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Success Story: Living From the Heart

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Care Management to Weather a Downturn

by Linda Kartell, LCSW, Care Manager


When I first met Mrs. Gold, who had recently moved to an independent living facility (ILF) (at her family’s insistence), I found a very intelligent, well read and articulate lady who had decided that her life was no longer what she expected or wanted. She told me, as her care manager, that she would just have to grin and bear it.

Mrs. Gold had been reacting to the recent loss of her husband. Although she seemed to be making an adjustment to her loss, she gradually began to pull back from social activities and she found it too hard to keep up with the demands of household maintenance and financial matters. The grief wasn’t going away and she seemed to start having some memory problems – especially her short-term memory. For these reasons, her family moved her to the ILF.

While the move to the ILF brought relief to her family, it only seemed to bring her a greater recognition of all of her losses. The result was that she withdrew even more. As her depression worsened, her family became more concerned and called SeniorBridge in to attempt to deal with this "uncharacteristic" negativity.

Unfortunately, the loss of her husband was compounded by the loss of her dreams of what her "retirement years" would look like. In her own thoughts, this was not the way life was "supposed" to end up for Mrs. Gold. My relationship with Mrs. Gold had to progress slowly. Even though I felt that I encountered a wonderful individual, this was not Mrs. Gold’s perception of herself or her life. As a trained care manager, I had to use my skills of empathy, validation, emotional support and an understanding of the intensity of her grief to connect with Mrs. Gold and to earn her trust over time.

Finally, with our trust established, I was able to help her engage with an excellent psychiatrist, who treated her with a combination of medications and therapy that reinforced her strengths and my relationship with her. Seeing a psychiatrist was not an easy step, as is true for most older adults. The idea of "needing help," or worse yet, "being crazy" was terrifying to her. With support, she came to trust the psychiatrist, as well and her grief and depression began to be more manageable.

Mrs. Gold was again able to engage in her bridge games, to have a bit of a social life and to feel less anxious and moody. Now Mrs. Gold reports that she has good days and bad days, but that is better than having only bad days.

As a Geriatric Care Manager it is important to understand that grief – especially the on-going grief of the loss of dreams – can lead to many more problems than simple sadness. When grief is continuous, it is important to enable people to have support and validation for their multiple losses. Treatment becomes a combination of medication, emotional support, counseling, lifestyle changes, and reinforcement of internal strengths to recreate an acceptable existence. This is not an easy task and it takes the continuous understanding of many people to bring together the right supports to make life livable again. Mrs. Gold had to create new dreams for this part of her life and she had to learn from others to live from her heart, once again.

Living from the heart and helping others to do the same is the best part of being a care manager.

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