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Care/Case Management Month
Tips for Caregivers: When to Think About Hiring a Care Manager
Rona Bartelstone Care Management & Home Healthcare to Hold Free Memory Screenings
Care/Case Management Month
by Rona S. Bartelstone, LCSW, BCD, CMC, C-ASWCM
Congratulations to the Care Managers who are employed by Rona Bartelstone Care Management & Home Healthcare and to the members of our network of care managers nationwide for the professional, compassionate and comprehensive care that you provide to our consumers.
Since October is Care/Case Management month, we want to focus our attention on some of the more practical reasons why individuals and families (especially adult children) engage our services. In addition to our helping them care for their loved ones, there are the more practical aspects of our providing financial cost savings and the reduction of stress and conflict that can be very costly for the family.
In most editions of Care Notes, we focus on the success of meeting the needs of the care recipient. This is always our primary mission. However, it is important to realize that there is a ripple effect that impacts the entire family system. Therefore, in this issue we are highlighting the cost savings to the family and the resultant peace of mind that comes from care management services.
Financial savings is especially felt by long distance caregivers. There is a fairly compelling financial reason to hire a care manager if long distance caregiving is resulting in any of the following:
- Unplanned time away from work;
- Last minute airline tickets;
- Expenses related to travel, i.e. meals, rental cars and hotel expense;
- Frequent trips that interfere with other family relationships;
- Conflict among siblings about “what to do about mom & dad.”
These costs can add up to a couple of thousand dollars for each trip. And each trip will no doubt bring with it emotional and physical stress, along with the frustration of not being able to “fix” the situation. Often, long distance siblings take turns visiting their parents and just as often, the care plan is changed with each visit. This causes confusion and stress for the care recipient and the support system of the care recipient.
While families who live close by do not have the same travel related expense, they have other costly burdens. Often the primary caregiver is a local adult child, who ends up bearing the burden of providing the type of hands-on support that becomes emotional and physically draining, in addition to becoming a major time commitment. This is often the child who ends up reducing or leaving employment because caregiving becomes overwhelming. If there are multiple health problems that cause multiple doctor appointments, complex medical treatments and the use of lots of prescription drugs, this is especially true. As the elder becomes more frail (of mind or body), the caregiving becomes more intense and therefore more exhausting. Lastly, depending on the nature of the parents’ illness(es) caregiving may last for many years, which takes a toll on the primary caregiver. Sometimes care management is a way for the long distance family members to help support the local caregiver.
The situations described in this issue are from actual client situations. Over the 26+ years of our business experience, we know that we have helped thousands of families to save precious (and sometimes scarce) resources, while making the most effective use of services to provide quality care. We are proud of our care managers and their devotion to working with families in a manner that supports everyone.
Examples of Cost Savings and Family Support:
Who Says that Private Hires Save Money? Click to expand/close
The children of Mr. & Mrs. S were very upset that their parents had lost their concept of money. The parents were paying two private duty aides for 24 hour care that was costing them over $500.00 dollars a day. Despite the fact that this was exploitative, neither the parents nor the family wanted to loose the good care and relationship that was being provided. The Care Manager assessed the nature of the care and felt that in fact, the private duty aides were very good caregivers. They had been with the couple for 12 years. Replacing the aides would have been emotionally catastrophic for the parents. The Care Manager was able to negotiate a more appropriate financial arrangement between the aides and the family. Both aides stayed with the parents through their final stages of life. The aides were still able to make a reasonable salary, while the family received excellent care and saved almost $200 per day!
Having to Decide to Support the Airlines or Support a Mother Click to expand/close
Mrs. J had only one son who lived in California. Despite the geographical distance he was very close to his mother and when she became physically frail, he was making frequent trips to handle her medically complex care. Because this was causing him financial, job related and emotional stress he finally hired a Care Manager. The Care Manager became the health advocate for Mrs. J and kept her son intimately informed of all of his mother’s needs and what was being done to meet them. After a serious hurricane, when the son couldn’t get to his mother because of airport closings, the Care Manager was able to transport her to her doctor in a medical crisis and essentially saved her life. Because of the excellent relationship that the Care Manager developed with Mrs. J, she was ultimately able to help her decide to move to an assisted living facility, which cost less than the up-keep on her home, and was a more stimulating environment for her. As a result of all this, the son was able to visit when it was more convenient. They saved a lot of money on airfares over a three year period, in addition to the reduced housing costs and the reduced stress of the only child.
The Younger Disabled also Need Support Click to expand/close
Mrs. K a psychiatrist in Boston engaged us to help her brother who was living in Florida with multiple medical and mental health problems. He was unable to work because of his complex health concerns that included recurrent cancer and hypertension. He was not good handling money, and despite receiving help from his sister he never had funds for the most important things, such as appropriate food and medical care. The brother was wary of public services because of prior negative experiences with public assistance programs. However, he was able to relate to the private Care Manager that his sister engaged to take him for medical care, and help to stabilize his living situation. The next step is to help the young man apply for Social Security Disability insurance for which he is eligible, even though this is a timely process. The sister is already saving money on the reduced number of visits to help her brother and she will be able to save more when he has an additional income stream from the SSDI.
Coordination of Appropriate Care Prevents a Costly Move
Click to expand/close
Mrs. V. was living in a facility where she was very happy with the transition from her home of 25 years. She is a diabetic and developed a wound on her foot. The Director of Nurses for the facility informed the family that in the lease it states “that after 30days she will be receiving a letter from management that their mother has 45 days to have her foot heal. If it doesn’t heal she will have to move to the nursing home for wound care.” The dilemma was that in order to keep the apartment she would have to continue to pay the rent at the same time that she would have to pay for the nursing home bed. This double expense would continue for as long as she was in the nursing home and planned to return to the assisted living section. The Care Manager knew that if Mrs. V. had hospice care, that she could continue to live in the assisted living section and have the necessary wound care, according to state laws. Since Mrs. V. was not ambulatory, and had other medical conditions she could qualify for hospice services until the wound healed and she could recover her ability to walk. The family saved over $7,000 per month, by not having the double expense of the nursing home and the assisted living rent for the three months that it took to heal the diabetic wound.
Accessing Public Services: A Huge Challenge Click to expand/close
Mr. W lived alone. His only relative was a niece who lived many states away, but was very concerned about his declining health status, and couldn’t keep traveling to care for him. Although he was reluctant to accept help, the Care Manager was able to gain his trust and establish a relationship with Mr. W. Gradually, he accepted the assistance of a home health aide to provide for daily assistance with bathing, dressing, meal preparation and getting to doctor appointments. The niece was relieved that she didn’t have to come to arrange all the care. After a year, Mr. W. got notification that he would have to move or pay a substantially higher rent, which he couldn’t afford. The Care Manager helped him to find and qualify for a senior subsidized housing apartment that the niece didn’t even know was available. Mr. W. now has more resources to meet his daily care needs and he is in a social, protective environment which gives his niece great peace of mind.
It Feels Great Saving Lives! Click to expand/close
The Care Manager went to see a client in a small assisted living facility. It was in a private home that the family had chosen. When the Care Manager arrived at the home the client was experiencing shortness of breath and she didn’t seem like herself. The air conditioning was turned off and it was too warm for the client. The CM inquired how long the elder had been experiencing difficulty breathing. Upon learning from the staff that she had been in discomfort since the morning, the care manager called 911. Upon admission to the hospital through the emergency room, it was discovered that they elder was in congestive heart failure. The Care Manager went with the client to the hospital and was able to provide medical history and a list of current medications for the medical staff. The elder was admitted to the ICU, and the Care Manager informed the daughters about the situation and what was being done to help their mother. Both daughters were distressed and even the local daughter felt that it was more helpful for the Care Manager to communicate between them and the doctors because they were so distraught. Fortunately, the elder made a good recovery and the Care Manager recommended that she go to a rehab facility to help get her strength back. After her rehab, the Care Manager found a new assisted living facility that would more closely manager the elder’s medical needs. The daughters were grateful and realized that the Care Manager really saved their mother’s life.
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Tips for Caregivers: When to Think About Hiring a Care Manager
by Rona S. Bartelstone, LCSW, BCD, CMC, C-ASWCM
Families often wait until they are at their wit’s end before they seek the services of a professional Care Manager because they don’t realize the extent or nature of the guidance and services that are provided. We hope that the vignettes above help to define our services a little more concretely, but here is a checklist to help you know when it makes sense to hire a Care Manager.
Think about Engaging Care Management Services when:
- There is a new diagnosis of a chronic or acute ailment that will mean that your loved one will require increasing amounts of medical care and emotional support over time;
- The care giving spouse pre-deceases the care recipient;
- There is a change in the spending patterns of an elder and it is unclear where the funds are going;
- Traveling long distances to provide care is becoming a frequent occurrence; There are disagreements among adult children about the most appropriate ways of caring for a parent;
- The primary caregiver begins to feel physically or emotionally burdened; Parents refuse to discuss care needs and suggestions for care despite complaining about needing help;
- Parents insist that the only one who can care for them is one particular child or an unrelated person, whose motives may not be beneficent;
- There are clear changes in the ability to function and meet the daily needs of the individual or couple
- There are changes in the decision making capability or judgment of a loved one;
- There are changes in appearance or mood that are inconsistent with the person’s prior patterns;
- When there is evidence of a grief reaction or depression that the person won’t discuss and refuses to seek help;
- The relationship with a parent has always been strained, but there is a clear need to provide care by an objective professional.
Rona Bartelstone Care Management & Home Healthcare is your eldercare and chronic care expert. Call upon us when you have concerns and we can help you to figure out the most appropriate and cost effective means of providing care. Don’t wait for the crisis! We’re here now and ready to serve you.
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Rona Bartelstone Care Management & Home Healthcare to Hold Free Memory Screenings
National Event Stresses Importance of Early Diagnosis
FREE Memory Screening
Tuesday, November 13, 2007
10 am – 4 pm
Rona Bartelstone Office
Map & Directions
Individuals concerned about memory loss can take advantage of free screenings as
part of National Memory Screening Day, an annual event presented by the Alzheimer’s Foundation of America
(AFA) to promote early detection of Alzheimer’s disease and related illnesses.
For more information Click Here
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