Utilizing Values When Contemplating Care for Older Adults in Transition

Aging in place is a goal for most of us: “…I’m leaving this house feet first!” This makes sense given how our lives build upon many decisions along the journey, including where we live and how we carry out our daily routine. When quality of life begins to diminish and safety risks loom larger and larger, generally a change or transition is not far behind.

As a gerontological social worker, my goal is to see that the change is not brought on by a physical or economic crisis such as a fall or financial exploitation. In my experience these transitions are sensitive and complex, with best practices calling for a person-centered approach that involves understanding the wishes and functional abilities of the older adult who will be impacted.

I recently consulted with two different older persons in their ninth decade; both are single and without children. Concerned family members from out of state and out of the country respectively were planning visits to better assess the situation and learn about options for the changes ahead. We refer to them as long-distance caregivers.

I shared with them core values, applied when addressing the needs of older adults, that can be useful guideposts and:

1. Strive to offer the least restrictive appropriate alternatives;
2. Marshall services to support aging in place whenever possible;
3. Center decisions to the greatest extent possible around client preferences and expressed needs;
4. Draw from a repertoire of available interventions to create an individualized care plan;
5. Support valued informal caregivers;
6. Enhance inter-professional communication, clinically integrating medical, social and legal

Using these values, the Community Resource Center for Aging (CRCA) has been able to align with these families and provide individualized recommendations, incorporating what we know of the older adults’ preferences and financial resources.

In addition to lifted spirits and social engagement, these visits allowed for the observation of functional abilities and to learn about their relative’s preferences for their own journey ahead.

One of these older persons has expressed her desire to stay in her local community where she has given of her time and resources, so I was able to provide the family with names and numbers of nearby residential care facilities to explore. The other individual is receiving some assistance through LA County’s In Home Supportive Services program and I have suggested they request reassessment to increase hours under the Protective Supervision category. The CRCA will stay in touch with these families as their journeys unfold. 

CRCA is hosting two Zoom sessions in September. On Sept. 21 from 3 p.m. to 4 p.m. our Navigating Dementia Series in collaboration with Alzheimer’s Los Angeles will feature a state resource, California Phones, about their free adapted technology.

And on Sept. 24 from 1 p.m. to 2 p.m., Conversations with CRCA invites Naomi Karp, a consulting research scholar of the Stanford Center on Longevity. She will be sharing a new resource on how to protect ourselves from financial problems such as fraud. Please register by calling (818) 949-4033, or emailing Adria.Navarro@med.usc.edu.