KEEPING A LOVED ONE AT HOME
We work tirelessly to ensure our clients’ can remain at home for as long as possible. This is often a challenge for both the caregivers, and the individual with medical issues. We have assisted families with Parkinson’s disease and early Alzheimer’s/dementia to keep them in their home as long as possible.
This process requires a complete medical review, a client assessment, a visit to the home to ensure the safety of the environment, as well as evaluating how the client functions in their surroundings. Health concerns are reviewed as well as a discussion of short and long-term goals.
We usually meet with clients monthly, or as needed, to re-evaluate their situation to determine if a change of plan is necessary. We can assist in coordinating physician visits, help families with living wills, healthcare proxies, and POA’s.
END OF LIFE DECISIONS
Our client was diagnosed with leukemia and placed in a clinical trial after traditional chemotherapy was no longer effective. Although living in New Jersey he chose to be in a hospital located in Manhattan. We visited with him and his wife at the hospital to discuss his prognosis and concerns. Everyone met with the oncologist, the assigned social worker, and nurse practitioner in order to be assured that our client’s wishes would be followed.
At a later point our client wished to terminate treatment and return home, his wife resisted and did not want him to end his participation in the clinical trial. It was at this point, that we intervened and discussed other options with the family. It was eventually agreed upon that all treatment would terminate and an inpatient hospice investigation would begin. We found a facility, and after a thorough inspection made the necessary arrangements for his transfer.
A LIFE CHANGING DIAGNOSIS
Our client was diagnosed with advanced lung cancer. We were immediately notified, and set out to find a top rated pulmonologist who was in the patient’s insurance network to perform a lung biopsy. We then proceeded to locate an oncologist, also in the client’s insurance network to discuss available treatment options. We coordinated the physician appointments, clarified test results, and treatment options. We consulted with the dietician and social worker to discuss dietary concerns and questions regarding available services.
Our client had successful immunotherapy treatments, and required more services as the disease progressed. Oncologist appointments needed to be coordinated with other treatment plans. We assisted our client in executing a living will, POA, and health care proxy.
OUT OF TOWN FAMILY MEMBER FALLS
We received a call from a family member living in Virginia that his mother had fallen and fractured her pelvis. At the time she was living alone and doing well. After her procedure, she was transferred from the hospital to an acute rehab facility near her home. However, she unexpectedly became confused and was not able to do anything for herself. At this point her son traveled to New Jersey and we accompanied him to the rehab facility.
After reviewing her chart, and speaking with the physician we performed our own evaluation and assessment. We explained to the son that after her fall and the amount of pain medication taken, it was not unusual to exhibit confusion. It was then decided to transfer his mother to a sub acute unit where she was able to stop the pain medication and regain her strength. We visited his mother during her stay when her son returned to Virginia.
We were pleased that our client was well enough to return home and resume an independent life style.
WHEN PLACEMENT IS REQUIRED
Our client, an 80-year-old woman was currently living in her own home. Her husband had died the previous year, and for the past 6 months her family noticed a serious change in attitude and behavior. She appeared to be unable to care for herself, and her home began to deteriorate.
Their mother previously enjoyed walking, biking, gardening, and bowling. All of these activities stopped abruptly, and this greatly worried the family. They were adamantly against their mother staying in her own home. They thought it best to find a place where she could socialize and be as active as possible. After our initial assessment was completed, we did a cognitive evaluation. The score on the test results appeared to indicate early stages of dementia. Due to the loss of her husband and recent behavior, we also screened for depression. At that point we suggested that they contact a geriatric primary care physician for further evaluation.
When results were reviewed, we recommended that their mother be placed in an assisted living program within a continuous care retirement community. We have since followed up on several occasions within the past four months, and found their mother engaged in sessions with a therapy dog, a walking group, riding a stationary bike, and beginning to participate in other activities. Our intervention, appropriate testing, and follow through have enabled her to once again enjoy life. She now lives somewhat independently in a safe, protective environment.