Of all the services Covell Care provides, Geriatric Care Management creates the most questions. Families don’t understand what a private care manager does. People have met care managers in other settings like hospitals and home care agencies and think all care managers do the same thing. Think again.
Geriatric Care Managers (also may be referred to as an Aging Life Care Professional) wear a multitude of hats when working with Covell Care clients. They may sit down with families and review concerns, plans for the future and give expert advice and guidance while breaking it down into tangible steps. Care managers may be tethered to a family throughout their loved one’s life through aging, dementia, disease progression, hospital stays and even hospice. The relationships between families and care managers are deeply personal on both sides. There is very little red tape in hiring a care manager because insurance rules and regulations do not limit all that a care manager can do. It can be incredibly powerful to remember that because insurance doesn’t pay for a service you can still receive it.
As anyone that is involved in the aging process with a loved one knows, the experience can be overwhelming, stressful and possibly the hardest thing a person will experience. There are so many moving parts in the aging process. You may have to tend to a loved one’s medical needs, physical changes and hardships, medication regimes, memory loss, personality changes, pain, recovery from surgery, safety concerns, incontinence, quality of life, adding ramps, grab bars, shower seats to the house, arranging appointments and maybe unexpected trips to the ER. The list can feel endless. On top of all of the moving parts, our current healthcare system is far from simple and navigating the system is harder than ever. A Geriatric Care Manager can co-pilot this process with a family offering emotional support, expert guidance, simplifying the most complex of situations and advocate for a family and their loved one throughout it all.
During a recent personal experience, I was reminded not only of the benefits of working with a care manager but really how imperative it actually can be.
About a month ago my husband and I flew home from vacation in Europe. Upon our return, my husband began to experience severe pain in his lower rib area. Within 24 hours of being home we were in the ER where a radiologist discovered my husband’s lungs contained multiple blood clots–also known as pulmonary embolisms. His pain stemmed from the damage the clots were causing inside the lungs and after multiple medications designed to curb the pain, one finally worked and he could rest. My husband was admitted to the hospital for 4 days. During that time, it was also discovered that he had two blood clots in his right leg. Because of the pain medication, my husband’s thinking was not clear and he relied on me to talk with the docs. As he improved, he continued to wear oxygen during the day and night to support his lungs.
I participated in monitoring the saturation of the oxygen by using the hospital’s pulse oximeter–a machine that simply measures how much oxygen is in your blood (the goal in Colorado should be always over 90%) and how many beats per minute the heart is beating. Throughout the 4 days, my husband could maintain good saturations without the oxygen when he was up and walking around. When he would rest, his lungs would then breathe more shallow and his oxygen saturations would drop below 90%.
Once we were given discharge orders from the hospital we headed home–without oxygen and without an order to receive it. I used my home oxygen monitor and discovered he was continuing to drop as low as 68% once we were home–this is not an acceptable oxygen level for anyone.
What followed next was incredibly stressful. We called his on-call doctor to report the findings. Because the hospital record did not indicate oxygen levels had dropped the doctor would not write orders for home oxygen. The records at the hospital were incorrect and no matter what I explained, the doctor wouldn’t budge. So, I called the hospitalist and received the same information. I called the nurse that took care of my husband in the hospital and she was certainly frustrated that oxygen had not been ordered but her hands were tied. I called the on-call doctor again. I took my husband to the ER and explained he would not drop below 90% unless he fell asleep–and he obviously wouldn’t be sleeping in the ER bed. No oxygen was ordered. I called the oxygen company. Nothing could be done without the doctor’s order. I was frustrated to tears. Because the health care providers were not helping (this all happened over a weekend) I knew we had a doctor’s appointment on Monday so we propped him up on pillows to help elevate the chest and lungs creating a better chance for him to breathe better at night and I woke him up every 1-2 hours. By the time Monday had come, I was as tired as he was.
What would have happened if I didn’t have a health care background? My husband would have continued to sleep every night dropping into those low numbers which can lead to passing out and not being able to wake up, long-term impairments and longer healing time for the lungs and potential other harmful–possibly fatal– issues. Luckily, we knew how to work towards getting a resolution and jumped through hoop after hoop.
These are the types of things a care manager can step in and help with. If I would have had a care manager in place would we have even made it out of the hospital without the order for O2? More than likely, a care manager would have ensured all the I’s were dotted and T’s crossed and the oxygen would have been ordered without all the headaches (we did receive the home oxygen unit on Monday!). A care manager could have stayed at the hospital with him waiting for the doctor when I had to go to work for a few hours to see clients of my own. I ended up missing the doctor’s visit and my husband had forgotten to ask several of the questions about the medications. Once I returned, the doctor was on to the next patients and didn’t return to repeat the information. That extra, knowledgeable, patient advocate would have really helped! The second night my husband was in the hospital the nurses wanted us to do education about his injectable medication at 10pm. Because of the jet lag, the previous late night and early mornings I was so tired I don’t remember driving home that night. A care manager could have potentially arrived at that 10pm time to participate in the education on my behalf. The list goes on and on. And this is only for a 4 day hospital stay. Can you imagine all the things that can go haywire with longer stays?
I share this experience with you to help frame where the Geriatric Care Manager could potentially fit into your life. Not only in the hospital for more acute issues but in the day-to-day. Hiring a care manager will make things easier and even make things better overall because details won’t get missed or forgotten. The pressure can ease up from you being the one-and-only person to keep it all together. Less stress. Less tears. More sleep. More time. More clarity.
To find out more about what a care manager can do for you and your family call our main line at 970-204-4331.