Earlier this year, Anne Underwood wrote about a program called Guided Care in Caring and Coping, a "New Old Age Blog" featured by the New York Times. The Guided Care program provides services from a registered nurse to help seniors get coordinated care. Research shows that repeat hospital re-admissions caused by often life-threatening complications are significantly reduced when care is carefully transitioned between the hospital and another care setting (home, assisted living, rehab, etc.)
Trained and experienced coordinators can do for our aged loved ones what we family caregivers wish we could do. They can ask the right questions, make sure that medication regimens are reviewed to make sure all of the meds are appropriate and that dosages are correct given other health factors such as dehydration, kidney failure, and other conditions.
Anne Underwood echoed my feelings exactly: She said,
"I remember the helpless feeling I had during my own mother’s final hospitalizations a year ago. It seemed as if I was at the wheel of a car that I wasn’t licensed to drive.
"Should I authorize more invasive care? Should I agree to additional tests and procedures that might help or hurt? Should I put her on hospice care rather than make her suffer any longer? I made the best decisions I could, but to this day, wonder if I made the right choices. I would have loved a program like Guided Care."
Studies show, however, that guided interventions like this can cost about $1,300/year. Savings for Medicare are not that huge. In this economy, sadly, it seems unlikely that programs like Guided Care will be covered by Medicare despite the findings that lives are extended and quality of life is improved.
Underwood cited various components of the most effective programs. Should you be in a position to pay a geriatric care manager, these are some of the things you will want to make sure the GCM will do for your loved one:
- Care coordinators need to interact in person with patients and not simply deal with them by telephone.
- They must collaborate closely with the patients’ physicians.
- Services are particularly important during transitions, when patients are entering and leaving the hospital.
- And when it comes to cost savings, the benefits are greatest when services are directed to patients with the most complex problems.
You can read Underwood's New York Times article <em>Care Coordination: Too Expensive for Medicare?</em> here.
You'll be able to read or download in PDF format Appendix F from my book <em>Taking Charge: Good Medical Care for the Elderly and How to Get It</em> here. Appendix F explains how you can find a geriatric care manager.
See earlier posts on how caregivers can reduce complications: Lack of communication in ER results in post-discharge complications explaining the research and conclusions of Dr. Eric Coleman on this issue and The checklist | A simple way to reduce medical error. The latter will help those who cannot afford a care manager negotiate the often difficult transition from hospital to another care setting.
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