Geriatric Care Management Case Study

Sarah, an 84 year old woman lives alone in her own home. Her only child lives 50 miles away. Sarah’s husband of 60 years passed away 9 months ago. Until recently, Sarah has been an active member at the senior center in her neighborhood. She has been driving herself to activities.

Sarah's daughter recently visited for several days and was concerned because, upon arrival, she discovers that her mother:

  • Has had 2 'fender benders' in the past month
  • Is not going to the activity center
  • Has a bruise over her left eye----AND reports falling twice
  • Does not want to go out for lunch or shopping
  • AND, has outdated and moldy food in her refrigerator.

Sarah's daughter assumes this recent decline is probably "a normal process of aging….something to be expected".

MY orientation as an RN Elder Care Consultant and Certified Geriatric Care Manager isthat all of the changes Sarah is experiencing need to be evaluated and a plan created that will reverse the decline.

After an appointment with her Primary Care Physician to rule out any acute causes for these changes, we created a plan that included:

  • Support from a "Peer to Peer" Counselor from the Alliance on Aging—a free service!
  • A driving evaluation from a specialist and transportation for Sarah that included our new iTN service and inexpensive senior taxi vouchers.
  • A physical therapy evaluation (ordered by Sarah's doctor and paid by Medicare) and, 3 months of personal trainer support to build her strength.
  • A companion twice weekly to befriend, observe, prepare tasty meals and accompany Sarah and her dog on additional walks, AND
  • Extra funds available because Sarah’s husband was a Veteran.

3 months later, Sarah returned to her independent (with support) self!!

With proactive planning, 'Living Long' can definitely be a blessing!!