Featuring Denise Cox, Care Manager, Arosa

If you’ve been keeping up with Jared Diamond (author, anthropologist and UCLA geography Professor), you may have listened to his TED talk on how different cultures in traditional and modern societies treat their elderly. In it, he talks about how people around the globe are living longer due to improvements in healthcare, nutrition and technology, and how a society’s treatment of these elderly depends on its cultural values.

For example, in Chinese, Korean and Japanese societies, treatment of elders is based on a Confucian ideal of filial piety – a virtue of respect for one’s parents, elders and ancestors. Nearly three quarters of elders in these cultures live with their adult children. For the quarter left behind, China recently passed an Elderly Rights Law mandating that children visit their parents frequently. The law may be unenforceable, but it does alert the country to the growing problem of lonely elders and lays the responsibility for their well-being squarely on their children. In African tribal societies, to survive until old age is often considered an accomplishment, reflecting personal strength, resourcefulness, and faith. Elders are respected, obeyed, and considered a source of tribal and family wisdom.

It’s different in modern countries like the U.K and the U.S. There, says Diamond, too many of the elderly live separated from their children and lifelong friends. As their health deteriorates, those people often move to retirement communities, assisted living facilities, and nursing homes. Fortunately for those seniors, the U.S. is a country of immigrants and families of blended cultures, who bring unique values with them into their communities, and into their workplaces – particularly into the field of healthcare.

Denise Cox, Care Manager with Arosa in Coachella Valley, CA, is one such healthcare worker. She was born to a military family stationed in South Korea, and lived as a proverbial ‘army brat,’ moving around constantly. Denise’s African American father and South Korean mother instilled in her their cultural heritage – one that “honors our elders,” she explains. Some of her fondest memories are of the stable, loving times she spent with her grandparents, and it was with them she developed an affinity for the senior community. So, when Denise finished school, she got her CNA certification and worked as a caregiver in subacute and Alzheimer’s settings. She knew she was good at the work and felt she was making a difference, but wanted to do more. She decided then, that one day she’d be a nurse and do an even better job.

As with so many dreams, life and children got in the way, so she continued as a caregiver until her private duty patient made her promise to go back to school and become a nurse. She decided she would do it to honor him and his spouse and to be an example for her own daughters. So, she returned to school, graduated at the top of her class, and then she and several of her classmates applied to Arosa to begin their new careers. As a home healthcare manager, Denise is responsible for conducting a comprehensive assessment and developing an integrated care plan for her clients. Care Manager support and oversight provides peace of mind, not only to her clients, but also to their families.

One Arosa co-worker who nominated Denise for the Ceca Award shared that history saying, “Denise became an LVN and went on to be a Life Care Manager, bringing her kindness, expertise, and guidance to all those she comes into contact with.” And others who work with Denise concur, citing her commitment to making sure clients get what they need, “even if that’s ice cream at 9 pm,” and even if Denise needs to “go to purchase items for clients on weekends and after hours when she is off.” Denise also helps with staffing by calling caregivers to work, and if necessary, works shifts herself to ensure coverage for all clients. There is no task she won’t do. And she even helps other caregivers, “once purchasing a tire for a co-worker who had a flat and couldn’t get to work.”

It is for her empathy, love, compassion, and commitment that Denise Cox was honored with the Ceca Award, which recognizes and rewards the work of exceptional caregivers across the country. When asked how it felt to receive the Award, Denise said, “Oh my gosh, I couldn’t stop crying. I was truly surprised and honored, and I thank you for acknowledging our care professionals.”

In discussing her work as home healthcare manager, Denise recounted a story that illustrates her role and the extraordinary care she brings to it. One client had Parkinson’s disease, and his wife had been his primary caregiver in their home. As his needs became greater, they reached out to Arosa, and the client was placed in a long-term care facility. Their son, a doctor, and his wife lived in Boston, and they wanted additional support for both their parents. Denise became their local care advocate, visiting the client in the nursing home, providing additional care management support, and acting as liaison between the facility, the wife and the family. One day, a Meals on Wheels volunteer was dropping off food for the wife and noticed some serious bruises. She alerted the daughter, who called Denise. Denise dashed over to check on the mother, who explained she had fallen and hit her head on the porcelain bowl. Denise encouraged her to follow up and get diagnostic exams, but the mother said she couldn’t because she had no one to take her to the doctor and no one to take care of the dog. Denise stepped-up of course, took her to the doctor for exams, and happily completed dog sitting duties while she underwent testing, all of which turned out well. The grateful son and daughter-in-law then asked her to provide more care for their mother. After more falls, Denise transitioned the mom into a 6-8 person boarding care facility, which was a good fit for her personality. The mother was initially angry and resented her children, but with a steady hand, Denise and her team continued to build rapport and trust with her and the family members, and advocate for her well-being.

Denise Cox represents the best of both traditional and modern societies in caring for elderly clients. She understands that family members who live far away, need a care manager in place to monitor loved ones and communicate with family members, giving them unbiased accurate information. And because of the love and compassion of her parents and grandparents, and the cultural affinity she has for seniors, Denise loves working with and advocating for them—as caregiver, as team member, as Arosa nurse care manager, and as a friend.