I love my job, but when most people ask me what I do, it’s really hard to describe what geriatric care management is. After several attempts to define care management with a variety of fancy ‘industry’ lingo like assessment, coordinate and monitor, I was lost for words. The obvious return blank stare indicated that – this is a strange new world. I therefore deducted, it was easier to describe care management by telling people what we do for clients. Care management often begs the question – how can you quantify peace of mind? How can you measure the impact of caring? How can what we receive be more powerful than what we give? Perhaps I can best describe what I do from the page of my diary…
I met Gene for the first time today. He was referred to our organization by a social worker at a local home health agency. Our initial assessment took about two hours. Gene was 74 years old and had limited family support and a monthly income of $1,100. He was eligible for Veteran’s benefits and needed the assistance of a home care aide. He couldn’t drive due to severe arthritis, Parkinson’s disease and limited mobility. Gene agreed to retain our services for a rate of $5.00 hour.
Home visit to client to discuss VA application process and upcoming appointment with new physician.
Spoke to VA clinic representative about setting up doctor ’s appointment and Aide and Attendance benefits.
Home visit to client to assist him in completing Aide & Attendance paperwork. We continue to build rapport and address safety issues, healthcare issues and social support. Gene has a knack for springing a “mini-crisis” at the last minute at every home visit. (For example, did I mention the time after months on working to get Gene help in the home through the Veteran’s Aide and Attendance program, he reluctantly informed me he had a long-term care policy since 1998 and it covered assistance in the home!)
Home visit to client to arrange appointment with urologist and VA clinic appointment. Client has numerous safety concerns and has fallen several times in the home. I encourage setting up LifeLine services. Today, I assisted client with opening the mail. Gene has difficulty holding many objects due to the tremors in his hand from the Parkinson’s disease. Attempted to organized ‘important’ papers in some logical order as Gene has financial statements, legal documents and bills starting from 1960 in every drawer in the house.
Over the next several months, I continue to visit Gene weekly and assist him with managing life issues. We continue to work through the “system” filling out applications and gathering information to take to the local Veteran’s Affairs office. Gene’s eyesight is so poor, he has great difficulty reading. After much resistance, but with Gene’s permission and blessing, I arrange Life Line and home care services. To my disappointment, during the next home visit, I discover Gene declined both these services, despite how badly he needs them. We’ll continue to work on those issues.
My experiences as a care manger transcend into many dimensions and roles. I am a surrogate daughter often wondering why he makes poor decisions, yet I continue to support and cherish him as if he was my father. I am an expert in insurance benefits, prescription drug plans, Veteran’s benefits, medical conditions and family therapy. I am his advocate and champion when no one else wants to be. I must listen and care despite the constant obstacles. I am there even when I don’t want to be.
As my day ends I wonder what would happen to Gene without someone to watch over him. How important it must be to have independence and control over one’s own life decisions. And how marvelous to know there are many resources and services that Gene can use to give value and meaning to his life. So, the next time someone asks what I do…. I’ll tell them, I’m in the business of caring.