OTs Uniquely Qualified For Geriatric Care Manager Role
Thursday April 8, 2010
Print This- Select Text Size:
advertisement
For geriatric care managers such as Eileen Berman, OTR/L, MS, CMC, devising care plans for clients is like solving a complex jigsaw puzzle. Navigating the caveat-filled network of geriatric medical, governmental and social programs, Berman pieces together appropriate elements from across the elder-care spectrum to create strategies to improve her clients’ quality of life.
Berman worked as an occupational therapist for five years before seeking geriatric care management certification in 1999 and founding Independent Living Solutions Inc. in Beverly Farms, Mass.
“When I talk about this puzzle, the first thing we do is an assessment, which is similar to an OT evaluation, where you look at how this person functions, their formal support services, informal [support], financial picture, their diagnosis and where they’re potentially headed and then figure out the recommendations,” she says.
Logical Career Move
Certified geriatric care managers hail from a variety of backgrounds. According to the 2,000-member National Association of Professional Geriatric Care Managers, members can hold a bachelor’s, master’s or doctoral degree in a field such as counseling, psychology, nursing, social work or gerontology.
“It seemed like a natural transition from OT into care management,” says Rhoda Goldberg, COTAL, BA, CMC, and founder of We Care Elder Services Inc. in Sarasota, Fla. “Very often, I’m asked to evaluate whether someone can remain at home, and then my OT skills come in to help determine whether someone is safe and evaluate how cognitively intact or impaired they are.”
In fact, the psychosocial dexterity OTs possess is one of the most valuable tools of a care manager. “We really look at how a person functions in their environment and what’s important to them,” Berman says. “When we talk about someone staying in their home, we’re not just talking about getting out of bed, washed and dressed. We talk about what makes them feel useful, what gives quality to their lives.”
Berman and Goldberg’s medical experience also has served them well. “I always like to think of the example of someone who can’t tie their shoes,” Berman says. “There are multiple reasons why they can’t — it could be arthritis, vision problems, peripheral neuropathy, bad back, bad shoulder — and each one has a different therapy. I think we look at all of those reasons. We also look at how all of the medical diagnoses, particularly in the elderly, when compounded create a different level of function than [with] a younger person.”
The Ins and Outs
Because geriatric clients often require occupational therapy, OTs have familiarity with issues particular to the demographic. Goldberg recalls receiving a call at 3 a.m. for a client who had been taken to the hospital after falling on the floor of her assisted-living facility.
“It turned out she had a fractured pelvis, and they didn’t admit for fractured pelvises. They wanted to send her back to her assisted-living facility,” Goldberg says. “I said, ‘She can’t go back. This is a lady with dementia — she’ll stand up and start walking.’
So the doctors said they could send her to a nursing home, but I told them they couldn’t do that without admitting her for a three-day hospital stay because Medicare won’t cover it unless she’s hospitalized. So I asked them if they could run some additional tests and try to find something to admit her with. So they ran some tests and found out she was anemic and they kept her.”
Goldberg’s familiarity with facilities and understanding of senior citizen benefits saved her client’s family thousands of dollars. “I pull in information from the different parts of the person’s life, deal with doctors, deal with any financial people, make sure their legal papers are in place and even discuss end-of-life care. Care managers do all of that,” Goldberg says.
Dynamic and Fulfilling
Care managers find gratification in juggling these myriad issues. “Every family is different, but each time you become a member of the team, you’re the expert on the team, you’re the coordinator,” Berman says. “And it’s always interesting. There is always another problem to solve.”
Like Berman and Goldberg, many of these specialized problem solvers start their own businesses. “It is a chance to become an entrepreneur and work for yourself,” Goldberg says. “The drawback is you will be on call 24-7, but I don’t mind that.”
As the nation’s largest population segment grows, so too has the number of programs available to these elderly citizens, Berman says, explaining that growth has fueled the need for on-call experts trained in elder care. •
Robin Huiras is a contributing writer for Today in OT.
Berman worked as an occupational therapist for five years before seeking geriatric care management certification in 1999 and founding Independent Living Solutions Inc. in Beverly Farms, Mass.
“When I talk about this puzzle, the first thing we do is an assessment, which is similar to an OT evaluation, where you look at how this person functions, their formal support services, informal [support], financial picture, their diagnosis and where they’re potentially headed and then figure out the recommendations,” she says.
Logical Career Move
Certified geriatric care managers hail from a variety of backgrounds. According to the 2,000-member National Association of Professional Geriatric Care Managers, members can hold a bachelor’s, master’s or doctoral degree in a field such as counseling, psychology, nursing, social work or gerontology.
“It seemed like a natural transition from OT into care management,” says Rhoda Goldberg, COTAL, BA, CMC, and founder of We Care Elder Services Inc. in Sarasota, Fla. “Very often, I’m asked to evaluate whether someone can remain at home, and then my OT skills come in to help determine whether someone is safe and evaluate how cognitively intact or impaired they are.”
In fact, the psychosocial dexterity OTs possess is one of the most valuable tools of a care manager. “We really look at how a person functions in their environment and what’s important to them,” Berman says. “When we talk about someone staying in their home, we’re not just talking about getting out of bed, washed and dressed. We talk about what makes them feel useful, what gives quality to their lives.”
Berman and Goldberg’s medical experience also has served them well. “I always like to think of the example of someone who can’t tie their shoes,” Berman says. “There are multiple reasons why they can’t — it could be arthritis, vision problems, peripheral neuropathy, bad back, bad shoulder — and each one has a different therapy. I think we look at all of those reasons. We also look at how all of the medical diagnoses, particularly in the elderly, when compounded create a different level of function than [with] a younger person.”
The Ins and Outs
Because geriatric clients often require occupational therapy, OTs have familiarity with issues particular to the demographic. Goldberg recalls receiving a call at 3 a.m. for a client who had been taken to the hospital after falling on the floor of her assisted-living facility.
“It turned out she had a fractured pelvis, and they didn’t admit for fractured pelvises. They wanted to send her back to her assisted-living facility,” Goldberg says. “I said, ‘She can’t go back. This is a lady with dementia — she’ll stand up and start walking.’
So the doctors said they could send her to a nursing home, but I told them they couldn’t do that without admitting her for a three-day hospital stay because Medicare won’t cover it unless she’s hospitalized. So I asked them if they could run some additional tests and try to find something to admit her with. So they ran some tests and found out she was anemic and they kept her.”
Goldberg’s familiarity with facilities and understanding of senior citizen benefits saved her client’s family thousands of dollars. “I pull in information from the different parts of the person’s life, deal with doctors, deal with any financial people, make sure their legal papers are in place and even discuss end-of-life care. Care managers do all of that,” Goldberg says.
Dynamic and Fulfilling
Care managers find gratification in juggling these myriad issues. “Every family is different, but each time you become a member of the team, you’re the expert on the team, you’re the coordinator,” Berman says. “And it’s always interesting. There is always another problem to solve.”
Like Berman and Goldberg, many of these specialized problem solvers start their own businesses. “It is a chance to become an entrepreneur and work for yourself,” Goldberg says. “The drawback is you will be on call 24-7, but I don’t mind that.”
As the nation’s largest population segment grows, so too has the number of programs available to these elderly citizens, Berman says, explaining that growth has fueled the need for on-call experts trained in elder care. •
Robin Huiras is a contributing writer for Today in OT.
To comment, e-mail oteditor@gannetthg.com.
Thursday April 8, 2010
