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Care Management – Building on Strengths
Making “Friends” with Assistive Devices Helps to Overcome Stigma
National Professional Social Work Month
Care Management – Building on Strengths
by Rona S. Bartelstone, LCSW, BCD, CMC, C-ASWCM
This month we take time to congratulate all of our care managers who are also Master Degree trained Social Workers. The national theme for Social Work Month this year is “Building on Strengths.” This we believe is consistent with our role as care managers working with older adults, the chronically disabled and their families.
When we work with families, we always want to learn the perception of each family member toward the concerns for the person who needs care. We also want to know the perceptions and definition of need by the potential care recipient. This is so that we can attempt to “start where the client is” – a primary tenet of social work practice. By starting with the consumers’ definition of the problem or challenge, we can help them to focus on their perceived needs, while also taking a more holistic perspective of the situation.
When appropriate the social work care manager arranges, coordinates, monitors, evaluates and advocates for a package of multiple services to meet the needs of the client based upon a comprehensive assessment. The assessment of needs includes the perceptions of all the individuals involved, as well as the objective professional assessment of the social work care manager. This assessment includes issues such as medical diagnoses, social situation, emotional needs, environmental/safety issues, medication and nutritional concerns, as well as functional and cognitive capabilities. Additionally the spiritual needs of the client will be considered and addressed as appropriate to the situation.
The goal of social work care management is to help the care recipient and their support system to be as functional and independent as possible. This often means helping the consumer to direct their own care so that it is consistent with the goals, wishes and lifestyle preferences of the individual and family. This requires a relationship of mutual trust between the social worker, the care recipient and the support system. Within this system, the social work care manager will always attempt to support the strengths of the system, while filling the gaps with a combination of public and private services from the community.
This approach helps the care recipient and the family to formulate a customized plan of care and individualized strategies for meeting needs. The care manager will act as an advocate with other caregiving systems, such as physicians, home healthcare workers, family members, and community services to assure that the care and the transitions between settings are of the highest quality.
While consumers may view social work care management as an expensive service, it has been documented that the intervention provided by a private care manager can be cost saving to both families and healthcare systems. Often, the care manger’s on-going monitoring of an individual’s situation will lead to intervention in health, medication and emotional issues before they become catastrophic, and therefore more expensive. Likewise, care managers will help the family to make decisions that are best suited for the individual and family, thereby avoiding mistakes that can be financially, emotionally and physically expensive.
We congratulate the professional social workers who dedicate themselves to supporting families in coping with these issues of chronic disability and age related challenges! Thank you for using the strength of your caring and professionalism to support the strengths of the aging population and specifically our clients!
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Making “Friends” with Assistive Devices Helps to Overcome Stigma
by Rona S. Bartelstone, LCSW, BCD, CMC, C-ASWCM
I recently heard a very powerful story of an individual who was struggling to accept her sense of independence and dignity in the face of debilitating physical changes. This woman was accustomed to being in control of her own life, in every way. She had been a working woman, she was involved in the community and with her family. She still drove in her mid-eighties.
When severe skeletal problems began to challenge her ability to function independently, Mrs. Franklin tried everything to strengthen her muscles and maintain her balance. She went for therapy, she exercised at home, she tried to maintain a positive attitude.
When the therapist told her that she would need a cane for stability, she fought against it with all of her will. What she found was that she was becoming limited in her ability to participate in life because of a fear of falling. In desperation, she finally agreed to try a cane. She was angry about needing the cane so she told it so…sort of like my rants against my computer when I can’t make it do what I think it should!
This talking to her cane was not a delusion. It was the very real venting of feelings about the fact that our sense of self is often compromised when we are suddenly dependent in ways that we never want to anticipate. She was getting out her disappointment and her frustration. A healthy coping technique!
In adapting to the new image of herself, Mrs. Franklin finally “befriended” her cane by giving her a name. Gertrude was the friend upon whom she could lean to give her a little more freedom and independence, instead of giving in to social isolation. Mrs. Franklin wasn’t happy about “needing” Gertrude, but she certainly was pleased when she was able to attend her granddaughter’s college graduation because of Gertrude.
As time progressed, Mrs. Franklin found she needed even more support. It was no longer enough to have Gertrude to lean upon. She found that she would become winded after walking any distance and it was hard to carry things when using the cane. Still feeling independent and wanting to maintain her social and volunteer activities, Mrs. Franklin gradually came to accept a walker with a seat and a basket for her outings. His name is Sam! Sam is the lap that she can sit in and the one who does the heavy lifting that is too much for Mrs. Franklin.
Mrs. Franklin is a feisty woman, who is determined to maintain as much of her lifestyle as possible, despite physical changes that are out of her control. She has found a healthy way to adapt without loosing her sense of self. Imagine the strength and determination that took!
Tips for Introducing Assistive Devices:
- Introduce the idea slowly. Plant the seed that a little help can often ensure a lot of freedom.
- Take training with the care recipient, so that you understand what it is like to use an assistive device.
- If appearance is important look for devices that are more sophisticated in appearance or that can be improved upon with stylish bins and comfy seat covers. I have seen some outrageous canes that are just grand!
- “Befriend” you devices with names and personalities so that they become part of your identity rather than a burden.
- Take pride in your strength…you have always adapted to challenging life circumstances in the past and you can do it again, if you choose.
- Reaffirm that sometimes a little dose of support, enables a large measure of independence and dignity.
- Use humor to overcome the resistance to the need for assistance – this is also a strength and a good outlet for negative feelings.
- And remember the old song from Cabaret…”no good in sitting alone in your room, come hear the music play!” Get out and go! You will be happy you did!
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National Professional Social Work Month
by Linda Kartell, LCSW
President Ronald Reagan first proclaimed March as National Professional Social Work Month in 1984. We at Rona Bartelstone are taking time to think about not only what we do but how we do it and why.
Professional Social Workers, in the role of Care Managers, understand that to approach people in need requires establishing a partnership with the individuals and families we serve. We are trained to look at each person as endowed with worth and dignity. We are trained to look at the situations and circumstances people are in not where we might think they belong. We are trained to help people actualize and realize their choices and their preferences and to help people use their strengths to make the decisions that are right for them.
We understand that as we age we may need a bit more help, a bit more time to do things, a bit more support, a bit more people, places and things to lean on, and we also know how to help people use their strengths and skills and life knowledge to stay as independent as possible for as long as possible.
Our Care Managers, Social Workers and Nurses are much more than the employees of a care management and home healthcare company. We have and are mothers and fathers, spouses, sons and daughters, grandchildren, sisters and brothers, friends and neighbors. We understand and feel about things both as professionals and personally.
The people we serve are much more than the clients of a care management and home healthcare company. They are just like our mothers and fathers, spouses, sons and daughters, grandchildren, sisters and brothers, friends and neighbors.
We are grateful for the following words issued by the State of Florida in recognition of March as Social Worker Awareness Month.
"Everyday social workers across the state fight for Florida's families and for Florida's future. Their energy, compassion and dedication are nothing short of staggering. During this month, we pause to remember all that social workers do."
Bob Butterworth, Children and Families Secretary
"This year's theme "Building on Strengths: Help Starts Here" - highlights the unique education and training of the nation's 600,000 social workers who work with families and communities to strengthen and support them during challenging times. Social workers understand that the foundation for growth and change in individuals, families, and communities are their strengths."
Jean Kline, R.N., B.S.N., M.P.H., Deputy Secretary for Health
We use our knowledge, our training, our experience, and our ethics to help people struggle with the demands of life that, from time to time, confront us all. We learn with and we learn from our clients. We encourage growth and hope for our clients and for ourselves. From our family to your family, we are proud to be a Social Work company and we are grateful for the trust and confidence that people throughout the nation place in us.
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