Care Management Techniques You Can Use
Did you ever wish you could just pick up the phone and call someone
who would take stock of your situation, help you access the right
services, counsel you and your family to help resolve some of your
differences, then monitor your progress with an eye toward channeling
your energy and abilities as effectively as possible? If your answer is
“yes,” you’re not alone. Having the help of a care coordinator (often
called a care manager) could make all of our lives easier and less
lonesome, and help us be more capable family caregivers. While most of
us may not have access to a care coordinator, we can all learn how to
think and act like one, thereby reaping numerous benefits for our loved
ones and ourselves.
What Is Care Coordination?
Although every case is different, the care coordination approach usually involves:
- Gathering information from healthcare providers;
- An assessment of your care recipient and the home environment;
- Research into available public and/or private services and resources to meet your loved one’s needs; and
- Ongoing communication between all parties to keep information up-to-date and services appropriate and effective.
an assessment of your abilities and needs is not necessarily a standard
part of the process, but it should be. A complete view of the situation
cannot be gained without one. An objective analysis of your health,
emotional state, other commitments, etc., are key elements in
determining how much you can and cannot do yourself, and what type of
outside support is needed to ensure your loved one’s health and safety.
Become Your Own Care Coordinator
By learning and applying at least some of the care coordination
techniques and ideas that follow, you’ll be in a much better position
to develop an organized course of action that will, hopefully, make you
feel more confident and in control — a goal well worth working toward.
Educate yourself on
the nature of the disease or disability with which you’re dealing.
Reliable information is available from the health agency that deals
with your loved one’s condition and the National Institutes of Health.
When using the Internet, stick with well-known medical sites.
Understanding what is happening to your care recipient will provide you
with the core knowledge you need to go forward. It will also make you a
better advocate when talking with healthcare professionals.
Write down your observations of the present situation including:
- Your loved one’s ability to function independently, both physically and mentally.
- The availability of family and/or friends to form a support network to share the care.
- The physical environment: Is it accessible or can it be adapted at reasonable cost?
- Your other responsibilities — at work, at home, and in the community.
- Your own health and physical abilities.
- Your financial resources, available insurance, and existence of healthcare or end-of-life documents.
assessment will help you come to a realistic view of the situation. It
will let you know the questions to which you need answers. It can be a
handy baseline for charting your caregiving journey and reminding you
just how much you’ve learned along the way.
Hold a family conference.
At least everyone in the immediate family should be told what’s going
on. A meeting can set the stage for divvying up responsibilities so
that there are fewer misunderstandings down the road when lots of help
may be needed. A member of the clergy, a professional care coordinator,
or even a trusted friend can serve as an impartial moderator. A family
meeting is a good way to let everyone know they can play a role, even
if they are a thousand miles away. It can help you, the primary family
caregiver, from bearing the brunt of all the work all of the time.
Keep good records of
emergency numbers, doctors, daily medications, special diets, back-up
people, and other pertinent information relating to your loved one’s
care. Update as necessary. This record will be invaluable if something
happens to you, or if you need to make a trip to the ER. If you can
maintain a computer-based record, that will make updating all that much
easier and it might even allow you to provide the medical team with
direct access to the information.
Join a support group,
or find another caregiver with whom to converse. In addition to
emotional support, you’ll likely pick up practical tips as well.
Professionals network with each other all the time to get emotional
support and find answers to problems or situations they face. Why
shouldn’t family caregivers?
Start advance planning for difficult decisions
that may lie ahead. It’s never too early to discuss wills, advance
directives, and powers of attorney, but there comes a time when it is
too late. It is also vital that you and your loved one think through
what to do if you should be incapacitated, or, worse, die first. It can
Develop a care team to help out
during emergencies, or over time if your situation is very difficult.
In an ideal world there will be lots of people who want to help. More
likely you’ll be able to find one or two people to call on in an
emergency or to help with small chores. The critical thing is to be
willing to tell others what you need and to accept their help.
Establish a family regimen.
When things are difficult to begin with, keeping a straightforward
daily routine can be a stabilizer, especially for people who find
change upsetting and confusing.
Approach some of your hardest caregiving duties like a professional.
It’s extraordinarily difficult to separate your family role from your
caregiving role, to lock your emotions up in a box while you focus on
practical chores and decisions. But it is not impossible to gain some
distance some of the time. It requires an almost single-minded approach
to getting the job at hand done as efficiently and effectively as
possible. It takes practice, but is definitely worth the effort.
©National Family Caregivers Association | www.nfcacares.org | Phone: 800/896-3650
Questions to Ask Your Healthcare Providers
Review this list of questions as you are planning and preparing for any interaction with the health care system (e.g., doctor visit, trip to the emergency room, hospital discharge planning
session, etc.) The questions are organized by category. Select the questions that best fit your
needs. Feel free to add your own.
About Medical Care in General
- What might have caused this illness?
- What is this illness called?
- Is this illness likely to go away on its own?
- Is the pain likely to diminish or go away?
- How do you want to treat this illness?
- What are other ways to treat this illness?
- What are the risks with these treatments?
- What is the likely future of this illness with the recommended treatment?
- Without the recommended treatment?
- What is the time frame for the treatment?
- Is a hospital stay necessary?
- What is the expected recovery time?
- What lifestyle changes can my care recipient expect in the future?
About Medical Tests and Procedures
- Is the recommended test or procedure necessary to confirm or disprove a diagnosis?
- Will the findings of the test change the way the disease is managed?
- What are the risks involved?
- What happens if my care recipient refuses to undergo this test?
- How expensive is the test and is it covered by my insurance?
- Will the test require a change in any of the medications my care recipient is taking?
- What are the chances of inaccurate test results?
- What is the test procedure?
- How will the test feel? Will it be painful?
- How should I help my care recipient prepare for this test?
- Will my care recipient need help getting home afterward?
- Who will interpret the test results?
- Will someone call with the test results or should I phone for them?
- Can test results be sent directly to me or my care recipient?
About How the Doctor’s Office Works
- What days/hours is the office open?
- How are medical emergencies handled?
- When is the best time to reach the doctor by phone, fax or e-mail?
- Which method of communication does the doctor prefer?
- Who can answer questions if the doctor is not available?
- Who can I call after hours or when the doctor is away?
Regarding the Costs of Medical Care
- What private insurance plans do you accept?
- Do you accept Medicaid/Medicare assignments?
- What costs are covered by Medicaid/Medicare? Supplemental insurance?
- What costs are not covered by insurance?
- Approximately how much can I expect to pay in the long run for treatment?
Regarding Discharge Planning
As part of the discharge planning process, many issues related to the patient’s care need to be
resolved. As soon as you know your loved one is going to be admitted to the hospital, find
out who is in charge of the discharge process and arrange a meeting to gather specific answers
to the following questions.
- Where is the patient going to go after discharge? (Return to the previous setting? Go someplace else temporarily? Move permanently to a new location?)
- Who will provide additional home health care if it is needed?
- Does the patient need any home health equipment? What kind?
- Do physical and/or occupational therapy visits need to be arranged?
Information on Seating & Mobility
Seating & Mobility As a caregiver, you need to
be very understanding to the individual's needs. This is a very hard
time as they are being told they need to start living their life in a
different manor than they had done so previously. It will be most
beneficial to educate them, either with a professional, or through a
support group. By becoming involved in different activities with others
in the same condition, the individual will be able to make the
transition much easier. As far as the actual device, you will want to
make sure that the individual is fully capable of performing all the
operations of the mobility device and can do so in a comfortable
manner. Areas to pay close attention to include an adjustable backrest,
a suspension system, a fore-and-aft track adjustment, an up-and-down
seat adjustment, an armrest and/or footrest, and lumbar region support.
How do you care for your mobility device? The most important areas that you need to pay attention to are referred to as the 3 B’s…Bad batteries, bent wheel rims and failed bearings. If
you notice something that doesn’t seem right, but it isn’t all too
annoying, you should still get it looked at right away. This could
prevent a more severe accident from happening. So as the saying goes
“it’s better to be safe than sorry”.
When a wheelchair is
purchased, you will want to make sure that all the correct adjustments
and modifications are made. This needs to be done by a professional and
should take up to a couple of hours if done correctly. As long as the
proper measures are taken initially, the work of maintaining the device
will be substantially easier.