Care Planning and Management
StayingWELL care planning and management services help you and your family develop an individualized plan of care based on your current needs, and anticipating future needs that may develop. The plan includes both short- and long-term goals, and addresses the types and frequency of all planned care and support.
As part of care planning, RVNAhealth conducts a home safety evaluation and care assessment, aiming to understand your needs and desires. We then implement and manage your plan of care, with ongoing monitoring by our supervisory team (licensed nurse and occupational therapist) to ensure adherence, and make adjustments when necessary.
Home Safety Evaluations
Prior to the start of an engagement, the RVNAhealth StayingWELL team conducts a home safety evaluation to review your home for safety and recommend any adjustments that may reduce risk of falls or accidents. Suggested modifications may be as simple as eliminating throw rugs, improving lighting, adding non-slip treads to the stairs, or installing grab bars in a shower. More elaborate solutions may include equipment such as lift chairs, ramps, or hospital beds.
At the start of each engagement, and at regular intervals following, RVNAhealth conducts a care assessment to understand your day-to-day activities, assess your current situation and your current needs, as well as anticipate potential future needs. During this assessment, we also learn more about you, your preferences and goals, and what you want in a caregiver, so that we can make the best match possible.
Through the assessment, we aim to learn:
- Current health status
- Any physical, nutritional, or mental challenges in daily living
- Any home safety concerns, including fall prevention, lighting, maintenance and comfort
- Current level of care at home, if any
- Current need for medical care and planning oversight
- Any current concerns related to living independently at home
- Caregiver preferences
Geriatric Care Management
RVNAhealth geriatric care management services help you or your loved one manage health care demands, including the routine activities of daily living, should they become challenging. These services help to ensure you or your loved one is getting the medical and personal support needed to achieve the best possible health for living life to the fullest.
We work to develop plans to ensure our clients are receiving the support they need:
- Regular care plan review and monitoring
- Advocacy and coordination with medical providers
- Hands-on coordination of nursing and rehabilitative care, as well as support care and services
- Assistance with hiring and supervision of live-in or hourly caregivers
- Assistance/referrals for home maintenance
- Assistance/referrals for budget management
- Assistance with insurance applications, long-term care insurance and other medical forms
- Long-term care planning
- Supportive counseling
- Referrals to and coordination with community resources
- Facilitation of ongoing communication and feedback to families
- Collaboration between patient, physician, family and RVNAhealth for independence in the home
Family and friends are often a very important part of the care equation, providing hours of support and care. RVNAhealth respite care services provide exceptional-quality caregiving help when family and friends require time to care for their own needs — for such activities as work, a special event, or even to go on vacation. In respite situations, we are able to offer coverage and peace of mind, ensuring excellent care, comfort and safety.
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Meet Laura Switzer
Laura Switzer, MSW, LCSW, ACSW, leads our geriatric care management program, and works closely with seniors and their families to provide consultation and to develop short- and long-term plans to ensure our clients are receiving the care, support and resources they need. The process begins with an initial assessment to help us understand your current situation and needs, and to anticipate potential needs to be prepared and ready for the future. We then develop a plan of care specific to your needs. Laura, together with our interdisciplinary team provides ongoing monitoring, reviews and plan updates as needed.