Care Management

Elyse with a Client

Care Management is a solution-based approach to aging and disability whose primary focus is assisting clients and families to find answers to the many challenges they are facing. Those challenges may be the result of a physical illness, cognitive decline, a change in the family constellation, an environmental issue or financial status, just to name a few. CRCM Care Managers help in identifying the needs and finding the solutions. The focus may be on providing short-term solutions or providing a roadmap with a longer-term perspective. We are always mindful that needs change; therefore our interventions are flexible and tailored to the unique “story” of the client, their preferences, the dynamics of the family, and their values and priorities. We listen closely to each client and offer the expertise that only comes with years of relevant experience. Our customized and compassionate approach to care management helps ensure that your loved one feels appreciated and respected and is recognized for their distinct needs and circumstances.

How We Can Help

 ASSESSMENT: Understanding Your Needs

  • A comprehensive and wide-ranging assessment to identify the client’s specific individual needs
  • Care assessment will include medical history, medication review, cognitive and memory profile, psychosocial background, functional status of Activities of Daily Living (ADLs), financial and legal review, home safety, spiritual needs, and insurance coverage
  • A detailed Plan of Action which includes recommendations to address specific issues and challenges and provides resources and practical solutions
  • Option to pursue implementation of recommendations independently or utilize CRCM to assist in implementation of all or portions of plan

RECOMMENDATIONS:  Putting Solutions into Action

  • Arrange, screen and monitor in-home care services
  • Assist with finding appropriate alternative living arrangements, including CCRCs, Assisted Living, Dementia Care and Nursing Homes
  • Referrals to elder law attorneys for legal matters or daily money managers for bill paying assistance
  • Assist with locating appropriate community resources and/or entitlement programs, including but not limited to: Adult Day Care programs, meal services, home modifications, transportation services and respite care
  • Care Plans for guardianship proceedings or other legal matters

ONGOING CARE MANAGEMENT:  Continuous Monitoring and Advocacy

  • Monitor the care received in the hospital, rehab facility, senior living community or at home
  • Attend medical appointments for proper follow-up and coordinate care for optimal health outcomes
  • Medication management
  • Liaison with medical specialists
  • Communication with family members and serving as mediator if conflict arises
  • Family support and education
  • Assess physical and/or cognitive health and implement changes in care as needed
  • Provide 24/7 on-call coverage, giving peace of mind for out-of-town family and/or for occasional travel

CRISIS INTERVENTION:  Providing Support During an Emergency

  • Complicated and/or unexpected discharges from hospital or rehab settings
  • Extreme behaviors related to dementia
  • Unsafe home situation