A few years ago, an elderly couple living in an independent living apartment at a Bethesda retirement community went to the hospital. The wife, who was in an advanced stage of dementia, had become ill.
Given her age and health complications, coupled with her dementia, doctors at the hospital presented the husband with two choices – putting in a feeding tube or allowing her to pass away with comfort measures.
Her distraught and frantic husband quickly phoned Chandelle Martel, MSW, LCSW, CASWCM, a Certified Care Manager and manager of the Bethesda Care Management department.
“He was hysterical,” Chandelle recalls. “He called me because he had no other relatives and he trusted me.” According to Chandelle, the man had taken care of his wife for years—bathing her, dressing her feeding her – and he could not make the decision about the feeding tube alone.
Chandelle drove to the hospital and sat with the husband for several hours. “We talked, we cried, we reminisced,” she says. Finally, the husband decided to bring his wife back to their apartment, and Chandelle arranged for hospice care and additional private duty services.
Today, this couple is still living in that independent living apartment at their Bethesda retirement community.
Care Managers Act as Guides to Aging
Chandelle compares her role as a Care Manager and the role of her staff to that of a guide. “We guide people as they consider all the choices they are presented with when they, or their loved one, begins to struggle with aging,” she explains. “Aging is a complex task, and it takes a lot of knowledge and experience to ensure the best quality of life for a senior in need.”
Care managers like Chandelle, who is an advanced social work case manager and a licensed clinical social worker, often enter the picture when senior residents begin to struggle in independent living. Many times, their involvement begins after the staff report some behavioral or physical concerns.
“They might tell me that “Mr. Johnson” hasn’t been coming down to the dining room for dinner, so I visit him and discover that he has been falling lately and not telling anyone,” she explains.
Once a person’s health, abilities or behaviors begin to decline, an assessment is arranged that involves checking with a resident’s physician, examining nutritional needs, and determining what personal care and medical services should be added. Residents may need to be escorted to doctor appointments, need errands run, or need help sorting their mail or with bill-paying tasks.
Knowing The Ins and Outs of Senior Care
Chandelle and her care management team know how to navigate the healthcare system, help arrange for veterans benefits, and can counsel family members and residents who have difficult healthcare decisions to make.
They answer questions about healthcare options and long-term care insurance. They review advanced directives that spell out the wishes of the senior when it comes to the type of medical care desired at the end of life and designates who will see that those wishes are honored. They also may guide residents to other professionals, like attorneys or estate planners, to address their needs.
Care managers also often help resolve conflicts. Family members may have differing opinions on the best course of care or treatment for their loved one, and the disagreements can become highly charged.
The care management team also looks for signs of depression in residents, which may become debilitating and dangerous if not addressed.
Nothing Routine About the Job
When the Bethesda care management program began, Chandelle left word at the front desk of every Bethesda independent living community that she wanted to be immediately notified whenever a resident left a community and when they returned.
Not only does she know about her residents, but she knows about their pets. She was aware that a resident taken to the hospital had a little dog in his apartment. He had no wife or family, so Chandelle received permission from the resident to care for the dog. She even took it to the vet.
Typical days do not exist for Care Managers. “I have to constantly re-prioritize my day. I’m checking up on people that went to the hospital the night before, talking to families about their loved one, coordinating what’s going to happen when they are discharged, and determining what they will need when they return,” Chandelle says.
Chandelle says that whenever her husband calls her in the morning and asks if she wants to go to lunch, her standard reply is “I won’t be able to tell you until 10:45 a.m.”
Results in Human Terms
As a result, the independent living residents at Bethesda stay in their apartments an average of three additional years after Bethesda’s care management team begins to provide service. Chandelle has yet to find a care management program in any long-term care organization that provides additional independent living time of this length.
“It’s vital to keep residents living independently for as long as possible,” she says. “They feel better about themselves and they keep pushing to stay that way because they have more control over their lives.”
A Worthwhile Venture
Chandelle has been a Care Manager for 26 years (nine years with Bethesda). Why does she do it? “Because I love it!” she says.
For more information about the Bethesda Care Management program, or to arrange for an appointment, please call (314) 963-2200 or send us an email at firstname.lastname@example.org.