By Deborah Jeanne Sergeant
Your dad has knee replacement scheduled. Your mom breaks a hip. Or maybe they both have cataract surgery on the calendar.
With the associated appointments, bills, in-home help, insurance paperwork and forthcoming bills, getting some outside assistance can help you help your folks while you keep up with your own work and family life.
That is where healthcare advocates or case managers come in.
Alana Russell, owner of Aging Connections, LLC in Webster, is a certified aging life care professional who helps people navigate resources to help during times of health crisis and transition. While she predominantly serves older adults and their families, she does help with care for people who are younger. Most of the time, older adults lack the social supports and resources of younger people, as their spouse and many of their other family members and friends have passed away. Their children may not live nearby.
Typically, Russell meets with the older adult first.
“We want to get to know them,” she said. “We want to know what’s important to them. Their perspective matters.”
She identifies services that can help meet their needs, but the choice is up to the older adult as to what they want to do. Russell knows the local providers of services such as meal delivery, in-home healthcare, senior companions, housekeeping and senior transportation so she can better match the older adult with the service that best fits their needs and budget. Her business is not forcing older adults into a nursing home.
“If someone really does need to move out of their home because it’s not a viable option, then we can explore assisted living and nursing homes,” Russell said. “Both independence and safety are important. We have to find something in the middle to make it work.”
Her agency also helps advocate for people currently using assisted living, as some have adult children living out of town, for example.
Many overworked hospital discharge planners push for as early discharge as possible. It is easy for a few details to get lost in the process. That is where Russell can help families plan for an easier transition to a family member’s home, a rehabilitation center or long-term care facility.
With her 20 years’ experience as a social worker, Russell feels comfortable having difficult conversations and helping families navigate what could be emotionally charged conversations.
She also guides family members in handling insurance and billing matters or manages it herself as the point of contact and emergency contact.
“We can be as involved as anyone wants or more on the sideline as a coach,” Russell said of all her company’s services. “More of our work is done by visits, phone Facetime and Zoom. There are a lot of ways we can help.”
Under new ownership, Constance Care Management, now in Rochester, also provides fee-for-service assistance. Owner Cara Rusinko said that the company helps clients of any age with care management, but most clients are older adults.
“In a crisis situation, we have good relationships with people in admissions at multiple nursing homes, whether it is a rehabilitation stay or long-term care,” Rusinko said.
Her business partner, Bridget Jarvas, said that it all begins with an initial in-home assessment as to what services would be appropriate for the client’s health and aligning with care providers’ recommendations.
“We discuss costs and reach out to connect them to the services that would be appropriate and the right amount,” she said. “We discuss the big picture. If it’s long-term planning to stay home, we look at if there’s a long-term care insurance plan.”
Health advocates can help connect community organizations, healthcare providers and other resources to assist older adults and their families in finding what they need. The process can otherwise become very time consuming.
“We’re already aware of the agencies that can provide adequate support and able to staff,” Jarvas said. “Some agencies say they don’t have the staffing to accommodate them. We know about community resources.”
The agency may also attend clients’ doctor’s appointments to assist in continuity of communication and advocate for the care the clients need. While this role may be filled by the patient’s adult child, many work full time, live in other areas or have other reasons for being unable to help.
“We make sure the follow-through is there and is communicated back to the caregivers,” Jarvas said. “We connect the dots with the primary care provider and specialists and make sure it carries over.”
While making decisions about health struggles is not pleasurable, health advocates can make it easier and better informed.