A Case Study in:
Case Management
AdvancedRM was contacted by a family member regarding his sister, Wanda G. Recently, Wanda was a pedestrian hit by a motor vehicle and she currently had an open auto insurance claim for the accident. She suffered multiple traumas including a head injury and intracranial bleeding at the time of the accident. At the time of referral, she was residing at a facility specializing in brain injury and just beginning the rehabilitation process. Case Management services were requested by her family member to assist in helping to facilitate treatment in an effort to assist Wanda to return to her previous level of functioning and to help the adjuster to understand her future care needs.
Client History
As Wanda progressed with therapies in the inpatient setting, she was ready to discharge to a lesser level of care. She requested to move in with her brother, Jack. He and his wife agreed to be responsible for providing any needed care 24/7. Once home with her brother, Wanda developed complications related to seizures and mood swings. Over time, Wanda’s care needs increased and due to his own health concerns, Jack was no longer able to provide the type of care Wanda needed; he was unable to assist her with increasing her level of independence. Assistance from the case manager was requested to transition Wanda to a group home setting.
Process
- When we first met with Wanda, in order to better understand the situation and provide a thorough assessment, AdvancedRM obtained medical records related to the motor vehicle accident and from her doctors who treated her prior to the accident. In addition, we met with members of the treatment team and family. This helped to clarify those conditions which were made worse as a result of her recent motor vehicle accident and medical issues that were not related.
- The case manager planned a visit to Jack’s residence for further assessment of living conditions, and to identify any safety concerns and modifications that would be necessary within the home. We assisted with obtaining necessary supplies and equipment and installation of grab bars, ramps, raised toilet seats, etc. to ensure Wanda would be able to move within the home in a safe manner. Participation in outpatient therapies was also scheduled by the case manager.
- As Wanda’s rehab progressed, we continued to focus on her goal of returning to independent living. We worked with her therapists to identify barriers to her achieving that goal, including fears expressed by her brother, Jack, who was increasingly overwhelmed by his care obligations for his sister. We identified a behavior therapist to work with Wanda and Jack to address ongoing challenges within their relationship, which had become strained as a result of the amount of care Wanda required.
Analysis
Because AdvancedRM firmly established injuries related to the motor vehicle accident, Wanda was able to receive treatment recommended by her therapists and as prescribed by her doctors. This allowed her to make progress toward her goal of returning to independent living in her own apartment. However, she was limited in progress while she lived with her brother as he was afraid she may be injured if she did more tasks independently. Through interventions taken by the case manager, Jack was able to understand options to help his sister reach her personal goals, including having her move from his home to a group home setting.
Outcome
With the help of AdvancedRM’s ongoing involvement, Wanda transitioned to a group home setting where she has been able to work on independent living skills bit is still able to receive supervision 24 hours per day until she is fully able to return to independent living. She receives support from care givers trained to meet her specific needs. She is now able to maintain a loving brother/ sister relationship with Jack.