A Case Study in:
Elder Care Management
AdvancedRM was contacted by George B., who had recently been awarded guardianship of his elderly and incapacitated mother. George sought assistance regarding the care of his mother, Edith; specifically in determining a best placement and a plan of action for her care moving forward.
Client History
Suffering from dementia, incontinence of bowel and bladder, and lacking the ability to care for herself, Edith was being cared for in her home by caregivers, hired by George’s brother.
Unsure of their qualifications, certifications, credentials, or insurance coverage, George requested AdvancedRM’s assistance assessing Edith’s condition, her home and the care being provided.
Process
- In order to better understand the situation and provide a thorough assessment, AdvancedRM requested permission to obtain medical records from her primary care physician. In addition, we planned a visit toEdith’s home to assess her home and living conditions for safety and comfort. Part of the visit would include interviews with the live-in caregivers and George’s brother, who also lived at the home. George agreed to this plan.
- Upon review of Edith’s requested medical records we learned she had been diagnosed with dementia, COPD, and chronic stasis dermatitis. A complete medication list was also gathered from the records. Information in hand, we developed a plan of action and prepared to visit her home in the coming week.
- The living conditions and safety assessment included a thorough analysis of the medical equipment being used in Edith's home, including the wheelchair and hospital bed. Based on our assessment, we concluded there to be no safe egress from the home in the event of an emergency.
- Edith’s caregivers revealed neither caregiver was licensed in nursing. We learned no one is monitoring Edith’s vitals regularly. We completed a review of recommended medications versus actual medicine being administered. There were significant discrepancies.
- After speaking with the caregivers, we sat down with Edith’s son, John, to discuss meals, activities, and medical care provided. This conversation revealed that a visiting medical agency administers Edith’s medical care on a monthly basis.
- Our last step in gathering information was to observe Edith. This observation helped us determine which activities Edith could accomplish herself.
Analysis
We easily surmised Edith’s current environment of care was neither stable, safe, nor sufficient. In a detailed letter to her visiting physician’s group we outlined our findings and concerns. Along with a letter of agreement from her physician regarding our findings, we presented our report and assessment to George and his attorney.
Following the submission of findings, George, who became overwhelmed with the process, asked us to speak with his chosen nursing facility to obtain information on what would be needed for Edith’s admission to the facility. Upon speaking with the Admissions Director, we learned that Edith’s insurance coverage was not sufficient and she would need to apply for Medicare coverage prior to being admitted to the facility. We also learned that George’s chosen facility was out of network for Edith’s insurance coverage, and this would cause issues with her treatment. Our findings were provided to George in a detailed report along with recommendations for other facilities.
Outcome
We are happy to report that because of AdvancedRM’s involvement, Edith has been successfully admitted to a wonderful facility. She is now safe and is receiving appropriate medical care. George was able to sell her home and prepare financially for his mother’s future needs.