The "Sandwich Generation"
Sue Tanner, M.D., a busy gynecologist from Greenbrae, worried about her eighty-seven year old mother who lived alone in a condominium in Florida. The increasing incidence of her falls at home caused Sue constant worry, and her mother required frequent hospitalizations. Often she had to be on the telephone trying to help make decisions for her mother 3000 miles away. Several times she had to cancel seeing her patients, rearrange childcare for her family, and go help with her mothers care. Sue's predicament was a classic example of someone caught in the "sandwich generation," working parents caught between the needs of their children and the expanding needs of their older adult relatives.
With the help of a Geriatric Care Manager, Sue was able to solve immediate problems and set up a plan for long term care. The Geriatric Care Manager worked with Sue to locate housing arrangements in California that would meet all of her mothers' needs. An assisted living facility was found for Sue's mother that would allow her to continue living in an independent apartment in California -- a thirty-minute drive from Sue and her family! Sue can visit her mother as a daughter and not just as a problem solver. Now her sixteen-year-old son, who has just started driving, delights in going to get his grandmother to take her out for lunch. A true bridging of the generation gap!
Accessibility and Assisted Living
After visiting her father in the hospital, Nancy wanted help in determining the best living situation for her ninety-year-old father. Four years ago when her mother passed away, he moved into an apartment in Novato, California and he loved having his dog live with him. The apartment was up fourteen stairs and both of his hip replacements were out of alignment. Sue contacted the Geriatric Care Manager to see what his choices would be.
The care manager met with Nancy and her father in the hospital to assess his condition and then visited the apartment to determine what needs he would have upon his return. After her father was given a walker and physical therapy in the hospital, accessibility was a key concern. The initial plan was to have him return to his apartment with part time nursing help coming to visit.
Eventually, Nancy's father was unable to use the walker and was told he would have to use a wheelchair. The care manager continued to assist Nancy they were able to find an assisted living facility with easy wheelchair access, a place for his dog to run, and the opportunity to dine with others for some social interaction!
Assistance from a Distance
Tony was preparing to take his one-week vacation to visit his Aunt Maria who was eighty-six years old and living in a nursing home in New Jersey. He wished that there were a way to bring her home to San Francisco! As her only remaining relative, Tony was named her conservator. He could only visit every six months when he had vacation time. He called a Geriatric Care Manager who was a registered nurse and able to help bring Maria home to San Francisco. Since Maria was wheelchair bound and unable to care for herself, a Skilled Nursing Home was found within walking distance of Tony's place of employment.
The plan was now in motion, and the Care Manager went back to New Jersey to visit Maria in the nursing home to prepare her for her trip. The trip was a non-stop in first class to make sure she would have plenty of room during the five-hour flight. When Maria was wheeled into the airplane, the look of panic on the flight attendant's face was alleviated, as the Care Manager explained that she was a nurse and would take care of Maria's needs during the flight.
Now Tony can visit his aunt every day and an eighty five-year-old friend from her working days at the post office travels across town three times a week on the bus to visit Maria!
Specialized Care Management
When Michael's eighty-year-old grandmother Lucille was admitted to a hospital, he was called to return home to San Francisco from his job and family in San Diego. His grandmother was told that she had cancer and had a short time to live. Lucille's principal concern was for the care of her fifty two-year-old daughter Sheila who had schizophrenia. Sheila had never lived on her own and had always been under the care of her mother Lucille. Michael was named conservator for his Aunt Sheila.
Michael was advised to contact a care manager in the local area to work with him in assessing what Sheila's needs were and what choices of living situation would suit her for long term care.
After living for three months in an assisted living facility that provided close monitoring of her medication, Sheila was able to join a group home that shared living responsibilities. She continued to attend the local church and started helping out part time in the church office. With the help of a care manager, Sheila was able to live in a safe and monitored environment in the community where she grew up!
