This story is about Martin
Freeman, an 87-year old man who lives in Brooklyn. I
was contacted by his daughter-in-law, Cathy, who called after he had been admitted to the
hospital, having just had a stroke. Prior to
the stroke he had been independent and was living in an assisted living residence in Brooklyn. His family consists of Cathy, her husband Steven,
who has a son and Martin’s sister, Helen, who lives in the mid-west. Because Steven is a very busy lawyer and Helen is
an equally busy professional, Cathy was given the job of solving the homecare problem for
Steven’s father.
Cathy questioned me about
my experience and made it clear from the start that they’re looking for someone to be
involved in a big way, who is going to be responsible for every aspect of things that come
up. That has included many different things.
The first step was that she
checked my references. Within a few days, she
told me, “OK, he’s going to be discharged soon.
We have nothing set up. We have
no idea what we’re doing. We need you to
come to the hospital and give us your professional opinion about what we should do about
every single aspect.”
That consisted of meeting
Mr. Freeman, but also talking to all the different staff people at the hospital who were
providing different services. That meant the
primary doctor, the neurologist, speech therapist, occupational therapist, physical
therapist, social workers, the nurse’s assistant and the head nurse. Cathy is very thorough. It’s not to say that it is essential that
every family use me to talk to every single professional involved in the hospital care; the family often is content to do that themselves. This family did some of it on their own, but
clearly wanted me to hear what all the professionals were saying, and offer some
on-the-spot feedback, not only to the family, but to these professionals. I was to serve as their advocate. All that went very well.
At this point, I was not
yet retained, but I knew this was sort of an audition, and if they weren’t pleased,
they would have stopped everything right there.
Steve’s Role
Cathy told me, “OK.
Steve I’m impressed, but I have to talk to Steven and Helen and tell them this is
what we did so far.” And then she calls
back and says that Steven and Helen want to talk with you. Once we did the conference
call, they were reasonable, very receptive to my ideas, to my assessment, to what I had
seen at the hospital. So we talked about the
practical things that we needed to do for the discharge home which was going to be three
days’ later. So, in three days time, I
had to put together a team of homecare workers that were going to be held under very close
scrutiny; the standards were going to be very high, and that if they didn’t perform,
it was going to be my fault.
So I said to the family,
there’s a wide range of providers of homecare and, obviously, there’s a wide
range of costs for homecare. I’m going to
give you the range; I’m going to give you each one and you’re going to tell me
which way you want to go. And I determined
pretty early on that they were going to go with the high range, the high end, and I was
pushing that because I thought their father would require that. I knew it was going to be a very difficult
situation because there are a lot of things [going on] and there’s a lot skills that
the workers have to have in view of the family’s needs.
They agreed and they appreciated the level of detail and clarity in helping
them choose which of these ways they were going to go as far as where the homecare workers
were going to come from.
I then contacted a company
specializing in high-end homecare providers; told them these are the parameters; this is
when he’s going to be discharged; this is what has to happen for this to work. “You guys will get your fee if you come
through with these very good workers in this very short period of time. And I have to meet them in person.”
In fact, we didn’t
have time for me to meet everybody before, but we worked it out so that they found all the
people, but there wasn’t time for me to meet them because he was already being
readied to go home. I spoke to them all on the
phone, and I determined which one I wanted to be the primary person, based on my initial
assessment, and it turned out to be correct.
And then we met at the
hospital, but I met the aide before we went up to determine if this was going to be the
person and I still felt confident about them. The
family knew that this was the best that we could do in view of the short timing they had
provided me with to pull this all off.
Outcome
So the outcome of this
story is not only does he have good care, from these homecare workers within an assisted
living environment. The other major part is
the medical care. There is a doctor for every
part of the body; the most recent ones were a psychiatrist, a neurologist, a cardiologist,
a pace-maker doctor, and a primary doctor. I
accompanied him to these doctors, got their instructions, and worked with homecare workers
to make sure they implemented the doctors’ instructions correctly, while also
conveying the instructions to the family, because they want to know all about his
treatment plan.
This case is an example of
what might be called the Premium Service of Elder Care NY.
It’s Premium because of the price and the totality of it. In most cases, the family deals with their
relative’s doctors. In the
“premium” service, I take care of the doctors, the homecare, making sure that
they have all the supplies that they need, making sure the medications are being disbursed
properly. We have recently added some perks like a musician comes once per week and plays
for a half hour, which Mr. Freeman loves. Also we have found an outstanding physical
therapist who has made an impact that the previous ones were not able to do.
I
offer this level of service when it seems appropriate, but I don’t push it. People seem to know and want to do it themselves,
so I really don’t say you should do it with me. I
tend to look at their level of stress and say “It looks to me like it would be really
helpful to you for me to take over some of these things.” So part of the offering is based on the observation
of need. It’s nice when the family comes
right out and says “We need it; we know we need it; this is what we want you to
do.” |
