Am I Being Effective?” — A Care Manager’s Lament!
By Linda Fodrini-Johnson
I heard the above question from one of my newer care managers, and then I saw a very seasoned care manager stressed over her client’s “non-compliance” – thus this commentary.
As professionals who truly have lots of answers and even more creativity to solve most problems that our clients present us with (or their family does), we can get discouraged when our bright ideas or resources to improve the quality of their lives are not embraced or even received as a “bright idea!”
It takes patience and foresight to walk the journey with our clients at their pace, not ours. This is especially true with those who are negative or have cognitive deficits or estranged or disgruntled family members.
We need to ask ourselves – whose journey is this? What is my role with this client or this family system? Do I truly understand their values and how they make decisions? The answers to these questions will guide your care plan, actions, and ability to be effective.
So, what is the most important role for us to play? I believe it is to advocate for our clients based on their values and history. It is not for us to be the “expert” but the “coach” as the trusted person to help and work with them when life leads them to potholes and health challenges. Thus, building a relationship and having the client trust you is the greatest gift we, as care managers, bring to our clients and their families. This takes time – so patience is the virtue needed in the early and even middle phases of the client relationship.
When that client, who had never been compliant with any health care directive, continues to smoke, eat high-sugar foods, and not take medications as directed – then you most likely are not going to “fix” it! But, building trust over time, you will be able to make small steps to change some behaviors and never others. Actually, we can’t change anyone – the change has to come from them. And, if you are anything like me, I am most resistant when someone tells me I should or must do something that is not part of my habits, traditions, or values.
Just think of that daughter of a client who wants you to get Dad to stop smoking, eating candy, and move to assisted living; and he will have none of it! He is competent and actually has a right to “folly.” He is 84 and these bad habits give him pleasure. So, as a care manager – you support his values, you educate the daughter, and you support her disappointment that dad just is not interested in changing and that he is aware of the consequences. This means you are doing a little pre-death grief counseling with her – she doesn’t want to lose dad; that is why she hired you! If you forgot – we are not God – just mortals doing our best! But, in this relationship, you build trust with Dad, and when he has a crisis, it is you he will listen to and maybe even make small changes – because he knows that his values and wishes will be respected by you!
What is most valued in life are “relationships” of trust based on mutual respect and common values. We are in a very honorable profession – respect the right to folly when appropriate – even if it goes against your values. We are the anchor, the lifesaver, and often the life enhancer – enjoy and savor a profession of honor.
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Reprinted with permission from Aginglife.org. Advocare Care Management is the place to go when caring for an aging loved one.