Care Management

Care Management services consists of a professional care management team that arranges for and oversees the care of older adults and individuals with disabilities. Our professional care managers are registered nurses and social workers who are experienced in a wide spectrum of health-related conditions including chronic illness, psychosocial issues, legal matters, and financial status.

Our care managers act as advocates, respect clients’ autonomy, and respect the dignity of each individual. Our services are available throughout Dane County and surrounding areas. We are available to assist our clients around the clock. You can feel confident knowing that your loved one is not alone.

We begin with an evaluation of the individual and their needs, leading to a comprehensive plan of action with cost-effective recommendations. We base care plans on our extensive knowledge and experience in dealing with aging adults and their families. Our care managers adhere to the highest standard of practice while designing and implementing services that maximize independence.

When Should you Consult a Care Manager?

  • A person has limited or no family support
  • Family is newly involved with care and needs direction, insight, and assistance
  • A person has multiple medical or psychological issues and needs professional advocacy
  • A crisis intervention is required
  • Concern for abuse, exploitation, and neglect is apparent

What is a Professional Care Manager’s role?

  • Medication management to ensure compliance
  • Alzheimer’s and dementia-specific intervention
  • Relocation service and coordination
  • Bill paying assistance and coordination
  • Transportation: Driving evaluation and alternative transportation support
  • Personal and home shopping
  • Home maintenance for safety and renovation for ease and accessibility
  • Grief and crisis counseling
  • Nursing home advocacy
  • Evaluating long-term care insurance policies and benefit entitlement
  • Exploring alternatives to guardianship
  • Referral to elder law attorneys, financial planners, and community services
  • Eligibility for state and federal entitlement programs: Medicare; Medicaid; VA

Comprehensive Assessment and Long-Term Care Planning:

Care starts with an on-site, comprehensive assessment designed to determine current and future needs. The care manager will assess–with discretion and with sensitivity–health, medical needs, functional capacity, limitations, psychosocial and/or cognitive abilities, general safety, and environmental needs. Following the assessment, we will provide a comprehensive plan of action along with recommendations and cost-effective goals and resolutions.

Complete Care Coordination and Ongoing Care Monitoring:

Our care managers help stabilize health and personal needs while promoting independence. Consistent monitoring and contact will allow the care manager to build a relationship of trust–encouraging security, minimizing feelings of isolation, and combating depression.

Client Advocacy:

The care manager will partner with an individual’s “client care system” to understand fully issues and concerns and to arrive at educated, measured solutions. This process allows maximum decision-making autonomy for the client and for the other individuals involved. Care managers act as liaisons, updating family members on significant changes or alerting them of problems.

Placement Assistance:

The care manager will explore all appropriate long-term placement options. Independent retirement, assisted living, or skilled care will be determined based on the client’s functional and cognitive ability. Additionally, the care manager will tour recommended facilities with the client and family. We will help the client and/or family evaluate payment options, complete admissions paperwork, and coordinate moves and transitions.

Nursing Home Advocacy Program:

Our care managers will visit individuals residing in a nursing home or rehabilitation facility to ensure clients are receiving proper care and treatment. The care manager will advocate for the client and provide local support while monitoring facility services and delivery of care. We review medical files with the facility staff, provide professional representation at care meetings to advocates for clients’ rights, and review the information with designated family members.

Our services are utilized by:

  • Individuals who need care or are planning for their own care
  • Adult children and other family members
  • Physicians and allied health professionals
  • Hospitals
  • The Alzheimer’s & Dementia Alliance
  • The Alzheimer’s Association
  • Attorneys/Trust Officers/Banks
  • Financial Planners/Advisors/Accountants
  • Guardians
  • Community service providers
  • Nursing Homes and Senior Living Communities
  • Employee Assistant Programs