By Shakima Tozay DSW, MSW, LICSW, CCM & Dulcy Stout MSW, LCSW, CCM
We’ve all heard the phrase, “Education is Power." But what does it really mean for older adults and their families as they navigate the challenges of aging in place? What should empowerment look like when the options feel overwhelming?
- When mobility, cognitive functioning, and caregiver availability decline, aging in place becomes more challenging. Concerns about the cost of out-of-home care, understanding the process involved in finding a home away from home, and learning about all the resources necessary for a successful move are among the top challenges reported by the older adults and families we serve.
- LTC in community settings, such as assisted living or nursing homes, is less frequently used, with only 37% of 65-year-olds accessing any community-based care (LongTermCare.gov, 2020). Nonetheless, it remains a major concern for older adults and their families.
- Because Medicare does not cover the cost of LTC and not all older adults qualify for Medicaid coverage for LTC, there is a higher likelihood that older adults will need to pay privately for LTC in a community setting. That’s why we believe mastering LTC planning through educational programs is imperative, especially when the topic is often avoided.
In Part 1, we (Shakima & Dulcy) laid the foundation for why proactive LTC planning matters and how social workers can lead efforts to shift the culture of LTC from reactive to proactive action.
In this piece, we explore the core details of our educational intervention program, offering professional case managers like you a practical blueprint to support your direct work with older adults and families seeking LTC assistance.
But first, meet Joe:
I (Dulcy) worked with “Joe”(pseudonym), an 80-year-old single adult, over the course of a year to address non-medical social needs. Within our first two meetings, it was apparent that Joe was struggling with a cognitive impairment. Early in our working together, I introduced Joe to the idea of completing an advance care directive and to start thinking about his plans if he were not able to remain living in his own home alone. I also brought his daughter into this conversation with his consent. Joe and his daughter were reluctant to have a meaningful discussion about long-term care planning. Approximately a year and a half after my initial meeting with Joe, his cognitive impairment worsened, this lead to concerns about Joe’s home safety. Joe ultimately moved to an appropriate residential care setting. (This case example is constructed from several client cases we’ve worked with. All potentially identifying characteristics have been modified to protect confidentiality).
As a professional case manager, how might you approach proactive LTC planning with Joe and his daughter?
How would you empower Joe to plan for his future care needs?
Stories like Joe’s became more common among the older adults we worked with as professional case managers. We also noticed a recurring theme—feeling overwhelmed and unsure where to start their LTC planning process. As a result, creating an intervention to educate older adults like Joe and their families about LTC planning for community-based care became my top priority. Below are the seven steps I (Shakima) used to start the program:
- Listen First: Conduct a Needs Assessment
With no prior programs on this topic at our healthcare center, I consulted subject matter experts known for their work with older adults. I asked about gaps in resources and information—this feedback was essential to shaping the class.
- Dig Deep: Do Your Research
After gathering peer input, I turned to credible sources like Google Scholar, AARP, and government websites to explore existing knowledge and educational options for older adults and caregivers.
- Spot the Gaps and Fill Them
Research revealed a clear need for a class focused on preparing older adults and caregivers for out-of-home long-term care. This was an underdeveloped area at our center, ripe for exploration.
- Build Smart: Design Your Curriculum
Rather than reinventing the wheel, I aimed to build on existing models—but found few instructional formats on this topic. Starting from scratch gave me space to infuse creativity and expertise into the design.
- Think Boldly: Focus on Innovation and Impact
According to this article from Harvard University's Continuing Education, innovation means solving pain points and creating impact. As a professional case manager, I drew on past conversations and experiences to center the needs and experiences of older adults and their families, ensuring that these narratives shaped the class content.
- Join Forces: Collaborate Creatively
I shared my ideas with other social workers and providers in my clinical setting. I also partnered with colleagues to co-facilitate the virtual class I offered. Gaining buy-in was critical to the successful launch of the program.
- Shine the Light: Get the Word Out!
Promotion was the final step—ensuring patients, caregivers, and providers knew this resource was available and accessible. I collaborated with our marketing department to develop materials, including flyers and brochures, that could be easily disseminated both electronically and through print.
If you’d like a copy, download our 7 Step Roadmap for Developing an Educational Program Infographic here. Finally, we conclude this three-part series by sharing the results of implementing the educational seminar we co-facilitate with older adults and their families within our healthcare system. Stay tuned to learn about the impact this program has made.
Looking to advance your career without the high cost of continuing education?
When you become a member of the Case Management Society of America, you gain full access to our Educational Resource Library, Webinars, and Publications. With all the FREE CEs included, your membership investment comes out to less than $1 per CE.
-Stay ahead of healthcare trends
-Sharpen your practice skills
-Support your certification journey
Stop overpaying for your professional development. Become a member today: cmsa.org/membership/
Author Bios: Dr. Shakima (Kima) Tozay is a Licensed Clinical Social Worker and Board-Certified Case Manager with over 18 years of experience in clinical, administrative, and leadership roles in social work, working with diverse groups across the lifespan. She currently serves as the Primary Care Social Worker within a large healthcare system. Kima holds a Doctor of Social Work in Organizational Leadership from the University of Alabama. She earned her Master of Social Work and Bachelor of Interdisciplinary Arts & Sciences from the University of Washington, Tacoma Campus in 2009 and 2006 receptively. Her research and passions center on patient advocacy, implementation science, quality improvement, and program development at the intersection of improving the patient experience in healthcare. Kima lives in the Pacific Northwest, in a charming rural town known for its rich Scandinavian history and its origins with The Stillaguamish, a Coast Salish tribe. Kima enjoys family road trips and walks on the beach.
Dulcy Stout is a Licensed Clinical Social Worker (LCSW) with nearly 20 years of experience in the field of social work. She holds a Master of Social Work (MSW) degree from the University of Tennessee Health Science Center and is a Board-Certified Case Manager (CCM). Dulcy has expertise across various domains, including trauma, mental health, and medical social work. In her current role within a large healthcare system, Dulcy works closely with patients to address their non-medical needs. She conducts comprehensive psychosocial assessments, provides advocacy, and offers case management services to improve patient’s overall well-being. Dulcy resides in the Pacific Northwest, where she enjoys spending time outdoors. Her coastal hometown is situated on Possession Sound with the Cascade Mountains to the east and Olympic Mountains to the west. During the wet, cold winters, Dulcy enjoys crocheting and reading.