Care Managers vs. Case Managers: Understanding Differences and Duties

Your mother has fallen and broken a hip. You’ve worried about this exact problem for years, and the reality is finally here. You know your mom will need surgery, physical therapy, medication management and ongoing therapy.

But you don’t know how to manage all of that and who will put all the pieces of the complex puzzle together and make sense of it.

You’ve been told there are people who can help, but it’s a confusing list of titles and certifications.

How can you find the help your mom needs and you need so she can heal, recover and get back to living her best life?

Understanding the differences and unique skills of the professional support teams available enables you to make informed decisions about care, to find the best services possible and to make the most of the support available.

We are often asked to explain the difference between CARE managements and CASE management.

Many clients wonder:

What is the difference between a care manager and a case manager?

Which services does each position offer?

Which situations would be suitable for a care manager or a nurse case manager and vice versa?

Let’s explore each of these questions.

What is a care manager?  What is care management?

Care management, also known as geriatric care management, is a holistic, client-centered approach to caring for older adults or others facing ongoing health challenges.

An Aging Life Care ™ professional or care manager works one-on-one with clients to help them (or their loved ones) manage chronic illnesses or disabilities. Their holistic approach to client care looks at the whole picture of care including medication, doctor’s appointments, in-home care needs, social and spiritual needs and more.

Care managers are concerned with quality of life and the daily needs of clients as they manage and navigate health issues, which often affect day-to-day life, client safety and individual living situations.

The professional organization for care managers is the Aging Life Care Association (ALCA), which provides oversight for this profession as well as certification.

Working with families, the expertise of Aging Life Care™ professionals provides answers to often confusing questions at a time of uncertainty. Their guidance leads families to the actions and decisions that ensure quality of life for loved ones and for the family as a whole.

What is a nurse case manager?  What is nurse case management? 

 According to Nursingexplorer.com:

Case management nurses are registered nurses who coordinate all aspects of the care of individual patients. They ensure proper utilization of services and resources as well. Case managers provide assistance within, between, and outside of facilities.

A nurse case manager is a registered nurse (RN) who works with patients and medical providers to determine the specific care a patient needs and how best to provide that care in a cost-effective manner. Nurse case managers act as patient advocates and help tie together all the medical pieces of a patient’s medical care. Nurse case managers identify resources and services patients need for overall treatment and care of complex and chronic illness.

Nurse case managers do receive specialized training and certification, and several certifications are available.In order to be eligible for certification, nurses must already hold an RN degree and have direct nursing experience and have held positions in which case management was part of their duties. For more on nurse management certification, see this article at nurse.org.

Which types of services does a care manager provide?

According to Aginglifecare.org, care managers focus on the following areas:

• assessment & monitoring
• planning & problem-solving
• education & advocacy
• family caregiver coaching

Some of the specific services provided by care managers include:

• Assessment and evaluation of client and family needs
• Nursing home advocacy
• Planned care management
• Coordination of personal care (helping clients match with personal care givers and providers)
• Consumer education
• Public notary services
• Providing and directing adult children to local resources and support
• Guidance, support and direction with considering and going through a move
• Dementia care, counseling, education and support
• Serving as a link between community services/support and client-specific needs
• Crisis intervention
• Adjustment support
• Education and support for family caregivers (including helping them understand specific diagnosis, develop plans in support of a loved one, and helping caregivers take care of themselves)

What types of services does a nurse case manager provide?

Nurse case managers provide the following services (and often more):

• Develop client-focused case management plans to ensure patients, medical team members and other healthcare providers are able to communicate in the best interest of the patient
• Schedule a patient’s doctor’s appointments and other medical appointments and assist in facilitating transportation
• Assist in transfer from facilities
• Helping high-risk patients decrease hospitalizations and re-hospitalizations
• Oversight of the discharge process (from hospitalization/outpatient procedures)
• Identifying client needs and linking clients with appropriate services and resources
• Screening clients or specific populations for healthcare/medical needs
• Collaborating and engaging with other healthcare providers
• Follow up with patients after hospital/outpatient discharge (often within 24 hours) to ensure care coordination and connection with services
• Medication monitoring
• Monitor and update patient treatment plans as needed
• Coordinate specialty care as needed
• Assist patients in navigating healthcare system for better outcomes and treatment planning
• Follow-up on test results and other procedures

Where does a care manager work?

Care managers usually work with clients in the home but may also visit clients in the hospital, in rehabilitation facilities and in assisted living and skilled nursing facilities.

Care managers help clients create and implement plans to address all areas of aging including financial, social, medical and more.

Where does a nurse case manager work?

Nurse care managers typically work in clinical settings such as hospitals, long term care facilities, outpatient clinics (such as oncology), public health clinics and palliative care clinics.

They can also work for government agencies, insurance companies, medical supply companies and other non-clinical providers related to healthcare. Most patients, however, will come into contact with a nurse care manager in a hospital, long term care facility or outpatient clinic.

When does a loved one need a care manager?

A loved one may need a care manager if she is considering moving from, for example, the family home to a smaller home in a new town or to a retirement community. A care manager is helpful when a loved one has a medical diagnosis requiring ongoing treatment and management, which often requires education and adjustment for the entire family and specifically for the client.

A care manager is helpful when life circumstances bring long-standing changes for a loved one, such as a medical condition, a fall or health crisis, a move, a financial change or a social change (death of a spouse, etc.). All of these adjustments require support, and care managers are trained to provide the support specific to this stage of life and the changes associated with aging. Care managers help loved ones adjust successfully, with as little disruption and negative impact as possible.

When does a loved one need a nurse case manager?

A nurse case manager is helpful when a loved one has a medical issue requiring case management, particularly if the issue requires ongoing treatment and follow-up. For example, if a loved one has a fall resulting in broken bone, a nurse case manager is helpful in overseeing the patient’s overall medical needs, linking the patient with multiple medical providers, overseeing the transition from hospital to home and ensuring the patient’s medical needs are understood and addressed from a big-picture scale.

A nurse case manager is necessary when a patient has a complex medical condition requiring several specialists, treatments or services. A nurse case manager can track the overall progress of the patient, which is key for overall wellness and recovery.

Quick Recap:

A care manager is different from a nurse case manager in several ways. Care managers often have social work degrees or gerontology degrees and focus on the overall quality of life of a client.

A nurse case manager has a nursing degree and manages a patient’s medical case, which often includes aspects beyond medical care (such as support and living conditions, which affect medical treatment).

These two professions often overlap but are distinct. Nurse case managers and care managers often work together to meet your needs. Their work compliments each other rather than duplicates each other.

 

Is it time to consider a professional care manager?

We can help. Call TODAY to schedule an in-person, phone or virtual visit.  910.692.0683

Aging Outreach Services is a multi-service elder care service provider.  Our guidance leads families to the actions and decisions that ensure quality care and an optimal life for those they love, thus reducing worry, stress and time off of work for family caregivers through:

• Assessment and monitoring
• Planning and problem-solving
• Education and advocacy
• Family caregiver coaching

The complexities of in-home care, care community placement, hospitalization, government programs, legal and financial professionals, health concerns and related costs can be overwhelming.  We have extensive knowledge and experience coordinating the needs and services that provide quality ongoing care to you and your family.

Our caring services begin with an intake of your needs to determine the first step needed in tailoring our services to meet your personalized needs.