’s disease and his wife, Mrs. Fisher, was no longer driving. The couple had moved to an apartment but their primary care physician was three towns away, nearer where they used to live, and so they were not able to see her regularly. The couple’s daughters both live in California. During a cardiology check-up, Mr. Fisher’s cardiologist, Dr. Summers, discovered that Mr. Fisher had driven on his own to his appointment at the large urban medical center.
How We Helped
Dr. Summers called the couple's daughters to express his concern and they contacted Your Elder Experts. The Care Manager visited the couple at their home and discovered how tenuous their situation had become. Mrs. Fisher even felt she had no choice but to send her husband out to drive to the grocery store for food even though his Alzheimer’s made such a task dangerous, if not impossible.
With the Care Manager’s help, the Fishers are now being seen by a local aging life specialist who can coordinate the various medical diagnoses for both husband and wife. She arranged for support for Mrs. Fisher and transportation to physician appointments. She is the daughters’ local eyes and ears to monitor the situation. Dr. Summers is also assured that the couple’s other needs are being met when he checks in with them during their annual appointments.