Handbook of Geriatric Care Management

Author: Cathy Cress
Published: December 2000
Publisher: Jones & Bartlett Publishers, Inc.
ISBN: 0834216671
Hardcover Book
Number of Pages: 336

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The book contains black-and-white illustrations.This cutting-edge book on the management of geriatric care is designed to meet a growing area that expands across the continuum of healthcare. This is the essential reference for professionals working in the field. It gives healthcare delivery systems, private and public healthcare practitioners, business professionals, and schools of nursing, social work, and related healthcare fields the definitive book on geriatric care management. This book defines the work of the geriatric care manager and offers an overview of what geriatric care management is, defines duties and procedures, and specifies the organizations that employ a geriatric care manager. Guidelines for setting up a geriatric care management practice independently or as part of a larger healthcare delivery system or business are provided, and key elements for marketing the practice are supplied. Several case studies are also included. Fifteen chapters overview what geriatric care management is, and define the duties and procedures of a geriatric care manager. The book begins with guidelines for setting up a geriatric care management practice independently or as part of a larger health care delivery system, and suggestions for marketing a geriatric care practice. It then discusses the clinical aspects of working with families, geriatric assessment, dementia, depression, and incorporating a spiritual perspective into geriatric care management.

Table of Contents
Contributors ix
Foreword xi
Acknowledgments xiii
Introduction xv
Part I Introduction to Geriatric Care Management 1
Chapter 1 Overview and History of Geriatric Care Management 3
Overview of a GCM's Responsibilities 4
History of Geriatric Care Management 6
The Birth of Geriatric Care Management Organizations 9
Conclusion 11
Chapter 2 Ethics and Geriatric Care Management 13
What Is an Ethical Dilemma? 15
Ethical Conflicts between the Client's Needs and the Client's Wants 17
The Ethical Conflict Regarding Client Exploitation 18
Conflict between the Client's Safety and the Client's Autonomy 19
Conflicts around Confidentiality and Disclosure 20
Analyzing Ethical Dilemmas 20
How To Resolve Ethical Dilemmas 21
Conclusion 22
Part II Beginning, Expanding, or Adding a Geriatric Care Management Business 23
Chapter 3 How To Begin or Add a Geriatric Care Management Business 25
Entrepreneurial Risks 25
Types of Geriatric Care Management Businesses 26
Creating a Business Plan 30
Financing a Geriatric Care Management Business 32
Professional Consultants 33
Developing Procedures 34
Business Insurance 35
Setting Up an Office 36
Hiring Good Staff Members 37
Billing 38
Integrating a Geriatric Care Management Business into Another Practice, Business, or Agency 39
GCMs and Managed Care Organizations 41
Conclusion 42
Chapter 4 After the Start-up: Issues for Mature Care Management Organizations 43
Introduction 43
Defining a Niche 43
Models of Geriatric Care Management 44
Maintaining the Organization's Image 44
Marketing 45
Organizational Development 52
Establishing Working Relationships with Key Organizations in the Community 57
Joining Organizations and Networking Nationally 58
Conclusion 60
Chapter 5 Fee-for-Service Care Management in Not-for-Profit Settings 61
Introduction 61
Terminology 62
Brief History of Case Management 62
Private Practice Care Management versus Public and NFP Care Management 63
NFPs' FFS Program Development Challenges 64
Costs, Rates, and Billing 67
Conclusion 68
Chapter 6 Improving Care and Profitability through Integrated Information 69
Introduction 69
Information and Geriatric Care Management Organizations 69
Information System Basics 71
Different Models for How Organizations Use Information 73
The Role of Information in Specific Care Management Functions 76
A Model Information System Plan for Geriatric Care Management Organizations 78
Information Sharing and the Value of an IIS 83
Barriers and Benefits of an IIS 84
Communications and Computing: The Internet and the World Wide Web 87
Conclusion 90
Appendix 6-A Hardware Fact Sheet 92
Appendix 6-B What Does My Agency Need To Get Started? 94
Part III Growing and Managing the Business of Geriatric Care Management 97
Chapter 7 Marketing Geriatric Care Management 99
Being a Care Manager as Well as a Salesperson 99
Seeing the Client as a Customer 100
What Is Marketing? 100
Developing an Image 102
Positioning the Agency 103
Revamping an Agency's Image 107
Writing a Mini Marketing Plan 107
Doing Public Relations 108
Advertising 113
Conclusion 114
Chapter 8 Revenue Sources for Geriatric Care Managers 115
Payment by Private Individuals and Their Families 116
Limitations of Third-Party Reimbursement and the Rise of Long-Term Insurance 117
Non-Insurance-Related Third-Party Revenue Sources for GCMs 123
Formation of Regional Trade Associations and Informal Provider Networks 127
Conclusion 128
Chapter 9 Care Management Credentialing 131
Introduction 131
Motivation 132
History 134
Overview of Selected Credentialing and Certification Organizations 135
Current and Future Issues 141
Conclusion 144
Part IV Clinical 147
Chapter 10 Geriatric Care Management with Families 149
Introduction 149
Geriatric Care Management with Families 149
Working with Long-Distance Caregivers 152
Helping Adult Children and Families Manage the Overwhelming Demands of Caregiving 155
Working with Dysfunctional Family Systems 157
Helping Families Develop Solutions for Their Needs 158
Building Partnerships with Professionals 159
Helping Caregivers Diffuse Conflict 161
Helping Caregivers Establish Good Communications 161
Encouraging Families To Communicate Their Needs 162
Helping Caregivers Strike a Balance 162
Assisting Spousal Caregivers and Working with Couples 163
Continuum of Care Resources--Working as Part of a Team 166
Helping Families Make the Decision To Place 167
Conclusion 174
Appendix 10-A How To Find a Qualified Geriatric Care Manager 175
Chapter 11 Geriatric Assessment 177
Introduction 177
Elements of the Assessment 178
Case Study in Assessment 179
Nursing Assessment 179
Functional Assessment 182
Thought Processes 184
Vision 185
Hearing 186
Urinary Incontinence 186
Nutrition 186
Height 187
Assessment Tools 187
Writing the Assessment Findings and Designing the Care Plan 203
Conclusion 205
Chapter 12 Dementia and the Older Adult: The Role of the Geriatric Care Manager 207
Introduction 207
Defining and Diagnosing Dementia 208
Dementia Experienced 211
The GCM Role in Dementia Care 216
Communicating with Other Professionals 234
Training Family and Paid Caregivers about Dementia Care 236
Conclusion 244
Appendix 12-A Evaluating Functional Assessment Instruments 247
Appendix 12-B Key Target Area Impairments: Impact on Dementia Clients' Abilities 251
Appendix 12-C Referral Checklist 254
Chapter 13 Depression and the Older Adult: The Role of the Geriatric Care Manager 255
The Case of Mrs. W 255
Suicide 257
Screening Instruments 258
Diagnosing Depression 258
Depression and Dementia 259
The Case of Mrs. C 259
Depression and Caregivers 261
The Case of Ms. A 261
The Case of Ms. H 263
Depression and the Role of the GCM 264
The Role of the GCM in Training 265
Conclusion 266
Chapter 14 Incorporating a Spiritual Perspective into Geriatric Care Management 269
The Purpose of Life's Last Stages 269
Spiritual Tasks in Old Age 271
Ways To Facilitate the Spiritual Process in Geriatric Care Management 272
GCMs Look at Their Own Values, Spiritual Beliefs, and Family History 274
Assessment of Clients' Values and Sources of Meaning 275
Facilitating Spiritual Connections with People Who Have Dementia and Their Families 281
Conclusion 284
Part V The Future 287
Chapter 15 The Future of Geriatric Care Management 289
Managing Care as a Mainstream Business, not a Boutique Business 290
Diverse Professionals Delivering GCM Services: The Lawyer, the Accountant, the Trust Department 292
The Impact of Changes in the Insurance Industry: The Deep Pockets of Third-Party Reimbursement 300
Integrating Technology into In-Home Monitoring: 21st-Century Changes 302
Ensuring Future Success in Geriatric Care Management: Thinking Ahead 304
Conclusion 309
Appendix A Contact Information 311
Appendix B Assessments 313
Sources 321
Index 325

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