Posted on 11/30/2021 - 3:33 PM by Jean Krsnak, MSN/MBA, RN, CCM
Making a Difference in Geriatric Care Management
By Jean Krsnak, MSN/MBA, RN, CCM
A guide for case managers
A person’s quality of health depends on a myriad of factors, particularly age. According to data from the 2020 U.S. Census, one in six Americans is over age 65, a total population of about 55 million people. By 2030, over 40 million more people will reach that age plateau. With so many seniors, case managers become even more vital in assisting them in navigating the healthcare system.
Case Management for Seniors
At its core, healthcare involves a patient seeking the advice and guidance of an expert. But the older a patient gets, the more complex the process can become, with more layers—and sometimes more red tape—including care beyond a doctor’s visit. “Even though I think some tremendous progress was made when healthcare reform and expansion were implemented, the process can be incredibly difficult to get things set up for people like outpatient care, home healthcare, or post-hospital prescriptions,” said Jean Krsnak, RN, CCM, who is based out of southern California.
Challenges senior clients may face are hours calling specialists, filing forms, and following proper channels of care. Investing such time and energy can be exhaustive, but a case manager may alleviate those concerns and implement a plan that helps seniors maximize their care.
Comprehensive Geriatric Care Plans
Every great plan begins with a unique assessment of a situation. A case manager should always approach each senior client’s healthcare with a blank slate and adjust the plan accordingly.
For example, many seniors have spent decades living without assistance, meaning they may struggle to come to terms with asking for help with their health. “Some of our seniors have been independent for more years than I've been alive,” Krsnak said. “But aging does take its toll. And sometimes when they're starting to fail at home, they don't want to tell you (or anyone else) about it.”
By treating each senior client as an individual, a case manager can adapt their plans to fully utilize the healthcare needed while maintaining a high quality of life.
Still, case managers recognize the needs of the client may extend beyond the individual. Relationships with family members, their availability, and expectation can all impact a senior’s healthcare plan. As with any interaction that involves the sharing of information with others than the client, it is imperative to ensure the client’s permission is obtained before including others in sharing of the plan.
A Plan that Involves Everyone
At all points a healthcare plan most greatly affects the client receiving the care and those around them, such as family members and partners. For senior clients especially, the impact of those around them can be even stronger.
Case in point: the management of clients requiring at-home care. Many senior clients may feel their younger family members or associates will be able to assist at home. “Seniors tend to believe their offspring will be able to stay at home full-time and help them,” Krsnak said. The reality may be the opposite, insofar as level of care or availability. “Those family members, no matter how much they’d like to help, may have their own families to support, or have jobs or other obligations.” Finding a balance can be difficult and many families may feel stressed by such strong expectations.
Alternatively, a senior client may already fill the role of caregiver to another senior, such as a spouse, partner, or sibling. The caregiver may feel a greater responsibility toward helping someone else in lieu of their own medical needs.
The key, according to Krsnak, is to slow down, stay patient, and communicate.
“Especially with managed care, we're all in a hurry to get more done faster, more often,” Krsnak said. “It can be tough to sit down at somebody's bedside and take the time to listen. But it's a wonderful investment in time. And the payoff is amazing.”
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