March 19, 2020 — Alissa Schramm regularly exceeds the continuing education requirement mandated by the National Academy of Certified Care Managers. The academy that credentialed Alissa as a “Care Manager, Certified” requires 45 hours of additional education during every three-year renewal period.
“Certified geriatric care managers are experts in the broad, complex field of senior care,” said Alissa, a certified geriatric care manager with 20 years of relevant senior care experience. “I feel it is imperative to remain current so I continually participate in seminars on a variety of topics affecting seniors, including medicine, care, finances, legal and social. That entails taking courses well beyond the required number of hours.”
Among the courses attended by Alissa are:
- “The Uninformed Medicare Shopper: Help Your Clients” Nationally-recognized Medicare pioneer Diane J. Omdahl, co-founder and president of Sixty-Five Incorporated, presented an in-depth look at the common pitfalls that trip up Medicare recipients. New beneficiaries, especially, need to be aware of permanent implications of their Medicare choices and deadlines not to miss. Ongoing beneficiaries need to know their rights and important enrollment periods.
- “Advocating for Clients in Skilled Nursing Facilities: How the Medicare ‘Maintenance Standard’ Applies” Attorney Moriah Adamo reviewed the 2013 landmark court case Jimmo v. Sebelius and the resulting settlement’s effect on claim denials for people with chronic conditions needing skilled maintenance therapies. The “improvement standard,” a fallacy that patients could receive therapy only if improvement was likely, was struck down in the ruling. Yet, years later, the standard is commonly cited as a reason for denial of physical, occupational and speech therapies. The attorney verified geriatric care managers’ understanding of the Medicare provision and rallied our profession to fight for our clients who are denied services.
- “Green Burial: Eco-Friendly Options for End-of-Life” Elizabeth Fournier, who owns and operates Cornerstone Funeral Services in Boring, Oregon, where she is affectionately known as “The Green Reaper” for her green burial advocacy, taught about the growing “green” funeral field. She reviewed the history of the modern funeral industry and the renewed interest in green burial, including the return of family-directed after-death care.
- “Life Insurance Settlements” In this webinar, Lisa Rehburg, a broker and owner of Rehburg Life Insurance Settlements, revealed more than 500,000 seniors lapse their life insurance policies annually. About 90 percent stated they would have considered a life insurance settlement if they had been aware of the option. Through a settlement, a long-standing legal possibility, policy holders can sell their unwanted policies for cash that can be used to fund their care needs or any other purpose.
- “Traumatic Brain Injury (TBI) 101” In this timely topic, Dr. Topher Stephenson, M.D., chairman of the Board of Directors of the Brain Injury Association of California, reviewed the basics of how the brain works; symptoms and diagnosis of TBI, and future developments. He discussed how brain injury affects more than just the patient and offered treatment options for TBI.
- “Managing Behaviors With People With Dementia” Legacy Healthcare Services managers Kristin Friedrich, a registered occupational therapist, and Laura Cambria, a physical therapist, presented a thought-provoking lecture about ways to communicate with people with dementia. Often, the person’s “behavior” is their only way to express themselves. By avoiding blame, assessing the situation and examining their approaches, care providers can find calm and de-escalate tense times. The Gardens at St. Elizabeth, a senior living leader in historic north Denver, hosted the talk. The independent living and assisted living community is building a memory care neighborhood as part of its wide-ranging, ambitious renovation.
- “The Biopsychosocial Puzzle: Effects of Chronic Pain/Opioid & Alcohol Addiction in Older Adults” Few geriatric care managers can say they have not encountered clients with addictions, most notably lately, opioid dependency. Dr. John Dyben, chief clinical officer at Origins Behavioral Healthcare, taught about prescription and alcohol addiction in older adults who present with different problems. He explained why admission to a traditional residential treatment program for individuals of all ages does not work for seniors. Dr. Dyben provided resources, including tools to help aging life care professionals evaluate the presence of opioid/alcohol addiction and a list of the handful of residential treatment programs designed for older people that accept Medicare.
- “Serving as a Client’s Decision Maker: The Pros, The Cons and What the Aging Life Care Professional® Should Consider” Social workers and Aging Life Care Association members Debbie Fins and Stephanie Swerdlow led a discussion about the ethical considerations that should be heeded by a geriatric care manager deciding whether to serve in a legal role as a guardian for a client. (Alissa does not accept guardianship appointments, opting not to cross traditional boundaries. Instead, she specializes in serving as a geriatric care manager, primarily for Denver-area seniors with out-of-state family members, some of whom are appointed by courts as guardians.)
- The “Multiple Sclerosis: What Every Aging Life Care Manager Needs to Know – Information, Services & Support” webinar provided an overview of multiple sclerosis, including information about how the disease is diagnosed; the different types of MS; the most common symptoms of MS, particularly those that may not be immediately visible or apparent; and treatment and management strategies to work effectively with clients with MS. As an aging life care manager, Alissa can help clients as young as 50 with a wide variety of diagnoses that affect people at an earlier age, such as MS, Crohn’s disease, early-onset Alzheimer’s disease, Huntington’s disease and Parkinson’s disease.
- The daylong “CIVHC Connect: Caring & Preparing for Serious Illness” seminar focused on advance care planning, one of Alissa’s areas of interest. Topics of exploration included “Navigating the Legal Side of Serious Illness,” “Guiding Patients and Clients Through the Advance Care Planning Conversation,” “Advance Care Planning and Technology: Registries and Portable Information,” “The Politics of Serious and Chronic Illness” and finally “Bridging the Vulnerable Moments: Current Care Transitions Initiatives in Colorado” about protecting society’s sickest patients.
- “30th Anniversary Alzheimer’s Association Rocky Mountain Conference on Dementia” An annual favorite for Alissa, the full-day 2019 conference presented educational programs about Alzheimer’s disease and other dementias by national and local speakers. Alissa attended numerous sessions including a research update by Rebecca Edelmayer, Ph.D., who works to accelerate the scientific agenda of the Alzheimer’s Association; “It’s More Than What You Know, It’s How You Show It: Cultivating Competence and Compassion in Dementia Care” and “Is There a Pill That Will Help Behaviors, Progression or Prevention” (regrettably, at this time, no but a record-level of research in ongoing).
- “Health Care Decision-Making and HIPAA Privacy Barriers: How to Avoid and Solve Problems” A high-powered trio – Charlie P. Sabatino, JD, with the American Bar Association Commission on Law & Aging in Washington, D.C.; Gregory French, JD, a certified elder law attorney in Cincinnati, and Rachel Seeger with the U.S. Department of Health & Human Services – parsed apart myths from facts concerning HIPAA privacy rules. Like seniors’ families, aging life care professionals often are told, “We can’t talk to you because of HIPAA.” Alissa learned these experts’ ideas on how to prevent and solve problems related to HIPAA so information can be obtained to aid her clients.
- “The Aging Life Care Professional As a Community Resources Expert” Alissa brushed up on her research and resource skills for federal, state and local assistance to help her clients and guide their family members. Julie Scott, a geriatric care manager in Florida, offered this refresher course and highlighted changes in programs like Medicare, Medicaid and Veterans Affairs.
- “Addressing Isolation Among Older Adults: The Role of Social Connectedness in Healthy Aging” Maureen O’Leary, program manager at National Institute of Senior Centers, and Conor F. McGovern, senior research associate at Economic Security, provided a better understanding of social isolation, loneliness and how they affect older adults; the importance of senior centers in preventing social isolation; and outreach examples and resources used by senior center professionals to connect with isolated older adults.
- “Comprehensive Training on Medical Orders for Scope of Treatment” Alissa served as the volunteer chair of the Colorado Advance Directives Consortium’s Medical Orders for Scope of Treatment (MOST) Revision Work Group in 2014, facilitating the MOST form’s first revision. After the update’s launch in April 2015, Alissa helped with this seminar for health-care professionals taught by Jennifer Ballentine, co-director of Colorado Advance Directives Consortium. The class reviewed changes to the MOST program and form, highlighted common errors with use of the original form and presented role-playing exercises on strategies to broach the oft-taboo subject of end-of-life care and wishes.
- “Frontotemporal Degeneration and the Need for Specialized Services” While frontotemporal degeneration (FTD) is the most common form of dementia diagnosed in people under age 60, it is not well-understood and appropriate services are seriously lacking. Sharon Denny, program director of The Association for Frontotemporal Degeneration, taught about FTD which causes profound personality changes rather than memory loss and typically strikes in the prime of a person’s career and family life. This training distinguished FTD disorders from other types of dementia clinically and in terms of the complex healthcare and psychosocial needs of diagnosed persons and their caregivers.
- “Medication Related Problems: Managing Risk in the Geriatric Population” An estimated 13 percent of the U.S. population over the age of 65 consumes more than one-third of all prescription medications. Pharmacist Stephanie Matinpour taught about the multiple clinical challenges due to age and disease-related alterations in drug absorption, distribution, metabolism and elimination; adverse drug effects that are frequently the source of problems such as confusion, impaired motor function and depression; and good medication management in the senior population that identifies and resolves adverse drug events instead of treating them with additional drugs.
- “Ethics and Business Alliances in a Changing Care Management Landscape” Emily Saltz and Jullie Gray, social workers and longtime Aging Life Care Association members and officers, led a discussion about ways for care managers/Aging Life Care Professionals™ to capitalize on new business opportunities and partnerships and thrive as clinicians and business owners while holding true to the association’s code of ethics and standards of practice. Extra attention was paid to the question of whether combining home care or guardianship with care management is ethical. Since the inception of Compass, Alissa has chosen to focus solely on long-term care management services, in part, to avoid even the appearance of impropriety.
- “Empowering Caregivers Facing Difficult Decisions” Clinical bioethicist and author Viki Kind taught a framework and tools to use when making difficult life, health and end-of-life decisions for people with dementia, brain injury or mental illness. Since she emphasized it was not a one-size-fits-all solution, Viki presented adaptations based on the patient’s level of incapacity and the situation.
- “Palliative Care Theories, Principles and Innovation for Care Managers” Carol Lovci, RN, who serves as a consultant for California State University San Marcos -Institute for Palliative Care, presented the principles of palliative care and the fundamentals of care management in palliative care. She explained the similarities and differences between hospice and palliative as well as addressing the frequent confusion between the two.