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Geriatric Care Management Services for Functional Status

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functionalstatusAs a geriatric care manager, I have to admit that we are very skilled at not only providing senior care options for those among our clients with medical conditions, but translating medical speak into a language that clients, caregivers and families can process.  A lot of these are chronic conditions that progressively impact the caregivers’ loved ones, and some have some rather scary names.  But one of the medical “conditions” that does not have a name associated with it is every bit as important as those medical jargon labels like chronic obstructive pulmonary disease or congestive heart failure and more.  It is called “functional status.”

If you are a caregiver, you may have seen your loved one’s chart at some point, and it has a lot of information on it.  A fair bit of it covers the ongoing record of a patient’s vital signs, measures like heart rate, blood pressure, temperature and more.  But you will not see a measure called functional status, what some in our field these days are calling the “sixth vital sign.”  The key reason to know your loved one’s functional status is because that is a really good predictor of how easily or rapidly they will recover from, for instance, a hospitalization.  If your loved one is going through chemotherapy, it will also dictate how aggressively the doctors can treat the cancer.  They call it performance status.

            But for every discharged patient, functional status is also a very important predictor of whether they will be re-hospitalized within the next 30 days.  How well one is able to take care of oneself is really critical to a healthy recovery.  And functional status is all about self-care like bathing oneself, taking one’s medications when they are supposed to be taken, preparing a nutritious meal and more.  Functional status is what gets a discharged patient back on their feet, and being up and about is one of the best ways to avoid having other problems like pneumonia or bed sores.

Getting back to re-hospitalization, Medicare is starting to take functional status very seriously, at least indirectly.  Starting in October they will be monitoring hospitals’ readmission rates, and those who are above the national average will begin to pay penalties.  So, doctors should start paying attention and recording their patients’ functional statuses.  Because it will not be the patients’ medical condition alone that will put them back in the hospital; it will be that interplay between how they take care of themselves – their functional status – and their medical condition.

It is interesting that we, as providers of senior care solutions, have been focused on those two dimensions all along.  We call the combination of good functional status and a medical condition to be “quality of life.”  If you are a caregiver, you can really help your loved one by helping them to be as active and self-sufficient as possible.  If they cannot be totally independent, then assistance in any of the activities that challenge them can still improve their net quality of life by leveraging their functional status.  It will be better for your caregiver quality of life as well.

Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends providing senior care options to older adults and their families in metropolitan Chicago.  Please email your questions to ccbishop@creativecasemanagement.com.

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