From the Fall 2016 issue of For Your Benefit newsletter
GIC member Suzanne is managing a chronic condition that reduces circulation and sensation in her feet. As a result, she is wheelchair bound and gets multiple recurring foot wounds – also known as foot ulcers. Foot ulcers take a long time to heal, are easily infected and tend to open, close and then re-open. A few years ago, she was hospitalized seven times to get antibiotics and extensive wound care for her foot ulcers. That was when the very real possibility of amputation came up.
Suzanne lives alone and takes care of herself. She was determined and strongly motivated to get better and avoid amputation. She worked with her GIC health plan’s nurse case manager to create a care plan that worked for her living situation. The Plan arranged for regular home visits from a visiting nurse and was able to arrange for the assistance of a homemaker through a local elder services program. They moved Suzanne’s care to a wound care clinic that provided the enhanced expertise needed to manage her condition. To help prevent Suzanne’s recurring hospitalizations, the nurse case manager also set up a long-term agreement with the Visiting Nurse Association (VNA) to provide ongoing assistance with wound management.
With Suzanne’s commitment, the support of her health plan case manager, and the care services they arranged, Suzanne has not been hospitalized for foot infection for more than two years. She has been able to maintain her independence in her own home.
Suzanne says, “The encouragement and follow-through I got from my case manager was as much a part of my healing process as any of the treatment I received.”
Suzanne is a member of the UniCare State Indemnity Plan, but her situation is one of many handled by case managers at all of the GIC’s health plans. Case managers are generally registered nurses, with expertise in helping members deal with serious, complex medical issues, like stroke, cancer, spinal cord injury, or any another condition needing multiple medical services. Getting health care can become very challenging for people in situations like Suzanne’s. Case management is a resource that can have a significant impact for GIC members and their family members with continued quality of life.
Thank you GIC health plans for this important work!
This information provided by the Group Insurance Commission .