For Older Adults and Families

Comprehensive Evaluations

ACCS provides assessments of older adults regarding mental health, functioning levels in activities of daily living, memory, and cognition. Clinically researched and respective testing tools are used in combination with a thorough clinical interview as well as input from family and care providers as appropriate.  

Assessment summaries include recommendations and referrals to resources.  Detailed written reports are also available for an additional fee.

Karin estimates to date she has provided assessments to over 900 older adults. 


A client's sibling said:
"I received the assessment... it explains much of what I have been experiencing with my brother. As always, I want to thank you for going above and beyond what you are required to do. You have been my angel through this." 

Care Planning

The ACCS proprietary Living Values and Choices Care Planning Process is based on clinical research and evidence based practices, incorporating her experience working with hundreds of older adults and their partners, families, and care providers.

See below for more details.
 

ACCS also provides consultation to family members and care providers who are seeking guidance on how to best support their older adult.


A local police officer said:
"Thank you so much for your swift reply. No one seemed to be able to figure out how to get him into the system before this.  You are the BEST!" 


A care provider said:
"Thank you, Karin, you sure are a great resource with the valuable resources you share from your contacts and knowledge base!"

Family Facilitation

ACCS provides family meeting facilitation to defuse tension and ensure all voices are heard, so that common ground can be found and care issues can be resolved.  

Having a neutral third party present encourages "good behavior" and helps family members avoid regressing into long-time unproductive patterns or resurfacing resentments. 

Family meetings can include the older adult or not, depending on your situation. However, all parties present need to agree to participate and to respect confidentiality. 


A client's son said:
"After you left on Thursday we had a heart-to-heart and she agreed to move and wanted to go then... Glad we didn't have to force a move... Thank you so much for all your help in this matter, you were essential..."

A daughter tells her story...

   My mother had been gradually failing for the past four years as a result of Alzheimer's dementia.  My mother was living alone in North Seattle.  I work full time and live on the island, so at best I was able to check on her twice a week. 

   In the fall... her condition began to deteriorate rapidly.  I tried to have visiting caregivers three times per week, but my mother would not allow them into the home. When my mother awoke and no longer recognized her own home, I knew that I had to do something.  However, she had always been adamant about leaving her home and flatly refused to accept a full-time live-in caregiver. 

   ...I was connected with Karin and she quickly arranged to come out and evaluate my mom.  She did a very thorough evaluation and explained to me and to mom in no uncertain terms what had to be done. I was very fortunate in that I found a wonderful home for mom in South Seattle and quickly arranged to have her move in.  

   Unfortunately, my sisters did not cope with this sudden change and were distressed and unhappy.  They were directing their anger towards me.  Karin suggested a family meeting, wherein she would mediate and explain to my sisters exactly why I did what I did and why it was necessary to move quickly. 

    The meeting was very helpful and my family has been more accepting of the situation since then. 

Unique Care Planning Approach

Living Values and Choices Care Planning Process©

    Researchers at the Benjamin Rose Institute on Aging and Penn State University developed a care planning facilitation process called SHARE (Supporting Health, Activities, Resources and Education) to help family caregivers and people with early-stage dementia to prepare for changes that lie ahead.  Their seven-session program addressed stress risk factors by improving communication between the care partners, building skills and resources and enhancing feelings of self-efficacy. 

    Clinical trials showed this process increased both care partners’ knowledge of dementia, improved communication skills and support between partners, and increased understanding of each person’s care values and preferences.

    In February 2016 at a local Alzheimer’s Association seminar, Dr Carol J. Whitlatch PhD, a lead researcher behind SHARE, presented the process development and results of clinical research trials. She gave permission for other professionals to adapt their approach for their own clinical work. 

    ACCS has adapted certain points of the SHARE approach, but not their terminology or materials.  Building on ideas regarding patient-centered care, patient engagement, healthcare advocacy, health literacy, family systems therapy, and other schools of thought, ACCS developed proprietary decision support tools to help partners determine their specific choices.  Incorporating other care planning approaches used with many clients over the years, unique structures are used to clarify individuals’ preferences.

    The Living Values and Choices Care Planning Process© can be used by spouses/partners, with aging parents and their adult children, or any type of care partner relationship, dealing with care related to dementia or any other chronic condition.

About this unique process

  • A framework for developing a care plan based on your own living values and choices for how you want to receive assistance and support.
  • A process focused on people living with memory problems and/or other chronic conditions, and their care partners, early in the disease process. 
  • An approach grounded in clinical research and supported by evidence-based practices. 
  • Typically 6 meetings, one with family/friends.

Advantages to the ACCS approach

Benefits to the “care receiver” partner:  

  • Have space to discuss their concerns and identify their preferences in a supported process. 
  • Actively participate in planning their own care according to their own values and choices. 
  • Address concerns about being a burden on partner/family.  

     Yes, people with dementia can, and should, participate in planning their care:  
             
"Nothing about us without us." 


Benefits to the “caregiver” partner:  

  • Gain a better understanding of what the care receiver wants in the future, in terms of the type of assistance as well as who will provide what assistance. 
  • Reduce stress, which hugely impacts the caregiver’s own health, as well as the partner relationship.

Benefits to both partners:  

  • The partner relationship is crucial for the care and well-being of the person with dementia or any chronic condition.  
  • Partners work together and become more comfortable discussing sensitive topics. 
  • Research shows that both caregivers and care receivers put the other person before themselves about 90% of the time.
    • This care planning process validates the importance of everyone taking care of themselves as well as each other.
    • Mapping tasks out helps visualize the burden carried by each person. 
  • Research shows both partners benefit from reduced stress, anxiety, and depression symptoms. 

Why work in partnership?     “Even with memory loss, I can…” 

  • People with memory loss still have the ability and right to decide and express their values and preferences around care.  
  • In early to moderate stages of dementia, people provide reliable answers about what are their values and preferences around care.
  • Caregivers are not accurate in estimating what the care receiver wants.  And this worsens over time: their perceptions become further and further apart from what the care receiver actually wants.  
  • Writing things down and reviewing notes frequently helps the person with memory loss as well as their care partners. 

How ACCS provides value

“It’s not therapy, but it can be therapeutic”

  • Creating opportunity for both partners to express their hopes, concerns, and viewpoints: 
    • Help families communicate more effectively.
    • Provide space and validation of families’ feelings and experiences.
    • Remain objective and ensure all views are stated and shared. 
    • Ensure meetings are positive, and support each person.   
  • Facilitating discussions:
    • Develop a supportive relationship to assist connecting with resources.
    • Support resolution of sensitive issues, misunderstandings, disagreements.
    • Use care planning framework as a road-map to guide decision making.
    • Encourage creative thinking and challenge existing ideas. 
    • Guide families toward realistic decisions that work for all involved. 
  • Providing specialized expertise:
    • Experience in diagnosing dementia and other mental health issues.
    • Expertise in care for dementia and other chronic conditions.
    • Knowledge of service providers and community resources.  

References

http://www.benrose.org/SHARE/INDEX.cfm 

    Orsulic-Jeras S, Szabo SM, Whitlatch CJ. (2015). The Evolution of the SHARE Program: The Development, Testing, and Commercialization of an Early-Stage Dyadic Intervention for Persons with Dementia and Their Family Caregivers. Symposium paper presented at the 2015 Annual Scientific Meeting of the Gerontological Society of America, Orlando FL.

    Tucke SS, Whitlatch CJ. (2005). The Values and Preferences Scale: Assessing the Care Values of Persons with Cognitive Impairment and their Family Caregivers. Presented at the annual meeting of the Gerontological Society of America. 

    Whitlatch CJ, Judge K, Zarit SH, Femia E. (2006). Dyadic intervention for family caregivers and care receivers in early-stage dementia. Gerontologist, 46(5), 688-694. 

    Whitlatch CJ, Femia EE, Szabo, SM, Orsulic-Jeras S, Zarit SH, Heid A. (2015). Support, Health, Activities, Resources, and Education: The Evidence-Based SHARE Program for Persons with Early-Stage Dementia and Their Family Caregivers. Paper presented at the 2015 Alzheimer’s Association International Conference, Washington DC
 

©2016 Aging Care Consultation Services / Karin Taifour, MA LMHC GMHS