As a nurse, you are caring for an 82-year-old woman who has returned home after abdominal surgery to repair an inguinal hernia, needing dressing changes and IV antibiotic therapy. Upon your arrival, her daughter meets you at the door and requests a private conversation after her mother’s care is complete. While your client is sleeping, her daughter relates her numerous concerns about her mother’s safety if she remains living at home alone. She indicates that her mother loses her keys on a weekly basis, forgets to pay her utility bills, and continues to hoard the food her daughter delivers weekly, eating very little.
a. What are your priorities regarding case management?
b. What are your priorities regarding care management?
c. How should the daughter’s safety concerns be addressed?
You are caring for a home care elderly client with newly diagnosed diabetes and recovering from open heart surgery complicated by pneumonia. The patient is on two medications. The patient is having difficulty getting in and out of bed and taking a shower and has leg cramps. The family has a contract with a proprietary agency to assist with activities of daily living two hours a day. The case manager made arrangements for continuity of care from the hospital to the home setting.
a. What is the difference between care management and case management?
b. There are a variety of reimbursement mechanisms that have evolved over time in home healthcare. This patient is being managed by a proprietary agency. What is a proprietary agency?
c. Both skilled and nonskilled nursing care has to be performed in the management of this patient’s diabetes, including filling insulin syringes and getting someone to pay the healthcare bills on time. Which one is skilled and which one is nonskilled nursing care in this situation?
d. The patient is having difficulty getting in and out of bed and taking a shower, and has leg cramps. The patient has fallen four times in the last 6 months. What are examples of intrinsic and extrinsic factors related to falls.