Toolbox Series: Care Coordination for Caregivers

As caregivers you often do it all–personal care, medical management, bill paying–as well as transportation and domestic duties.   In most cases there are three main differences between you, the family caregivers, and professional care coordinators. Professional care managers:

1. Educational expertise specific to case management
2. Emotional AND  physical detachment from that of a direct care provider
3. A paycheck

–Can’t do too much about the last two, but by using the care management tips and techniques utilized by paid supports, you can make your caregiving journey less stressful and more effective.

WHAT IS CARE COORDINATION?

Care coordination is the management of services and supports. Care Coordinators are the liaison between health care and insurance providers, support systems, and families.  According The CommonWealth Fund, a nonprofit that promotes quality health care, care coordination is the organization of community and health services.

care coordination model

Family caregivers can adopt professional practices by breaking care coordination into manageable steps. After all, time (and sleep) is usually at a premium.

 STEP ONE: ANNUAL ASSESSMENT

• Evaluate your loved one’s abilities
• Evaluate your abilities
• Evaluate your care environment (accessibility; safety; etc)
• Evaluate financial status (insurance; documents; etc.)
• Evaluate legal status (guardianship; power of attorney; etc)

STEP TWO:  IDENTIFICATION

• Medical services (type; frequency; location –home, clinic, community)
• Mental health supports
• Community supports
• Education (on loved one’s challenges)
•  Circle of support
•  Funding
• Advocates (Ombudsman; The Arc)

  STEP THREE: ACTION PLAN

• Create an Individual Family Support Plan (IFSP)
• Develop a caregiver team
• Establish a daily routine for stability
• Implement recordkeeping
• Begin “next step” planning (transitions – into/out of school; into adulthood; home to group settings; advance directives; etc)
• Find yourself supports (groups; respite providers; on-line networks; a clown)

Tools

–          IFSP (adapt to your needs)

–          Medical Home

–          Organization techniques

This is a process. Just begin at the beginning and follow the care coordination road from there. You will need courage and confidence along the way. You already have the heart.