A Case Study in Case Management

By Anne Moon, RN, CRRN, CCM Rehabilitation Advisors

Dave was an ambitious, self-motivated man who lived in Minnesota at the time of his life changing accident. He was married to Lily and had two sons, ages eight and ten years old. Dave and Lily married at a young age and worked together for years to develop his construction business. By the time of his accident, Dave had grown his business into a successful enterprise that provided him with a very satisfactory income. He and Lily were happy with their two sons, living in the house that Dave had built for his family. He enjoyed living near his parents and Lily’s family, with whom they spent leisure time. Having grown up in the community in which they were living, Dave and Lily were surrounded by friends and life long acquaintenances. Life was good and their hard work had begun to pay off.

One Sunday afternoon, Dave and his family were returning home from a winter day’s outing. It had been a cold and sunny day with some of the snow melting. There was a stretch on the two-lane road that had been shaded, and the ice on the road surface had not melted. Dave, who was driving the family van, hit that slick spot and went into a spin. He managed to maneuver the van to the opposite side of the road before it turned on its side. As a result, Lily and the boys were unhurt, except for a few bruises and scrapes, but Dave had sustained a serious injury and could not move his lower body.

Dave was treated at the local hospital in his community, where he stayed until he was able to transfer to Craig Hospital in Colorado for spinal cord injury treatment and rehabilitation. Following his discharge from Craig, he returned to his home in Minnesota, with no opportunity for further rehabilitation efforts locally. While he had learned how to take care of some of his personal needs, such as dressing and grooming, Dave relied on his wife for bathing, skin care, transportation and whatever else was required. With Dave unable to work, the family lived off savings and by curtailing expenses. The term “budget” had taken on a new and painful meaning. Eventually, Dave had become so discouraged that he handed over all the finances to his wife.

It was during those late winter months that Dave and Lily decided to move to Florida. He had family living near Sarasota who offered to help them find an appropriate home in the same area. They moved south that spring. Shortly after their arrival into their new home, Rehabilitation Advisors was contacted by Dave who requested case management services. Within the week, authorization had been received from the carrier involved and case management services began.