People ask me the question, “What is the role of a geriatric case manager?” In my essay submission for The Gospel Coalition, I described myself as a ‘rentable responsible adult’ to come alongside the client and family caregivers. While that is certainly true, there is, of course, much more. In this blog, I’d like to talk about the patience, wisdom, and foresight required by both caregivers and GCMs.
Both the GCM and caregiver’s jobs include walking this journey with you at YOUR pace, not ours. Probably the most important role we play is the role of an advocate, not just for what we think might be best, but for what YOU think is best, based on YOUR values, not ours.
GCMs are not so much ‘the expert’ as much as the ‘coach.’ I can (and will!) warn you of ‘potholes in the road’ or that we’re way too close to ‘a ditch,’ but YOU are the one driving on this path, not me. Obviously neither GCMs or caregivers can let someone drive the wrong way on a one-way street; safety is critically important. What if, maybe, your circumstances are less severe than that example. Perhaps the loved one we are caring for just isn’t ready to be compliant with the doctor’s instructions to stop smoking, following the prescribed low-salt diet, or to taking medication as ordered. Maybe they aren’t ready to give up those car keys. My prayer is that by building a relationship based on mutual trust, respect, and common values, we can take forward steps, however small they may need to be, as your loved one is ready. Most of us are resistant when we’re told we MUST take some action (or stop some action) when it is not a part of our values or habits. I can show you the ‘road map’ – talk to you about the health consequences of ‘driving in potholes’ or ‘off the road’ – but ultimately you are the adult with the right to make those decisions – and face the consequences of those choices.
Just like the family caregiver, the geriatric nurse case manager may indeed play the role of the anchor or the life vest in a crisis (perhaps cognitive disfunction?), but our loved one needs to know that his or her values and wishes are respected by us. He or she may not be willing to make many changes until a time of crisis forces a change in those values. We are not God; we can only do our best under the guidance of the Holy Spirit to serve our dear ones with love, trust, respect… and patience.
“But the fruit of the Spirit is love, joy, peace, patience, kindness, goodness, faithfulness…” (Galatians 5:22)