Following the initial consultation….
- A comprehensive, customized assessment is conducted and presented to client
Care starts with an on-site comprehensive assessment to determine current and anticipated future needs. Your Care Manager will assess their present health, medical needs, functional capacity/limitations, psycho social/cognitive abilities, safety and environmental needs. Care Managers are skilled at assessing relevant issues with sensitivity and discretion. Following the assessment, we will provide a comprehensive written action plan along with recommendations outlining cost effective goals and solutions.
- Care Coordination and Ongoing Care Monitoring:
A dedicated Care Manager will be assigned to implement and coordinate services that have been authorized by you and designed to meet the specific health care and personal needs of each client. We carefully select all necessary services with a focus on quality and cost effectiveness. On-going monitoring and communications will allow your Care Manager to build a relationship of trust, encouraging the client to feel more secure, minimize feelings of isolation and loneliness that often times lead to depression. A plan of care will be developed based on the client’s individual needs. Ongoing communication and updates will be provided as determined and agreed to by all parties at the start of care.
Your Care Manager will communicate with those involved to fully understand all the issues and concerns while recommending solutions. Your Care Manager will act as a liaison to families, keeping them abreast of significant changes or alerting them of problems.
Your Care Manager will explore all appropriate long-term placement options. Independent living, retirement communities, assisted living residential care or skilled care will be determined based on the clients functional and cognitive ability. Your Care Manager will tour facilities with the client and/or family. We will assist the client/family in evaluating payment options/benefits that fit the clients specific needs. We will assist the client in completing admissions paperwork and coordinate the transition to their new home.
- Nursing Home Advocacy Program:
Care Managers will visit individuals residing in a nursing home or rehabilitation facility to ensure the individual is receiving proper care and treatment. Your Care Manager will act as an advocate and provide local support while monitoring facility services and delivery of care, consulting with the facility staff and reviewing the medical file. Your Care Manager will also provide professional representation at the care plan meetings to ensure the clients rights are respected, and review the information with designated family members.