Our Services

A whole person wrap-around support team. 

Care Management means having a team of Care Professionals.  A team of Registered Nurses, Certified Geriatric Care Managers, and Management Staff are all committed to the mindset of surviving is not thriving.   Focusing on medical needs, nutrition, emergency planning, long and short-term goal setting, as well as finding activities that fulfill that desire we all have to continue to contribute to society. 

 

Clinically speaking, our Care Managers can transport to and from appointments, and attend both social or doctor appointments.  They will listen to your goals and questions and then advocate for the health care goals that are important to you and then work side by side with your physician.   We provide monthly, or even weekly check-ins to ensure medications are being taken as prescribed. Having a personal liaison between physicians, hospitals, and different labs or testing keeps every physician up to date on your medical status.   All of our visits, notes, recommendations, and family communication is kept in a family portal that all family members have access to. 

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Socially and legally speaking, our Certified Geriatric Care Managers (CGCM) make sure that you have your Advanced Directives and Power of Attorney's in place.  They complete a very extensive intake to ensure that your final wishes are all written and in place.  They also work with our nurses to complete the circle of care and assist you with community resources, waivers, or additional Medicare / Medicaid services that are available.   We take the time to complete enrollments and make sure the services are started or scheduled, not just provide you with a phone number.   Our CGCM's can assist with maintaining  appointment calendars, setting up transportation options,  assisting with in home care task planning, and these are just a few of the tasks we focus on. 

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Care Management is on call 24/7.   Getting to an urgent care or meeting a client in the emergency room,  our team is here to walk right beside you.    This provides family with an extra level of security knowing that someone is with their loved one and able to give immediate reports back to the family.

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Success Stories:

A client had struggled with high blood pressure for nearly 3 years.  Our Nurse made an appointment with their physician, and they discussed parameters in which the physician wanted to be notified vs going to the ER.  We enrolled the client on Vital Monitoring so that every time the blood pressure was taken and was outside of what the physician set as acceptable, we were notified.  Calling the physician's office daily for several weeks, they were able to change medications before the follow up that was scheduled a month out.  We are happy to report that this client still has what is considered perfect blood pressure.  Having a nurse work side by side with your physician can make a huge difference. 

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We met a sweet lady that was her husband's sole caregiver with no family in town.  During our conversation she mentioned that she was very concerned that if something happened to her; she knew her husband would not be ok.  After a meeting with our Certified Geriatric Care Manager they were able to assist with Power of Attorney's, Advanced Directives, and putting them in touch with an attorney for a Living Will.  During that meeting, they enrolled in Smart911.com and the CHAMPSS program, as well as discussed some additional resources they might want in the future.  This lady called to let us know that she feels like the world has been lifted off her shoulders knowing that if something does happen, we will be notified and we will stay with him until he is able to get moved to the facility she has chosen. 

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After getting a call from a long-time friend we scheduled a meeting with her father.  He has Parkinsons and although his hands and balance may slow him down, mentally he is still a very capable man.   When we discussed what he misses most he revealed that he feels like he is just waiting to die and that he no longer has a purpose.  We discussed what he did for a living and what types of things he could do to bring him joy.  It turns out that he loves working with wood and his hands.  We made a post on Facebook asking for people that wanted home made bird houses.  He is now selling birdhouses for $10.00 through his daughter.  He loves getting the new orders and meeting the people that get them.  Giving someone purpose is like giving them a renewed zest for life.

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