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What is Care Management?

Why didn’t I call your organization earlier?
We so often hear this question when a client contacts us in response to an immediate need for a family member. More often than not, that family member is in a hospital or a rehabilitation center, ready for discharge the next day, and unable to care for himself. Suddenly, the family faces a very real dilemma.

Concern for the safety of an elderly parent (or parents) living independently is another all too common scenario. Mom or Dad has grown forgetful and disorganized, isn’t navigating in the home well, and continues to drive, even though she or he really shouldn’t. Often, by the time we receive this kind of call, families are operating reactively. Emotions are running high and family members frequently disagree about what to do. They want realistic options and potential solutions fast.

As we face issues of aging and end of life with our clients, our loved ones (or even ourselves!) preparing for a change in health should be top on our list of priorities. Too often, it never makes the list at all. I’m convinced that the drama and enormous strain these emotionally charged care-related situations place on families can be improved vastly if professionals proactively engage in health care planning, just as we do in estate and financial planning. It can be as simple as knowing in advance who to call and when.

What should I do?
When clients ask us this question, care management is usually the answer. Care management should be an integral part of any well-planned health care delivery system.

What is Care Management?
Though some people have heard the term, few seem sure of its meaning. Care management encompasses a variety of activities and steps required to properly plan for and deliver care to a person whose limitations prevent him from caring for himself. It often includes the coordination of client access to various community-based services.

The main components of care management include the following:

The care management function takes the burden of determining what’s best for mom or dad, for example, and the onerous task of finding and arranging appropriate services, off the family’s shoulders. Understandably, families find this an immense relief.

Who is the Professional Care Manager?
The professional care manager is a health and human services specialist who formally assesses the needs of the individual and then creates, coordinates, and monitors his care plan. The care plan might include transportation to doctors’ visits, home health aides to assist with activities of daily living, and any number of other nonmedical services. Most care managers are trained and experienced in fields such as social work, nursing, geriatrics, psychology, or other disciplines related to health care or mental health.

Some care managers work specifically with older adults to help them attain and maintain their maximum functional potential. These geriatric care managers serve as specialized resources for families of older adults and others with chronic illness, including people suffering from Alzheimer’s or Parkinson’s disease, or those exhibiting symptoms of dementia. It’s best to look for geriatric care managers who are members of the National Association of Professional Geriatric Care Managers (NAPGCM). As members, they commit to a prescribed code of ethics and standard of practice.

The Primary Challenges
Lack of awareness
Many people do not realize care management services even exist, let alone understand the role of a professional care manager. In other words, families of individuals who need support (and sometimes even their professional advisors) don’t know what they don’t know, until they are thrust into a situation where they are trying to find and coordinate services on their own. Education is one of the greatest hurdles, but testimonials from our clients tell us that once they get the concept and experience the service, they wouldn’t trade it.

Cost concerns
The economy has had a dramatic impact on service organizations and their clients. Care managers should strive to develop a cost-effective, comprehensive care plan that meets a client’s needs and budget. At first, clients may question the expenditure; they may not initially realize that having a care manager is an investment that will pay significant personal dividends in quality of care and peace of mind.

Choosing a trusted resource
The health care system is an incredibly complicated maze to navigate, even for an experienced professional. Clients caught in a family predicament feel predictably overwhelmed. This is where a highly credentialed, experienced care manager proves invaluable. Care managers should have extensive knowledge about the cost, quality and availability of health care and long-term-care services in the communities we serve. They have access to programs that families and their professional advisors may never know about otherwise. They manage every detail with the goal of restoring our clients’ independence wherever possible.


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Boomers Resource Guide is a special supplement to the Senior Citizen's Guide