Rick — Former Triathlete
Rick led an extraordinary life. He was a triathlete and great outdoorsman, who had traveled virtually every inch of the world. He climbed all of the great mountains. He, alone, hitchhiked across the United States, wrote books and poetry and taught literature at a New York college. At age 70, Rick became ill. What was thought to be a mere virus led to pneumonia, sepsis, and a shutdown of Rick’s major organs. A tracheotomy was made and a feeding tube inserted to keep Rick alive. Ultimately, the feeding tube was removed, but the virus left Rick with permanent neurological damage.
Rick was entirely bed-bound and limited to a pureed diet. Rick could no longer walk, write, or speak in any discernible way. Long divorced and with no children, Rick was left to the care of his extended family and loving friends, none of whom lived in the NYC area. After his hospital discharge, Rick’s family had him admitted to a nursing home/rehabilitation facility in New York City, where they believed he would receive the best care.
Alighieri Care Management was retained after Rick spent two years in the nursing home as a private pay patient. The family was overwhelmed with the thought of how they could care for Rick at home, and the nursing home did not encourage or help facilitate a discharge plan. Rick showed minimal improvement over the two years in the nursing home. He was severely depressed, often enraged, and even hospitalized for a short period due to threats of suicide. He desperately wanted to live at home. His family, like many other families, had never heard of geriatric care managers. Alighieri Care Management immediately brought in a companion to work with Rick several days per week. The companion took Rick on regular outings, read poetry and books to him, and accompanied Rick to physical therapy so that he could reinforce the therapy. Within a few months, Rick’s emotional and physical health started showing signs of improvement and action was being taken to allow Rick to return home.
Alighieri Care Management hired an architect who specializes in disability renovations, and Rick’s apartment was modified so that he could safely return home. Alighieri Care Management hired and continues to oversee two live-in aides and numerous therapists. A ballet bar was installed in his apartment to assist him in exercising. Rick’s companion and aides have worked with him daily to reinforce his physical, occupational, speech and swallowing therapies. Now, one year later, Rick is able to walk with a walker. He has recently begun swimming therapy at a local pool. He is eating almost all foods without assistance. His speech has improved dramatically, as has his disposition. Along with the assistance of estate and elder attorneys, Rick has now made adequate arrangements for his future and his health care. While Rick’s life is certainly not what it once was, he is able to appreciate the progress he has made and sees value in his life.
Margaret – Niece Overwhelmed by Care
Alighieri Care Management was retained by Lori, who was caring for her elderly aunt, Margaret. Once a highly successful businesswoman and a pioneer in her industry, Margaret had never married and had no children or other family members to assist with her significant care needs. Lori was completely overwhelmed by her responsibility to care for Margaret, who was bed-bound and afflicted with dementia as well as significant behavioral issues. Margaret was also a bit of a hoarder and her apartment was filthy, badly cluttered, and dangerous.
Lori had just spent three years caring for her own dying mother, Margaret’s sister and best friend. Lori had hired 12-hour split shift home health aides to care for Margaret. With insufficient oversight, the aides were neglectful, leading to one crisis after the next. Lori was burdened with phone call after phone call from Margaret on a daily basis.
Once retained, Alighieri Care Management rearranged and thoroughly cleaned out Margaret’s apartment, replaced all of the split shift aides with live-in companions, cutting their home care expenses in half. We brought in our nurse to manage Margaret’s medications and hired an art therapist, and a physical therapist to work with her. We purchased games, movies, and music to improve Margaret’s quality of life. We established a relationship with Margaret so that she ultimately could depend more on us and become less and less dependent on Lori. We referred Lori to an elder attorney to assist with Margaret’s tax and estate issues. With the assistance of our team, Margaret’s life has greatly improved, as has Lori’s. Lori can now simply enjoy Margaret’s company, without the weight of managing her day to day care.
Rose — Needed Better Care
Rose, the client, was living in a nursing home in the NYC area covered by Medicaid. She had a diagnosis of dementia accompanied with serious behavioral issues. When the family came to us, Rose was languishing in a substandard nursing home that was overmedicating her and failing to provide appropriate care. None of the reputable nursing homes would accept her, given her behavioral history.
Rose had two daughters, Jamie in New York and Tracey in Maryland, who were extremely distressed by their mother’s living conditions and were also under considerable pressure due to their mother’s significant care management needs. Jamie, a single woman with a high-pressure career, was struggling with Rose’s care, which took up most of her free time. Jamie was at her breaking point. Tracey, who also worked full time and had two young children, was trying to help but was limited in what she could do. The sisters’ historically close relationship was being severely strained.
Once Alighieri Care Management (ACM) was retained, ACM used mediation skills to help the sisters realize that Jamie could no longer emotionally handle her mother’s care and that a move to Maryland, where Tracey could take on more responsibility, was in everyone’s best interests. The sisters had tried this in the past but were discouraged since residency requirements were a prerequisite for a nursing home placement paid for by Medicaid.
Given Rose’s behavioral issues, she could not be cared for in Tracey’s home in Maryland while waiting to meet her residency requirements to be placed in a Maryland nursing home. Alighieri Care Management found a Maryland elder lawyer, who had an existing relationship with a highly reputable nursing home near Tracey’s home. Due to our combined efforts, we were able to negotiate an immediate move to the nursing home with Medicaid pending. Rose is now flourishing in her new environment and our mediation and clinical skills helped the sisters mend their damaged relationship. In short, our team, along with the assistance of a highly skilled elder lawyer, was able to help a family through a major crisis and allow them to go back to being a family again.