Megan Vogt is immersed in the issues of caregiving. As program manager for the Aging and Disability Resource Connection (ADRC) at the NE Georgia Area Agency on Aging (AAA), her office at AAA is the hub for the 12 counties in the Athens region.
“Most people don’t plan for caregiving – they’re thrown into it,” Vogt says, and that’s why “ADRC should be the first stop on the caregiver’s journey.” Funded by state and federal money through the Division of Aging and allocated by state legislators, ADRC’s main purpose is to coordinate services in all 159 counties so that older adults can remain independent and delay or prevent nursing home placement. It costs the state 10 times more for Medicaid to pay for a nursing home bed than it does to fund the resources for in-home care, according to the Georgia Council on Aging.
“We understand all the resources and the rabbit hole of caregiving issues,” Vogt explains. Not a program or a service, ADRC is a coordinated system of partnering organizations, public and private, whose goal is to alleviate the need for multiple calls or visits to find long-term support and services in the home and community. “They call the Area Agency on Aging because they don’t know where to start – they often don’t know what they want or need, or what they qualify for.”
And that’s exactly where Susan Brown found herself recently.
Brown, 69, was profiled in the Fall issue of Boom where she shared her experiences as a caregiver both for her brother, who has Alzheimer’s and her sister, who has debilitating back issues. Patterson, 65, is beginning to require more care than she can provide herself. But when she inquired about day care at the Bentley Center, part of the Athens-Clarke Council on Aging, the cost was more than she could afford. They encouraged her to call ADRC since her only other option was a private pay home care agency for a few hours each week, which can also be costly and is not covered by Medicare or Medicaid.
Within 24 hours, an ADRC counselor returned Brown’s phone call, discussed the issues with her, and went through a screening questionnaire.
“I felt guilty because some of the questions were meant to determine whether a person was in much more difficult circumstances than we are,” she explains. But, much to Brown’s relief and surprise, her brother’s Social Security income is such that he qualifies for partially subsidized day care, and van transportation to and from the Center through Medicaid’s Elderly and Disabled Waiver Program.
As part of the waiver program, a registered nurse will complete a face-to-face assessment of Patterson, and then a care manager will come to the home to establish services and assess whether any in-home supports are needed.
In the meantime, her brother doesn’t want to go to day care, and asked her “is this for you or me?” Brown explained that it’s for them both. He simply watches television all day so she hopes the activities at the Center will keep him engaged both mentally and physically. She hopes it enables her to continue to shoulder the unending responsibilities of 24-hour caregiving and allows him to remain at home as long as possible.
Geriatric care management
Another resource for navigating the overwhelming array of caregiving resources, particularly in the middle of a crisis, or from a long distance is to hire a geriatric care manager. The Athens Community Council on Aging (ACCA) is such a resource as is Senior Care Options. Both are private pay services.
The care management program at ACCA can involve various aspects, including assessment of the person and their situation; living arrangements; a personalized care plan; health care coordination; home safety evaluation; caregiver support; and crisis intervention. Julie Hanna has been the care manager at ACCA since 2015, prior to that she worked for 15 years with Elaine Gunter and Aging Resources, which introduced the concept of geriatric case management to the Athens area. Fees range $250 for two-hour consultation in the individual’s home, whether a facility or a house or apartment. “Sometimes that’s all they need,” says Hanna. Ongoing management is $90 an hour and is often something that long-distance caregivers need for a parent. However, free phone consultations are available by calling the main ACCA office and asking for Hanna.
Hanna says her caseload might include people who are just beginning to have trouble living independently and need her to arrange a few resources that allow them to continue to remain at home, wherever that is. Other times, it can be a crisis such as a fall and a broken hip, or other surgeries. She then helps with the various transitions and living arrangements. And sometimes trust officers or attorneys reach out because they might have clients who are beginning to decline but have no children or relatives, she adds.
Abbie Vogt is an Aging Life Care Manager®, (ALCM), a newly recognized part of the profession that requires higher education in fields such as gerontology, social work, psychology or nursing in addition to credentialing through the ALCM professional association, and case management liability insurance.
“We’re a cross between a medical case worker and a ‘daughter for hire,’” explains Vogt who is employed by SeniorCare Options. Typically, her clients have complex needs such as movement disorders, psychiatric or cognitive disorders, or their children live elsewhere, and there’s no other support.
Vogt says she “builds a team.” That can involve determining the level of living arrangements and support. It can also include doing interviews with home care agencies or arranging for assistive technology or medical equipment, but also mediating family conflict, arranging legal, financial and medical services, and interacting with health care providers. She says some clients want just a thorough one-time evaluation, and others need ongoing care management. Fees range from $125 to $160 an hour.
Some caregiving resources
According to AARP, there are 40 million unpaid adult caregivers – 60 percent are female. Fifty-one percent experience high levels of stress, and 40 to 70 percent of family caregivers have significant symptoms of depression.
The caregiving role can be isolating and lonely but in the Athens region, there are resources of many kinds, ranging from dementia support groups, agencies, health care organizations, as well as books and websites with practical advice and self-care suggestions.
Here are a few:
The first stop.With a robust database of 40 categories of aging and disability-related services, including providers, support groups, organizations, businesses, private contractors, assistive technology, grants, the Aging and Disability Resource Connection (ADRC) is the first-stop for caregivers. 706-583-2546 or www.georgiaadrc.com.
Your county senior center. There are Senior Centers in each county, which contract with ADRC to provide a range of services that may differ from county to county but typically include meals, recreation, transportation, and outreach.
Dementia support groups. The Athens Community Council on Aging and the Oconee County Senior Center both offer Dementia Support groups that meet monthly. Robin Lacrimosa manages the ACCA adult day center and the support group. She describes it as informal and a way for caregivers to share their emotional stresses as well as practical tips on coping skills and challenging behaviors. While there are sometimes guest speakers, more often, the person “who’s closest to the edge that day,” shares their frustrations, she says. “Some people aren’t looking for a solution but just an opportunity to share their grief – as one of the wives said, ‘I just want it to not be happening.’” The ACCA support group meets the third Tuesday of each month at noon; it includes a light lunch. Oconee meets the 2nd Tuesday each month at 1:30. For more information, email firstname.lastname@example.org or call the Oconee Senior Center at 706-769-3979.
In Madison, a new dementia support group began in February, facilitated by Mary Jo Johnson, manager of Wellbridge, a continu um of care community now under construction. It meets the third Thursday at 6:30 at 230 W. Washington St. Email email@example.com.
Geriatric care management. Julie Hanna at ACCA (706-549-4850) and Abbie Vogt at Senior Care Options (770-722-9340).
Websites. AARP provides a range of tools and resources; visit www.aarp.org/caregiving and to share your story and connect with others visit www.aarp.org/iheartcaregivers. The organization’s “Prepare to Care” planning guide is an excellent resource as is the “Caregiver’s Handbook,” published by Harvard Health Publications; visit www.health.harvard.edu. “Share the Care™ How to Organize a Group to Care for Someone who is Seriously Ill” is a highly regarded model and guidebook that began in 1995 by a dozen women who came together to help care for a mutual friend; visit www.sharethecare.org. Teepa Snow, founder of Positive Approach to Care is one of the world’s leading advocates and educators in the field of dementia caregiving. She developed the GEMS® Brain Change Model; her website is www.teepasnow.com.
Books. Too numerous to list but this is a helpful article listing best books of 2018: https://www.caring.com/articles/best-books-about-caregiving.
Betsy Bean started BoomAthens Magazine in 2016, and was a long-distance caregiver for her parents for eight years.