The Professional Geriatric Care Manager’s Blog

Life in the week of a Geriatric Care Manager- Making Headway

There are many times that we know what is best for our clients given their medical history, knowledge of who they are as individuals and their families. Our plan of care that we coordinate for them should reflect all of these considerations and as many Care Managers do I try my best to keep all of these personalized needs in mind when moving forward with my plan. It seems that often even with my client on board with these plans they can be sabotaged knowingly or subconsciously by their children. This is frequently while their children genuinely love their parents. This past week it happened twice! I gave a lot of thought and consideration about what was needed in two cases where my client’s needs were not being met. One is H- whose daughter was on the phone every other day concerned, worried and genuinely caring. H is charming, bright, and cute as a button. She has been extremely independent till now. Called in by her daughter due to some of H’s lapses in memory, an assessment was made and recommendations were given quickly. Yes H. still drives and takes care of all her needs independently, but the accuracy of her medication administration was seriously questionable. It took 5 visits and lots of conversations with H’s daughter and finally she is viewing us as an advocate for her mom. Her medications have been set up in her med minder and I will keep you posted on how she does.
The second client who a similar situation occurred with is R. I have been R’s Care Manager for some time and although he finds it difficult to express his feelings he has improved with this over the past several months with the assistance of our Geriatric Care Counselor, Bobbi. Bobbi just has a way about her and a lot of knowledge to add to this. R had shared with me previously that he had enough of his visits to the Emergency Room for recurrent resistant seizures. This was in spite of his frequent calls and visits to the Neurologists. His visits to the Emergency Room were lengthy, draining and stressful for not just him but his family as well. He did not want to go. The question arose many times- “Do you really need to go with each and every seizure?” I had suggested discussing with his children and he asked me to become involved which I had. However his children ever lovingly trying to do the very best – continued to take him to the Emergency Room with the onset of his next seizures. EEG’s were done, medications adjusted, precipitant conditions noted and R was sent home after many hours of anxiety for all. Our discussion occurred last week after his most recent seizure and subsequent visit to the ER- He was upset and told me “Six times I’ve been brought to the Emergency Room” and held up his hands with six fingers extended to punctuate his point.
He was scheduled for a visit to his Neurologist the following day. I clearly stated- “Ask your Neurologist on your visit tomorrow if it continues to be necessary?” Well R did and basically as we Nurse Care Managers know- unless it is extended with symptoms of anoxia – “No a subsequent visit to the ED is not necessary”. R will be happy- he wants to be home with his wife and Care Givers.