Friday, September 27, 2013

Medication Management: The Role of the Care Manager

From ensuring medication safety and compliance, to identifying ways to keep medication costs affordable, care managers play an important role when it comes to medication management.

As health care advocates, we work closely with prescribing physicians to communicate important information such as health and functional status, known allergies, and other medications and supplements being taken. In our often fragmented health care system, the care manager can ensure that multiple health care providers are communicating, and working with the same information.

In the home, we ensure that physicians' and pharmacists' orders and special instructions are included in the care plan, providing assistance with medication set-up by the care manager or medication reminders by the in-home caregiver as needed.

And as clinicians, we can spot possible medication-related problems early, detecting potential issues and addressing them with the physician or pharmacy. Our consulting geriatric pharmacist is available to provide expert medication review, and can follow up with providers regarding recommended changes. Should new side-effects or symptoms arise, we can follow up right away, to help prevent serious medication-related problems.

Medicare's Open Enrollment period is fast approaching (October 15 - December 7), and this is another area where care managers provide an invaluable service to our clients. During this annual opportunity for Medicare enrollees to change their health plan and prescription drug coverage for 2014, care managers are available to talk with their clients and their families about their current coverage, and review their options for prescription drug coverage. When necessary, we'll work with local insurance specialists, or bring in our consulting pharmacist for recommendations. With the implementation of the Affordable Care Act and the forthcoming opening of the state's health benefit exchange, Covered California, we're prepared with the information and resources we need to support our clients in making sound decisions about their health insurance coverage.

Friday, September 13, 2013

Birthdays are good for you


This post dedicated to Mrs. M.

Having recently celebrated the 100th birthday of one of our clients, and next week celebrating my own (with a much less impressive number), I'm giving a lot of thought to these tours around the sun, hoping that I'm carrying with me through my own aging process even a fraction of the wisdom that's been passed along to me during my years of work in geriatric care management.

A few months ago, Richard Lederer, a local linguist, writer, and entertainer, posted the following on his Facebook page, in celebration of his 75th birthday. I share it with you today in the spirit of "about-to-be!"

I’m button-burstingly proud to announce today, Sunday, May 26, I turn 75 years of youth. Five years ago, I passed through the portal of my biblical threescore years and ten, and I've reached the point in my life when I have stopped lying about my age. Rather, I brag that I am so full years. I’m no longer a spring chicken; I’m a winter chicken. I’m no longer wet behind the ears; I’m dry behind the ...years. I’m no longer knee high to a grasshopper; I’m sky high above a grasshopper. I’m not a has-been. I’m an about-to-be. Yay! Yippee! Huzzah! Woo-hoo! What a ride!

Some of us try to turn back our life’s odometer. Others of us want people to know why we look this way. We admit that we have bumps and dents and scratches in our finish and the paint job is getting a little dull. And sure, the fenders are too wide to be in style and our seats are sagging. The battery no longer holds a charge, and the headlights have dimmed. The hoses are brittle, and much of the original tire tread is worn away. The transmission stays in low gear and doesn't easily shift to high. We don’t convert our fuel as efficiently as we used to, and climbing any hill is liable to cause sputtering. And whenever we sneeze or cough, our radiator seems to leak.

But you know what? We've traveled many, many miles, and some of the roads weren't paved. Wisdom and laughter are our shock absorbers. We've become classics.

And we’re not alone: Today, 518 million men and women worldwide are 65 or older, including more than one out of every eight people (13.4 percent) in the United States.

The poet Robert Browning wrote, “Grow old along with me! The best is yet to be. The last of life, for which the first was made.” While growing older is mandatory, feeling old is optional. Attitude is ageless. More than two millennia ago, the Greek playwright Sophocles wrote, “One must wait until the evening to see how splendid the day has been.” Only at sunset is the day truly golden. The later the hour of the day, the longer the shadow you cast.

Gentle Reader: You’ll never be younger again than you are right now! You may be over the hill, but that’s better than being under the hill – and it’s not till you’re going downhill that you really pick up speed! Birthdays are good for you: The more of them you have, the longer you live.

There is only one way to live a long life, and that is to age. And there is only one way to age – with a smile. If you are able to laugh at yourself, you’ll never cease to be amused. After all, you’re only old once.

Adapted from The Gift of Age (Marion Street Press)