Care Planning

From the assessment, a detailed care plan will be developed and proposed to the client and his/her family. Choices of services will be offered by the care manager with plans for the client to contract directly with the services selected. It is most important that the client agrees to the expectations of the Care Plan in order to have the maximum benefit from these services.

The Care Plan will be a contract with the client and family. This Care Plan will be evaluated and revised regularly. The client’s satisfaction will be the focus of this evaluative process.

The Care Plan will be reviewed and modified as needed and desired. Care management may be provided as a short-term service, or on a long-term basis. The fee structure will relate to the intensity of the services needed and requested. Family members and friends will be encouraged to continue to provide for the needs of the client to the extent possible. Hopefully, meaningful relationships will be enhanced with more time to experience positive experiences.

A proposal will be developed to meet the needs and preferences of the client(s), providing support to the family, and other resources requested by the client(s), while identifying the range of supplemental services that will offer the maximum of independence for the client(s). Goals of the care will be included in the Care Plan as approved by the client(s). Family members and friends will be encouraged to continue to care for the client to the extent desired. The Care Plan will be reviewed by the client(s) and the Senior Care Manager (and others involved in decision-making), revisions will be made if requested, and a Contract will be signed by the client(s). This Contract will be considered the agreement between the Senior Care Management & Consultation for the services to meet the needs and preferences of the client(s).Learn more here: http://metromedicaldirect.wordpress.com/2014/01/17/geriatric-care-managers-what-to-expect

The Senior Care Manager will assist the client(s) (and others involved in decision-making) to select at least three choices for each potential service of their choice and arrange for interviews between the client(s) and the potential service provider until the desired services are located. The client(s) will contract directly with each service selected. The Senior Care Manager will coordinate and monitor the services that are chosen by the client(s). The Senior Care Manager will also maintain communication with the client(s) (and others with permission) regarding the progress toward the goals identified in the Care Plan. Revisions to the Care Plan and Contract may be made at any time, but, at a minimum, the Plan will be evaluated monthly with the client(s) (and others with permission).