The Role of a Geriatric and/or Complex Care Manager

For Reliable RN, care management is part medical advocate, part resource identifier, part counselor and part cherished friend. Getting old is not for sissies! It’s hard work and comes with many challenges. This is also true for younger individuals with complex diagnosis (advanced cancers, Parkinson’s, early onset dementia, mental health issues, etc.) A care managers #1 job is to make life easier for the individual and the family. Often that means minimizing outside visits to urgent care, multiple MD offices and even the emergency room. If it can be handled well at home, then your MD’s and specialists are asked to allow you to stay there. A geriatric care manager fights for increased quality of life despite challenging medical issues.
A Care Coordinator also identifies areas where outside resources can be helpful. Are all necessary documents in place so that a loved ones wishes will be respected? Is skilled home care needed to prevent possible worsening of conditions? Is a caregiver getting overwhelmed or worn out and in need of respite? Is a person in the right care setting (would they maybe do better in assisted living, nursing home or on hospice)?
Often, a geriatric care manager utilizes communication skills to find common ground between family members, or to mediate issues between hospital staff and families or assisted living’s and families. Sometimes, one or more family members would benefit from education about the illness and/or realistic options. The role of the care coordinator is to provide that education in an accurate yet sensitive way. Tension over treatment decisions or care needs can create family conflicts that increase the stress on a senior or ill individual as well as the family members. Finding mutually acceptable solutions that meet the needs of all is critical. Reliable RN, as a trained engineer, was taught that creative problem solving was a necessary and critical life skill. Sometimes the best solutions are a little outside the box.
The best geriatric care managers and care coordinators get to know their clients, their families and their care team. You cannot advocate for someone unless you fully understand and embrace their goals as your own. This is what one client just wrote to Reliable RN: “Just wanted to let you know that our Mom passed away last night in her own home and in her own bed (she didn’t care too much for the hospital bed right from the start!), almost two months after her last real meal! Such a surreal experience to witness but so grateful we were there. Thank you so much for all your guidance and support these last six months. You are such a necessary advocate for all of us trying to navigate our messed up hospital system and if you don’t mind, I’ll keep recommending you to others. ❤️ 🙏. “