Let’s start with the definition of a care conference (CC). First of all, it is a meeting between your elder’s provider team and you (and possibly your elder). Secondly, it’s goal should be to set objectives and timelines for the care of your elder over a certain period (ex. the next week of rehab). Now, what does a successful care conference look like?
#1 – Assemble the Whole Team
To get the most out of a CC, you need to have all the team members there. If you don’t, you won’t have accountability from that part of the team. You know it’s hard to commit for other people on your team at work; the same goes for a care team. The nurse is unlikely to be able to answer questions about occupational therapy or to commit to goals that the occupational therapist (OT) will accomplish. This goes for most of the members of the team. They might bring a report from the other members, but a commitment to timelines and goals is probably unrealistic from them. So get all the players there if you want the BEST CARE as the outcome.
Who could those players be (it will depend on the setting of care):
- Nurse or a representative of the nursing staff
- Doctor, physician’s assistant or nurse practitioner
- Physical therapist (PT)
- Occupational therapist (OT)
- Speech therapist (ST)
- Respiratory therapist (RT)
- Dietitian or food services representative
- Social worker
- Activities director
- Hospice representative
- Elder’s aide or sitter (CNA)
- You and/or your siblings
Do this often! Timing will depend on the type of care and the facility or location where the care is being given.
- A rehab facility should have a CC every week. This is a short-term facility, Medicare usually pays for only 20 days of care and, if you don’t focus with a laser-like beam on your elder’s rehab, you likely won’t have a great outcome.
- A hospital setting might have a CC every few days or, at least once a week. It might be daily.
- An assisted living facility or memory care facility could have a CC every month (especially when your elder first moves in), then perhaps quarterly.
- A nursing home could be the same as assisted living, but could be required more frequently if there is acute care needed.
- Hospice care CC could be anywhere from every two weeks to daily, depending on your elder’s situation.
- Home care could be monthly, quarterly or more frequently as the need arises.
- Don’t be afraid to ask for a CC! If you don’t ask, you likely won’t get it. I mean that! Be bossy. Get out your big-person pants and be as loud as it takes to get all the team together. If you are paying any of the team, give out their checks at the CC!! 🙂
#2 – Demand the Best Care
I know that sounds a) rude and b) obvious. Here’s how I see it: if you don’t ask for the kind of care you want for your elder, your elder won’t get it. By demand, I mean be assertive, lay it out in clear detail and don’t be afraid to get specific with your questions on how the care is going to improve or help the condition of your elder.
Here’s what a productive CC looks like:
- The team members give a report or a summary of what they are doing for your elder. If you don’t understand, ask for more explanation.
- You address any needs you see or any questions you have about their care.
- Goals should be set for the time between now and the next meeting. Remember the acronym for goal setting: SMART. S = specific, M = measurable, A = actionable, R = realistic, T = time-driven. Goals should be clear, specific and outcome-oriented.
- Set the next meeting time and place – right there. Don’t leave without this!
- Take notes. You have every incentive to write down what the team is going to do and how they are going to do it – YOUR ELDER’S CARE DEPENDS ON IT! Bring those notes to the next meeting. You can really make a difference in their care with continuity and notes make sure the continuity is being kept. If you think it will help the team, make copies of your notes and share with each member.
Your role at the CC:
- Observe the care your elder is getting and their overall condition before the meeting.
- If feasible, get your elder’s input on how their care is going.
- Write down your thoughts, comments, questions and suggestions before the meeting.
- Take donuts or bagels to the meeting.
- LISTEN when you get there. Pay attention to what each team member says and what they are reporting.
- Make notes. Not just general notes, this is the place to be nit-picky in your note taking. We’ve all had teachers or professors who tested based on their instruction and you had better have taken good notes. This is just like that!
- Ask questions. Just like your grade school teacher said – “there is no dumb question.” The team might look at you like that – but that’s just because this is their profession – it’s not yours.
- If you can’t take notes and ask questions/listen at the same time, bring along someone who can take notes for you. I used my 7 year old for that – it was a little hard to read but it was helpful (and it was precious too!).
- Make sure they set goals and timelines for upcoming care. Make sure they understand that this is where they’ll be held accountable. If some team member is not attending, ask for a written report to be sent to you and give a due date.
- Set up the next meeting – ask for a time, a place and a firm date. Don’t let this slip into “well, we’ll just see how it looks next week.” No – we are going to meet again – check your calendar now.
- THANK the team for coming, for giving great care to your elder and for doing their best to insure the outcome you’ve all set as the goal.
Your advocacy on behalf of your elder is essential to them receiving the best care and achieving the best outcome. That may be a stressful task – but it feels so good to know you can make a difference. You are the difference! Now, go get ‘em! High fives all around!
**There is another version of the CC – I call it the “Roving Care Conference” where you essentially do the same thing but you rove around the facility collecting the info and setting expectations for care. I’ll talk about this in the next blog. **