Case Managers: The Other Frontline of COVID-19

Case Managers must make impossible choices to manage the complexities of an unstoppable pandemic—and they are working against the clock.

Unless, like me, you are married to or related to a Case Manager, you’ve probably never thought about what they do, yet they are critical to the healthcare system that we all rely on. They reside in the central command center of a crisis. The unrecognized role of Case Managers changes slightly depending on whether they work for a healthcare organization or hospital, long-term care facility, or social service department, but in general, they are responsible for overseeing a patient’s case to ensure the best outcome.

Case Managers, most of them registered nurses and social workers, coordinate with physicians, nurses, mental health and insurance companies, and family and friends of the patient, their client. They receive constant input from stakeholders with vastly different viewpoints, and it’s their job to bring all of that information together to ensure the best interest of their patients is being served. In addition, as part of interdisciplinary teams, professional Case Managers are responsible for tracking outcomes, not only for case management but also for the interventions of the entire team.

Case Managers have a stressful job on the best of days. COVID-19 has made it untenable.

The coronavirus has had an extraordinary impact on their professional and personal lives because we’re dealing with a pandemic that could not only infect patients but also the very system tasked with mitigating the outbreak. Doctors and hospital nurses are often spoken about as being on the frontlines of the coronavirus. I would argue that Case Managers represent another frontline; one that requires them to take incredible risks and make difficult choices every day. And for them, there is no triage.

As I mentioned, my wife is one such person. Due to the unwelcomed, invisible intrusion that is COVID-19, she is now working from home, but with an increased caseload, greater complexity, and more responsibility. And that is on top of adjusting to the reality of being isolated in our home day in and day out. As the world we’re in now calls for social distancing there’s no way for her to distance herself from the call of duty. Things were very different for her when she was able to walk down the hall to speak with a doctor or nurse about something. Now, she is tasked with coordinating people without the benefit of human connection. As many workers in America are finding out, working from home often results in a loss of work-life balance. This is especially true when your job was already taking over your life.

This week alone my wife has been charged with helping cancer patients who are unable to have critical follow-up appointments because oncology offices are closed. A two-year-old asthma patient who was discharged home because his lung doctor’s office is closed. Patients with terminal diseases who came down with coronavirus and, therefore, are unable to see their families when time with them matters most. And patients who are discharged from the hospital after testing for COVID-19 who are being told to self-quarantine but are then unable to get their results.

A lot of patients have become stranded, and even getting critically ill patient-placement has become a challenge. It’s like a scavenger hunt for empty hospital beds! And the virus hasn’t even peaked yet. All of these situations bring tears, confusion, fear, and loss—all of which my wife, and Case Managers like her, are supposed to alleviate from a remote location with little support and in the middle of a system plagued by glitches and breakdowns.

This is ground zero, folks. Case managers are in a battle behind the scenes, huddling daily to plan for the next six months. But mostly these men and women are alone, hunched over computers in trenches of their bedrooms or living rooms, making frantic phone calls, staying focused on the needs of patients even when their families need them, too.

There is no denying that the doctors and nurses you see online sharing photos of their bruised faces after spending hours in protective masks and goggles are heroes. But when those people need the go-ahead to perform surgery or need to know where to send a patient next, they turn to a Case Manager like my wife. She is a hero, too.

If God forbid, you or a loved one ends up in a hospital during this pandemic, utilize your Case Manager, trust your Case Manager, and, please, be kind to your Case Worker. He or she is making a great sacrifice to ensure the best outcome for you.

Foster Care and Online Technology: Are you Keeping your Child Safe?

As a foster and adoptive parent myself, I recognize the importance of technology in the lives of children.  Indeed, technology is everywhere, and for our children today, it is a large part of their lives. Yet, social network sites, such as Facebook, have opened up a whole new world for those involved in the foster care system. Foster children, foster parents, birth parents, and social workers have all felt the impact of this powerful technological communication tool. Social Networking allows foster children to stay connected to friends and family members from all over. For these children in need, it can very much be a benefit as they stay in touch with birth parents and biological family members.

socialmedia_menThese sites open up a new way to communicate with birth parents and other biological family members. Facebook and other networking sites allow foster children and birth parents to remain in day to day contact as it allows the foster child the opportunity to continue in a relationship that is important to him. This may help in allowing the child to cope with the separation from his family.

However, social networking can present challenges for children in fostercare. Some caseworkers may prefer that contact with birth parents be limited. Yet, with social networking, this can be most difficult and almost impossible for foster parents to monitor. More and more birth parents are contacting their children through social networking sites, and many times against the wishes of both foster parents and caseworkers. Birth parents are able to openly communicate with their child unsupervised, which can lead to false accusations as well as false promises.

Indeed, social networking is a whole new world for all involved in foster care; a world that can be both wonderful and dangerous at the same time. “There is the chat component of Facebook,” one caseworker noted, “where a child and their parent could essentially have a conversation that no one would be able to monitor unless they were sitting right next to the child, which is a grave concern.” Case managers would have to be familiar with the birth parent’s Facebook page before the foster child was to even access it. Along with this, there are many reports of foster parents being bullied and stalked by the birth parents through social networking.

Another caseworker suggested that, “I am personally aware of inappropriate things that parents post on their Facebook pages that would not be appropriate for their children to view. Not only might there be inappropriate information and comments on there, there also might be inappropriate photos and other harmful content that the children do not need to be exposed to, not just from the birth parents, but from the internet, in general.”

Indeed, social networking is a whole new world for all involved in foster care, and its a world that can be both wonderful and dangerous at the same time. Much more information and research is needed before the social network explosion engulfs foster care.

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