Our Care Management Case Studies:

The Special Offender: When Psychiatric Issues Undermine Judgement and Lead to Crime

Matthew’s psychiatric history was infinitely more complex than his criminal history. Six diagnoses — Schizoid Personality Disorder, Attention Deficit Hyperactivity Disorder, Tourette Syndrome, Asperger’s, Oppositional Defiant Disorder and Obsessive Compulsive Disorder — had made a young life of just 26 years incredibly difficult. Matthew’s criminal history was far simpler: There had been no trouble at all.  His record was perfectly clean until poor social insight and a broken heart changed everything. Read More…

Games People Play: When Virtual Reality Crosses Paths with Mental Illness

Katrina was living in an alternate world. There, in an online fantasy game environment, she was powerful.  She had control over her own life and those of others.  Success in this world was fully achievable for her, and it felt so good to win. In this alternate world, Katrina was not mentally ill or depressed, and there was a legitimate use for her aggressive tendencies.  Where the real world failed her and offered so much disappointment, this world presented the illusion of friendship and the delicious thrill of self-determination. Read More…

A Coach for Life

Sandy had a tendency to read too much into random life occurrences. The boys who lived behind her house played quite a lot of baseball and, occasionally, one of their fly balls would come over the fence and land in her yard. Sandy, thinking it might send a message if she followed suit, threw a variety of garbage – coffee grounds, banana peels, empty carryout containers — back over the fence into the boys’ yard. Not surprisingly, the neighbors were both confused and upset. Sandy had never talked to them about the baseballs in her yard so the sudden appearance of garbage was simply inexplicable. Read More…

Tides of Change:

“There may be a little water in the basement,” confided Roger, en route to the hospital for a long overdue review of his psychiatric medications. A little water, indeed. What we discovered in Roger’s basement was three feet of water, much of which was gushing from a dysfunctional water heater. An influx of rain water had rusted out the water heater’s base, causing the unit to desperately try to refill its empty tank. Furniture and other household items bobbed in the water like ice cubes in a punch bowl. Sewage swirled through the water, too. Read More…

A Solitary Man

An already limited world was slowly becoming smaller. Jeff, a 62-year-old man living alone in his home, was retreating from the world. He wasn’t answering phone messages or emails, and generally kept to himself. His environment was literally shrinking. He filled each room with waist-high paper and debris of all kinds. Narrow pathways allowed him to go from room to room. Deaf from birth, Jeff was comfortable with the silence. Less comfortable for Jeff was the stark aloneness he was experiencing, and the creeping effects it was having on his outlook, his house, and his day-to-day movements. Read More…

“We Thought She Was Sleeping”

The sisters had lived with their mother for most of their adult lives. Sadly, for at least five days of this timespan, their mother was dead. Marge and Annie stayed in the home with their mother’s body until police made this discovery during a wellness check.  They may well have suspected she was dead but feared, perhaps, that reporting such a thing would lead to some kind of trouble for them.  It’s possible they didn’t know how, or to whom, a death might be reported.  It’s also possible that the idea of their mother’s death was too much for them to process so they willfully convinced themselves she was sleeping.  Read more…

Obese, Psychotic and Immobile: How Out-of-the-Box Thinking Led to Out-of-the-Bed Placement

In clinical circles, Maria might be called “complex.” Maria has cerebral palsy and developmental delay. At the tender age of 32 she is obese. She has gastro esophageal reflux disease (GERD) and a stomach tumor. She has the additional psychiatric diagnosis of schizoaffective disorder and bipolar disorder with active psychosis and incidents of agitation. When Maria, in one such incidence of agitation, struck the Director of Nursing at her facility, this assemblage of diagnoses became even more acutely problematic. Maria needed to be placed anew…but what one community could manage this collection of needs and the very real person who harbors them? Read more…

Developmentally Disabled and Alone

Lifecare Innovations met Hal when he was 54 years old.  Hal had lived with his parents until he was well into his forties. When both of his parents passed away, Hal was forced to move out of his parents’ stable, middle-class home for the first time in his life. When Hal was born he had a deformity in his brain that caused seizures and left him in a coma for many weeks as an infant.  Later, as a youth and young adult, Hal suffered from learning problems, socialization problems, and a wide variety of challenges that commonly accompany those with developmental disabilities. Read more…

The Dysfunctional Family: Providing Care in the Midst of Drama

Families fight. Some are loud and combustible, while others have slow-simmering feuds and long-standing resentments. There are spats, and there are wars. Conflicts tend to erupt around holidays and other occasions that bring family members into the same airspace. When the occasion involves the failing health of a parent, family conflict can impact the patient, the care they receive and those who do their best to provide it. Read more…

Insurance Coverage Denied For Cochlear Implant Surgery

A 56-year-old woman came to Lifecare Innovations, Inc. (LCI) for assistance with a difficult insurance issue.  Her insurance company had recently denied her coverage for a much-needed cochlear implant surgery, basing their denial on the false impression that cochlear implants are hearing aids. Read more…

Miles from Home

Frank and Esther had been our clients over 10 years.  They both had multiple medical problems and they utilized LCI to assist in obtaining second opinions, reviewing medical bills, and finding rehabilitation options.  They had always been the perfect clients, seeking advice when issues arose and then following the advice.  We helped them maintain their independence as they managed two cancer diagnoses, kidney failure, sleep apnea and more. Read more…

Stabilizing Chaos with a Life Coach

M. is a 49 year old male.  He is currently residing independently in an apartment in Chicago.  Lifecare Innovations, Inc. (LCI) has been providing Lifecare Management services to M.  since July 2007.  M. has a developmental disability and also appears to have a significant history of depression and anxiety.  Previously, M. managed to live in the community and manage his own affairs.  He was employed as a janitor for over 25 years, was married, drove independently, and ran a household.  His now deceased father provided him with the monitoring and direction he needed to maintain his quality of life.  This “coaching” he received from his father was essential in his ability to be successful in the community.  Read more…

The Value of Care: A Daughter’s Custodial Claim

Related to Margot Gordon’s insightful article above, we offer the following case study from our own files.  This story illustrates the sacrifices made by the adult daughter of a man afflicted with progressive dementia, and the legal course she pursued after his death to seek compensation for the services she offered during his life.  Read more…

Managing the Alzheimers Tsunami

Jack was an 83-year-old, recently widowed male living in his large, isolated home with 12-hour caregiver services when LCI first began working with him in the winter of 2006. Jack’s wife, also a client of LCI before her death, asked us to promise that we would continue to care for her husband after her death, having herself noticed his increasing cognitive deficits. Jack’s Health Care Power of Attorney and LCI agreed and obliged. LCI observed increasing safety issues in Jack’s multi-level home and advocated for him to move into an assisted living apartment.  Jack was successfully placed in a nearby facility where he could meet new friends and enjoy a more active, social environment. Using our Surround Care™ model, which features a variety of services designed to offer customized care for the specific needs of each client, LCI then assisted with the management of his home.  Read More…

Surround Care™ In Action

Lisa is an 89-year-old female who had been living alone in her one bedroom apartment on the north side of Chicago. She was referred to Lifecare Innovations (LCI) by her attorney due to her increasing memory deficits and concerns for her safety in the community.  She has dementia with significant short- and long-term memory loss.  Lisa was an only child and, after her parents passed away, the only family she had was three second cousins with whom she had very little contact .  Lisa had the option to continue to live in her home with the assistance of a caregiver to help with safety, medication oversight, and all activities of daily living.  Lisa, however, had expressed a desire to leave her home of 35 years with the goal of moving to an assisted living facility.  LCI quickly developed a care plan that encompassed all of Lisa’s needs using our Surround Care™ model.  Surround Care™ allows for the development of a unique, multi-faceted plan that encompasses all of an individual’s care needs, essentially surrounding them with the services they need to remain safe and supported.  Read More…

The Cost of Independence

Robert is a 52-year-old male.  He is reported to have a developmental disability which causes him to struggle with processing information, using appropriate social skills and understanding abstract concepts.  He also has a history of depression, anxiety and alcohol abuse.  Upon further assessment of his medical and psychiatric history, LCI discovered that Robert had also had acute psychotic episodes, had been treated for alcoholism and been diagnosed with schizophrenia many years prior. Given Robert’s clinical deficits, his relationship with his father, his only living family member, was tenuous at best.  Read More…

I’m Here and You’re There: A Far Away Son and a Family in Need

The National Institute on Aging estimates that there are seven million long-distance caregivers in the U.S. These are the people who receive calls in the night, at work, during a son’s soccer game, and often have no idea what to do. Their parents, once the solvers of all family problems, have developed problems of their own, all heart-wrenchingly real and difficult to fix. Someone has fallen. There is a new diagnosis. The caregiver has vanished. The neighbor called to say Mom is wandering. Something has to be done. This was the situation in which Brian found himself, situated 1000 miles from his aging parents and a cancer-stricken brother, all of whom were rapidly unraveling. Something had to be done, indeed. Read More…

A Moving Experience: A Special Boy on a Singular Journey

Most of us remember at least one occasion in childhood when we were the “new kid”. In this almost universal childhood story, there is a crazy casserole of new house, new room, new school, new teacher, new friends, and the unsettled feeling of not quite knowing where we belong. These stressors were hard to measure in nine-year-old Kyle’s case. He cannot speak and can hear only a little out of one ear. His vision is poor. Walking is difficult for him and his muscles are weak. An accident at birth triggered for him a diagnosis of hypotonic cerebral palsy, which made moving from room to room difficult and moving from home to home exceptionally complex. Read More…

The Caregiver is Drunk and Other Stories: Auditing Care to Protect both Client and Trust

“What do you want?” We would learn rather quickly that this was Jane’s standard greeting. At the age of 84, her tolerance for small talk had been replaced with terse comments and plain-spoken sarcasm. What we wanted, standing there at the door of her suburban home that day, was to audit her care. Jane had just resigned as her own trustee and her bank had taken over as successor. Not entirely certain that Jane’s level of care was still appropriate, the bank asked us to assess her overall well being, care needs and living environment. Read More…

The Serious Consequences of Casual Care: How Loose, Informal Care Can Lead to Plan Derailment

Those who fail to plan, plan to fail. But what about cases where the plan is carefully developed, well managed, and equipped with safeguards to prevent derailment? We like to believe our best-laid plans culminate in happy outcomes, and often, they do. Any plan can and will fail, however, particularly when vulnerability intersects with exploitation. Read More…

GPS for Life: How Surround Care™ Leads the Way

Sammie, as he is known to all his friends, has risen to the rank of number one client – the valedictorian of his class. How has he done this? By using the most services? No. By paying the most money? No. He did this by embracing our concept of surrounding his life with care. The Surround Care™ concept brings in the services that mirror the ebb and flow of the family’s life. The Lifecare Management tracking system monitors progress and events to keep life steady. Obstacles always appear along the path – life happens and the global view is the fastest, most efficient and wisest way over, under, around or through the road hazards. Read More…