Published in October 2013 Boomer and Senior News.
By Vanessa Salvia
It’s a sad fact that as we age, our ability to take care of ourselves diminishes. Some people may need only a little help throughout the week, perhaps assistance driving to the grocery store or doctor’s appointments. Others need daily care. And in addition to household management, help with personal needs and medication, some people may not be capable of making important legal or health care decisions for themselves.
In those situations, care managers, such as Elder Care Resources or Rent A Nurse, work alongside a care provider to ensure the person gets the help they need, whatever their situation is.
Karen Fabiano is vice president of Elder Care Resources. “We’re the only private care company in Lane County that has registered nurse care managers,” she says. The organization was founded in 1990. Fabiano and her staff assist in numerous ways, some large, some small.
If a person is no longer able to make decisions for themselves, Elder Care Resources can act as legal guardian or power of attorney. Fabiano is the legal guardian of one man who was referred to her by a hospital when they recognized that it was unsafe for him to go home by himself. That man recently fell and fractured his hip. When Fabiano got the call, she leapt into action. She went to the hospital with him, provided his current medical and personal information, stayed with him until he got all of the diagnostics done and until he was admitted. Then, Fabiano handled calls about whether he needed someone to personally sit with him because of his confusion. She coordinated with the surgeons, talked to his attorney and talked to his regular care provider to make sure that everyone knew what was going on.
Another private paying client with a family member who lives out of state fell a couple of weeks ago and had been in the hospital. The family member hadn’t made a decision about where she was going to go when the time came for her to be discharged. Fabiano spoke to a mechanic about care repairs, purchased groceries and filled prescriptions. “I took care of everything that is going to allow this woman to go home with 24-hour care and be safe and be appropriately cared for,” says Fabiano.
Fabiano uses the analogy that Elder Care Resources are “team managers.” Organizations such as hospitals will often have their own care managers, but the difference is those care managers are coordinating care only within their own practice, not coordinating care with the entire team. “They’re not the high-touch care managers that we are,” says Fabiano.
In-home care is a valuable service, but when you’re considering care mangers, an important aspect to understand is where their care ends. “Care givers or care aids are another, important part of the team,” says Fabiano, “but we do a lot of things that they can’t do. We pull together the team. We come into play when a family member can’t play that role. Sometimes there’s not a family member who can do it all.”
If you already use a care provider or are looking into care managers, ask questions about whether or not the organization provides a 24-hour response. Can the care providers go to the hospital with you or a family member whenever you need it? “Ask, ‘Where does your service end and what other services might I need and where would I get them in my situation?’” says Fabiano. “Anyone who is involved with an emergency should have an advocate at their side. You may not be thinking clearly yet you will be asked to make many important decisions.”
An 89-year-old woman named Sarah Marshall (she requested that her real name not be used) has used Elder Care Resources for a couple of years now. “My daughters set this up,” says Marshall. “My daughters don’t live here so they were concerned about me.” Her representative from Elder Care picks her up and takes her to her doctor appointments, and stays with her to fully understand what the doctor is ordering. “They always email my daughters to give them all the information,” Marshall says. “They make suggestions to make my life easier.”
Fabiano says that they have people who sign up “just in case.” In these situations, the person doesn’t need care yet, but they or a family member are concerned that one day they will. Elder Care assesses the entire situation and gathers up all of the pertinent information, so if there is a crisis, all of the team members are ready to jump into action to help the person.
Deanna Schilling is a 50-year-old registered nurse who started her own care management business called Rent A Nurse. “I love being able to help people sort out the medical puzzle that we’ve created in our society,” Schilling says. Schilling fills a gap that she saw in the home care field. She says there are growing numbers of disabled people aging, or autistic children growing into adulthood. She often provides travel companionship, so that an ill or disabled person can travel to visit family or take a trip with their family without relatives “drawing straws” to see who needs to take care of them. “People want to take the one last trip before a loved one dies,” Schilling explains, “or maybe someone diagnosed with a terminal illness wants to go on a trip but they don’t want their relatives to be stuck in the hotel. I’m totally responsible for the care of the loved one in those cases. If they’re up all night sick, I’m up all night. If they can’t venture out with the family we stay in the lobby and people watch. If there’s a need I can escort the people to emergency services. It doesn’t matter what the vacation is, I’m focused on the clients.”
Schilling also provides hospital advocacy, medication management and verifying nursing tasks that are given to care givers. “I really try to take the time to get to know the family and the client,” says Schilling. “I really focus on their needs and their wants and coordinating their doctors and care givers.” For instance, Schilling had a patient who went to a long-term care facility. She didn’t think their rehabilitation was adequate, so she was able to coordinate more care, putting the client way ahead of their recovery schedule with a good outcome. “I look at the whole picture with everything that’s going on,” she says.
These services do come with a price tag. Rent A Nurse charges $85 an hour, generally, and more for off-site vacations. Elder Care Resources charges $95 per hour for general care management, $105 for guardianship, $95 for money management, and $125 for estate planning. “It’s not cheap, but we only charge for services that we provide,” says Fabiano. “We are the most established, most full-service most long-lived entity in Lane County.” It’s hard to put a monetary value on these life-changing services, but if you have to pay someone, you’ll know you’re getting the best care possible.
Rent A Nurse
Elder Care Resources
399 E 10th Ave. #211, Eugene