What happens when your private case manager is also a part of your community, or the community in which a subject client lives?
The short answer? Great things. Great things happen when your case manager is a part of the community in which you or a loved one live.
Let’s look at some of the advantages of having a locally-based private case manager who is also a community member.
Strength in Small Numbers
In contrast to corporate agencies, a private case manager from a smaller local agency is able to provide more personalized care management. It may sound cliché (but it’s cliché because it’s true); to a smaller, local agency you are “more than just a number”. You’re a member of a much smaller crowd. And it’s hard to get lost in small crowds.
A private care manager based in your community as opposed to a large third-party agency (which could be based almost anywhere), an insurance company, or a hospital or facility, will have a smaller case load to manage. Their case load will be less transient and more stable, too, which means better ongoing support and attention that is more focused on your or your loved one’s case.
Specialty Care in the Specialties You Need Care In
A case manager employed by a smaller, focused home care agency or similar provider is more likely to have a focused field of care, specializing in the services in which the agency specializes. For example, because home care agencies typically deal with chronic conditions, long-term injuries, workplace injuries, elder care and aging-in-place, the nurse case managers working within these agencies will also be focusing on managing these types of cases. This is quite different than a third-party contractor case management scenario in which the cases they deal with may run a much more varied gamut of patient needs.
Knowledge, Access, and Familiarity—They KNOW People!
Case management at its heart comes down to coordination of care and services. That means aligning and synchronizing a lot of moving parts. In order to do that job effectively, one needs to know what the potential parts and pieces are that can fit together—the coordinator needs complete knowledge of what services, vendors, suppliers, care providers, doctors, specialists, auxiliary services and therapies are available.
It helps, too, when they know which of these parties work well together. Knowing whose personalities might be a good fit is essential in making a comfortable and workable match. That is a tall order for someone who is not a regularly involved member of the local healthcare community. For a community-based private case manager, it comes with the territory.
“Case management serves as a means for achieving client wellness and autonomy through advocacy, communication, education, identification of service resources and service facilitation. The case manager helps identify appropriate providers and facilities throughout the continuum of services…” – Case Management Society of America (CMSA)
More localized care managers know where to find the necessary equipment and supplies, who has the best price and quality, which companies will deliver on time, on short notice, etc.. They’ve worked with many of the providers and facilities including doctors, rehabilitation services, physical therapy, occupational therapy…the list is nearly endless. And this means that they know a lot about the level of care and expertise, service, and success of those providers and facilities. They also know where to go when something isn’t working, or when a second opinion is needed, which is equally important.
The Ability to Integrate Care and Services Through Local Coordination
Integrated care means more streamlined care. More streamlined care means more efficient and effective outcomes and services. It means cost-saving solutions for all parties—client, insurers, and providers. It means that more can get done with less stress and less physical pressure on the patient or client.
“The underlying premise of case management is based in the fact that when an individual reaches the optimum level of wellness and functional capability, everyone benefits: the individuals being served, their support systems, the health care delivery systems and the various reimbursement sources.” -CMSA
The ability to align services and supplies, facilitate communication between patients, providers, doctors and health professionals, smooths the seams and wrinkles in care that are becoming all too common in the specialized, compartmentalized healthcare system we have today. Being able to stitch this kind of seamless care together is the work done by a good case manager. This requires a level of regular presence in the community and immediate area of service provision.
Nearby and Accessible
If a private case manager is also a part of your or your loved one’s community, that means they are nearby. Nearby means that, within reason, they are more immediately accessible and available.
While this may seem obvious, it is not the case in all case management situations. For some, an assigned case manager may be hours away, or even live in a different state. They may have a vast list of services and providers with whom they have worked or come in contact, but their intimate knowledge of local providers and services will be limited. That makes a difference when the goal is to access the best quality of care without excessive travel, or in an age-in-place scenario where travel may be restricted.
There for Patients and Clients
Having your case manager work and function in your community means they are nearby enough for regular visits and check-ins, and close enough to home care services and other providers to keep a steady pulse on all aspects of care and living. They can then attend doctor’s appointments and other important services with you or your loved one. They can be there with you or your loved one when you cannot.
One of the greatest advantages to this is that the case manager can help translate the language of medicine, make it understandable for the client, and communicate that information to designated family care team members. The case manager can then take that information and fit it into a service and care plan and use their community knowledge and experience to obtain the best fit for the best outcome. The case manager can also provide ongoing evaluation to see what is and isn’t fitting, what is or isn’t working, and pivot as needed.
There for Providers and Others
Further, having a case manager that functions in the same community as their client means that they are accessible not only to the client—which is, of course, of utmost importance—but it means that they are also accessible to doctors, service providers, insurers, home care providers, and others. When your case manager is a part of your home care agency, that is an even higher level of accessibility and awareness.
“Case management services are best offered in a climate that allows direct communication between the case manager, the client, and appropriate service personnel, in order to optimize the outcome for all concerned.” – CMSA
“Feet on the Ground” When Family Can’t Be
There are different reasons why a family member may not be able to be the Johnny-on-the-spot, feet-on-the-ground their loved one needs.
Family may not live close by. They may not (realistically they likely will not) have the experience and networking to understand the needs of their loved one and coordinate that with the right care services and vendors. After all, if you don’t work in the field, why would you? The demands of their own household or job may make it difficult to dedicate the time to the management of their loved one’s care. (This is, after all, a full-time job for case management professionals!) Or the individual may not have a family member to take on the job. Certainly managing all the facets of care when you are the patient or client in need of care is an unreasonable expectation.
You may not need to be as far away as you think to be considered a long-distance caregiver, either. The U.S. National Institutes of Health-National Institute on Aging states, “If you live an hour or more away from a person who needs care, you are a long-distance caregiver.”
This makes sense if we think about it—how familiar are you with all the services and vendors an hour or two away from you?
It would be unrealistic to expect a physically distant family member to be able to coordinate care from afar; the reason largely being a lack of knowledge and access to services, vendors, and providers. If this is the case for family, why would it be realistic to think the best outcome would come from a care provider who is not involved in the local care community?
A Phone Call Away
Similarly, if you, as a long-distance family member, friend, or designated healthcare advocate, have a case manager with a regular presence in the life and care of your loved one, you have a connection within the community who can regularly communicate with you and make you a part of that special person’s care, even when you are away.
A phone call, an email, a video call…today’s technology is a wonderful tool to help us when we want to be there, but can’t. Knowing that there is someone literally there to check in on the things you think need checking and to answer the questions you need answering is empowering to you as an overseer, too.
Invested in YOUR Community
Finally, an agency or case manager that is a part of the community is more than just a provider. They are also a contributor. They contribute to the fabric and structure of the community, and that effects the quality of life for you or your loved one, too.
People who live and work in a community contribute in many, many ways. They give back through such acts as volunteerism, charitable contributions, involvement in groups, clubs, public resources, and more. They are also able to help connect interested clients with such activities and opportunities, too—all part of being a part of a community, and being part of a community is part and parcel to a better quality of life, too.
These are people invested in the community in which they live and work. They have a personal stake in the quality of life of their home. Part of building a quality of life in your community is ensuring that others are living a quality life, too. Community-based providers have a vested interest in extending quality care, but also in connecting the dots and filling in the gaps they see in their communities. It is a part of the ripple effect of enhancing the local economy, options and opportunities, and quality of life and services. Community care managers are a part of that!
Private Home Care Services is Committed to Our Community!
Building a network of high-quality, affordable care in our community and providing the tools for clients to be able to age in place or overcome or manage a chronic condition or injury is a priority for us here at Private Home Care Services.
We have extended our services to include Private Care Management because we know that we can achieve better outcomes by being a community provider that delivers focused, personalized care for every one of our clients and their families.
To learn more about nurse case management at Private Home Care Services, click here:
Or Fill out a referral form:
Or Call PHCS:
Further Reading and Additional Resources: