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Options for the aged

Maria Freda could barely eat or sleep during the weeks her 77-year-old mother languished in a hospital bed, deemed too frail to return to her daughter’s home but not sick enough for the constant care of nurses and doctors.
FEAX Geriatric Care Advice 20100527
Jill O’Donnell is a private geriatric-care manager who

Maria Freda could barely eat or sleep during the weeks her 77-year-old mother languished in a hospital bed, deemed too frail to return to her daughter’s home but not sick enough for the constant care of nurses and doctors.

Freda knew her mom needed a long-term care facility, but she was overwhelmed by the choice. She spent days scouring the Internet for advice, talking to hospital discharge staff and workers with Ontario’s much-lauded Community Care Access Centres, who are mandated by the province to help needy seniors connect with services.

“They were all very nice and gave me tonnes of pamphlets. All I remember them saying is, ‘You just have to choose three (nursing homes) and put in applications.’

“I didn’t know what to do, where to turn or what was the best option. One of the social workers at the emerg gave me a nice big book on retirement homes in Ontario and said, ‘This may make the decision easier.’ But I didn’t know any of these places. I didn’t want to abandon my mother. I almost had a nervous breakdown.”

In desperation, Freda sought out pricey help to get her, and her mom, through the maze of care options in Ontario. She hired one of the growing number of “geriatric care consultants” springing up across the country — private-sector “experts” who are helping frazzled baby boomers find care for their aging parents.

Freda felt comforted immediately by the reassuring voice and take-charge attitude of Jill O’Donnell, the founder of Iris Consulting for Seniors (www.irisforseniors.com).

“I think a lot of baby boomers are the same — we want to do the best for our parents because they’ve done so much for us. But I wasn’t getting the information I needed. I was being expected to do a lot of the legwork myself, and in my gut I couldn’t tell what was the right place for my mother,” says Freda.

O’Donnell met with Freda and her mother at the hospital, took a look at medical records, then assessed the elderly woman’s needs based on her rapidly worsening dementia.

Within a week, O’Donnell gave Freda a list of suggestions, including a 16-bed home specializing in the care of people with dementia. In the end, Freda opted for another of O’Donnell’s suggestions, across the city from her home.

The whole thing cost $850 — although more complicated cases can cost thousands.

“I was prepared to pay anything, I was so frazzled,” says Freda. “This is not my area of expertise.”

O’Donnell was one of the first to start offering geriatric care advice back in 1981 after spending years working in hospitals and long-term care facilities and seeing families overwhelmed by both the lack of adequate resources, and knowledge.

In many ways, things are even worse now, says O’Donnell. The growing number of elderly, and especially those with dementia, is putting even more pressure on the limited number of long-term care beds, many older nursing homes are in need of updates and it can be difficult to know, even if you can come up with a shortlist and do a personal tour, whether the care provided is best for your relative’s specific needs.

O’Donnell has not only seen all the facilities she recommends personally, but she also knows the administrators and some of the staff. She knows their strengths and weaknesses.

And sometimes a personal call can make the difference between a wait and a bed.

Increasingly, busy baby boomers, especially those who live far from their aging parents, will pay her to drop in from time to time and keep an eye on how their folks are doing.

“We’re like surrogate adult children,” says O’Donnell.

They’ve also become an alternative to public-sector social workers and CCAC staff who can be overloaded with cases. O’Donnell and her staff handle about a dozen cases at a time, which allows them to highly customize their efforts.

But a lot of people can’t afford her services — or the growing number of private home-care companies and retirement facilities that are springing up to pick up the slack as the first wave of baby boomers hits 65 next year.

“Families are often waiting until a crisis hits, rather than working proactively (to plan ahead for where their parents should go as they age),” says Jacqueline Campbell, of Campbell Consulting (www.campbellconsulting.ca).

“What you hear from families is they’ve always thought the government would take care of everything, and (politicians) certainly do talk a lot about Ontario’s ‘aging in place’ strategy” for providing services and supports to seniors.

“Families are often surprised to find that they can’t get what they thought they would for free, and they’re shocked to find how much money they’re having to spend.”

Campbell says geriatric-care consultants can be especially valuable if family members can’t agree on the best options for aging relatives, or have parents who are determined to remain in charge, despite their failing health. Sometimes an independent assessment, delivered by an outsider, can make the choice more obvious.

“A lot of people aren’t willing to pay for consultants because they don’t understand or appreciate the value that they bring. Or they tend to think they can handle it all themselves,” says Bruce Mahony of Home Instead, a private-sector company often called upon by geriatric-care consultants to provide interim care for frail seniors in their homes.

“In a sense, they can be a financial planner — if you don’t have the means, they’re going to help you find a place that is safe, affordable and sustainable. If you have lots of means, then there are more options. So they’re not just for the rich.”

The best consultants, Mahony stresses, are those who have worked in the health- and long-term care system.

“A lot (of people now advertising themselves as geriatric-care consultants) managed their parents through the system and consider themselves experts. The reality is that when you get into health care, it’s a life-long learning experience.”