Q: You write, "The eldercare system in the United
States has become such a tangled spider web that it's virtually impossible to
navigate." How have you attempted to guide people through the system?
A: I am an eldercare consultant. That means that I
talk with families (via phone, in-person, or via email), conduct a needs
assessment, and help families find care providers throughout the country who
meet those needs.
I also help them to make sure that they receive benefits
that they need, that they have an attorney to put legal documents in place,
that they have access to good medical care, and that they have good financial
advisors so that they can afford the care that they need.
I’m in the process of developing a web-based software and
system so that I can reach more people – SeniorSherpa. Think of me as the
guide who carries the equipment up Mt. Everest and makes sure that everyone is
safe on the journey.
Q: What, in your opinion, are the most difficult problems
facing the elderly and their family members and caregivers?
A: Finances are a huge concern as are family dynamics.
People are outliving their resources – not always due to poor planning – it’s
often simply that no one planned to live to 100 years old and it’s expensive to
do so.
Also, in the “old” days, Grandma and Grandpa would move in
with one of their kids, and the family would provide the care. That’s
often not safe or practical now.
Finally, medical advances mean that people are living longer
with complicated medical conditions that need to be carefully managed. That
often requires an expertise that many families (and even doctors) don’t have.
The result? Multiple hospitalizations, stints in rehab, and
the need for someone to actively and regularly “quarterback” the person’s
medical care.
Q: You advise people to "know your options." How
can someone best determine the options for themselves or someone they are
caring for?
A: Becoming an educated consumer is vital. Gathering
information from RELIABLE resources is key. There are medical professionals,
legal professionals, care managers, Medicare’s website, and other places that
can provide real, unbiased information.
This is a case of “buyer beware,” however. It’s
important to know whether or not your referral/information source is getting
paid by the providers to which you are being referred. Consumers can research
on Medicare’s website, on their state’s long term care/eldercare website, or
hire a professional.
People should not be afraid to ask questions or to walk away
if they aren’t comfortable. If it looks too good to be true, it probably is.
Q: Do you foresee any changes for the eldercare system?
A: I think that there is a movement towards well-designed,
senior-friendly retirement communities that will provide shared home health
care services, assistance with activities of daily living (bathing, dressing,
toileting, transferring, and eating), and in-home primary medical care.
By living in higher-density housing like apartments, condos,
or retirement communities, the provision of care becomes more cost-efficient
and effective.
Q: Are you writing another book?
A: Now that’s a loaded question! I’m exploring that
possibility now – on the specialized care needs of people with
Alzheimer’s/dementia and their families.
Q: Anything else we should know?
A: It’s important to have honest conversations with family
members and make a plan before the crisis hits. While the conversations
are difficult, it’s easier now than it is when the family member is in the
hospital, etc. Our “job” is to clearly understand the person’s wishes and
to do what we can to fulfill them.
One place to start the conversation is the Medical Orders
for Life Sustaining Treatment (MOLST) form also known as the Physician Orders
for Life Sustaining Treatment (POLST). See www.polst.org for more information.
--Interview with Deborah Kalb
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