Case Studies

I am a specialist to long-distance caregivers and professionals who appreciate having a partner in managing the care of a loved one or favorite client. With my guidance, management, and advocacy, long-distance caregivers are able to reclaim their professional and personal lives, lessening their feelings of overburden and overwhelm. Even just a one-time or intermittent consultation can help caregivers sort through their information overload. People who retain my services also learn how to build a stronger relationship with their loved one, who often might be difficult to deal with due to illness, mental incapacity, behavioral issues, or age.

The Situation
Sadie's trust officer called me on a Sunday afternoon. The staff of Sadie's retirement community was calling him at least daily about her health problems and behavior issues. Sadie, who was suffering from pulmonary disease, was experiencing episodes of severe breathing difficulty. When these episodes occurred, Sadie would call 911. When her trust officer called me, Sadie was summoning an ambulance to her apartment 1-2 times every day.

Our Solution
As a result of her breathing trouble, the retirement community moved Sadie to their skilled nursing facility. Per the trust officer's request, I assessed her for her appropriateness to return to her apartment in the retirement community.

My recommendation was instead for her to remain in skilled nursing, but also to arrange for private companions to provide Sadie with support and diversion. The trust officer agreed and asked me to serve as the liaison and advocate for Sadie's care. Over the next six years, her companions and I worked as a cohesive team to ensure that her needs were met, and that her life in the skilled nursing facility was as optimal as possible.

Case #2: Helen and Doris

The Situation
Doris was one of Helen's four children. Although Doris was the long-distance caregiver of the four, she was the most involved in her mother's medical care. Like many families, Helen's children experienced some conflict around Helen's needs and health concerns. Her oldest son lived on the same street, but was peripherally involved in his mother's care. Helen's two other local children were busy with their own lives. All of this put stress on Doris, who was in a high-powered job in Boston, but would drive four hours round-trip to see her mother on the weekends.

Helen was a widow who lived alone in her own home, and suffered from serious health problems including paralysis, kidney failure, and depression. She would often get into "health trouble" during bouts of depression; she would either not eat or eat minimally and poorly. She was also experiencing difficulty managing and attending medical appointments.

Our Solution
I took some time to get to know Helen. We agreed on a plan where I would take her to some medical appointments over the course of 2-3 months. In the meantime, Helen reluctantly agreed to have me locate an agency-based companion who could assist her with meal planning, shopping, social outings, and, eventually, medical appointments. Helen bonded well with her companion, Cheryl, who served her until Helen's death.

Over the course of two years, Helen's health slowly declined as her kidneys failed. During this time I continued to visit Helen and to closely monitor her changing status and needs. The close monitoring of Helen's care required frequent communication between her primary-care doctor and various specialists. For a while, Helen was very resistant to increasing the amount of care in the home and refused to accept help with personal care. While there was no question that Helen was competent to make this type of a decision, it was nonetheless not optimal.

Over time, Helen allowed me to locate more care for her, but only after she developed a pressure sore on her buttock that would not heal due to her kidney failure. Before Helen's death from kidney failure, she had someone at her side at all times, including hospice staff, home care, and family.

Case #3: Larry and Carol

The Situation
According to Larry's daughter, Larry's long-standing personality issues included gruffness and vulgarity. Larry had opinions that were bigoted and did not shy away from conflict. His daughter, Carol, was hearing from the assisted-living facility (ALF) staff at Larry's retirement community several times a day with complaints about Larry's balance and walking difficulties, incontinence, and uncooperative nature. His apartment was filthy and the ALF seemed not up to the challenge of dealing with him. Carol, his only daughter and a high-powered attorney, lived 400 miles away.

Our Solution
I assured Larry that I would be his ally to achieve the best solution for him. Larry agreed with me that things were not optimal. I assured Carol that the ALF issues would be handled and that I would field all problem-report calls and serve as her liaison with the ALF staff. She said she would prefer updates via e-mail, which I was happy to provide.

After a thorough assessment of Larry, I was concerned with his physical well-being and took him to the ER for an evaluation. He was admitted to the hospital for a urinary tract infection and increased symptoms of Parkinson's disease. His doctor in the hospital and I agreed that Larry should be discharged to the skilled nursing facility at his retirement community. I then arranged for private companions to take Larry on outings and spend time with him.

Over time, Larry's aggressive, anti-social behavior became more than the facility was willing to tolerate, and Larry was told he would have to leave. I worked with Carol to arrange for Larry to move back to his own home, accompanied by continuous home caregivers. Larry lived at his home for three more months before passing away from Parkinson's disease.