Geriatric Care - The Role of a Geriatric Care Management Agency

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Sally Smith:  Welcome to Age to Age.  I’m Sally Smith.  Let’s talk.  We’re lucky to have with us a wonderful professional of many years in the field of geriatrics, Mary Peters, who is the president of Care for Life.  What is the basic concept of Care for Life, Mary?


Mary Peters:  Our concept is to keep older people at home with their memories and possessions for as long as possible.  That is what we do.  We try to keep them out of nursing homes, out of assisted living, hospitals, and we do that with, basically, risk management.  That is, we look for problems to solve.  If we don’t have a problem to solve, nobody is going anywhere. 


There are basically five things that we look for.  One is safety, safety in the home; they’re going to be alright, they’re not going to turn on the stove.  Problems like that, we look at.  A second thing is nutrition.  Elderly people don’t get enough nutrition in their diet.  They have tea and toast, or they don’t fix anything because they don’t like to eat alone, so we make sure that they have enough nutrition.  Medications, that is really a big one because elderly people can’t anticipate when they need refills.  They may be taking two medications for the same problem, so that’s a problem that we address.  A fourth thing is hygiene and home health.  What we hear a lot is, you know, since Mom died, Dad is wearing dirty clothes.  He doesn’t keep up the yard and the house like he used to, so that’s another thing that we address.  The fifth and final thing is unaddressed medical problems.  It’s amazing to see elderly people, living in a neighborhood that they’ve lived in for a long time, decline.  They have dementia, or they’re sick, or something.  As soon as we get a client, we take them to their doctor so that we can see if there are any problems there.  Those five things are what we look for at Care for Life.  That is our concept. 


Sally Smith:  And when you say that these are the five things you look for, then how do you address them?  How do you address whether they have nutrition?  What if the daddy isn’t taking baths anymore?  What happens once you are alerted to a situation and you go in, how far can you go with it?  You can assess it and say that there is a problem, do you then solve the problem?


Mary Peters:  Let’s say an adult child, or neighbor, calls us, we’ll go do an assessment.  That adult child, or maybe even the client, wants a caregiver in the home, and they can be in the home four to twenty-fours a day.  We have eighty trained and skilled caregivers that we can match up with personalities, and so on.  So, if the problem is nutrition, we’re going to go to the grocery store and the caregiver is going to prepare the kinds of meals that the client likes, and wants.  The client may want them to go to a particular restaurant to get the food that they like and bring it to the house. 


As far as medications are concerned, the professionals, the nurse or the social worker, will go by the house every day and make sure that the medications are being taken.  We had a couple that took each other’s medication and said they felt better.


Sally Smith:  That’s scary.


Mary Peters:  And so we monitor the medication.  And, like I said, we have eighty caregivers, and they’re out there providing 2,500 hours of care a week to people with these various problems.  If it’s safety, they make sure that there are no falls, that there are no risks for falls.  If there are unaddressed problems, we have the nurse going by.  We’re checking their diabetes.  We’re taking vitals.  We’re talking with their doctor.  We’re doing everything we can do to keep those problems from getting worse.


Sally Smith:  I love the idea that you’re problem solving all the time, and only as much as you need.  If it’s medication and you can solve it by having somebody drop by with the pills once a day, that’s great.  Somebody else may need someone in the house 24 hours a day.


Mary Peters:  Yeah.  Well, we have boxes that you fill the pills with so we can tell whether they’ve taken them or not, or if they’ve been switched, or something like that, and we have a drug store that delivers all the pills to our office.  We can keep the pills and put them in the containers as they’re needed.


Sally Smith:  I understand that there’s something called a home health agency.  You’re a geriatric care management company.  People, like me, don’t know what the difference is.


Mary Peters:  Let’s talk about the caregivers with a geriatric care management agency.  That’s called custodial care.  A Medicare home health agency is an agency that is licensed by the Department of Health and Human Services.  The services are ordered by the doctor.  You have physical therapy, occupational therapy, speech therapy, if you need it, and that is ordered by the doctor and monitored.  And that is under Medicare Part A and Part B.  For example, my father is having some problems right now and he is receiving Medicare Part B.  They’re not there all the time.  They come in to provide the services, so he has custodial care, which is from the homecare agency, like ours.  And then you have homecare companies that provide sitters.


Sally Smith:  Mary, thank you so much.  I love learning more about what you’ve put together here.  Thank you for being with us.


Mary Peters:  Thank you, Sally.


Sally Smith:  Thanks to all of our listeners, too, for joining us today.  We welcome, as always, your suggestions and questions, and comments on our website.  This is Sally Smith, Age to Age, saying good-bye and wishing you courage and joy on your journey.  We are all connected.


If you have any questions about the services or programs offered at the Medical University of South Carolina, or if you’d like to schedule an appointment with one of our physicians, please call MUSC Health Connection:  (843) 792-1414. 

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