Families often call me when they don’t know what do to next. They know that they need help because they are feeling overwhelmed and health or safety issues are escalating, but they don’t know exactly what would help them.
A comprehensive assessment is a way for a family to get a better understanding of the care needs of their loved one. When I begin working with a new family in my role as an Aging Life Care Manager™, this is often my first step. This assessment provides me with information about the person in their environment, their challenges, concerns they may have, and most importantly, I learn about their goals.
When I begin my comprehensive assessment with a new family, the first thing I want to know is what is most important to them. That is an open-ended question, and it provides me with very valuable information. Is the family’s goal to have their loved one age in place? Is it for their loved one to move to a place where additional support is available? Is it to keep Mom and Dad together? Is it for Mom to remain independent and active while Dad is supported with memory care? It is for Dad to have more social interaction and companionship? I want to know the short and long term goals so that I can assess the situation, and then create a Plan of Care that addresses the needs of the family based on what they want to see happen.
The Greenberg family is a great example of the benefit of a comprehensive assessment.
I met the Greenberg family after the eldest daughter called Care Options because she felt that they “needed help”. The daughter, Caroline, wasn’t able to articulate what it was that she felt that they needed, but she knew that she and her younger sister Rachel were beginning to feel overwhelmed with the care of their elderly parents and they needed a professional experience to help guide them.
We scheduled the comprehensive assessment for that same week. Caroline and Rachel had explained to their parents that reason for hiring a Care Options Care Manager was to provide additional support to the family. Their parents were reluctant at first, which is a normal reaction to the idea, but ultimately agreeable to the assessment.
The Greenbergs presented as a frail couple, with multiple health issues that prevented them from being as independent as they once were. I asked Mr. and Mrs. Greenberg their goals and the response was that they wanted to remain in their home together, and would “do whatever it takes.” Married for nearly fifty years, they were fiercely insistent that they would grow old together and take care of each other. They were financially able to do so within a certain budget, and their daughters fully supported their parents’ wishes, although they expressed concerns with the couple’s health issues and recent falls.
Mrs. Greenberg discussed her diagnosis of Parkinson’s disease and history of depression with me. Her daughters also shared that Mrs. Greenberg had three recent falls in the home and Mrs. Greenberg’s anxiety with having to “watch over” her husband every day. Mr. Greenberg was beginning to show signs of short term memory impairment. He was physically strong, but would often repeat himself and ask the same questions multiple times, and the family was concerned about what might happen in the future.
Their home was clean, but some safety hazards were apparent. The Greenberg’s medications appeared disorganized, and there was a slight scent of urine in the bedroom. Reluctantly, Mrs. Greenberg discussed having some accidents at night because it was difficult for her to get up from her bed in time. During these types of discussions, I am empathetic and compassionate with my approach. I understand that the topics that I need to cover can create embarrassment and shame. It is always my goal to maintain the dignity of the individual as I assess.
In approximately two hours I completed my assessment. At the end of the assessment I created a preliminary Plan of Care to give to the family so they knew exactly what I was recommending, why I recommended it, and how they could accomplish the tasks.
My recommendations to the Greenbergs included (generalized for the purposes of this case study): consultation with additional medical providers, medication management, specific adaptive equipment, routine caregiving services, two community based resources, and a protocol for times when both daughters were away on travel. My recommendations included specific instructions and referrals, and we delegated each task prior to my departure. I would continue to work with the Greenberg family on an as-needed basis, along with scheduled quarterly visits to remain current on their situation in case of emergency if the daughters were unavailable.
The example of the Greenbergs is a great illustration of the power of a comprehensive assessment. The few hours we spent together saved the Greenbergs valuable time and energy because they knew exactly what needed to happen, and this eased the stress they had been feeling.