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Concierge Care: A Successful Solution to a Very Challenging Situation
When Mr. King (not a real name) first came to our office 2 1/2 years ago, requesting assistance for
his spouse, the situation was a fairly typical one for Rona Bartelstone Care Management & Home Healthcare.
Mrs. King had been diagnosed with coronary artery disease, Parkinson's, Alzheimer's, major depression,
spinal stenosis, and chronic pain after two hip replacement surgeries ten years earlier. Mr. King was
her primary caregiver and appeared exhausted and overwhelmed. He had recently fallen and hurt his shoulder,
and was scheduled for surgery the following week. He requested a home health aide for 12 hours daily to
help care for Mrs. King until he recovered.
Mr. King had some difficulty giving up any part of his caregiving
role, so there were many adjustment problems to be worked out
between the home health aides and Mr. King. In the early part
of his relationship with our staff, he met infrequently with the
Care Manager, and then only to discuss concerns about issues with
the home health aides. Over time, he began to trust the Care Manager
more and called for more frequent meetings regarding his own coping
strategies.
As Mrs. King's condition began to deteriorate, Mr. King found he needed more help and requested
aides around the clock, 7 days a week. Mrs. King was becoming increasingly violent, hitting,
kicking, and throwing things at the aides as a result of her dementing illnesses. Mr. King
took his wife to psychiatrists, neurologists, and internists, who prescribed medications for
her behaviors. Mr. King was fearful that these medications were too sedating and he refused
to give her the prescribed dosages. As a result, her behavior became more challenging and it
became increasingly difficult to keep aides consistently with her. To complicate matters, Mr.
King hovered over the aides constantly, offering "advice" on how to handle Mrs. King.
Many aides refused to stay because of his demands and his interference.
After more than two years it became apparent that Mr. King was not allowing the doctor's plan
of care and medications to work and this was undermining the ability of the aides to work with
Mrs. King. Since we could not stabilize the situation, without Mr. King's cooperation, the
agency and Mr. King agreed it would be best if he engaged another home health agency to try
to meet his needs. This was a disaster and within a month, he called the Care Manager and
requested a meeting to discuss the possibility of contracting again with Rona Bartelstone
Care Management & Home Healthcare.
This time the Rona Bartelstone team felt that it would be necessary
for the Kings to utilize our Concierge
Care service, which would provide more of a team approach
that included: more specifically trained home care staff, more
coordination between the DON, the visiting RN, the Care Manager
and Mrs. King's doctors. Mr. King was also included in this team
approach to help him begin to let go of needing to control every
aspect of his wife's care and to be more trusting of the caregiving
experts.
A meeting was held in our office with Mr. King and our Executive
Director, the Director of Nursing, a Psychiatric RN, and the Care
Manager. The purpose of the meeting was to develop a Plan of Care
that would consist of a team approach to meet the needs of both
Mr. and Mrs. King. The Plan of Care would have the following components
that were made possible because of the Concierge
Care approach to services:
- Carefully selected and trained home health aides: three 8-hour shifts around-the- clock
- A visit from the Psychiatric Nurse once a week to monitor medications, assess the patient,
and consult with Mr. King; The nurse makes recommendations for any change in the care plan
and discusses this with the team leader and the patient's physician(s)
- A Care Manager weekly visit to monitor patient, spouse, and progress in care plan. Any
problems or difficulties will be discussed with the spouse and the team members. The Care
Manager will assist in conflict resolution, with a special focus on meeting the needs of
Mr. King
- Mr. King will be an integral part of the team for meeting his needs and those of his wife
- The medication regimen prescribed by the patient's physician will be strictly followed
- The care plan will be reviewed continuously for any changes needed
This extraordinary team effort is the hallmark of our
Concierge Care program
that leads to the satisfaction of all concerned. The key to successful
Concierge Care plan implementation
is to have everyone involved and informed in a team approach that
leads to meeting all of our goals.
For more information on any of the above and how we can help you, please contact:
Rona Bartelstone Care Management & Home Healthcare
phone: 1.800.678.7224
email: info@rbacare.com
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