With 25 years of experience in the health care industry as a registered nurse and working closely with seniors, there is one thing that keeps resonating with me: the need for case management and medication management within the senior population. In this article, I will specifically discuss case management and medication management as it relates to seniors.
If you think about it, our seniors, parents, and grandparents have experienced a lot of change over their lifetimes. The changes that have occurred may include changes in health, living arrangements, family, support systems, and independence, to name a few. Unfortunately, most of these changes involve losses. To further complicate matters, seniors have to navigate the increasingly complicated health care system, insurance system, Medicare and Medicaid systems, new technology, medical lingo, and the speed of which information is delivered. This would all be a lot for anyone to manage but, let’s add to it, a loss of vision and hearing. Whether it be a family member, preferably with experience in the health care system, or a paid provider who assists with case management and medication management, there should be someone present to help.
Private insurance, Medicare, Medicaid, and prescription drug coverage are sometimes difficult to obtain and access. The question that is always asked is “what is covered?” The answer is not always easily found. In fact, finding the answer may take several phone calls.
The next questions are: who to have as a physician and does the physician accept your insurance? Today patients are often referred to physicians that specialize. This is a change from the past when a patient had one family practitioner who provided all of their care. Some of the specialty areas could include cardiology, pulmonology, endocrinology, nephrology, podiatry, immunology, oncology, neurology, and dermatology to name a few. The terminology is quite a mouth full and a challenge for a patient to remember.
Once the patient chooses a physician and receives any suggested referrals, getting to the medical appointments can prove to be difficult due to a lack of transportation and immobility. In the health care arena, it seems that everything has gone bigger and faster, including the volume of patients being seen, the use of high tech equipment, and the size of the facility itself. It can be overwhelming to our seniors.
Okay, so now that the senior patient has navigated this far, they are probably pretty frazzled and fatigued and everything they wanted to say to the physician went right out the window once in the office. So, it is not surprising that there will be gaps in communication between the client and health care provider. Adding to the miscommunication, many clients tell their physician that they are “feeling good” even though they have had health problems for weeks.
In addition, patients sometimes unknowingly suffer from side effects related to their medications (for example medications like pain medications, opioids, antibiotics, and blood pressure medications). It is important to remember that all medications have side effects and each person reacts to medications differently. I have been a personal witness to many mishaps with medications. It is important to have someone able to assess the side effects and monitor that the medications are taken correctly. In the long run, case management and medication management can save you an unplanned trip to the emergency room or physicians office.
If you have a family member that is struggling with their health care with frequent hospitalizations or frequent emergency room visits, you may want to consult with them and obtain their permission to attend their medical appointments in order to understand the physician’s orders and your family member’s health care needs. It is especially important to have an advocate/case manager present during hospitalizations or emergency room visits, because this can be a time when the ill patient needs the most help. A case manager can provide an assessment of the symptoms leading up to the office visit or hospitalization and assist with communication between patient, family, and health care providers. The case manager may also set up appointments, assist with transportation, setup medications and see that they are accurately taken, and provide education/information to both patient and other family members, etc.