Initial
Evaluations
· Thorough
review of client’s preferences and needs in the home or institution
· Work
with your family’s current health care, legal and/or financial
professionals or provide referral, as needed, to public and private
services/agencies and professionals
· Evaluation
of social supports and of the psychological, medical, social, financial,
and environmental status of the older person
· Consideration
of options available to meet needs and preferences of the older person
and the family, and cost benefit analysis of those options
· Advocacy
to make services responsive to patient needs
· Recommendations
regarding specific services including, as necessary, selection of institutions
best suited to the needs of the client
· Completion
of assessments and paperwork required for institutional admissions
· Medical
evaluation or on-going medical care in an office or in the home may
be arranged as appropriate
· Evaluation
of use of entitlements including Medicare and Medicaid
· Written
evaluations may be sent, to include a summary of findings along with
recommendations for addressing preferences and needs of the client
and family
· Assistance
will be provided as requested in implementing recommendations
· We
typically see the older person in his or her familiar setting for an
initial evaluation
Consultations
· If
families request single sessions to address specific issues, such sessions
are held at locations convenient to all parties
On-going
Monitoring
· Follow
up is done as requested by the client/family
· Frequency
of contacts depends upon assessment of need consistent with patient’s
wishes, with sufficient frequency to monitor changes in status and
respond to those changes with appropriate services
· Periodic
written reports evaluate progress and include additional suggestions
to meet the client’s [changing] needs
· When
in-home services have been arranged, we represent the client to the
provider to insure that the needs of the client
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