Excerpt: Why A Book??

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The Stemwinder: Stories of a Faithful Care Manager


Chapter 10: The Gentle Soul

Why? Why a book? I’ve gone back, forth, and back again. Sat on the fence of indecision only to be stirred into motion by emotion. Screw it. Why not? I get to tell 3 wonderful stories about 3 wonderful people who have impacted my life like a meteor strike that leaves a lasting mark on the earth. These individuals have come into my orbit for reasons (other than business) I’ve only started to discern: clear enough to see it as a Venn diagram, myself at the center of these interconnected lives; obscure enough that I keep peeling away layer after layer, discovered in retrospect.

Objectively speaking, I think it’s safe to conclude I was predisposed for this kind of work. I’ve always thought of it as a calling especially after I emerged from the harshness I was exposed to early on. The sum total of my childhood experiences conditioned me for the interpersonal challenges of this field. When I tapped into that self-realization, I just plowed forward right into the muck (I’ve seemed to have developed a penchant for that). Revisiting the concept of gathering a specific set of tools for the job, with each client a new one is added to the toolbox. Ever evolving, it keeps you on your A-game.

When I started Valerio Care Management, my vision was to build a homegrown operation—very grassroots and organic with a personalized business model. Part of my pitch when I meet with a prospective client was the emotional roller coaster of being a caregiver to my mom when her health took a turn. Or I’ll mention one of my clients to offer a tangible point of reference. It’s a way to assure them that even though there’s a challenging road ahead, ultimately it’s going to be okay. Before you can take that next step, you first have to meet the client where they’re at.

With 35 years under my belt in care management and social work, there’s not too much I haven’t seen or dealt with, with few exceptions, like my client Bella.

Bella was the uncharted territory I stumbled into the day a Montgomery County judge appointed me her temporary guardian. That was a major move on the chessboard placing me right in the middle of a stormy battle between her family members.

A vicious, costly, crazy hot mess.

The best place to begin with Bella is where her situation is at present, and the most recent incident that had me fuming: Bella landed in the ER with a boot on her right foot. She sustained a fracture (old injury) as a result of a fall. The fall was the result of one of her episodes where she gets herself worked up into such a state she collapses. The medical term is syncope.

On this particular day the aide took Bella outside for some fresh air. Soon after, she said she was feeling weak. So the aide suggested they go back inside the house, which inadvertently triggered a tantrum. Down she went to the pavement. The aide couldn’t grab her in time. A neighbor happened to be outside and saw what was happening. Taking initiative to be helpful, his actions turned out to be harmful as he came over and dragged Bella along the gravel to her wheelchair.

That’s the day my blood pressure took a hit. Shot right up. It hasn’t been that high in seven years.

Rewind three years ago: Bella was my very first guardianship case for the books. I was introduced to her in the summer of 2015 after I received a call from her daughter, Chloe, who requested some professional guidance or “needs assessment” in care manager lingo. There was a background dispute between Bella’s sister-in-law in Florida, Chloe, and another sister in New Jersey. The central issue from the day I got involved was who would take on the responsibility as her legal guardian. Another point of contention was where Bella should reside (she had previously lived in Florida).

I was told the family was “in agreement” that Bella should relocate to Pennsylvania to live with Chloe. As it turned out, that wasn’t quite the case.

I was charmed by Bella the day we met at Chloe’s home in July of 2015. I asked her various questions about her health, medical concerns, and how she felt about moving up north to live with her daughter. I wanted to make certain there was no consternation to suss out and where my services were most needed. Like Irene, Bella had been diagnosed with dementia. I found her to be very pleasant and warm. South Philly Italian, she reminded me a lot of my mom. Big-boned. Very nurturing. She had this real presence, a gravitas, that allowed me to engage with her in a way that she understood I was an agent of support.

At the time Chloe was researching home care agencies and decided to move forward with one that was based on my recommendation. She had Bella set up on the first floor of her house where she made the office/den into a bedroom/bathroom. It was done beautifully with the appropriate provisions and I felt her mom would be very comfortable.

At that point I thought I was just going to be brought on as a care manager or a consultant. And then, the crap hit the fan in a very hellacious way.



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