Quality case management is critical in how end of life care is carried out by hospice teams in the Santa Clara community.
In honor of National Case Management Week (NCMW) this October 8-14, we will go over the importance of this key aspect of end of life care. According to the American Case Management Association, this year’s theme is Case Management: Exceptional People. Exceptional Care.
First off, though, what exactly is case management? Case management refers to the collaborative process of assessing, planning, facilitating, coordinating, evaluating and advocating for options on how best to meet an individual’s and family’s comprehensive health needs, says the Case Management Society of America. This is achieved through communication and resources to enhance quality, cost-effective outcomes.
The theory behind this is that when the optimum level of wellness and function is achieved, all parties involved benefit, from patients and families to support systems and healthcare teams. It even extends to the reimbursement sources as well. Most hospice teams will have a case manager of some kind assigned to each patient. This person is typically certified, backed by the education, skill and practical experience necessary to provide appropriate services based on the best interests of the individual involved.
Good case managers identify appropriate providers and facilities, while at the same time ensure that available resources are applied in a timely and cost-effective manner. This, in turn, provides value for both the patient and the reimbursement source, predicated on open, direct communication between everyone involved. However, the NCBI finds that the most significant barrier in coordinating and providing end-of-life care is inadequate communication. Therefore, early discussion of the patient’s prognosis and end-of-life care options will facilitate earlier entry into hospice. Currently, only 25% of patients eligible for hospice actually enter hospice programs.
Benefits of Strong Case Management
There have been many proven benefits to strong case management during end of life care. One study outlined on PLOS found that the involvement of a case manager can reduce hospitalizations at the end of life in cancer patients, despite the fact that the case manager acts only in an advisory role and does not provide hands-on care or prescribe medicine. The study compared cancer patients receiving additional support from a case manager versus those receiving standard general practitioner care with no case manager. The results showed that the place of death is more likely to be in the home and less likely to be in the hospital, with fewer hospitalizations in the last month of life.
In addition, the rapport between a patient and case manager is integral to the whole process. Trust and compliance improve when a connection is formed with the patient, with this small investment of time leading to positive results in terms of patient compliance and positive case management outcomes. Simply put, patients who don’t feel a connection with their end of life care team aren’t as likely to trust them and follow recommendations. At the heart of the matter is trust. A patient has to know that their case manager and nurses understand what they’re going through. Those at the end of life need coaches, not dictators. By allowing the patient to feel they are in charge of their own treatment, a sense of collaboration is formed.
The Unwritten Word
Eye contact…positive body language…tone of voice…these unwritten forms of communication separate a good case manager from a great one. A good case manager will make time for their patients every day, sometimes multiple times a day. They will recognize language barriers and bring in bilingual staff and interpreters if needed, in an effort to remove those barriers that may make the patient feel isolated. They will keep an open mind, viewing the patient not just as a body at the end of life, but as a soul with spiritual and psychological components. They will recognize that some patients’ cultural background don’t always allow for treatment compliance and work around it. They know that open and ongoing communication with the entire hospice care team is imperative in ensuring the patient’s needs are met. They give the patient control over their choices when possible, from scheduling appointments to treatment options.
In the end, good case management is built on a foundation of rapport to result in patient loyalty. Everyone wants their basic needs to be met, not just with medicine and treatments, but they need to be heard, cared for and respected every day. That’s what we strive to do with end of life care for our Santa Clara patients.
Contact Pathways Home Health and Hospice
Here at Pathways Home Health and Hospice, we provide end of life care by a team of seasoned professionals who value strong case management. Contact us now at 888-755-7855 to see how we can help.
