years of care

by Amy Phariss

I did that for a year. At the time, she was starting her business, so then I had to do an internship. I did that with Amy, and I started doing caregiver services for a couple of years after I graduated and was working in Alzheimer’s care. Fox Hollow “promoted” me to marketing. I didn’t care for marketing, so I called Amy. I was already working with her as a caregiver, so when she opened an office in Chapel Hill, I was working with a nurse Sherri. She told Amy she needed to hire me full time. So, I started doing scheduling and marketing. Then, I did scheduling, marketing and care management at the same time.

After I had my first child, I focused just on care management. So, I’ve actually been working with Amy for 22 years and full time for 20 years and in full time care management for 16 years.

ONC: What do you like about care management?

JT: I like that nobody is the same. There’s always continued from page 1 something different happening. I can make a difference in the lives of older adults in different ways. There’s nothing monotonous about it. Every day changes.

ONC: Can you describe what care management means to you and how you view it?

JT: I view it as being a liaison for older adults with their families, their doctors, their caregivers, their attorneys….I help them by being the central hub for all the things that happen in their lives so I can make their aging process more successful.

ONC: What does more successful mean? How is that defined?

JT: Less crisis. Fewer admissions into a hospital. Being healthier for a longer period of time. Being happier. Helping them create a plan and meet goals. We’re like personalized social workers for older adults. Whatever our clients need, we try to make sure they have all the resources available to them to make the best decisions to handle whatever situation they’re facing. Let’s say they don’t have family or a local support system, we become that support system. If they have multiple falls and don’t know why, we make and get them to appointments to figure it out and find out how to prevent them.

ONC: What’s the most surprising thing you do?

JT: Maybe it’s crisis intervention, when we’re at the hospital with a client all night. Or we might help with psychiatric admissions during a crisis and facilitating what they need to get better. I’ve been at the ER at Chapel Hill for two days straight.

ONC: What do you see older adults needing most that they’re not getting?

JT: Individualized care.

I feel like doctors or families kind of just expect that everybody ages the same, and they don’t. We’re not just throwing a dart at the dart board saying: here’s what you have, so here’s what to expect. No, the individualized care is so important.

ONC: What ways do you see people need individualized care?

JT: For example, this happens a lot, someone will start having memory loss and get put on one of the memory medications without finding out what is really going on. So, depression can mimic dementia. So, the memory loss medication isn’t treating the depression. If they’d had the proper testing, they could be put on the right medication.

Or, when you tell someone to come to your house, the caregiver needs to do the housekeeping. We all think of housekeeping as different things. If we do it the way we’d do it at our house, it might not be the way the client wants it. One client, for example, didn’t want anyone vacuuming. So, you need to talk to clients and find out what their wants and needs are and find ways to meet those goals.

ONC: What’s the hardest part about care management?

JT: I think it’s finding the right caregiver for each client. We try to find the right fit. It’s so important to find the right caregiver for each of my clients. They’re the people with them day in, day out. They’re the people who communicate with me as their care manager. I may see them once or twice a week, but the caregiver sees them every day for multiple hours a day.

ONC: What do you think families need to know about helping their loved one age well?

JT: Again, just being reminded that they’re an individual. They’re still a person. They still require a lot of care and love. Also, they’re not the expert in all things aging. Getting an expert in to evaluate their situation and guide them is the best way to make sure they’re aging successfully.

ONC: So, is part of your work working with the family and educating them?

JT: Oh, yes, always.

We work closely with the families to help them understand what’s going on with their loved ones to make sure they also have the resources available for them, the right research, support groups, tools – to make sure they can help their loved ones as well.

ONC: What do families need for support and to make the best decisions?

JT: I think they get a lot from having a care manager to make sure they have those resources. Our goal is to work together with families, not to replace family care. Families want to educate themselves and a local care manager can help find the resources you need to help your loved ones.

ONC: What do you like least about your job?

JT: Losing clients. That’s an easy answer but a sad answer. Even those clients we help out of their crisis and they’re better and no longer need our services, it’s still a sad time for us. We’ve lost the relationship we’ve felt with them.

ONC: What’s the hardest conversation for families to have about the aging process and care?

JT: The hardest conversations seem to be about driving or placement. Those are the two top ones. Taking away someone’s access to drive because they have dementia or other health issues that make it unsafe on the road, that ends up being such a hard battle with families. Also, talking about placement is hard. Most of us want to age in our house and get care there, but it’s not always feasible to afford to do that.

ONC: What advice would you give for those conversations?

JT: Again, everything is individualized. It would depend on the client. You might say that the doctor says it’s not safe to drive. That client might respect the doctor but won’t listen to a son or daughter. Or you can get the DMV involved and then you can say, “I didn’t have anything to do with it. The DMV made the choice.”

And for moving to a facility, letting the loved one take a look at everything, all the documents, all the financials, so they can see the concerns and be part of the decision.

ONC: What is the biggest misconception about working with older adults?

JT: That it’s always sad.

There is so much joy in working with older adults.

It’s not just death and dying. People don’t think of all the happy times and memories we make with them. There are so many rewarding aspects to it.

ONC: What would you say is the biggest lesson you’ve learned in 20 years of working in this field?

JT: Everything changes. Again, nothing stays the same. People change. The industry changes. We have to continue our education so we can make sure we’re continuing to be the experts in the field and leading our clients in the right direction.

ONC: What has been the most rewarding part of the past 20 years?

JT: Bringing joy to so many people’s lives and making it easier on older adults and their families – being that central hub for so many people. Making a difference.

ONC: What makes AOS special enough to keep you around for two decades?

JT: The fact that I know that Amy’s mission is always to do what’s best by the client – her dedication to the aging population and knowing she wants to make a difference. It shows throughout our company with how she treats her employees and staff.

ONC: What should a family look for when they’re looking for a caregiver?

JT: I think you want to make sure they have reference checks, criminal background checks, personality matches, likes and dislikes – you wouldn’t want to put someone who loves board games and puzzles, you don’t want to put them with someone who just wants to be a sitter and not a companion. You don’t want to put someone with dementia who has never worked with dementia before.

ONC: Finally, are there any books or resources that stand out to you after more than 20 years in the field that you think our readers might benefit from?

JT: Mine always end up being about dementia because that’s sort of my forte, if you will:

Dementia Alliance of NC - https://dementianc. org

Aging Well. George E. Vaillant

Finding Meaning in the Second Half of Life. James Hollis, PhD

The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer Disease and other Dementias. Nancy L. Mace, Peter V. Rabins, et. al.

The Art of Aging: A Doctor’s Prescription for Wellbeing. Sherwin B. Nuland, Arthur Morey, et. al.

Each July, ONC likes to take a little journey on the topic of travel. This year is the first year since COVID that many of us feel up to travel much beyond our hometowns. Many of the COVID-related restrictions have been lifted. And many of us are ready to explore. We reached out to Elizabeth Armstrong of Rosewater Travel Company here in Pinehurst to find out what travel looks like now, what we need to know to travel well and how to plan the trip of a lifetime (or the summer) with as little hassle and as few headaches as possible. Armstrong delivers with tips, trends and travel advice we can all use, whether we’re traveling solo or getting the family together for a multigenerational cruise. We appreciate Armstrong’s experience, openness and professional perspective on the next great adventure.

ONC: Elizabeth, thank you for agreeing to give us a bit of the inside scoop on travel as COVID restrictions ease up and we’re free to move about the cabin, so to speak. Can you speak to what’s going on with travel right now?

Elizabeth Armstrong: Travel is booming. We’re experiencing something called “revenge travel” – people who were locked up during COVID and couldn’t travel, see family, go on specialty trips (honeymoons, etc.) –they’re coming out in full force.

Restrictions are pretty much gone, for almost everywhere, especially major travel places. It’s in full swing.