Growing old means passing another milestone and beginning a new chapter in the book of life. However, despite the many benefits of reaching the golden years, there is no denying that ageing comes with its own set of challenges.
For one thing, your body is not as strong and healthy as it once was, making it difficult to complete daily tasks. There’s also the issue of the mind’s gradual cognitive decline, which makes ageing in place and living independently even more difficult.<
What’s worse is that some elderly people who need more care and support don’t have access to high-quality medical care.
Fortunately, there are case management services and case managers available to assist seniors in living the lives they deserve. Continue reading to find out more about case management services.
Elder care case management is in charge of elderly adults’ physical rehabilitation and recovery. Case managers put together a plan that addresses a patient’s specific medical care needs. They work with other healthcare or aged care providers to connect seniors with appropriate services and resources.
Case managers may offer the following services:
- Assisting patients in navigating the healthcare system
- Making medical appointments for a patient
- Helping with location transfers
- Medication supervision
- Coordination of specialised care
What is Case Management?
Under the Consumer Directed Care model, your Home Care Package is yours to spend as you feel like. You select a home care provider and advise them on the support services you wish to fund.
In most cases, the provider will appoint someone to be in charge of all aspects of your package, including budget management, finding the right services, and hiring and paying service providers. Different providers give them different names – coordinators, case managers or care advisors – but they all provide what is known as ‘provider-directed case management’.
There are two critical points to understand here. To begin with, these case managers are clearly expensive, accounting for up to 30% of your package. Second, because you ultimately control your package, you can decide how much to spend on this service – or whether to use it at all.
According to CCMC, case management is a collaborative practice that plans, coordinates, monitors, and evaluates a wide range of services required to meet a senior’s health and overall needs.
Case management services, in a nutshell, aim to improve seniors’ health and wellness by meeting all of their needs. They will be able to achieve the highest quality of health and life that they deserve in this manner. Its primary goals are to help you or a loved one achieve an optimal level of wellness.
Second, assist you or a loved one in achieving functional self-management capability.
Some of the services offered may include:
- Medical, psychological, and behavioural health
- Employment
- Services for the poor
- Education of high quality
- Other important human and health services
A case manager will be in charge of connecting the client with the services and resources they require.
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What are case managers responsible for?
A case manager’s primary responsibility is to manage your budget and organise your services. But it does not end there. Your case manager (who should be from a nursing or social work background) should take a holistic and goal-oriented approach to your treatment. They are responsible for developing an individual care plan for you that considers your desired outcomes – where you are now, where you want to be, and how you will get there.
They should have good contacts and be able to find high-quality providers of the services you require, as well as recommended services provided by a volunteer or community-based organisations. As a result, they should be able to assist you in getting the most out of your package.
They should stay in touch with you to assess how your services are progressing and to act as your advocate with service providers. They will also manage the administrative side of things, ensuring that all services are paid, and your budget is balanced.
While the case manager assumes these responsibilities, the decisions about your services and the direction of your care ultimately rest with you – you are in control.
A case manager’s primary responsibility is to connect seniors with appropriate providers and facilities. They will also organise and evaluate the best care option to meet the needs of your loved one.
Furthermore, case managers provide senior clients with services that are safe, timely, and cost-effective. Among the things they do are:
- Meeting with the senior patient and their loved ones to determine their specific needs.
- Creating a care plan to meet the patient’s health and lifestyle requirements. For example, they could look for the best assisted living facility for them or apply for a benefits programme.
- Communication with both the senior client and the institutions involved in their care
- Monitor the patient’s progress and contact them on a regular basis to assess their overall well-being.
Case managers may also come from a variety of educational or professional backgrounds. They could be nurses, social workers, behavioural counsellors, or mental health advocates, for example.
Important points:
- A case manager can help you simplify your Home Care Package services or in-home and community care services and ensure you get the right care for your needs.
- Case managers manage your care, communicate with service providers, and advocate for you.
- If you hire a private case manager, you will not have to wait for their services or be placed on a waiting list.
Case managers play a role in this. Case managers, also known as care managers or care coordinators, will collaborate with you and your family or carer to develop and implement personalised care plans that are tailored to your specific needs.
If you are eligible for government-funded services, your service provider may assign you a case manager as part of your Home Care Package or home care services.
If you have complex and multiple needs and are considering different care options, or if you prefer not to use a government-funded package, you may choose to hire a private case manager.
An integrated approach to your assistance
Your case manager will get to know you, learn about your preferences and goals, and arrange for the personal, allied, or health services that will best meet your care needs.
The goal of a case manager is to assist you throughout your entire home care service journey and to provide an integrated approach to any support that helps you live at home independently for a longer period of time.
A case manager will do the following:
- Conduct ongoing assessments of your health and care need to ensure you are receiving appropriate care and to determine whether the care is effective.
- Communicate with service providers, medical and allied health professionals, and others.
- Make arrangements for services, personal care, and appointments on your behalf.
- Negotiate with legal and advocacy groups to protect your rights while receiving aged care services.
- Provide aged care education so that you, your family, and carers understand how the Australian system works.
- Keep yourself, your family and your carers updated on your progress.
Because your case manager is monitoring your care, if they believe a service isn’t producing the desired results or isn’t improving, they will discuss this with you and may suggest finding an alternative service that will better aid your care.
It is essential to communicate with your case manager about what is and isn’t working for you. For example, if you are having difficulty with social engagement, your case manager may be able to arrange for a service that encourages community involvement and social inclusion.
Case managers are hired based on your needs. For example, you might need the services of a case manager for a short period of time or on an ongoing basis.
While your case manager’s primary focus will be on you, the client, they will also assist your carer or family.
Furthermore, if you have any concerns about the care or services you are receiving, you know who to contact to have the issue resolved.
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What Is the Case Management Process?
Case managers use a nine-step process to provide seniors in need with health and human services. This includes the following:
1. Examination
The screening process entails determining your or your loved one’s needs in order to determine which services they can benefit from. During the screening process, the case manager will collect data on:
- The physical, mental, and emotional health of the senior client
- Financial and socioeconomic status
- Health insurance coverage for the home
- System of psychosocial support
- Ability to care for oneself
2. Evaluation
Case managers will review the information gathered during the screening and identify the key problems of their clients during the assessment phase in order to develop a specific case management plan.
3. Risk Stratification
This phase involves categorising the senior patient into one of three categories based on health assessments: low, moderate, or high risk.
4. Preparation
Building a case management plan of care for your senior loved one is part of the planning phase. This action plan should include specific objectives and actions, such as services or treatments, that meet the needs of the senior.
5. Coordination of Care
In this case, the case manager will carry out the care plan in collaboration with various health and human service providers.
This also includes guiding the senior client on an ongoing basis as they interact with the various institutions that can provide the care and resources they require.
6. Follow-up
Case managers will then assess your senior loved one’s progress and the effectiveness of the services provided. Finally, they will monitor and reassess the senior’s condition to determine whether changes should be made or the current care plan should be maintained.
7. Transitioning
>If the follow-up phase was successful, the case manager would arrange for transitional care. This entails transferring your loved one to a higher level of care based on their condition and requirements.
For example, following successful hospitalisation, the senior client may be transferred to their home to continue their recovery.
8. Communicating Post-Transition
Case managers will follow up with their clients to learn about their progress, health, and care concerns.
9. Evaluating
This entails assessing the care plan that has been implemented. Furthermore, this is where case managers distribute result reports to the agencies involved in their clients’ care.
When should a private case manager be used?
Private case managers offer assistance and coordinate your care to ensure that your needs are met.
You may choose to hire a private case manager if you have little or no other support or if you want to relieve family members or other loved ones of the burden of coordinating your care.
Waiting periods for private case management, if any, are significantly shorter than for any government-subsidized packages, which some consider to be an advantage.
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How to get started?
Private case management services can be requested by you, the user, or by family members or carers. A private case manager does not require a government aged care assessment to be hired; however, they may have their own assessment process to determine your care needs.
Do your homework and ask lots of questions when choosing a private service provider. These may include:
- How will they manage your assistance?
- What kinds of services are offered?
- Can they provide an example of a case where they successfully managed similar care needs?
- How much will you be charged per hour and how will you be billed?
- What extra fees will you have to pay?
- How and how frequently will they communicate with you, your family, or your carers?
- Who will serve as your case manager?
- What is the procedure for filing a complaint if you are dissatisfied with the service?
You want to know that you’re getting good value for your money, that you can trust your case manager, and that you’re getting relevant, high-quality services delivered on time.
Fees for case management
It can be difficult to determine how much case management will cost because home care providers calculate the fee differently. Some organisations charge separate fees for administration and case management, while others combine the two into a single administration fee. Some charge a percentage of the package price, while others charge a flat rate. Whatever model they use, they must make these fees transparent, so you know how much you’re paying.
Case management fees can range up to 30% of your package price, but many providers are now offering tiered options rather than a one-size-fits-all rate. You should be able to choose your level of involvement in managing your Home Care Package under the Consumer Directed Care model. So, if you believe your case management requirements aren’t as severe, look for a provider who will allow you to pay less for a lighter service. Some providers will simply manage your funds for as little as 10% of your package value, leaving the remainder of your package available for the services you require.
Do you need case management?
You may decide to manage your own care plan and coordinate your own services if you have low-level needs, plenty of time on your hands, and even some family support. It can be time-consuming and stressful, and the administration can be difficult to understand. The benefit: up to 20% more money to spend on the services you really want. This can amount to hours of care, assistance, or pampering each week.
A good case manager, on the other hand, will have tried and tested contacts and will know who the best support providers are. They should be able to help you get the most out of your package, which may offset some of their fees. Having a case manager’s support and guidance can be well worth the expense, especially if you’re on the higher end of the care scale, with greater needs and higher funds to administer (and possibly less energy to do so).
Keep in mind that the level of case management you require is entirely up to you. When choosing a home care provider, be sure to discuss how much assistance you require and how much you will pay for it.
