Let me start by saying that I am a firm believer and advocate of the public system in Montreal, and in Quebec at large. I feel that the public is entitled to receive services and support from the system into which they have been paying. Unfortunately, the growing demands of the senior population are too much for the public system to support. Families are turning to private social workers more and more to fill these gaps in service.

Private social workers can offer a variety of services for seniors and their families. For example, Erickson Resource Group can complete psychosocial assessments for mandate homologations and private curatorships throughout greater Montreal and its surrounding communities. We can also complete these same psychosocial assessments for a public curatorship if a private or public facility requires this service. (http://ericksonresource.com/senior-services/)

Many hospitals and local community agency social workers are not able to provide psychosocial evaluations for mandate homologation and private curatorships because they are overstretched with the critical needs of the population. With public waiting lists for social services ranging from 3 months to eight months, Erickson Resource Group can become a family’s “safety net” during, through and after the acquisition of public services.

Erickson Resource Group private social workers can act as a liaison between the public and private systems, guiding families through the relocation or placement process, the accessing of public or private home care, and care management and/or coordination of private and public health services. In addition, Erickson Resource Group is a complete resource center for seniors and their families. We are available to advise seniors and their families as to how the public system and private system can collaborate together.

Erickson Resource Group has a team of private occupational therapists, private nurses, private dietitians and private recreation therapists to provide professional evaluations and treatment plans for seniors and their families. (http://ericksonresource.com/about-you/ ) If a senior or family requires an advocate to help them navigate the public system or to work with public and/or private health care professionals, an Erickson Resource Group team member can act as this advocate.

We are in no way attempting to replace the public system. Our intention is to supplement services when a family needs it and when the family is able to afford it. If the senior or family need help NOW, we can be there NOW. We do not have waiting lists. Call us at 514-795-7377 for further information.

To learn about Erickson Resource Group’s services: http://ericksonresource.com/senior-services/

To learn about Erickson Resource Group’s team: http://ericksonresource.com/about-you/

Written by: Stephanie Erickson, MSW, PSW, LCSW 

As our parents age, it becomes harder and harder to feel secure that they are safe and healthy in their home.  This becomes even more difficult if we do not live nearby and are unable to “pop in” to make sure they are okay.  We are left to rely on their self-report of their situation. 

If our parents have memory problems, we wonder if they are accurately reporting what is happening.  We may also believe that they are minimizing their struggles for fear that they will be forced out of their home.  Even if our parents live in senior’s community, assisted residence or full care facility, we still worry if they are getting all the care and attention they need.

There are some things we can do from a distance to increase our full understanding of their situation, to improve the communication we have with them, and to manage the risks inherent in long distance (and close distance) caregiving.  All of these suggestions can be done via the internet and phone.

1. Ask your parent to sign a consent to release information from all of their health care providers so that you can gather collateral information about their functioning.  Get a list of the names and phone numbers of these individuals.
2. Encourage your parent to complete a power of attorney at all of their financial institutions so you can monitor their management of money.  Make sure to tell them that you do not plan on taking over; you just want to oversee to ensure they are not being taken advantage of by another and if they have questions, you can assist them. 
3. Encourage your parent to draft a Mandate/Living Will/Durable Power of Attorney for Health Care so you have the legal authority to make decisions and manage their finances if they become unable to do so.
4. Ask your parent to list all of their utility providers, their mortgage carrier, car insurance, etc. and account numbers and to give these facilities authorization to share information with you so if they are confused about their accounts, you can assist them.  (See our website for a complete list). 
5. Arrange for automatic bill pay where applicable.
6. Ask your parents for the location of all important documents (power of attorney, birth certificate, deeds, etc.). 
7. Obtain LifeLine, Medic Alert, or another type of safety system so that your parent can access help if he/she falls or has another emergency.
8. Obtain a list of individuals nearby who could stop by your parents’ home if you have an immediate concern (neighbor, friend, relative, etc.)
9. Obtain a complete and updated list of all medications, prescribed and over-the-counter.
10. During a visit to your parents, conduct a home safety assessment and make all necessary modifications to the home.  (See our website for a complete list of areas to observe).
11. Prepare a list of private and community agencies that are available to make visits to your parents for future or immediate reference.
12. If your parent is at a facility, get the names, phone numbers, and emails of at least two professional staff members (nurse, social worker, etc.) and make contact with them periodically to foster an on-going relationship.
13. If you can afford it, arrange for a monthly visit from a social worker or nurse to monitor your parents’ safety and report back to you.  The money spent will be worth the peace of mind and may prevent major crises.
14. Begin a journal of all of the above information, as well as on-going updates about your impressions of their functioning, including specific examples (i.e., my mom called me again to ask about her phone bill; I noticed she has lost weight since our last visit, etc.). 
15. Monitor the following when you visit: Physical appearance and hygiene, medication administration habits, ambulation risks and falls, home cleanliness and organization, food acquisition and preparation, driving, memory loss, ability to express thoughts, social interaction or isolation, judgment, decision-making, etc.)

For further information and more detailed toolkits that outline each of the above areas in more detail, please refer to our website. http://www.ericksonresource.com/estore/

Written by, Stephanie Erickson

www.ericksonresource.com

So often in working with families, adult children ask me for suggestions on how to get their parents to acknowledge their deficits and accept help.  The children believe their parent is no longer able to live autonomously, but is refusing to consider a supportive environment.  At times, the adult children add that they have a power of attorney and believe they have the right to facilitate the move, even without their parent’s consent.

That is not always true, legally speaking.  In addition, forcing a change upon another is not the way to preserve a relationship, nor help another to adjust to a major change in their life.

If you find yourself in this situation, I suggest the following:

1. Process and accept your own frustration.  Look at your frustration at a deeper emotional level.  Most likely your frustration and anger stems from the fear you feel.  Understanding and accepting this will help you to communicate differently with your loved one.
2. Imagine yourself in your loved one’s shoes.  The frustration and fear you are feeling is most probably identical to what your loved one feels.  Imagine if someone was telling you to leave your home.  You would be scared at the thought of losing control of your life too and dig your heels in and deny and resist help.
3. Don’t pull the “Power of Attorney” card.  Bringing up a position of power is not going to decrease defenses and open up the lines of communication.  In fact, it will do the opposite.
4. Engage the services of outside professionals.  Sometimes, including geriatric care managers, social workers, psychologists, physicians or other professionals can help to open up the lines of communication and mediate the discussions between family members.
5. Explore your state or provincial laws regarding your legal options.  Just because you may have a power of attorney, does not necessarily give you the right to initiate a placement.  Individuals, even when they are at risk or incapacitated, still have the legal right to advocate for themselves and make their own decisions.
6. Don’t rush things. It takes time for people to accept their limitations and make changes in their lives.  If a doctor tells you, “you must lose weight”, do you leave the doctor’s office and immediately start a diet and lose the weight?  Probably not.  People need time to process changes in their lives and make adjustments in increments.  Be sensitive to that.
7. Make small changes first. Whenever possible, start with small changes, like bringing in help a few hours a week, or visiting more often, to give your loved one time to see that the assistance is valuable.
8. When possible, let your loved one decide that the time is right. All people do better with change when it was a change they initiated, not one that was forced upon them.  Try to guide conversations, but allow your loved one to determine when the time is right.
9. Look at options together. You may need to do the initial research on the options available for a move, but do not make decisions autonomously.  Include your loved one in the decision making process at every level possible.
10. Understand that a crisis may need to occur. Unfortunately, it is often a crisis, like a major fall or hospitalization that facilitates a change.  It is not ideal, but it is often the reality.

If you find yourself in this challenging situation, enlist the support of friends, family, or a professional to guide you in navigating this difficult situation.  Feel free to contact me to discuss your personal situation at: stephanie@ericksonresource.com www.ericksonresource.com

1.    Making a decision too quickly:

When your loved one is in the hospital, we often make a quick decision in order to avoid a prolonged stay at the hospital.

Solution: Let the hospital team take the time needed to complete a full assessment to ensure the placement meets your loved one’s needs.

2.    Leaving the hospital without the proper discharge information:

Sometimes we are in such a rush to leave the hospital, or we cannot find a staff member with whom to speak, we leave without gathering all of the information we need.

Solution: Make sure you have a complete list of all medications your loved one took at the hospital as well as the ones given upon discharge.  Try to get a written discharge summary to give to the placement.

3.   Choosing a placement not suited for your loved one:

We often choose a placement, hoping that our loved one will be able to function in that setting in the future.

Solution: Be realistic about the progress and improvements your loved one will make based on the diagnosis, rehabilitation and treatment now.

4.    Choosing a placement based on a few criteria only:

There are many areas to consider when choosing a placement.  Some may be of more importance to you than others.

Solution: It is important to look at the overall picture when choosing a placement and decide what your priorities are.   No facility will meet all of your loved one’s needs.

5.    Not visiting enough facilities prior to a decision:

When in a rush, we are often quick to choose the first facility that has a room available.

Solution: It is recommended to visit at least 3 facilities before making a decision.  If possible, have a meal at each facility.  Talk to a few staff members, to get a sense of how the facility “feels.”

6.   Letting your emotions make the decision:

Making a decision to place a loved one is draining and stressful.  Don’t let these feelings overshadow the objectivity you need to have in choosing the appropriate facility for your loved one.

Solution: Take a deep breath, and think your decision through.

7.    Making a decision alone:

Placing a loved one is a big decision and you should try to avoid carrying the burden by yourself.

Solution: Include family members in the decision making whenever possible.  Ask for another professional, such as a nurse, social worker or doctor for their opinion.

8.    Not reviewing the power of attorney:

In our haste to make quick decisions, we sometimes forget to reference the document that our loved one prepared for just this situation.

Solution: If your loved put his or her wishes in writing, review them as soon as possible.  It may make your decision easier if you know what your loved one wants.

9.    Not including your loved one in the decision:

Even if your loved one has deficits, they may be able to understand some, if not all of what is happening to them.

Solution: Include your loved one in making a decision if possible.  It will empower them and may help their adjustment if they feel they have a choice in what happens.

10.   Ignoring your instinct:

You know that feeling in the pit of your stomach.  It is telling you something.

Solution: You know your loved one better than anyone.  Don’t discredit professional assessments, but advocate for your loved one and make decisions that you feel are right.

For more information on placements and simple tools to assist you in finding the right facility, visit our Services page.