The South Pasadena Chamber of Commerce gathered for its monthly “ShopTalk” breakfast at Mike & Anne’s restaurant on Tuesday to highlight managing small businesses in balance with caring for aging family members.
Laura L. Morgan, a certified geriatric-care manager, was the featured speaker. She shared that people are living longer, and that the older population is growing faster than at any other time in history, which presents a pressing need for families to be well-versed on navigating the complexities of geriatric care.
She detailed myths about elderly people, include they’re often cognitively impaired, isolated and dependent.
“The facts are that most older adults maintain close contact with their family,” said Morgan.
“Community-dwelling older adults have lower rates of diagnosable depression than younger adults. They’re a diverse group. Most older adults live independently, which I think surprises a lot of people. And for most adults, if there’s a decline in some cognitive abilities, it’s not severe enough to cause problems in daily living.”
Morgan said that when things go wrong in health, symptoms to look for include change of appetite or sleep patterns, poor grooming habits, sadness from loss and grief, isolation, confusion or disorientation, inability to handle activities of daily living and lack of interest in things previously enjoyed.
More care options are available now than ever before, when staying at home or nursing-home facilities were the primary common choices, she said.
In-home care, known as aging in place, is popular and includes custodial care or skilled nursing care in the home. It is paid for by individual, and insurance will not cover it.
Medi-Cal provides some support for those with low income. Board and care homes are private houses within residential areas for a small number of seniors. It is paid for by the individual, and Medi-Cal will assist with some costs with the Assisted Living Waiver Program (ALWP), which helps to get people out of nursing homes.
Independent or assisted living facilities have varying levels of assistance and are paid for by the individual. Continuum of care facilities are a combination of independent, assisted and skilled living assistance paid for by the individual and Medicare with some limitations. Nursing homes involve the most extensive care and are paid for by Medi-Cal for long-term care and Medicare with limitations.
“The bottom line is, buy long-term care insurance,” said Morgan.
Morgan said she often sees “the three D’s” in her practice: depression, denial and dementia. Depression is often linked to loss of independence, a spouse or connections.
“It’s difficult to convince members of the Greatest Generation to seek help because it’s the grin-and-bear-it generation,” said Morgan.
With denial, an unwillingness to give up driving privileges and family members disagreeing that elder members need additional specialized care are common examples of challenges in facing elderly care reality.
In dementia, Alzheimer’s can sometimes be a reality, and Morgan cautioned people to be wary of rushes to judgment on a diagnosis.
“There are conditions out there that mimic the symptoms of dementia and Alzheimer’s — for example, a urinary-tract infection can result in behaviors like someone with dementia,’’ she said.
Morgan said elder abuse is also on the rise, corresponding with a growing aging population. There are various kinds of abuse, including physical, sexual, emotional, financial, abduction and isolation. The most common abuse types are neglect and self-neglect.
With neglect, signs to look for include pressure sores, malnutrition, poor hygiene and abandonment. Signs of self-neglect include denial of issues, delays in obtaining medical care and malnutrition.
Morgan recommended taking steps in investigating potential retirement-care facilities thoroughly before a decision is made with an elder family member.
She advised visiting unannounced in the day and evening, asking to see the latest inspection report, sharing a meal there, not to be seduced by attractive furnishings, looking over the menu and activity schedule, asking other residents about their experiences and paying attention to how staff interacts with the residents.