Staying Independent Home Story

How LifeStages helped the Smith Family

Meet Mary.

Mary is in the early stages of Alzheimer’s. She is also struggling with COPD. Her family, who all live outside of Maine, is very concerned about her ability to remain at home safely and whether she can manage all of her medications appropriately. They are also concerned that as her disease progresses, no one will be there to ensure her safety. In this example, our geriatric care manager would meet with Mary and her family and she might develop a plan that consisted of the following:

  • A nurse would be responsible for managing Mary’s medications including doing an initial assessment; contacting the physicians if necessary. Once the medications and dosages are finalized, the nurse will fill the medication box on a monthly basis ensuring the correct dose is scheduled at the correct time.
  • It is important for Mary to be home. To ensure her safety, the geriatric care manager would develop a LifeStages team who would be with Mary in the mornings and evenings. They would be trained on when to remind Mary to take her medications. The care manager would be oversee the team and Mary to adjust the plan and hours of care as Mary’s needs increased.
  • During the initial assessment, the geriatric care manager would also learn a lot about Mary, her likes and dislikes, and her favorite activities, events and pastimes. She would oversee the team ensuring they spend time doing the things that Mary likes to do including cooking, going shopping, going to church and taking walks on the beach. This focus on Mary’s quality of life is just as important as monitoring her medications.
  • The geriatric care manager would continue to meet with Mary and over see her team ensuring everything is running smoothly. If changes in Mary’s condition occur, she will be available immediately to work with the family on next steps and how they would like to move forward.
  • Communication is critical when family members are not close by. The geriatric care manager would communicate regularly with the family sharing how Mary is doing, how she spends her time with her care giving team and any changes in her condition.

As Mary ages, the geriatric care manager would be there for her family helping to guide them through the complexities of the long term care maze. A critical part of her role is to be the one point of contact for the family for all issues that arise giving them peace of mind knowing that their geriatric care manager knows Mary and her wishes, knows the family and knows the elder care community in southern Maine.

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