How Care Management Can Improve Chronic Disease Care


Posted on March 30th, by Mark Winter in Chronic Conditions, Health, Senior Health, Senior Medical Care. No Comments

How Care Management Can Improve Chronic Disease Care

Care management is an essential component to effective chronic disease care.

Juggling the numerous medical appointments, procedures, tests, medications, lifestyle changes, and more is a way of life for the many seniors with chronic health needs. According to the Centers for Disease Control and Prevention, a full 85% of seniors have at least one chronic health care need, and 60% are diagnosed with two or more. The challenges may seem overwhelming. But there’s one essential component to effectively managing a chronic health condition: care management.

Diagnoses such as diabetes, COPD, heart disease, and more are life-changing. They impact a person’s mental as well as physical health, and it’s important to enlist help in meeting all care needs. Geriatric care managers, also known as aging life care specialists, are skilled professionals with expertise in meeting all of the diverse care needs of seniors. 

Here’s how care management works:

The Assessment

An initial, in-depth assessment, performed in the senior’s home, allows the care manager to understand the senior’s particular concerns and challenges. The care manager will evaluate cognitive, physical, nutritional, and mental acuity, as well as the overall safety of the home environment. With all of this in mind, a comprehensive plan of care is then developed.

The Plan

The senior’s personalized plan of care will include a full range of recommendations, such as:

  • Education as needed to improve chronic disease management
  • Referrals to community resources 
  • How to ensure medications and other care needs are managed properly
  • Home modifications to enhance safety and reduce falls
  • And much more

The Result

Implementing the plan may involve, as appropriate:

  • Coordinating and collaborating with the senior’s medical team and network of support
  • Problem-solving to overcome any obstacles to effective care and management of health conditions
  • Advocating for the senior 
  • Mediating through any difficult family dynamics
  • Serving as the “eyes and ears” for family members living at a distance
  • Helping with documentation for long-term care insurance or other necessary paperwork
  • Accompanying the senior to medical appointments to ensure doctors’ orders are understood and followed
  • Legal guardianship 
  • And more

At Hired Hands Homecare, we’re pleased to offer professional care management services in conjunction with our trusted in-home care services, to best meet the varied chronic care needs of seniors. 

Discover the peace of mind and better quality of care our care management services offer. Contact us today for a free in-home consultation and help a senior you love enjoy a healthier, safer, and more independent lifestyle. You can reach us anytime at (866) 940-4343. We’d love to share more about why we’re the top home care company in Santa Rosa, CA and the surrounding areas. 





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Want to find out more about our senior care in California and how it can improve safety, comfort, and independence at home? Contact us at (866) 940-4343 to request a free in-home consultation to learn more about our customized care solutions in Novato, Pleasanton, Santa Rosa, Napa, Sonoma, and the surrounding areas.


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