Getting old is hard. Planning for your old age is even harder. Despite what plans you might have put in place, few are truly prepared for what lies ahead. Whether you are a single adult, an elderly couple, the adult child of an elderly parent, a faraway caregiver, or a disabled individual, there is a professional who is ready to help create a road map for your later years. The service can reinforce the support system you have in place, provide you with the tools and resources for aging well, and help you in a crisis.
Betsy Lichtenstein is the point person when navigating complex situations such as hospitalizations, falls, moving from or to a nursing or assisted living facility, addressing chronic health challenges, cognitive loss, offering resources for legal and financial planning in later years, and much more. Her ultimate goal is to provide clients with the necessary support to be self-sufficient and independent for as long as possible. This necessity speaks for itself but we spoke to Betsy for more.
What is the role of a Geriatric Care Manager/Aging Life Care Professional™?
Geriatric care management is a holistic effort to provide counsel and support to seniors and their loved ones, empowering them to cope with the challenges of aging. Aging Life Care Professionals™ are there to support clients and to be a trustworthy advocate in times of crisis. Geriatric care managers lift the burden from members of the caregiving community, especially those who may live far away or lead busy lives, and provide assurance that there is someone nearby looking out for the best interests of their loved ones and who can take action in the case of an emergency.
What motivated you to become involved in caring for aging adults and persons with disabilities?
Many years ago, I was asked to help an elderly Holocaust survivor open her mail a few times a week, as her closest family lived in another state and overseas. This woman captivated me: I was inspired by her life story, her resilience in the face of significant loss, and her playful humor despite the challenges in her life. When I discovered she was in the hospital overnight and had no one to advocate for her there, I was happy to offer my assistance. Once she was discharged, she found herself sent home with a dense packet of complicated follow-up recommendations, which she was not equipped to understand. I realized that, as a compromised senior, she didn’t have sufficient support at home to keep her safe and also to help her navigate the complex health care system. Once I realized this was something I could train for and practice professionally, I was driven to help more people like her.
What are the benefits that a Geriatric Care Manager can provide?
We help families take advantage of services, programs and entitlements that may benefit the client. A geriatric care manager can help select housing or residential options, facilitate communication with doctors, empower clients to engage in social, recreational or cultural activities that enrich their quality of life. We refer clients to, or consult with, lawyers and other professionals as necessary. We monitor clients at home and recommend technologies and modifications that might keep them safe, watch for any changes in their condition or potential risks of exploitation or abuse, and coordinate care such as crisis management.
When is it time to bring in an Aging Life Care Professional™?
There are many warning signs that a loved one may be in need of assistance. These may include an inability to properly engage in daily self-care activities such as personal hygiene, dressing, feeding oneself, maintaining continence and transferring, going from seating to standing or getting in and out of bed. If any impairment is noted, in activities such as basic communication skills, transportation, for example driving or using public transportation, meal preparation, shopping, housework, managing medications, and managing personal finances, these may also be important signs that a greater level of assistance is needed.
What is your personal approach as a Geriatric Care Manager?
My main goal is to identify experiences that bring my clients joy. By staying physically, mentally, and socially engaged, they may retain better cognitive function, remain healthy, and live independently.
Whether it’s playing bridge, visiting museums, attending shows, doing art projects or going to the movies, I identify programs that make these activities more accessible. I encourage engagement with the social and cultural spheres of society, as isolation can have detrimental effects on a person’s mind, heart, and soul. I urge people to use assistive mobility devices to retain their independence and safety. Using wheelchairs, canes, walkers or other devices is not a sign of weakness, but a mark of strength that allows them to maintain a level of control in their lives. I want my clients to take advantage of the city just outside their front door; enabling people’s mobility can open up the world to them.
The idea is to meet clients where they are, to acknowledge that as they have aged, they can no longer do the same things they used to do. However, it is very important to refrain from doing everything for them, instead it is better to do tasks with them. It is important to respect the client’s autonomy, and I encourage them to make their preferences and ideas known when coming up with a plan. I also rely heavily on input from others in the caregiving community, who can provide history and context for the client, while sharing their concerns.
Do you have special talents that you use to connect with the elderly?
Music is definitely a powerful tool in connecting with the elderly; it reawakens their cognitive and emotional centers and creates meaningful experiences. I have classical voice training and sing with a chorus. I love singing with and to my clients, and I have an extensive musical lexicon from the 1920s and onwards (most of my clients can’t believe all the lyrics I know!) that I access to develop playlists that may have emotional significance to them. In general, I have a keen ear for figuring out the musical tastes of my clients and love to adapt to their preferences.
Additionally, I think that food is another way in which I can connect with my clients. Whether it’s playing bridge, visiting museums, attending shows, gardening, doing art projects or going to the movies, I identify programs that make these activities more accessible and doable for those with challenged abilities.
I love to identify my clients’ food preferences and curate menus that cater to their tastes and eating abilities; I can also pass on this information to home health aides and caregivers.
I love gardening and have an extensive knowledge of plants and flowers. I’m happy to give mini-tours through beautiful, local parks and gardens. As a lover of the arts and a native New Yorker, I find it exciting to recommend shows, concerts, and cultural experiences that cater to my clients’ preferences.
How often do you report to the client’s family about their well-being?
I always report back to a client’s family after I have spent time with their loved one and provide frequent feedback to the caregiving community. If there is an emergency, I make sure that the designated care partners are notified ASAP. I generally take their cues on communication frequency and on how to contact them in case of an emergency. Depending on the situation I will text, call, or email the client’s family.
How can families address the cost of Geriatric Care Management?
I make an effort to be mindful and sensitive to the financial burden this service places on a client and their caregiving community; I always look for opportunities to lessen this burden wherever possible, through avenues such as entitlements, resources, government subsidies, long term care insurance, etc. Caregivers have often told me that the peace of mind they have, knowing that their loved one is in very good hands, is priceless.
How do you manage to match a client’s life history, interests and hobbies with activities that meet their current needs?
Those living with memory loss need specialized care. Part of the intake process includes an interview to learn more about the clients’ life histories, passions, hobbies and interests. I also identify any past interests and sources of joy, as mentioned above with music, for example, that may have been sidelined due to their condition. I aim to match clients with activities that meet their socialization, emotional and spiritual needs, and I refer them to available classes, activities and volunteer opportunities. I work with third-party agencies to refer companions who can accompany them to cultural activities, restaurants, museums and other activities. In New York City, I can recommend many local programs designed for those living with memory loss.
What do you find the most challenging and rewarding about your profession?
I find it challenging to respect a client’s choice to maintain their status quo, despite being shown the potential risks to their health and safety. It can be heartbreaking to realize that certain actions could have prevented or lowered the risk of a significant health crisis from which the client can never rebound.
Observing the real-time benefits of my work may be the most rewarding aspect of my profession. I am so grateful to be an advocate in times of crisis because it’s imperative to have an advocate and a voice when you most need one, regardless of your financial situation. I am also thankful to be there for the families; if caregivers, especially adult children, live far away or lead busy lives. I know that having me there is a great comfort to them. I think of my clients as family—and I try to advocate for them as if they were my own.
Betsy Lichtenstein is a Geriatric Care Manager/Aging Life Care Professional™ and founder of the care management company, Aging With Dignity. An Advanced Professional Member of the Aging Life Care Association™, she received her certification as a Care Manager Certified (CMC) from the National Academy of Certified Care Managers (NACCM). She also has a certificate in Geriatric Care Management from the Brookdale Center for Healthy Aging at Hunter College (CUNY), a B.A. from Boston University in Psychology and French Literature, and an MBA in International Mar≠keting from Baruch College (CUNY). Betsy has also had training in Alzheimer’s Disease and Dementia Care from the National Council of Certified Dementia Practitioners (NCCDP). Betsy uses her creative talents as a trained singer, music teacher, accomplished gardener, arts aficionado, expert cook, and knowledge as a lifelong New Yorker to help bring joy and connection to her clients. She uses these tools to develop a customized plan of care for each client.
For further info, please contact Betsy Lichtenstein at: firstname.lastname@example.org or visit her website at www.agingwithdignityny.com