To be published this summer:
Preface to The Practice of Care Consultation and Care Management: Working With Elders and Their Families With Compassion and Respect, by Joan McGinnis and Gary Bloom
If you were anything like me, when you were a child, you yearned to be a care consultant. You dressed in care consultant costumes on Halloween. You asked for care consultant outfits for birthday gifts, and you asked the multicultural gift-giver of your choice, sometime around the winter solstice, to deliver care consultant action figures. Your parents humored you, sure that you’d grow out of this fantasy, because when you were growing up, there was no such thing as a care consultant!
I began working with elders in 1984, but I didn’t start calling myself a care consultant until a decade later. Even today, hardly anyone labels themselves as such, sticking with the well-known term, care manager. Yet, there is a significant difference between their roles. In short, a care consultant guides the concerned parties—usually, family members of the client (who is the elder, or otherwise, infirm)—to appropriate services. This typically requires a thorough assessment of the situation that includes the needs and wishes of the client, and an agreement among those involved in the care decisions—usually, the family. If the family is unable or uninterested in managing the care, they hire a care manager to do that. About one-third of the time that I’m hired for care consultation, I’m retained in the role of care manager.
While you may have guessed that I didn’t really plan let alone “yearn” to be a care consultant when I was young, I did plan to become a social worker. However, my work with elders was a fluke.
Before graduate school, I did some work in an inpatient hospital and became determined to work with the severely mentally ill. Following getting my MSW, I took a position working in a residential treatment center for chronic schizophrenics. During my five years there, I rose to program director. Moving on from that program, I followed my husband-to-be to a small town, where the only opening in the counseling center was as director of geriatric services. I was hired for my supervision experience, as I had no experience with elders.
My grad-school classmate and friend had been working with elders since her graduation. My agency agreed to pay for distance supervision, via phone calls. With her help, I managed my own work, supervised a nurse and clinician, and earned my state’s recognition as a Geriatric Specialist.
Unlike with many non-fiction books, we couldn’t have transformed a short book into a longer one by front-loading it with the history of the subject. We would have had too little to work with. The history of care consultation has less in common with a distinct profession and more in common with a town meeting led by whoever marched to the podium and grabbed the mic—usually a social worker, nurse, lawyer, wife, husband, sibling, daughter, or son. When the management of care of an elder is taken on by a professional—usually, a nurse or social worker—it’s sometimes referred to as case management or the all-encompassing care manager, but these terms can mislead. Case management has a historical association with the mental health system and various social work, and care management is just an optional component of care consultation. I identify as a care consultant who sometimes gets hired to do care management.
Care consultation and care management training is often treated as a stepchild—by adding a certificate program or the like to a university department that studies and teaches geriatrics. But there is more to working with the elderly than understanding the aging process. Clinician-led care consultation and care management training is rare, and I believe it should be done by those with clinical training, whether in social work, counseling, or nursing.
Our goal is to create a source that can be used either in a formal school setting or as a self-educational guide. It is not meant to be an instruction manual, but an offering, an invitation to what I’ve experienced and learned in my three-plus decades of working with the elderly. It’s not meant to be an exhaustive reference but an aid to give you a head start, whether in private practice or within an agency.
This book was written by Joan McGinnis (me) and Gary Bloom. I’m a social worker, who assembled a career as a care consultant during three decades. Gary is a marriage and family counselor, who has advised me on working with families. We happen to be married, which made this book both easier and harder to write.