The GCM or aging professional can recommend more than one intervention to solve a single problem. For example, an additional intervention to assist live-in lover and care giver Sally Hemingway to get respite from caregiving for her male companion Tom Jefferson could be as follows:
Problem: Problem- Caregiver Sally Hemingway is in need of respite
1. Arrange trial day at Elderday day Adult Day Program. This will provide Sally with some needed relief and a few hours to take care of her own personal needs. Although he has resisted the idea of being left at a center, Mr. Jefferson was willing to give it a try, when it was posed as a card group. On Tuesday and Thursday there is an active card group playing bridge. Mr. Jefferson is an avid bridge player. He had been apprehensive about being at this complex because it has a Nursing Home, along with Day programs, Assisting Living, apartments, memory center and a very busy activities calendar. One can come and go from the social program and participate in other activities within the complex.
a. Interventions GCM to a arrange trial day at Elderday Adult Day Program. This will provide Sally with some needed relief and a few hours to take care of her own personal needs. Although Mr. Jefferson has resisted the idea of being left at a center, he was willing to give it a try, when it was posed as a card group. On Tuesday and Thursday there is an active card group playing bridge. Mr. Roosevelt is an avid Rummy player. He had been apprehensive about being at this complex because it has a Nursing Home, along with Day programs, Assisting Living, apartments, memory center and a very busy activities calendar. One can come and go from the social program and participate in other activities within the complex.
b. GCM work with Sally to arrange Trial Day with program manager on a Tuesday or Thursday for cards.
c. GCM to stop by while he is in Day Program, meet Sally for coffee to help her with her anxiety about leaving him.
d. If trial works, GCM will arrange for half day once or twice a week (any 4 hours for $22) to give Sally an afternoon to take care of her own business
e. GCM follow up with Marsha Dowling MSE, Director o the Elderday Social Day Care program.
Because the family and Mr. Jefferson and Sally want Sally to stay as Mr. Jefferson’s care provider you have crafted multiple intervention for respites and multiple sub interventions or steps to achieve that intervention, in this case respite.
Make Care Plan Interventions with a Timeline
Your care plan interventions should have measurable goals based on a timeline. For example, let’s return to the problem of caregiver burnout with Sally Hemingway
Ms. Hemingway had caregiver stress and burnout from caring for her aging live-in partner Mr. Jefferson days a week with no respite.
Here is your care plan goal:
To reduce caregiver stress and burden from extended family caregiver Sally Hemingway so she is able to continue to care for her elderly “ partner” Mr. Jefferson
Here is your Intervention’s with a timeline in each:
1) The GCM Miss Fullcharge will visit weekly for 3 months on a day Sally does not have respite to talk with her and to assess whether Sally’s caregiver burnout and stress is improving.
2) Miss Fullcharge will meet privately with Sally, without Mr. Jefferson present, during the visit to assess whether she is less, stressed,
3) Miss Fullcharge will talk to Mr. Jefferson, privately, on each visit to make sure he is satisfied with the care provider and all his needs are met while he allows Sally respite.
4). Miss Fullcharge will review the charting of “ Good Help” care, to make sure the care provider is completing all the tasks on the care plan to reduce Sally’s stress
5) Ms. Fullcharge will phone the supervisor at Good Care private duty home care agency each week or as problems arise Mr. Jefferson ‘s care provider either improves the care or is replaced.
How are these goals measurable? You should have a Care Monitoring Report that you complete each time you visit. The results can be summed up in a monthly report to the client, weekly e-mail to the client or by submitting a copy of the reports if requested. Your own charting and reports should show over times that Sally’s caregiver stress is reduced and Mr. Jefferson remains comfortable with this arrangement. If not you will have to create new interventions.
So this is how you have one care plan goal and measure it.
Make Interventions Measurable
Your recommended care plan interventions should be measurable. This means you should specify the number of times an intervention will be carried out.
For example, let’s take the case of elderly client Tom Jefferson , who I have referred to in this blog. You the aging professional or geriatric care manager have created a dual assessment care plan to give respite to his live in woman companion and love interest 80 year old Sally Hemingway .
The measurable respite you create in your care plan is hiring a private duty home care agency. How do you make this measurable? In your care plan you state the name of the agency- that is “Good Care “. You state how many times a week Good Care will come to Mr. Jefferson’s home. You state 4 days a weeks in your care plan. You state how many hours a day the Good Care care provider will be there. Good Care will send an aide 8 hours each of the 4 days. You have made the intervention more measurable.
You need to show the family exactly how to measure whether the intervention was completed. For example the private duty care should supply charting for each day and the care provider should fill out and sign in and out on a charting page for each day of their shift. This also provides the GCM or aging professional who monitors the care of the older person a basis to review both status of the older person and whether the care provider was present.
If the care provider has come only once a week, you know you need to follow up. If the family wants to monitor the care, this approach also tells them how to measure the care. You can also measure the care by reviewing the charting when you make a home visit and by getting feedback from the family and client about how tasks were completes, and in Ms. Hemingway’s case, did her caregiver stress diminish, with this respite and help with care for Mr. Jefferson. This is how you make care plan interventions measurable.
Make Interventions Doable
Interventions in a care plan need to be doable. Let’s take for example with Mr. Jefferson the client we have used in my You Tube on Dual Assessment . In creating care plan interventions for him, as an aging professional or geriatric care manager, you want Mr. Jefferson to accept your intervention of having a replacement for careprovider Sally, his live in 80 year old companion, to do ADL’s and IADL’s 4 days a week. After all he is mentally competent and very attached to Sally and could reject your intervention.
How do you make this doable? What you as an aging professional or geriatric care manager may use to convince him to ” do this” is what I said in the You Tube about him – he would rather die than burden Sally. If you can convince Mr. Jefferson that by relieving some of the care for him four days a week, this will relive Sally’s burden. This will also mean conferring with Sally and having her agree to this intervention and get her buy in.
Then this must mean having a small meeting with Sally and Mr. Jefferson where consensus can be reached that they both agree to this intervention and that Mr. Jefferson is willing to pay for this private duty care provider. A geriatric care manager or aging professional would also reach out to the adult child who hired you, Alice, and explain your strategy and reasoning to her. As she is worried about Sally’s health, this would be a way to show you that you are working professionally to answer both her and her Dad’s needs along with Sally’s.
It may be that the family, Sally and Mr. Jefferson, may want you to interview the care providers and recommend which one they should hire. So, remember to create a solution based on facts derived from your assessments plus the art of convincing the client to accept your intervention. This makes the solution doable.