Care Management

How does care management work?

At Peace Aging Care Experts, our specialty care managers start by listening to you and developing a clear understanding of your unique situation. We then meet with you and your loved one to perform a comprehensive care management analysis, which includes our independent Certified Nursing Evaluation.  This evaluation provides an in-depth review of all facets of your loved one’s state of well-being, including:

  • A comprehensive summary of health history
  • An independent nursing evaluation of physical, cognitive, and psychological health
  • Review of medication protocols
  • Evaluation of home care setting and potential needs, including risks of fall and injury
  • Identification of potential care issues and options
  • Specific recommendations for any indicated support services

Once the evaluation is complete, we develop a Customized Care Plan. Our Customized Care Plan is a “road map” for care of your loved one, providing specific recommendations and resources to meet his or her needs, including:

  • Support for ongoing medical needs, such as coordination of medical providers, organization of medical records, and accompaniment at key medical appointments.
  • Set-up of medications, prescription refill management and monitoring
  • Referrals to physicians, specialists, home safety modification specialists, elder law attorneys, etc.
  • Recommendations of improved living options, including retirement and assisted living communities, skilled nursing facilities, etc.
  • Assessments in home, hospital or long-term care settings to ensure quality care and appropriate discharge plans
  • Arrangement of home health care, companionship services or adult day programs
  • Coordination with safety equipment specialists to assist with ordering, delivery and set-up
  • Identification of community resources such as Meals on Wheels, senior groups, and transportation
  • Guidance and assistance with identifying and applying to available government programs
  • Personal attention through regular visits and active care plan monitoring to meet ongoing needs

We offer access to all the support you need, both from our care management team and through our expansive network of professionals and organizations within the community.