From a distance: Help is there for families providing care from afar

By Barry Caine - STAFF WRITER

Bay Area company helps families with elder care issues

Hilary Lane (above, left), who lives in Colorado, employed Sandy Cohen, R.N., an Oakland elder care manager, to help handle affairs when her mother, Jetta Tiger Lane, moved into a skilled nursing facility in Alameda.

When her mother was hospitalized in Alameda early this year, Colorado resident Hilary Lane did not have time to panic.

There were medical questions, insurance issues and housing considerations, as well as her 90-year-old mother’s mental and physical deterioration after a fall.

Locked into the busy-ness of everyday life, Lane could not afford to regularly fly 2,400 miles round-trip to assist her mother’s transition to a skilled nursing facility and monitor her ever-changing needs.

But the Oakland native had to do something, and quickly. So she jumped on the Web, made phone calls and looked for help. “Each piece of research I did landed more information, like a domino effect,” Lane said during a phone interview early last week. “It’s going from naiveté to 100 mph in 10 seconds because I had to.”

Like so many people suddenly forced to help their aging parents from afar, Lane ran through a host of referral agencies and organizations before hiring a care manager - Sandy Cohen of Oakland-based Cohen Cormier Group.

“If I didn’t have Sandy, I would be spending all my time just doing everything it takes to manage an elderly parent, from daily care and what falls through the cracks, to government rules for financial resources, nursing-home regulations, attorneys, paperwork, you name it,” Lane said.

“As it is, I spend a couple of hours daily on something related to my mother and her estate. ... Sandy takes about half of my load, and does it well.”

It is difficult enough dealing with a parent’s declining health, let alone having to do it from a distance. The situation has become more common, though, as elderly parents choose to stay close to home and friends rather than move near their adult children.

“I have no vacation time left,” Lane said. “All my vacations were spent with my mother’s issues. So even if I wanted to spend more time with her, I could take family leave but I won’t get paid. At least I have Sandy to deal with the medical parts, or the health concerns. She was instrumental in getting her into a skilled-nursing facility, a good one.”

No price seems too high when your parent’s health begins to decline. The details are endless and any help is appreciated - whether hiring in-home care or finding an appropriate assisted-living or skilled-nursing facility.

Before making any decisions, someone has to determine your parent’s level of need. Minimal problems might allow him to remain living at home with someone to come in to help with cooking, cleaning or bathing.

More serious concerns might necessitate moving. If that’s the case, you have to find a facility that fits your parent’s needs, gauge the type and quality of care, and investigate whether the place is considered good, average or best to avoid.

Once your parent has moved in, you or your care manager may need to deal with ongoing problems about medications, treatment, exercise, nutrition, bathing, activities, insurance - and getting your parent enough attention.

Care varies. Staff turnover is common. And, often, the nurse-to-patients ratio is way out of proportion.

Price of peace of mind

Elder Care Manager Sandy Cohen, R.N. (right), talking with Edith Greenberg and her daughter Mona Reeva (left), says it's her job to "be the eyes and ears for the family who can't be here. [Photo - Sean Connelley - Staff]

You have to decide whether you can, and are willing to, do everything by yourself, or if, like Lane, you might be better off hiring an elder care manager to help.

Of course, that requires going through another selection process to find a good match, both personally and financially. If you can afford a care manager, the cost is worth it for peace of mind.

Most geriatric care managers, like Cohen of Cohen Cormier Group, have either a nursing or social-work license, and can help you interpret information that comes up during treatment and at care-plan meetings at the facility. They can also communicate your concerns to doctors and nurses in their language.

“I’m there as both a listening post and as someone to come up with suggestions,” says Cohen, who is also a nurse. “We assist with evaluating what the needs are and helping the family put a plan together. Especially when families are at a distance, they often want us to make the arrangements and oversee the delivery of the services and coordinate and trouble-shoot.

“Most important is to report and be the eyes and ears for the family who can’t be here.”

Mona Reeva, a Berkeley resident, also uses Cohen, a close friend, as a consultant regarding care of her mother, Edith Greenberg, who is in a skilled-nursing facility in Berkeley.

Although distance is not a problem, care and emotional issues remain the same.

“My mother lost a lot of weight, needed a nutrition supplement, and was not getting it on time,” says Reeva, a psychotherapist and consultant. “I needed some intervention because I was getting worn out, burned out. I had ’compassion fatigue,’ as we call it. ... Her support provides the additional strength that helps me continue with my caregiving in the way that I do it.”

Reeva says having someone to case-manage or consult on issues that come up on both the health and emotional sides can be invaluable. “Even when we are doing other things and we are working, it (worry about the parent) is always in the background,” Reeva says. “The support is vital.” Lane agrees.

Her mother died last Sunday evening.

At Lane’s request, Cohen went there Sunday afternoon, spoke with the nurses and stayed in touch with Lane by phone.

“Mom woke up while Sandy was talking to me, and she apparently rallied quite a bit, as she did so many times,” Lane wrote in an e-mail the next day. “Sandy put me on the phone. Mom was lucid and asked good questions about family members and about friends. Sandy heard the entire last conversation. I’m so glad she was there, as I believe she made my mother’s last hours more comfortable than she would have been otherwise.”

This article is an excerpt of the original article and was printed with permission from ANG Newspapers

Call (510) 652-3377 or (925) 945-8855 or email Cohen Cormier Home Care & Care Management for a free personal review of your elder care situation by telephone with no obligation. We'll help you identify affordable solutions and ways we can help you achieve them. Click here.