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Kay Paggi, Professional

My goal as a care manager is to maximize the elder's independence and quality of life, no matter what the setting, and increase the quality of life for the caregivers at the same time. The average time spent providing care for aging parents in the U.S. now is 18 years. Caregivers need guidance in this new, uncharted territory, they need permission to take care of themselves first, and as a Professional ElderCare Consultant, I can provide that.

    Depending on the situation, I often become more a surrogate family member than an outside professional.  You, the caregiver, have a limited amount of time and energy.  You may spend it running errands, going to physicians, arranging care, cooking and cleaning, etc.  Or, you can choose to spend quality time with your parent and allow someone else to do the routine tasks.  Only you can provide the love.


    I prefer to begin my association with your family in an initial in-home or in-hospital assessment. This initial visit takes about an hour and includes a functional assessment, nutritional assessment, review of medical diagnosis and current medications, mental status tests, and depression screening. I ask for enough financial information to help me determine how much care can be afforded for how long. I discuss the older person's experiences with their own parents, their expectations for this time of their life, their fears and hopes. The more I know about the client, the better care planning recommendations can be made.

    If the initial assessment is in the elder's home, I do an environmental evaluation while there to assess fall risk and environmental safety.  Falls are the 5th leading cause of injury and death among older adults. Whether your care receiver lives there only a few more days or the rest of their life, it should be safe.
    In 2005-6 I was part of the Gilbert Guide team of professionals in aging care who visited every long term care facility in the DFW area. We completed the same survey in each community, so they could be fairly compared with each other along the same areas. The results along with ratings were published in May 2006. Subsequently the Gilbert Guide went online nationally. Since every long term care facility in the U.S. could not be surveyed, the local surveys were stopped. As a result of my experience with the Gilbert team, I was invited to become an Expert at Caring.com, where I respond to reader requests for information about ElderCare issues.

    Using all the information I’ve gathered, I write a Care Plan for you and your care receiver. This is a guide to eldercare options that lists current needs along with options for improving the situation, both short term and in the future. We then meet to discuss the Care Plan. This can be an informal meeting between you and me, or we can meet with your parent and/or your siblings or other family members. I can assist you as you struggle to make the best care decisions and discuss the pros and cons of each option.

     Alternatively, if you would rather begin less formally, I can meet with you to discuss the issues that are challenging you now. In this meeting my suggestions will be more general because I will not have assessed the elder but we can discuss broad outlines.


    Going forward, after you have decided on a plan, I can assist you by implementing some of the changes. I can find and supervise in-home help, find a facility with an opening in your price range, and even take your parent to visit facilities so they feel they have a part in this decision (after all, it is their life). I can manage the relocation without you, if you prefer. Or I can take your parent out while you manage the moving of household items.
     I can counsel with your parent to help them adapt to the changes. I can help them say goodbye to one chapter of their life while they greet a new one. I can also do some counseling with you and your family to teach you how to cope successfully with your feelings of guilt, relief, hope, disappointment, resentment, and all the other feelings that are inherent in caregiving.
I can take your parent to the doctor, sit in on the examination, ask questions about the diagnosis and treatment, and report to you. I can be a liaison between you and your parent or between you and the medical community. I am always an advocate for the elder’s best interests, and try to find what tests are necessary and which can be avoided or delayed.

     I can help with travel plans if your parent wants to make a trip, such as arranging items such as oxygen, baggage handling, wheelchairs and escort between planes.
     Perhaps best of all, I am always available. I am here when you are out of town. I can take phone calls from the facility, or intercept calls from an irate parent or sibling. I can meet you at the emergency room, or if necessary, take your parent to the emergency room. I coordinate with hospice, and have been present when beloved clients died.

In short, I can be a surrogate daughter for your parent. I add to your support system and theirs, allowing you to have more quality time with your parent, to be an advocate not an adversary (I can remind your mother to visit the dentist so you do not need to.) I can give you the freedom to go to work and do your job, rather than make phone calls to search for eldercare options.

My fee is $105/hour. Before I begin an assessment I ask for $500 in advance to cover my initial hours. I charge for drive time and time spent on the phone.  I suggest that you arrange to pay me yourself, as most elders in this generation believe such a service as care management is unnecessary.  Their parents aged and died.  Your parents age and live.  The average time spent providing care for aging parents in the U.S. now is 18 years.


National Certified Counselor (NCC) 
Issuer: National Board for Certified Counselors

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National Certified Counselor (NCC)



"Kay did an excellent job of evaluating and summarizing Moms needs.  She was especially helpful in locating an appropriate place for Mom.  Within 2 days we were able to get a terrific place.  We would have spent weeks doing that and probably not found as good a place." -Wayne 



 I was lost in potential facilities that would have been more than happy to have my father as a resident.  However, web sites, public listings of the top facilities and even the answers from the principals of the facilities did not provide the in-depth answers that we were looking for.
    Your methodical approach to get to know us, then fully understand the physical and mental status of my father provided the initial confidence , that, "hey -  Kay is here to help"  and UNDERSTANDS what we as a family have as priorities. Your experience and "street wise" knowledge of things such as staff stability , dining quality, levels of service actually provided on a day to day basis only further gave us comfort that we were headed toward making the best decision for our family.
    I particularly appreciated your knowledge of costs (short term and long term) and providing the various "never thought about that" items that seem to always pop up.  These days, an accurate budget of future costs becomes highly important. 
     Finally, we also appreciated how you followed up with our questions and requests, even as you were providing one on one care yourself to clients.  Knowing that our communications had been received and being informed when we could expect to receive answers is just as important as the answers themselves when in the midst of an emotional ocean dealing with a parent's life transition. 
    When dealing with an emotional subject, the less "noise" one has to face , the more quality thought and time one can give to a parent who is so much in need.  We thank you for providing that high quality to our family.




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