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Unread 08-01-2013, 06:35 AM   #1
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Default Anyone have a case manager - what do they do?

When I was last in the hospital, my treatment team, decided that I really needed a community case manager. I somewhat resisted the idea, as I don't think I'm that sick, but they pushed pretty hard, and I passed all the criteria for getting one, so I was put on the wait list for one from my part of Toronto. I got a call yesterday, from my new case manager, saying she wants an initial meeting next week. So I'm meeting her next Thurs.

Just does anyone have one, know what they're meant to do?

Thanks.

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Unread 08-01-2013, 10:16 AM   #2
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Default Re: Anyone have a case manager - what do they do?

Quote:
Originally Posted by splitimage View Post
When I was last in the hospital, my treatment team, decided that I really needed a community case manager. I somewhat resisted the idea, as I don't think I'm that sick, but they pushed pretty hard, and I passed all the criteria for getting one, so I was put on the wait list for one from my part of Toronto. I got a call yesterday, from my new case manager, saying she wants an initial meeting next week. So I'm meeting her next Thurs.

Just does anyone have one, know what they're meant to do?

Thanks.

Splitimage
here in NY a case manager is like the boss... a mental health client has a whole team of treatment providers and the case manager makes sure everyone is working on the same page for the best of the client. they meet with the client, find out what their mental health problems and needs are. then helps the client get hooked up with all the community agencies and resources that can help that client have a better out patient prognosis and progress...

example I have a therapist, psychiatrist, medical doctor, neurologist, physical therapy, not to mention being a new mom to twins, my wife does what she can to help but even she cant be the one to keep me stable and out having my mental health symptoms of mania, depression, PTSD, Dissociative Disorders, eating disorder problems, nor can she be the one to keep my Multiple Sclerosis symptoms from causing problems.. So I need a wrap around me type of treatment program. with this wrap around me type program i can continue to work, and function outside of the hospital.

with so many services there needs to be someone who can act as an advocate over seeing all these treatment providers and ensuring everyone is working on whats in my and my family's best interest.

that where my case manager comes in. she meets with me and my wife, checks in on how things are going, whether we have any problems that are not being addressed and if so helps me to get hooked up with the right community agencies and services that will best a fit that problem. She has even filled in when my wife had an emergency to deal with at her work, by taking me to drop off the children at the sitters and taking me to my physical therapy appointment for my MS. If I hadnt had this case manager navigating all the services in my life would be quite stressful /frustrating. She was even able to tell us of some services that my wife and I did not know existed in our location for new parents and the type of mental and physical health problems I have.
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Unread 08-01-2013, 04:05 PM   #3
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Default Re: Anyone have a case manager - what do they do?

Thanks Amandalouise. I do have a lot of care providers that need to be coordinated.

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Unread 08-01-2013, 04:14 PM   #4
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Default Re: Anyone have a case manager - what do they do?

Amandalouise really answered this question the best. there really isn't much left to say. I had a case manager for a while. I didn't feel I needed one but my pdoc kept insisting on one so I agreed to services. after about six months of my case manager not being able to do anything but check in on me she agreed it was a waste of her time to be providing services to me so closed my case. so if you truly don't need their services they will let you know. if not, they are good advocates to have on your side.
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Unread 08-02-2013, 03:35 PM   #5
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Default Re: Anyone have a case manager - what do they do?

You are going to love this...I case manage mentally ill, and I am probably more ill than some of my clients!! The difference is that I mostly take my meds...for a while

We help to refer you to the appropriate services that will best assist you, i.e. special housing, good counseling, financial assistance if needed, filing for permanent disability, as well as just being there for you and helping you make decisions.

Most of all, we advocate for you when you are being discriminated upon...and as much as other agencies deny that they discriminate, THEY DO. Especially housing agencies... they just are not trained to deal with us

I love the advocating part the most, as I can be very calm, yet poignantly sharp as a knife, and I have won for my clients time and time again.

I will admit, however, that this job has stressed me out to no end, and in two months, I am switching back to sales. That goes with my swings much better than this, as I can often swing low when my clients need me most, and that is so not fair for them. Regardless, I will miss it!
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Unread 08-02-2013, 08:16 PM   #6
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Default Re: Anyone have a case manager - what do they do?

Well it sounds to me like all of you are talking about the type of case manager that makes the patients well being their chief priority. A patient advocate and coordinator.
The term Case Manager can be used for many other roles in the medical field however. And unfortunately some of the roles are definitely not making the patient their first priority.
Most hospital case managers are actually there to make sure costs are controlled and in the U.S. that often means they are reporting directly to the insurance companies. They don't work for one particular company but they are about controlling costs. I have also found out that they get paid incentives from the insurance companies for making the hospital stay as short as possible.
I have a rather poor opinion of these kind of case manager based on two personal family situations.
The most recent was when my adult son had an accident resulting in brain injury and was hospitalized.(he has subsequently recovered about 98% and is back fully functioning)
During his recovery in the hospital as he was transitioning from ICU to Acute care and beyond, the case manager had her clipboard at hand measuring his progress and reporting to back to her contacts in the hospital business office and the insurance companies. For every possible health situation they have what is considered "the normal" amount of progress a patient should be making. One example. My son was briefly in a coma. His brain was damaged and at first he couldn't do anything for himself. As he was progressing into routine things like walking the case manager was counting how many steps he could take before needing help etc. Every possible symptom and recovery was compared to the "norm"
When it came time to leave the hospital the head neurologist told us that the insurance company was questioning how long he had been in Intensive care and a couple of other aspects regarding length of care. The doctors had made every decision based on their vast experience dealing with my sons type of injury. Despite this when all the bills started pouring in the insurance company said he spent 2 days longer than they would cover in intensive care and 2 days longer in acute care plus a couple other "overages" We appealed and had medical records and letters from all his doctors saying he got the exact care he should have received. They modified their position by and allowed 2 of the 4 disputed days. We were stuck with the bill for the rest.
I guess this has been a long rant but believe me this is fairly normal in healthcare these days. (despite a downgrade of my prior excellent credit it will be a cold day in he.. when they get paid)
So if you hear someone talk about a case manager when you are in a hospital, proceed with caution before assuming they are the "good type" of case manager.

peace.
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