Saturday, January 22, 2022

Prevent the crisis: care management choice for caregivers



No matter how much stamina they have, caregivers need a reprieve from providing around-the-clock care. If they suffer from exhaustion or become ill, they can no longer fulfill their promises or responsibilities. I can vividly remember telling my parents that, if anything ever happened to them, I would never place them into a nursing home but would take care of them, and I meant it! Have you made this promise to your parent(s) or aging loved one?  Even as a nurse with more than thirty years of training care giving can be an overwhelming task; and although rewarding, it can create countless physical, medical, and financial issues for caregivers.

The desire for family members to keep loved ones at home, or to “age in place” has created the emergence of many related healthcare services: senior care management, home health care, adult day services, and various non-medical and custodial types of care, as opposed to care in an institutional setting. The ultimate goal is to keep our loved ones in the home for as long as safely possible.

According to a study by Met Life Mature Market Institute in conjunction with Life Plans, Inc., in 2008, many baby boomers are seeking quality care for frail or ill parents who are unable to stay at home alone. Some (an adult child, spouse, or sibling) want an option that allows them to go to work. Others live far from their aging loved one and can’t just pick up and travel freely to check in on them. And there are those who are looking for some relief from 24/7 care-giving. Caregivers desire an option that is reliable and stimulating yet affordable, but they cannot navigate the fragmented health-care system alone, especially when they are long-distance caregivers.

This is the time to look for a Senior Care Manager! These are professionals who specialize in assisting older adults and their families to establish short- and long-term care needs. Care management is truly a holistic approach to caring for an aging adult. Care managers are problem solvers who match seniors to the appropriate services needed and they monitor their outcomes.

As an advocate of the client and the family, this service provides a series of steps including developing an initial personalized assessment of, at a minimum, the client’s health, lifestyle and home environment for safety hazards, and a review of medications and the physician orders so they can develop a comprehensive plan of care. Plans may encompass financial planning, bill paying, transportation and other services necessary to lighten the burden on the family.  Most care managers are RNs, social workers, or case managers with experience in geriatric care, but they also have a keen knowledge of the availability of local resources in order to provide the family member the most professional goal-oriented care possible. The care management process improves the quality of life not only for the aging adult, but for all family members involved because the services can save the family both time, money, and stress. The senior-care manager acts as an extension of the family. Most are on call 24/7, year-round, and communicate with family members on a regular basis, allowing the family and the aging adult to make informed and appropriate decisions regarding any long-term needs if and when necessary.

More than 44 million families and other informal care-givers provide the vast majority of the long-term care in this country. Most have limited preparation for the job and receive limited ongoing support, although they contribute more than $350 billion annually in uncompensated care, according to a most recent AARP report.  To meet the goal of keeping the client as independent as possible and autonomous in decision-making, the care manager is the “eyes and ears” for family members.

Home-health-care staff can be hired through an agency or registry, or privately.  Because every state has the authority to license and regulate its home-care agency system, there are often variations, with the exception of Medicare-certified agencies that must comply with federal regulations.  Typically provided by nurses, therapists or specially trained home-health aides under the direction of a physician or nurse, skilled-care services are needed after an acute event, such as a heart attack or stroke, once a patient has been discharged from a hospital and/or requires rehabilitation services.

Paraprofessionals (home-health aides and nursing assistants), custodial or supportive care provides hands-on assistance to people in their homes who need help with activities of daily living, such as bathing, dressing, eating, toileting or continence. Homemakers or companions provide services that include light housekeeping, meal preparation, transportation and companionships. This type of care is often appropriate for those with Alzheimer’s or other forms of dementia, or people who may be physically healthy but require some supervision and interaction.

Don’t feel guilty about hiring a care manager in order to lighten your labor of love in your role as a caregiver! Having a third party who is not a family member can allow for more objectivity and may help seniors see things from a different point of view. Having a professional opinion as opposed to those of family members may make the decisions less burdensome.

Paula Camposano Robinson, RN, is co-founder and owner of Sanitasole Senior Health Services. This is an information-only column and is not intended to replace medical advice from a physician. Email or visit for more information. Phone: 239.394.9931.

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