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Serving Elders on Boston’s South Shore and Cape Cod

An Aging Life Care™ Consultant (also called a Geriatric Care Manager) is an expert in the complex changing needs of older adults. We might be called upon in a crisis such as a hospitalization. Or perhaps when a family begins to notice subtle changes in their loved one’s ability to manage day-to-day tasks independently. Or, we may be contacted before changes occur to begin planning for future needs. In any of these situations, we begin by providing a comprehensive assessment of the elder and their current living environment in order to make recommendations and carry out a plan to maximize independence and safety. This might be achieved through coordinating home care and support services available in the community or transitioning to a more supportive environment.

 
 
 
 

A little about us...

Grace Life Care is a medically focused care management practice, founded by a Registered Nurse with over 30 years of experience in the care of older adults. Our comprehensive assessment includes the following areas:

  • Medical assessment to include history and currently treated diagnoses
  • Medication review including what has been prescribed, adherence to regimen, review of potential adverse effects in older patients, interactions and potential duplicate medications from multiple prescribers
  • Physical assessment for strength and balance
  • Cognitive assessment for any memory impairment
  • Psychological assessment for depression and/or anxiety
  • Social assessment to identify available support systems
  • Home assessment to identify potential safety concerns
  • Financial assessment to determine eligibility for entitlements
  • Legal assessment to determine if Health Care Proxy, MOLST (Medical Order for Life Sustaining Treatment) and Power of Attorney forms have been properly completed and filed
 
 
 
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Following this comprehensive assessment, we work with the elder and their support system to determine their goals of care. This may be the most important piece of the assessment and necessary to put a realistic and effective plan into place. After gathering all of this information, recommendations are provided verbally or in a written report, if requested.

 

Some examples of recommendations and interventions might include:

  • Scheduling a medical appointment with Primary Care Provider or specialist to further evaluate an identified issue

  • Accompanying the elder to medical appointments when necessary to advocate for needs and assure information is understood and followed up on

  • Obtaining a referral for Physical or Occupational Therapy or Skilled Nursing if there is a qualifying need

  • Advocacy in a hospital or rehab setting to assure seamless continuity of care during any transitions

  • Reconciling medications with prescribing doctors, prefilling a medication planner if necessary, considering a review of Medicare D plan with a cost analysis of current plan vs. a more cost effective plan

  • Strategies for challenges with cognitive, visual, or mobility impairments

  • Recommendations for home modification for safety concerns

  • Transportation options if driving is becoming more challenging

  • Recommendations for private caregivers or community supports or a transition to a supportive living community *

  • Discussion about advanced care planning while clarifying goals of care

  • Assistance with completing documents such as Health Care Proxy and MOLST (Medical Order for Life Sustaining Treatment) forms

  • Recommendation to Elder Law Attorney to review any complex legal matters


*Grace Life Care does not employ private caregivers and will provide recommendations only to reputable agencies with demonstrated reliability in high quality of care, always giving a choice between two or more recommendations. We do not accept any referrals fees or gifts from any agencies or facilities to which we refer.