DorlandHealth

Joan Quinn, RN, MSN, FAAN, GSA Fellow, who has initiated community care management for chronically ill adults for more than 20 years, is the executive director of Connecticut Community Care, a statewide, $100 million program in Connecticut for low income, chronically ill adults.

Q: One of the challenges case managers face is working with patients and their families with chronic conditions as they age. How do you suggest the practice prepare to handle the aging baby boomer population?

A: Since the early 1980s, many publicly funded care management and care coordination organizations have been providing their services to older adults with chronic conditions and their family caregivers. The baby boomer population will expect the care manager to assist in the identification of their needs with them, provide service options responsive to these needs, and educate them about appropriate providers to deliver the necessary services.

Many baby boomers have had good and bad experiences with their own parents and will not expect the same for themselves. Care managers will need to be knowledgeable about medical and social services, their location, and costs for service. Care managers should be professional nurses and/or social workers with support staff as necessary based on their client caseload. If the caseload is 125 or more, care management can become ineffective.

Can you share some insight into the role of nurse practitioners serving as case managers?

Nurse practitioners can be very effective care managers if it is the focus of their practice rather than just treating acute episodes of illness. Nurse practitioners in the community would be a great advantage to care managers who are helping to manage long-term care needs as a result of chronic illness.

Caregivers are under a tremendous amount of stress. What can case managers do to assist caregivers?

Caregivers must be a primary focus of the care manager as they deliver the majority of care to the person with chronic conditions. Most of the time the care delivered is exceptional, and in many instances the caregiver needs assistance more than the chronically ill person. Caregiver stress is a common problem and the caregiver does not ask for assistance until they are on the edge themselves. In addition, it is a lonely task which is rarely spoken about to others.

What of great importance should readers know  regarding long-term care?

One of the crucial roles of the care manager is to establish confidence and trust between themselves and the chronically ill older person and their caregiver. Following through on the establishment of a care plan with them and reassessing the care plan as the person’s condition changes is key to fostering the trust necessary to provide positive outcomes for the older person and their family.