March 2024
Bhupinder K
Dhanoa
,
RN,BS,HCL,ACM
DOD Managed Care
Capt. James A. Lovell Federal Health Care Center
North Chicago
,
IL
United States
Ms. Dhanoa was the glue that kept this family together. She made sure that all financial resources were tapped into, home care services were available for the wife, medical supplies were delivered, and the appropriate resources and supports were in place.
An Active Duty Service Member’s (SM) wife, who has Multiple Sclerosis (MS), sustained a stroke while giving birth in 2020. The service member, his mother, and mother-in-law assisted him in taking care of his wife, who requires total care, is bed-bound, requires tube feeding, and has communication difficulty; as well as caring for their three children.
In 2022, the service member was involved in a motor vehicle accident and sustained a traumatic brain injury (TBI), which required a lengthy hospitalization and inpatient rehabilitation. He did not make a full recovery and was medically retired in 2023, about a year and a half after his accident. The concern was keeping the family unit together with the appropriate financial and medical resources and working with the service member with cognitive deficits, who was deemed decisional and is the legal guardian for his wife and children, and needed guidance on obtaining community and medical resources, which were only attainable with his permission.
Once the patient was stabilized, the service member and his family were transferred from the East Coast command to their home in Illinois. Ms. Dhanoa assisted him and his wife with navigating the healthcare system and care coordination for them both; setting up home care for the wife, supportive services for the entire family, and educating the service member regarding the appropriate medical insurance and in-home care for his wife, so she would not have to travel by ambulance for an hour to every medical appointment.
The wife and two younger children stayed with and were cared for by her mother, and the service member and older child stayed with his mother, who lived near his mother-in-law. Ms. Dhanoa communicated regularly for over a year with the service member, mother, and mother-in-law, providing care coordination, education, resources, and support. Ms. Dhanoa was the glue that kept this family together. She made sure that all financial resources were tapped into, home care services were available for the wife, medical supplies were delivered, and the appropriate resources and supports were in place. Ms. Dhanoa's role as a RN Case Manager provides services while the service member is on active duty and assists with the transition of care to veteran status, which included an ongoing recommendation for the service member to apply for Medicare, Medicaid and social security disability for his wife as the wife would lose many of the home care and support services once the service member is medically retired and had veteran status.
The service member, who was the only legal guardian for his wife, was resistant for months to applying for social security disability, Medicare, and Medicaid on behalf of his wife. Without funding from social security, Medicare/Medicaid, in-home agency caregivers would no longer be sustainable. Several months prior to his retirement, he agreed to apply for the services above. Even with Ms. Dhanoa providing verbal and written instructions on numerous occasions for months for the patient, as well as in person one hour plus meetings regarding the process and the social security application—the service member still did not complete the needed applications.
Finally, the patient agreed to meet with Ms. Dhanoa and allowed her to walk him through the social security process, contacted the social security office through a conference call with him and his mother-in-law, assisting them with the social security disability process, and assisted with making arrangements for him to pick up his wife’s social security card. He also agreed to joint guardianship regarding social security matters with his mother-in-law.
Without the social security disability, Medicare, and Medicaid approval, the wife would not be able to be cared for in her home, where she can see her children on a daily basis. Ms. Dhanoa not only assisted in providing exceptional medical care for over a year for the service member and his wife transitioning from military to veteran status in 2023, but also provided support services for the entire family.
Due to Ms. Dhanoa's professionalism, persistence, advocacy, sensitivity, clinical expertise, and commitment to I-CARE values, the entire family has improved quality of life and has a sustainable healthcare plan, which would not have been achieved without her involvement. Ms. Dhanoa did more than provide outstanding healthcare services; she assisted in holding the family unit together.
In 2022, the service member was involved in a motor vehicle accident and sustained a traumatic brain injury (TBI), which required a lengthy hospitalization and inpatient rehabilitation. He did not make a full recovery and was medically retired in 2023, about a year and a half after his accident. The concern was keeping the family unit together with the appropriate financial and medical resources and working with the service member with cognitive deficits, who was deemed decisional and is the legal guardian for his wife and children, and needed guidance on obtaining community and medical resources, which were only attainable with his permission.
Once the patient was stabilized, the service member and his family were transferred from the East Coast command to their home in Illinois. Ms. Dhanoa assisted him and his wife with navigating the healthcare system and care coordination for them both; setting up home care for the wife, supportive services for the entire family, and educating the service member regarding the appropriate medical insurance and in-home care for his wife, so she would not have to travel by ambulance for an hour to every medical appointment.
The wife and two younger children stayed with and were cared for by her mother, and the service member and older child stayed with his mother, who lived near his mother-in-law. Ms. Dhanoa communicated regularly for over a year with the service member, mother, and mother-in-law, providing care coordination, education, resources, and support. Ms. Dhanoa was the glue that kept this family together. She made sure that all financial resources were tapped into, home care services were available for the wife, medical supplies were delivered, and the appropriate resources and supports were in place. Ms. Dhanoa's role as a RN Case Manager provides services while the service member is on active duty and assists with the transition of care to veteran status, which included an ongoing recommendation for the service member to apply for Medicare, Medicaid and social security disability for his wife as the wife would lose many of the home care and support services once the service member is medically retired and had veteran status.
The service member, who was the only legal guardian for his wife, was resistant for months to applying for social security disability, Medicare, and Medicaid on behalf of his wife. Without funding from social security, Medicare/Medicaid, in-home agency caregivers would no longer be sustainable. Several months prior to his retirement, he agreed to apply for the services above. Even with Ms. Dhanoa providing verbal and written instructions on numerous occasions for months for the patient, as well as in person one hour plus meetings regarding the process and the social security application—the service member still did not complete the needed applications.
Finally, the patient agreed to meet with Ms. Dhanoa and allowed her to walk him through the social security process, contacted the social security office through a conference call with him and his mother-in-law, assisting them with the social security disability process, and assisted with making arrangements for him to pick up his wife’s social security card. He also agreed to joint guardianship regarding social security matters with his mother-in-law.
Without the social security disability, Medicare, and Medicaid approval, the wife would not be able to be cared for in her home, where she can see her children on a daily basis. Ms. Dhanoa not only assisted in providing exceptional medical care for over a year for the service member and his wife transitioning from military to veteran status in 2023, but also provided support services for the entire family.
Due to Ms. Dhanoa's professionalism, persistence, advocacy, sensitivity, clinical expertise, and commitment to I-CARE values, the entire family has improved quality of life and has a sustainable healthcare plan, which would not have been achieved without her involvement. Ms. Dhanoa did more than provide outstanding healthcare services; she assisted in holding the family unit together.