Rachel Lopez: Life as a Care-Giver

Northeast-20130314-00130Rachel Lopez, MSW, CRC of Mesquite, Texas, is no stranger to care giving. In addition to being a wife and mother, Rachel has been a case manager for more than 20 years.

After graduating from the University of Dallas in 1989 with a B.A. in History, she went on to the Rehabilitation Counseling program at the University of Texas Southwestern Medical Center where she graduated with a B.S. in Rehabilitation Counseling. There, Rachel was introduced to her passion for social work, and later attended the University of Texas at Arlington, earning her Masters of Social Work in 1999. “This educational journey of mine was awesome and each degree that I earned helped me so much, especially in the process of finding my ultimate career choice,” says Rachel.

Some of Rachel’s favorite aspects of working in care management include helping people through education, and making connections between clients and resources within their communities.

“It brings joy to my heart to see the relief on a client’s face or the face of their caregiver when I’ve been able to alleviate a burden from their shoulders. Maybe I was able to get needed respite care in place for the family, maybe I was able to increase my client’s quality of life by getting them a needed piece of equipment¬–but it’s that smile and peace of mind that I can help bring to the client and/or their family that is absolutely priceless to me.”

“My least favorite thing about my job is having to say goodbye to a client, whether by their passing away or just reaching a point in the case where my services are no longer required–that is the saddest part of my job.”

Rachel offers the following advice for case management professionals:

  1. Always be patient and understanding with your clients.
  2. Meet the client where they are¬–it is easier to engage them and show them that you respect whatever or wherever they are at that time.
  3. No two cases are the same. Even if the diagnoses are the same, every client is an individual and they deserve respect.
  4. Always remember your client’s name.
  5. Learn to love chaos and master the art of multitasking.
  6. Never rush your client visits.  Always allow adequate time for visits so you don’t miss out on crucial details.
  7. Take care of yourself. Rachel advises, “Our jobs are stressful–be sure to exercise, get massages and rest when you can.”
  8. Never assume anything and document everything.

A typical day on the job for Rachel includes the following:

  • After receiving a referral, Rachel contacts the referral source to get as much preliminary information as possible regarding her client’s condition, situation, and motivation level.
  • She then reviews medical records and supplemental information thoroughly to gain the best understanding of her client’s condition.
  • Rachel contacts the client, introduces herself and describes her role in the case. “I then ask to set up a meeting where we can talk some more about their situation,” she says.
  • Once an initial meeting is secured, she follows up with the client on the day before the meeting to confirm.

When asked about one of her most memorable care management cases, Rachel recounts the story of a diabetic 41-year-old truck driver who, through medical negligence, ended up a paraplegic following a complicated rotator cuff surgery.

When she met her client for the first time, he was in an undersized hospital bed. His room was the living room of a manufactured building–a now defunct salon and tanning business-turned-home. He had no adequate accessibility throughout the home, and no safe ways to enter or exit. For three years since onset of his condition, his life consisted of lying in bed and watching a small television in his room.

“The only person that would care for him was a nurse practitioner who would occasionally visit him at his home. After I performed an assessment, I made some hefty recommendations to the trust officer: he needed a new house; new doctor(s); more in-home care; a new bed; a new wheelchair; and a life! His quality of life was not good at all.”

In over two-and-a-half year’s time, Rachel advocated for her client’s needs and succeeded.

“I was able to get my client into a completely accessible home. We demolished the existing bath and created an over-sized roll-in shower, which he loved. I worked with local resources and his existing care agencies to make the recommendations and changes that would ensure adequate home care. We also set him up with the best doctors we could find in his area, and brought him to Dallas for a hospital stay for when we couldn’t locate adequate care in his town. We helped him through some rough spots and hard times, and he pulled through.

We shared so many successes with this client, and just as we were just in process of getting him into a part-time job and finalizing the purchase of an accessible van–his health took a turn for the worse.
He passed away suddenly.

One week before his death, he told me how much he appreciated all the work I’d done for him, and how much I meant to him and his family. He said that he did not know if he could ever say thank you enough¬–and that he would never forget me. He said he ‘hoped I would stay on his case forever.’ That is the last conversation I had with him and one that I will never forget.”

In addition to making strong connections with her clients, Rachel encourages fellow case managers to branch out and build broader community connections. “I am very involved in my community, both politically and as a community leader,” she says.

“I add this bit of information because I firmly believe that the passion I have for my job and for giving back to the community go hand-in-hand. They both involve helping, educating and serving others. My job as a case manager allows me the flexibility to be involved in areas that benefit my job, but benefit my passion for community involvement, as well. I feel very blessed to have found this very fulfilling vocation.”

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