Posts Tagged ‘geriatrics’

Care vs. Case Management: 7 Structural Differences

December 12th, 2013 by Cheryl Miller

While there’s no law defining the differences between care and case managers, there are seven structural differences, says Jullie Gray, MSW, LICSW, CMC, principal of Aging Wisdom, and president of the National Association of Professional Geriatric Care Managers, NAPGCM.

Despite the differences, geriatric care and case managers ultimately face the same issues: an aging population, a dwindling supply of geriatricians, and caregivers that need help caring for their ailing family members, while at the same time honoring their “autonomy and safety,” Gray says.

Following is her assessment, based on reviews of NAPGCM’s standards of practice compared to the Case Management Society of American’s (CMSA)’s standards of practice, and various national and regional group member meetings.

To find a care manager, go to National Association of Professional Geriatric Care Managers To read an interview with Gray, click here.

Care Management

Case Management

Background of professional

Diverse – Social work, nursing, psychology, gerontology, other health related fields

Social workers and nurses primarily (with some mental health counselors)

Employed

Primarily private for profit (some nonprofits)

Agency/organization: insurance company, hospital, community mental health, etc.

Government: Medicaid program, housing authority, adult/children’s protective services, veterans’ programs, etc.

Limits

Client defines the scope of work (based on a care plan that is developed with the client’s input)

Agency defines the limits/scope of work. Typically will be managing a specific disease, issue, condition or event, and focus may be constrained by regulations, policies and funders

Focus

Holistic, client/family centered approach

Understanding underlying client/family dynamics

Advocating for client needs & the client’s maximum benefits (i.e., from an insurer)

Client/patient centered but also considers medical/legal/financial issues that can involve stakeholders

Eliminating  non-compliance and over-utilization

Stakeholder

Client

Can be a funding source (i.e., insurance company, entitlement, hospital, etc.)

Payment

Client pays cost (occasionally some reimbursement from long-term care insurance but this is not typical)

Agency specific funding (hospital system, insurance company, government program, for example)

Goal

Promote better quality of life, maintain independence to the extent possible, improve communication among those involved in client’s care, ensure client’s needs are met and client’s goals are achieved, provide education to client and family members

Improve health status, cost effective outcomes and efficiencies, reduce overutilization of services

New, FREE Case Management Trends Download

For additional data on care and case management trends, download the FREE executive summary: More Care Team Integration; Face-to-Face CM Encounters Edge Out Telephonic

With each year, a larger swath of the healthcare industry comes to rely upon the skills of healthcare case managers to influence clinical, quality and financial outcomes. According to the 2017 Case Management Survey by the Healthcare Intelligence Network, the percentage of healthcare organizations enlisting case managers in care management rose from 88 percent in 2013 to 94 percent in 2017. Further, patients are much more likely to encounter a case manager in a provider’s office this year than they might have been four years ago. Two-thirds of 2017 respondents embed or colocate case managers alongside care teams today, versus 54 percent in 2013.

Download this HINtelligence report today for more data on the top clinical targets of healthcare case managers; the top means of identifying and stratifying individuals for case management; and the most common locations of embedded or colocated case managers.

Meet Geriatric Care Manager Trish Colucci: ‘Jersey Girl’ Finds Passion Helping Others

November 26th, 2013 by Cheryl Miller



This month we provide an inside look at a healthcare case manager, the choices she made on the road to success and the challenges ahead.


Trish Colucci, RN, Certified Geriatric Care Manager, Certified Gerontological Nurse, Certified Case Manager, current president of the New Jersey chapter of NAPGCM, Owner of Peace of Mind Care Management Services, LLC

HIN: Tell us a little about yourself and your credentials.:

(Trish Colucci) I have been a N.J. state Registered Nurse (RN) since 1985 and have additional certifications in gerontological nursing, case management, and life care planning. Currently, I am the president of the N.J. chapter of the National Association of Professional Geriatric Care Managers (NAPGCM). Prior to that I served two years as treasurer and two years as vice president.

What was your first job out of college and how did you get into case management?

When I graduated, I started working as a floor nurse at a local hospital. Although I always saw myself in pediatrics, there were no positions available at the time, so instead I accepted a position on the orthopedic floor. It was serendipitous! In that unit, I developed a love for working with elderly folks. I was later offered a shift in career to insurance case management, at the time when that field of nursing was brand new. In that position, I developed valuable organizational skills and clinical knowledge that helped me coordinate care for our catastrophically ill or injured claimants and to ensure that they received the best medical care possible.

Has there been a defining moment in your career? Perhaps when you knew you were on the right road?

Years later, I gave birth to my son who has Down Syndrome, and who had a lot of special medical needs. I was able to utilize my case management skills (which were now second nature) to coordinate a team of top-notch doctors who addressed Michael’s multitude of medical problems and worked together, with my management. It was after that that I noticed friends coming to me to ask advice for coordinating care for their own loved ones. It helped me realize how valuable my case management skills were and how they could be helpful to others trying to navigate the confusing worlds of medical care and insurance.

In brief, describe your organization.

Peace of Mind Care Management Services, LLC is a care management firm that assists families, guardians and caregivers with the management of their loved one’s personal and medical care. We specialize in crisis management, often finding families confused and overwhelmed by their responsibilities in an arena with which they are not familiar. As care managers, we assess the situation and create a specialized plan of care that addresses the needs of the client within the available budget. We offer support, resources and guidance so that families feel more comfortable and informed in making important decisions for the care of their loved one.

Serving as president of the New Jersey chapter of the NAPGCM has opened my eyes to opportunities for care managers on both the local and national levels. Although the field of geriatric care management has been around for over 25 years, it is not well known by the general public. Our chapter’s main focus over the past year has been on developing a solid, working public relations committee, and to make, “geriatric care management” a household word and the first point of contact for families who need help with their loved one.

What are two important concepts or rules that you follow in care management?

  • The most important concept in care management is a trusting relationship. Our clients need to know that as care managers we provide honest, caring advice that is in their (or their loved one’s) best interests. We are not financially connected to any resource we may offer to a family, and this keeps our advice objective and trustworthy. We refer to resources we would use for our own family members and this provides an extra level of trust with our clients.
  • Compassion is another important concept. At Peace of Mind, each client is as precious as the next, coming to us with his or her own history and special needs. We reach out to our clients and their caregivers with compassion and empathy, developing an understanding about where they’re coming from so we can tailor our guidance in a way that makes them the most comfortable.

What is the most satisfying thing about being a care manager?

What I derive the most satisfaction from is the look on the face of a client or caregiver we’ve helped. Seeing on their faces the signs of relief…of tensions easing…because they got the help they needed to care for their loved one, provides me, as the care manager, the signs that I’ve done a good job for the family. Even in situations where clients are in the process of dying, knowing that I have coordinated their care such that they will leave this world feeling comfortable and loved, makes me feel good about the work I do.

What is the greatest challenge of care management and how are you working to overcome the challenge?

What I love about being a geriatric care manager is the diversity of duties, however that’s one of the things that makes this job such a challenge! Each day brings forth some new challenge, and my schedule can change hour-to-hour. It helps to be flexible! I am fortunate to have a strong, warm and wonderful care management team made up of nurses and social workers. When we are faced with tight situations, we reach out to one another for assistance and support. Whether it’s a race against time to get medical equipment in the home before a client comes home from the hospital, or a family member who needs extra hand-holding and reassurance on a particular day, or an unexpected emergency with a client that needs immediate attention, we are ready to act.

Where did you grow up?

I grew up in Denville, N.J. and am the eldest of three girls. I am a “Jersey Girl” through and through. My dad was a police officer and my mom was a bank teller. Sounds like the makings of a good Bruce Springsteen song, doesn’t it?

Click here to learn how you can be featured in one of our Case Manager Profiles.

Meet Geriatric Care Manager Jullie Gray: “We Need More People That Specialize in Aging”

September 27th, 2013 by Cheryl Miller

This month we provide an inside look at a healthcare case manager, the choices she made on the road to success and the challenges ahead.

Jullie Gray, MSW, LICSW, CMC, Principal, Certified Care Manager Aging Wisdom, Inc., and president of the National Association of Professional Geriatric Care Managers (NAPGCM)

HIN: Tell us a little about yourself and your credentials.

(Jullie Gray) I attended the University of Washington where I earned a bachelor’s degree in social welfare, master’s degree in social work with a specialty in healthcare, and completed a certificate program in geriatric mental health.

What was your first job out of college and how did you get into geriatric care management?

My very first job in healthcare was as a medical assistant in a practice made up of mostly older adults. I loved it!

After I completed my master’s degree in social work, I landed a job with a public hospital district that had many programs besides just the hospital’s programs. For years, I worked in the acute care hospital with people of all ages.

The hospital system also owned a geriatric medical practice (primary care clinic but specializing in older adults). I was recruited to manage that clinic, which I did for several years. Being focused solely on management was fine for a while but I started to miss clinical work. I had the opportunity to work in the hospital’s hospice program part-time (a job I absolutely loved). I took the part-time position because I wanted to start a private care management practice. I did both jobs for several years and then my practice demanded more and more time so I quit my hospice work and the rest is history!

Has there been a defining moment in your career? Perhaps when you knew you were on the right road?

As my career progressed, I came to realize my most favorite patients (clients) were older adults. At one point while working as an emergency room social worker, whenever an older person would arrive, I would gravitate towards them. I found they had so much life experience to draw upon; they had fascinating lives and I just knew I had found where I wanted to go next in my career.

In brief, describe your organization.

I am the president of the National Association of Professional Geriatric Care Managers (NAPGCM) and a principal at Aging Wisdom, a care management, consulting and home care company located in Seattle, Washington.

The National Association of Professional Geriatric Care Managers (NAPGCM) is an organization whose mission is to advance professional geriatric care management through education, collaboration and leadership. The NAPGCM is over 2000 members strong. Our vision is to define excellence in care management and we are looked to as the gold standard in the field.

What are two or three important concepts or rules that you follow in care management?

  • Follow the code of ethics and standards of practice of NAPGCM;
  • Do good work; and
  • Be responsive and follow through with what you say you are going to do.

What is the single most successful thing that your organization is doing now?

At NAPGCM we are helping care mangers from across the country to do their best work. We provide a great deal of business and clinical support to practitioners so they in turn can serve their clients at the highest level.

In my practice at Aging Wisdom, we have gathered together an amazing team. We try to nurture our employee’s creativity and encourage them to grow as practitioners. We know that by investing in our staff, it pays off for our clients because they are all performing at their best.

So, really, in both of my roles, I focus my energies on nurturing strengths and promoting a culture of professional growth and development.

Do you see a trend or path that you have to lock onto for 2013?

There’s not enough people in the field of geriatrics who understand the special needs of older adults, and the problems that come up when people age. Right now there’s a shortage of not only care managers who understand older adults but if you look around at the medical field, there’s a shortage of geriatricians, social workers and nurse practitioners. As I understand it, nurse practitioners are no longer being offered specialized geriatric practice training; instead they are focusing on adults for a generalist view. This worries me; we need more people that specialize in aging.

What is the most satisfying thing about being a care manager?

It’s hard to pinpoint just one thing that makes my job satisfying. I guess like most people, I want to know that I make a difference. I am fortunate to have a job that allows me to help people. And, at the same time, my clients help me by sharing their wisdom. Working with older adults is tremendously rewarding because they come with a lifetime of experiences. Even those who have memory problems are able to draw upon their rich history and find creative ways of coping. My clients have a tremendous sense of humor even in the face of really difficult challenges. The fact that they let me be there for them during their most vulnerable moments in life is a real honor.

What is the greatest challenge of care management and how are you working to overcome this challenge?

The greatest challenge for me right now is juggling my role as president of NAPGCM and as principal of a growing company. Being president of NAPGCM, I have access to a great team of fellow board members and staff. They help keep me on track and inspire me by their commitment to excellence.

In my practice, I’m lucky to have a wonderful business partner. We laugh a lot and set small and large goals for ourselves. Because we’ve assembled a really great team, we are able to let go of many responsibilities and feel confident that the work will be done right.

What is the single most effective workflow, process, tool or form care managers are using today?

I think most practices are using some sort of care management software program. These programs typically interface with Quick Books to help with invoicing. Even though no software program is perfect, I can’t imagine working without one to document case notes and invoice clients.

Where did you grow up?

I was born and raised in Seattle. In fact, I often joke that I was born at the University of Washington Hospital, obtained my bachelor’s and master’s degree there and will probably end up there at the end of my life to complete the circle. I can honestly say that I was born a Huskie! Usually, that story gets a good laugh.

What college did you attend? Is there a moment from that time that stands out?

I attended the University of Washington. The moment that stands out for me is when I attended my first social work class. I knew right then that I was at home! The profession really made sense for my values, personality and temperament.

Are you married? Do you have children?

I am happily married. I didn’t get married until I was almost 40 years old. This year I turned 50! It was weird turning 50 because it seems like it just snuck up on me so fast. I actually celebrate my age even though I know many people worry about growing older.

We don’t have any children but we do have a rescue dog named Gracie. She’s a Shepherd mix and loves to jump on top of me (all 50 pounds of her) early in the morning around 5:30 AM. It’s her way of getting me out of bed to take her for a long walk before my workday starts. Can’t beat that for motivation!

What is your favorite hobby and how did it develop in your life?

My husband is a landscape photographer so whenever we have a chance, we visit national arks and soak in the beauty. I love to watch him photograph and sometimes I even pull out my own camera to try to capture a scene.

Is there a book you recently read or movie you saw that you would recommend?

I really enjoy a book called The Leadership Challenge. By Kouzes & Posner. It’s helped guide me in my role as president of NAPGCM and also in my own practice.

Any additional comments?

I would encourage anyone who is interested in the field of care management to think about joining NAPGCM, and you can click here to get to the Web site. We have started a great webinar program for budding entrepreneurs called the Building a GCM Business Series. The association is ready and eager to help care managers be successful in their careers.

Click here to learn how you can be featured in one of our Case Manager Profiles.