Ellen Platt: Why You Need a Geriatric Case Manager For Your Loved One
by Steve Heisler
About Ellen: Ms. Platt is founder and owner of The Option Group, LLC. Her team conducts comprehensive evaluations, makes recommendations, implements a plan of care and coordinates resources to support it. They provide a thorough knowledge of the healthcare industry and can help families skillfully navigate the maze. Additionally, they provide advocacy services and can assist with care in the home or placement in a facility. Ongoing monitoring can also be set up so that the most appropriate plan of care can be implemented at all times and changes can be made to address changes in condition and avoid crises. The goal is to identify ways to enhance the quality of life for the clients she serves, in the safest, yet least restrictive environment possible, taking safety, independence, function, and comfort levels into consideration.
Ellen is both a Certified Rehabilitation Counselor, and a Certified Professional Geriatric/Aging LifeCare Manager, with a span of 30 years providing care management and case coordination services to those with catastrophic injury, chronic diseases and disabilities. Out of that experience, she created The Option Group to address similar needs and services specifically for seniors or those with special conditions and their family caregivers and guardians. Her primary practice focuses on working with caregivers and aging families and the large variety of issues and needs specific to that population.
In this episode, Steve and Ellen discuss:
1. Ellen, can you tell our listeners what a geriatric care manager does?
- Care managers cover a wide variety of tasks. We help people navigate longevity, whatever that means for them, we go to the person where they are in that stage of life, and we help them navigate the system. It’s really a holistic, client centered approach of caring for people. We look out for people with a variety of health challenges. We’ll do an assessment. We’ll make recommendations for care and come up with an individualized care plan. Then we monitor it and tweak it to make sure that it’s meeting their needs and we also do some health, education, advocacy, family coaching, and crisis intervention. So we cover a wide scope of variety of tasks and a variety of people in situations.
2. Would it be correct to say that you are geriatric care managers, more focused on seniors and the elderly?
- We do a lot of work with seniors in cognitive or physical decline but we also utilize our team to help younger people with M.S., mental health issues, traumatic brain injury, or catastrophic injury. People with these issues still need an advocate and someone to help them navigate the resources and their care.
3. What issues, would you say, are generally the most important to the senior and elderly community?
- One of the biggest things is that people want to know what their options are, understand the options, given their situation, and they want to understand why they might pick one over the other. We’re able to educate them, give them ideas of what the options are, what the costs associated with those options are, and they know who is paying for it. Is it an insurance paid benefit, or is it something that they’re paying out of pocket? We’re helping them to pull together this holistic care plan and create a solution that’s going to help them remain safe, as independent as possible, functioning as well as they can, and maintaining their dignity in the process.
4. What are some of the significant injuries that you deal with and see the most?
- With an aging population, we see all different types of dementia, Parkinson’s, or stroke tend to happen more frequently with people who are advanced in age. We also deal with folks who have had traumatic brain injuries, concussions, a medical malpractice case, catastrophic injury that left them with significant residual disabilities, or they sustained a permanent injury of some type and now they need to reclaim their lives and have the best quality of life possible and function as well as they can give in their new circumstances. So they often need some help navigating that process.
5. At what point during the process does either a senior, an injured individual or their family contact a certified geriatric manager after a catastrophic injury?
- People are often contacting us when there’s been a crisis and they don’t know how to navigate the various systems involved. We often are able to jump in pretty quickly to do that assessment and come up with recommendations and stabilize the situation. First thing we address is safety issues. Then we also look short term, then ideally, long term. So that’s where we come in with that full assessment, looking at the clinical picture, and figuring out what it is they need and care managers really have eight core areas of expertise that we work within. We navigate health care for people, look at the clinical picture of their health and disability, the financial picture, their housing situation, advocacy, and we look at their legal documents to make sure that they have their planning documents in place. We often do crisis intervention. Ideally, we’d like to be called before the crisis so that we can do some planning and they have some options in place.
6. What are some examples of crises that you see a lot?
- Often we’ll see a husband and a wife living together and maybe one spouse has a lot of physical disability and there’s another spouse that has the cognitive disability. And together they make one person but if something happens to one of them, things start unraveling quickly prior to that they were compensating for each other’s difficulties and were able to maintain their living situation. But if something happens to that it topples pretty quickly. And families are looking to us to help. Right things.
7. If someone reached out to a geriatric care manager would they provide someone who would be able to step in and make sure that everything financially in a household is kept up to speed?
- Yes, exactly. We would be able to link them with somebody who would be able to step in quickly and be able to keep them fiscally organized, make sure that they’re not receiving collections notices, or getting things ready for their accountant.
8. What’s the important part of consulting with a geriatric care manager before a loved one is placed in a nursing home?
- Many times people say they want to stay at home. We’re able to help them bring in resources and services and put in that infrastructure that allows someone to stay at home longer. Sometimes there are situations where it’s going to either make more financial sense, or they have certain needs that need a special level of care on a consistent basis that you’re not able to establish in the home. We would then help them navigate to a facility. Working with a care manager, you have somebody who knows the systems, knows the local resources, and can look at the clinical picture and find a care facility that is going to support their particular needs. The care managers can help with all the paperwork and the legwork needed to be able to move into a facility. We also work to help set up the expectations with the care facility and how we expect the care to be provided to this individual.
9. What is the difference between what a geriatric care manager does as compared to a placement agency?
- The primary difference between us and a placement agency is our payment source. We don’t get any payments whatsoever from our referral sources, whether we’re referring them to facilities or home care agencies, or other senior services. So there’s no temptation or no tendency to see things from a financial perspective of where that person is going to go for their care.
- Care managers also work across the continuum of care. It could be somebody who’s independent, somebody who needs assisted living memory care, or skilled nursing so we can work in any level of care all the way through end of life. When you use a certified care manager, you’re getting someone that has a master’s level education and they’re held to a code of ethics. They have ongoing peer review meetings and ongoing continuing educational requirements so that they’re staying on top of the latest information. Care managers will work directly with the client and the family and are really their advocates. Our concern is the clients best interest.
10. Is a placement agency always going to place a patient in the best possible place for their needs?
- You want somebody with a minimum standard and code of ethics that really understands the resources and the various systems out there to be placing an individual into the proper facility for them.
11. What is the most important thing for a geriatric care manager to do for a senior or elderly individual who has just sustained a catastrophic spinal injury?
- In an incident like that, we would probably use a catastrophic case manager, a nurse case manager that we would have because they would be more in tune with the medical issues that are involved with a spinal cord injury.
- That case manager would be getting the information from the physicians, the hospital, discharge records, and health history information to really understand the injury itself and how any underlying conditions may impact that injury.
12. Would a nurse case manager go with the individual to their medical appointments, review records, and keep an eye on what’s going on to make sure they’re getting the best possible care?
- They do a lot of medical care coordination. They may even be doing things like scheduling appointments, requesting medical records, taking them to get imaging, coordinating surgery, and being there the day of surgery so we can do some really hands on stuff.
13. Do nurse case managers have a specialty like orthopedic injuries?
- Yes, that’s possible.
14. Is it correct that another catastrophic injury that you might see a lot is traumatic brain injury?
- Yeah, especially when in a sports world. We do work with some professional sports teams that have issues with head injury and concussion, and then older sports retired players who need assistance with coordinating their care as maybe they have dementia developing or other medical conditions and they need they have special circumstances that we need to help navigate.
15. Can you work with older individuals who have had sports injuries earlier in their lives?
- Yes, and many of them need help navigating because they’re no longer able to do it for themselves. If you think about it, whether it’s football, rugby, soccer, ice hockey, boxing, there’s all different sports, where people are sustaining head injuries and over time, they may have some special circumstances arise.
16. When are you brought in to handle care for a patient with dementia?
- In the instance of dementia, often people have symptoms or issues relating to dementia, possibly even 10 years before they actually get a diagnosis. It might be mild forgetfulness, it might be getting lost in a familiar area while they’re driving their car, it might be starting to forget names, more than just the typical stuff you see with aging, it becomes problematic and that’s when we get the call. It becomes problematic and difficult for somebody or the family to function given the person’s new ability or declining ability to function independently. That’s typically when we get the call and when services will be started because that’s when they’re really noticing it.
17. Are you brought in when you have individuals who might have gotten a clostridium difficile infection, pneumonia, or sepsis?
- We do, but that is generally secondary to something else going on. Or while we’re managing their care, they get an infection. For instance, it may be because they have a catheter, they get a urinary tract infection, maybe pneumonia, maybe they have swallowing issues, and they have aspirated and it leads to pneumonia. So those are conditions that we’re always keeping our antenna up on. That’s not typically why we’re called but it definitely is something that needs to be watched.
18. What other professionals would you make part of your team in a situation where you had a senior or elder with catastrophic injury or dementia?
- We could bring in a Certified Daily Money Manager to keep them fiscally organized on a day to day basis, a professional called a Senior Move Manager who can help coordinate and orchestrate a move from beginning to end, and a home care company to bring in all the hands on caregivers that are going to help with those activities of daily living. We also put into place systems for medication management, transportation, housekeeping, meal planning, and cooking.
“When you use a certified care manager, you’re getting someone that has a master’s level education and they’re held to a code of ethics.” — Ellen Platt
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
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