"Visiting older people after church was a regular part of Janice Paul's childhood. She grew up around her grandparents and even worked in nursing homes when she was in high school. "Care for older people is seen as a burden instead of an opportunity to learn something," she said of her frustration with society's tendency not to embrace aging in a positive way. "I've gotten good advice. They have things to share; they can listen."
As a geriatric care manager, Paul's work parallels that of a wedding planner or a general contractor. "If you have hours to spend and have the connections, you can do it yourself," Paul said. A geriatric care manager, however, knows the community and the available resources and can help a client get the best services for family members, from support groups for caregivers to home modification procedures to government assistance.
Paul hails from Houston and has a bachelor's degree in biology from Texas Woman's University in Denton. In 2000 she entered the gerontology program at UK, where she was a Lyman T. Johnson fellow, and completed her Ph.D. in 2004. "I loved interviewing residents and participants in my study, during my dissertation," she said. "Sometimes people in nursing homes don't have anyone to listen to them." One lady told Paul she had shot her husband. "Her story was matter of fact," said Paul, "and she just started talking." After working at the Sanders-Brown Center on Aging at UK, Paul started her own business in July 2005, calling it The Next Step Aging Services, LLC.
Nursing homes aren't the only choice these days, but if you are investigating them, Paul advises looking at how the management treats their employees, because these are the people who will be taking care of your loved ones. There are also retirement communities and independent living facilities, assisted living and skilled care facilities, personal care and home health care services, and most of these arrangements can be full-service or á la carte. "Investigating is so important, but your mind can spin," said Paul. "They're all different and there's so much to know." Paul is a liaison between families and service providers.
"Providing care for anyone can be demanding," said Paul. "Caregivers have to preserve their health and maintain normalcy as much as possible." Pouring energy into caring for an elderly parent can put a strain on a marriage, for example. "It's noble, the thought that 'they can live with us,' but day in and day out, when you're living your life and now someone has special needs, it's an adjustment." One of Paul's clients was a woman here in town whose elderly parents were out of state. Should she move them here or attempt a long-distance care-giving situation? Paul's goal was to minimize stress for the daughter, who did decide to bring her parents to Lexington, and Paul helped the daughter find a facility for them.
She helped a man, whose wife was showing symptoms of Alzheimer's, find a system that worked for both of them by getting the wife into an adult daycare program. Recently she had a client who didn't even know if her mother had a will, much less where the legal documents were, such as the deed to the house, life insurance and care insurance papers. "I recommend people sit down and talk about all this," said Paul. "Nine times out of 10, someone's going to have to do something for us. You can't think clearly under stress, so discuss it ahead of time."
Paul encourages us all to have a living will and designate a healthcare surrogate, but check with an attorney about the different state laws that govern these things. "People need to be educated about legal and financial issues," said Paul. "Long-term care insurance is now recommended in your 50s or even in your 40s."
Care management is a fairly new profession and isn't covered by insurance, nor is it yet regulated. By 2008, care managers will have to be certified, though. To find a qualified care manager, check their references, ask about their background and experience, and see if they are a member of the National Association of Professional Geriatric Care Managers.
"I do what people want to do but may not have the time, resources or education to start doing," said Paul, who calls herself the "eyes and ears" for people who have to make decisions in emotional situations. "I know the work I do is important and makes a huge difference for families."
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