Care management as an integrated component of services to older adults is booming and becoming a more typical component of the team of professionals who help families through the eldercare maze.
Care management has evolved from a social model of care based upon a social, functional or medical need. Often these are chronic-care concerns resulting from changes in the social environment (i.e. loss of a spouse); the need to cope with a chronic illness (i.e., Alzheimers disease, developmental disability, etc.); a change in functional status caused by physical or emotional impairment (i.e. Parkinsons disease or depression); environmental changes caused by deteriorating living arrangements; or cultural changes that leave the individual unsafe and /or socially isolated. Assistance for decision making about end-of-life issues, care alternatives and surrogate caregivers may also trigger care management. Care management sometimes has the opportunity to be proactive, which can lead to better compliance with care, stabilization before a crisis and an individualized plan of care. The care manager often focuses on empowering the client and the support system to maintain a level of functioning and a quality of life. The care management process includes the following components:
- Intake
- Assessment
- Care Planning
- Care Implementation
- Monitoring and reassessment
- Quality assurance and advocacy
- Termination when appropriate
Care managers, as defined by the National Association of Professional Geriatric Care Managers (GCM), are professionals who are trained and experienced in the assessment, coordination, monitoring and direct delivery of services to the elderly and their families. Their goal is the advancement of dignified care. Care managers are committed to maximizing the independence of the elder, while striving to ensure that the highest quality and most cost-effective health and human services are used.
Families often struggle with the fact of caregiving without identifying the true nature of the work that they are doing and the struggle that they encounter. We dont think of ourselves as “caregivers”, rather we define our role by the relationship that we have to the care recipient. I am my mothers daughter, my husbands wife, and not their caregivers! This makes it challenging to reach out to families when they are facing all of the difficult decisions and choices around the care being provided. This is why families look to their physician, hospital and Medicare providers to refer them to qualified care managers!
Care managers also can assist in implementing and monitoring long-term care plans. The goal of this process is to provide an individualized service that maximizes the elders independence and dignity. This allows involvement of the family, without the burdens of guilt and helplessness. The customizing of care plans is becoming increasingly important as managed care and social services move toward the use of protocols and clinical pathways that can result in one-size-fits-all solutions.
Questions to ask when looking for a qualified care manager:
- What is the care managers professional training that prepares her to work with elders, those with chronic illnesses, and their families?
- How long has the care manager been in practice? Is this a full-time or part-time endeavor?
- What licenses or certifications does the care manager hold that permit functioning at the independent level of practice?
- What are the care managers hours and how can she be contacted in a crisis? Does she have an on-call system for after hours, weekends and holidays?
- In a solo practice, how does the care manager provide backup or coverage during illness or vacation?
- In a larger practice, what are the staffs professions and qualifications? Do they work under supervision? Are they employees or independent contractors?
- What are the fees for service? How often will you be billed? How can you control your expenditures?
- Which services does the manager provide directly? Which are arranged through outside provider? What is the care managers role in relation to other providers, especially after the referral is made?
- How does the manager keep the family informed? How often?
- Does the care manager or the practice have references that you can contact if you have not been referred through a personal recommendation?
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Care management is a consumer-centered service that helps clients navigate the health care and social services systems, assisting elders in meeting their own unique goals. It is rooted in a trusting, caring relationship between the care manager, the family members, and of course, the person receiving care. Elders and their families remain in charge of all decisions, including who provides the care, where it is provided, the amount of expenditures, and the duration of care.
Since care management currently is an unlicensed discipline in most states, families need to make certain that care managers have the education and experience to effectively perform their duties. Thats why most care managers in private practice come from human service fields like social work, nursing, psychology, mental health, gerontology or family therapy. Below are some questions for consumers to ask when looking to hire a private care manager.
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