As you read about Ann’s new business, AMK Creative Care Management, what will strike you is how that journey can often lead us to just the right place at just the right time. I can’t think of a more timely business to start right now than a Care Management firm. As the parents of the baby boomers age --- not to mention the baby boomers themselves --- finding good solutions at life’s very challenging juncture of aging is becoming a main focus in households around the world.
I hope you will enjoy Ann’s voice as she shares with us her personal and professional path.
Ann Kositsky Ann, I first met you when you were a mother to very young children. You were quite inspirational to me because not only were you raising children while caring for elderly parents, but you in fact were home schooling them, and quite brilliantly, I must say! Thanks to your advice, I spent many happy days at the Tilden Farm with my kids. Please share with us your decision to home school, how it was formed, what resources you used, and how you crafted such a successful education for your sons.
Home schooling was not part of my education plan for my kids until we started looking at schools for my oldest child, Aaron. He was really not ready to go onto school without his family and I couldn’t find any school to support this. In addition, my mother was one of the master teachers in Berkeley, and I would listen to her and her compatriots talk about how frustrated they were in the classroom. These were the best teachers, and they were so unhappy. I did not feel that I could subject my son to this. So we decided to home school. I had read books by John Holt on education and agreed with him that people learn best at their own pace and in their own unique ways. So we started. I found a support group for the kids and me to meet other families. Some of these people have remained close friends 20 years later.
I basically followed and supported my children’s interests. We incorporated the skills needed to support those interests. For example, Aaron was very interested in animals. The Tilden Little Farm was in our backyard, and though they never had volunteers before, the director and farmer supported our request that we volunteer as a family. When Aaron was five years old, our family volunteered weekly working at the farm. This led to studying about animal husbandry, breeding, creating and keeping charts on growth. In order to do these things, it required skills such as math and reading. These skills made sense to Aaron. When Joshua was four years old, he wanted to join the activity—so he did. The boys worked hard, they were able to assist in the birth of goats, talk with the public about the animals, care for and work with many different animals. They did this for nine years.
Aaron and friends at Tilden Little Farm When the boys became interested in birds, and we went to some classes on raptors, this lead to an 18 year volunteer participation in the Golden Gate Raptor Observatory. This scientific project monitors the migration of raptors over the Pacific Fly Way. To understand what was being done there, the boys needed to learn statistics; and in order to learn that, they needed to learn math and computer programming! We were on a team of other bird watchers, so they had an opportunity to work with others of all ages as equals. The public would come to visit and birdwatch. The boys learned to talk to strangers and share their passion. Over time, each boy became leader of a team. They participated in helping develop policies to improve team function. Aaron became an intern for a season.
Their interest in knights led to participating in the Society for Creative Anachronisms and then to studying history, economics of the time periods, learning blacksmithing and building armor and more. This led to lots of reading, planning, meeting people and discussions. Going to the grocery store was always an adventure, each kid would be given a list of products to find and to figure out the cost and best quality. Thus their learning was based on their interests and needs.
This sounds crazy, but we watched “Star Trek, the Next Generation” very regularly. This became a major part of our core curriculum. There is so much material that is presented: ethics, philosophy, physics, medicine, literature, history and other sciences. After watching a program, we would discuss the material and end up by reading myths, Shakespeare, talking with various experts and so much more.
Aaron, Joshua and friend waiting to be beamed aboard.Aaron wanted to learn Latin, so I found a good program and the two of us learned it. Joshua wanted to learn Spanish and he and I worked on this. I can’t say I taught Aaron and Joshua, I can say that I learned with them and supported them in their pursuits. This type of learning continued until they decided to go off to community college. My goal was always to support and encourage learning and curiosity. As long as they were learning and enjoying it, I continued the path. The pace did not concern me. Since each person learns at their own pace, that is what was focused on and supported.
Tell us how Aaron and Joshua are doing now. What are their dreams and pursuits?
Aaron is in a PhD program studying ornithology and Joshua has a business as a jeweler-designer and is also a Scottish highland dance teacher. Both of them have partners and are happy, creative, thinking people. They continue to be independent learners and problem solvers. They continue to study and participate in historical reenactments.
Aaron and Joshua (and Ann in the background) at an historical reenactment. What is your own educational background, Ann? How did your childhood influence your choices later in life?
I went to University to be an anthropologist. I decided early on that would not be my vocation. Instead I went into nursing. Since I have always been drawn to helping others, nursing fit me well. I continued on after my undergraduate degree was completed to earn a master’s in nursing and nurse practitioning. I also have many certificates in gerontology. I wanted to be available to help my parents and friends as they aged.
During the time I worked in the intensive care nursery, it was clear that there was no information for families going through these difficult times. I co-authored a book for parents struggling with the neonatal intensive care unit.
Though my focus was originally in neonatology and recently has shifted to gerontology, I have found there to be a lot of similarities.
Your parents were amazing and an incredible influence on your life. You were really there for them as they aged and came to depend on you. Tell us about your relationship with them, and why you decided to handle their care yourself. It was a lot to juggle while not only raising, but home schooling your young sons.
My parents were very involved in the first 13 years of my children's lives. I thought that it would be good for my parents to enjoy their grandkids, but I didn’t realize how meaningful it would be for my boys. I made an effort for the kids and grandparents to spend a lot of time with each other 3-5 times a week. My dad was an engineer and architect, so he would take them on building inspections and talk to them about the history of architecture. He also was handy at repairs, so he had them help him with projects around the house. Our home school community also embraced my parents--so they were very much part of our lives. My parents had lots of opportunities to share their values and beliefs with the grandkids—and that has stayed with them.
The kids were around and involved as my parents aged and died. This is sad—but allowed for both kids to see how to be part of an aging life. We also live in the house that my father designed and built. I am very lucky, I grew up in the house and my kids did as well.
Ann’s Dad and Mom. After your sons came to depend on you less and less, you seemed to really come into your own and found that you actually had a passion and huge talent for Care Management! Walk us through that “ah ha!” moment, and what path you took to pursue this new-found career that you love so much.
Over the last 15 years, I have been caring for various family members as they declined. I found this so very interesting that I got further training in geriatrics and Care Management. I worked for another company and decided that working on my own would be more satisfying.
You recently launched your own Care Management Company, AMK Creative Care Management. Your educational background on top of the care you provided for your folks, all seem to have led you to this perfect moment in life. Tell us about your vision for your company and how you define “Care Management.”
My goal is to support people to live as independently as possible with whatever support they need. As a Care Manager, I work closely with the elderly, caregiver(s) and/or other family members to fully understand the needs and desires of each party. I function as an independent and knowledgeable partner who will provide objective guidance on how best to care for the elder in need. Although my primary goal is to do what is best for the elder, I also understand the importance of supporting the caregiver who will likely implement the care plan. As such, my caregiver plans will include specific caregiver support and guidance to ensure they can care for their elder while maintaining appropriate energy and balance in their own lives. I strive to serve not only the elder, but also those caregivers who love and care for them.
It’s incredible to me how much is involved in Care Management. Tell us about some of the issues that you assist with and take responsibility for.
I coordinate community and medical care. I often accompany the client to doctor visits and act as their advocate. I review medications and discuss tests and the client’s condition with the medical care provider. Often the doctor contacts me to follow-up on necessary recommendations and care.
It will vary from elder to elder, but here’s just a partial list of what’s involved in my field of work and some of the services I provide:
- Provide geriatric assessment as an initial assessment of an individual's physical, mental, financial, and social needs. Creating a "Customized Plan of Care," including long-term care.
- Create personalized care plan based on individual need, preferences and situation that is free of family dynamics and bias and then provide consulting and long-term care planning.
- Provide assistance maneuvering through the healthcare system including assisting with Medicaid, Medicare, and Veteran Benefits planning and application and maximize the benefits and coverage of health insurance plans.
- Assist with domestic, legal, and financial service coordination and provide basic day to day fiscal management such as bookkeeping and monthly bill paying.
- Speak with the elder's medical providers to enhance understanding of elder care plans and to communicate concerns and then help elder and family to understand and assist in implementing a doctor’s treatment plan. Also creating and implementing a plan to facilitate safe medicine taking, scheduling and refilling as well as providing education about safe use of medications.
- Assist in scheduling of appointments with primary care doctors, specialists and other providers of care for the elderly and arrange for senior transportation to medical appointments.
- Evaluate the home safety environment to maximize the independence of the elder while minimizing safety risks and make recommendations to decrease the risk of injury for the elderly.
- Help address concerns about the elder’s ability to drive and suggest alternative transportation options.
- Determine the need for home health aides, homemakers and companions and advise on how best to obtain elder care providers of these services.
- Guide and support family and elder in the evaluation and selection of the following types of alternative living options: assisted living, skilled nursing care, long-term care rehabilitation settings, adult day care, respite care, and make on-site visits to ensure that elder is receiving the best care possible.
Learning to age gracefully is an important challenge. Our society does not support the elderly in society. We are not so used to being multi-generational families. We will all need to learn how to honor the elderly while at the same time providing care for them. Many people will develop dementia and need support as they age. Just looking at the partial list of things that I provide as a Caregiver can give you an idea of the tremendous amount of issues that can be involved for just one person.
Your approach is so hands on, Ann, and you look at things from a perspective of not only compassion, but also practicality. One such example is “Go Wish” which you introduced to me recently, and which I think is a phenomenal tool for families to use. Tell us about how this actually helped in your own family, and how important these, and other tools are in launching and facilitating what can be very tough conversations. How involved are you, as a Care Manager, in facilitating these moments in your clients’ and families’ lives?
Go Wish is a set of cards with value statements. The idea is that you identify what is important to you at the end of your life and communicate these values to significant others who will be making decisions on your behalf by prioritizing the statements on the cards.
Recently, I had surgery and before the event, I used the cards to start the discussion of what is important for me with my two boys. We each went through the cards and each of them prioritized the cards as they thought I would do. Then we compared our rankings. Though basically we were in agreement, there were some significant areas that we were able to talk about. This process led to my kids doing this for each other. I was really touched by how helpful these cards were. Talking about death is hard and asking questions like “what do you want?” can be too open ended. Having these cards as a springboard for thought and direction was so helpful. I use the cards with my clients and their families and keep a record of their responses. This is revisited as needed.
I continually look for ways to enhance my clients' lives. This means finding a folkdance teacher for one client, a Russian tea house for another so she can practice her Russian in a setting that she felt comfortable, or for others, it means getting a handyman to fix up the house to make it safer. One client would take her dog for long walks—and she was at risk for getting confused and then lost. The police found her one day and expressed their concern to the family for her safety. The client wants to stay in her own home. I found a small GPS that we placed on the dog’s leash. Now the client is safer and the family and police are not worried! Also as a side note, when the family wants to find their mother to take her to an appointment, they can easily locate her!
I am always looking to support my clients' wishes and desires. I will give my thoughts and advice whenever helpful. I support my client even if it is not the way I would do it—that is not the plan. It’s about supporting them.
Ann, do you have any seminars planned or community outreach events?
I offer blood pressure screening, Go Wish Seminars and support groups to those with aging parents. I will do an initial free one hour phone consultation with interested people.
How can Blog readers learn more about you and contact you?
I can be reached at annkositsky@gmail.com or by phone: 510/410-1984. You can also visit me on Facebook: www.facebook.com/amkccm.
So, from “Super Mom” to Care Management --- maybe not such a big leap after all, but a logical progression in Ann’s very inspiring life journey. Any of you needing Ann’s loving, well educated and thoughtful approach with family members will be in good hands.
Ann, thank you so much for sharing your journey with us and inspiring us to be brave about continuing to redefine ourselves and our passions --- both personal as well as professional --- as we evolve. You set a great example for us all to embrace life’s many changes.
Joshua and Aaron on their own journey… 