The following illustration provides an example of how the Personalized Eldercare Program can work for IU employees:
Situation: Carolyn, a paralegal living in Indianapolis, contacted My Health Care Manager for advice about her parents, who were living in suburban Detroit. Despite the distance, Carolyn was the primary caregiver and made frequent trips to visit her parents on weekends. Carolyn and her husband, Jim, were also raising three teenage children and worked full time.
Carolynís parents were in their 80ís and lived independently in their original two-story home. However, Carolyn was becoming increasingly concerned about them living alone, as they appeared forgetful and didnít seem to be eating properly or taking their medicine correctly. During her frequent trips, she would find medicine bottles still full and an empty refrigerator. No matter how hard she tried to get things ďback on trackĒ over the weekend, she soon recognized that things fell apart when she returned home.
Carolyn was worried about her parents and the detrimental physical effects they experienced due to the lack of proper nutrition and poor prescription compliance. Additionally, she was drained from the weekly eight hour drive and missed spending weekends with her husband and children. The responsibilities of caring for her parents and her family soon became overwhelming. She wanted to be a good daughter and help her parents make good decisions about the future but wasnít sure what to do next. Her brother, who lived in California, wanted to move their parents to a nursing home Ė an option that would quickly deplete their parentsí finances and one they would vehemently resist. Carolyn could not bring herself to encourage this plan, yet felt it might be their only option.
Fact Finding Consultation (Step 2): Carolyn and her brother participated in a Fact Finding Consultation with My Health Care Manager. During the call, they noted their concerns and shared their perceptions of their parentsí physical and mental health. The information was based on their observations, and the siblings admitted that they were not clear when their parents had last visited the doctor and/or whether they had received any neurological or physical evaluations. Because they lived out of state and the long time family doctor had retired, they did not know the names of their parentsí physicians or anything else about their health care, including insurance coverage and legal preferences such as health care power of attorney, living wills, and other directives.
The information they could share was based on their experiences in the home when visiting their parents. It had become apparent to them both that their mother, who had always managed household tasks, could no longer do so due to forgetfulness, confusion and an inability to make decisions even about simple things like sorting the laundry. Their father, while suffering from some physical maladies, was mentally sharp. However, he had no idea how to manage meals, grocery shop or do the laundry, as these chores were well outside the experience of his 50 year marriage.
My Health Care Manager Recommendations (Step #3):
Carolynís Health Care Manager recommended that they:
- Conduct a Situational Assessment to identify doctors, prescribed medicines, environmental concerns, and their parents’ sense of well being.
- Follow up with doctors to verify diagnoses/treatment plans/prescriptions and open lines of communication.
- Obtain appropriate HIPAA releases so that doctors could share information with Carolyn and My Health Care Manager.
- Schedule checkups (if overdue) with a family physician.
- Schedule a visit for Mother with a neurologist to assess cognitive function.
- Coordinate in-home care to assist with housekeeping and daily living tasks.
- Arrange for bi-weekly visits from a Health Care Associate to assist with medication management and healthcare coaching, as well as to provide an evaluation of their parents’ ability to live safely in their home.
Carolyn and her brother followed the proposed recommendations and helped their parents age in place, as was their wish. They learned that neither parent had been taking their medication appropriately and were pleased to see improvement with increased compliance brought about by medication reminders and schedules. Additionally, they found that a few hours of help each day from a housekeeping and companion service allowed their parents to live independently and avoided the expense and upheaval of a move to an Assisted Living facility.
Carolyn and her brother kept in touch with My Health Care Manager to find out how their parents were really doing and Carolyn was able to reduce her trips to once or twice a month. The trips were less stressful, as Carolyn no longer had to catch up on housework or manage medicines. Everyone enjoyed the visits much more than in the past. The tension between Carolyn and her brother lessened too, as Carolyn felt that she no longer had the full responsibility for her parentsí care.
The worry that their parentsí healthcare needs might change in the future became less of a concern, as Carolyn and her brother realized that they would not have to face these challenges alone. They agreed that working together with My Health Care Manager would allow them to continue to help their parents in the best way possible.
Note: Please refer to our website, www.MyHealthCareManager.com for additional examples of how My Health Care Manager has helped families.
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