Case Managers' Support In Sickness and In Health

For 30 years, Jim and Lyn Desmarais have been sharing their lives in marriage. That partnership became even more important in 2019 when Jim was diagnosed with amyotrophic lateral sclerosis (ALS) and Lyn became his primary caregiver. As they've coped with disease, Blue Cross Case Manager Tess Thomas has become an integral part of their lives as a partner in wellness.

Case managers are our registered nurses and licensed clinicians who work one-on-one with our members. Each individual case is different and assigned to a manager who gets to know the ‘whole’ member and what support they require (and even some they don’t anticipate.) 

Some common areas where case managers can help include:
•    Addiction 
•    Cancer care 
•    Chronic condition and disease management
•    End-of-life care
•    Maternity - Better Beginnings®
•    Mental health
•    Transgender support 

In this case, Tess provides complex case management for both the member and caregiver. 

A nervous system disease that weakens muscles and impacts physical function, ALS is an overwhelming disease. Lyn recalls that Blue Cross reached out to them when they were having a hard time even talking about the diagnosis, let alone handling the calls, appointments, and paperwork that followed. “It was so important that [Blue Cross] reached out to us because we just couldn’t reach out to them,” she says. “I also had no idea that we were entitled to case management at all.

Case management is voluntary, free, and available to all our members. Case managers like Tess are there to help our members with various aspects of life, but especially when there are issues that need resolving. “I call Tess whenever I need help,” Lyn says. “And within a day, she will have a solution.”

Knowing she has the power to help is what keeps Tess going day-to-day. “It can feel very lonely and frightening without people to help you and I love being able to take my time to listen, connect, and be with someone during a tough time,” she says.

The Role of the Caregiver 

According to Tess, nothing happens without the caregiver. “If the caregiver is not supported, then the person who is ill won’t get as much support either,” says Tess. With a progressive condition like ALS where symptoms worsen over time, a caregiver is fundamental. 

Caregivers help the patient with completing daily living tasks, taking them to appointments, and assisting them with making decisions that impact their care. Unfortunately, it is common for caregivers to re-center their life’s focus and neglect caring for themselves. “I didn’t even think about myself because I was so focused on Jim,” Lyn says. Knowing this mentality can often lead to burnout, Tess encourages Lyn to care for herself.

Tess says she always takes time to check in with caregivers and family members to see how they are doing and feeling. “I cannot tell you how many times I hear back, ‘You’re the first person to ask me this’,” she says.

Through Blue Cross, Lyn found herself a mental health counselor and sees them regularly. “It’s incredibly helpful,” she says. “Especially because I feel I can’t burden my family with my thoughts and feelings about Jim’s illness.” She has also reconnected with her longtime passions. Lyn loves to be outdoors, grow flowers, and write. Today, she writes a gardening column for a local paper. 

“Would I have done any of it without Tess? Probably not,” Lyn says.

Sharing Gratitude

While life with ALS is not what they planned for or expected, Jim and Lyn remain grateful. “Every day we wake up and say: we have this day and it’s wonderful,” she says. “We live in this beautiful state and we feel that we’ve had excellent care through Blue Cross and we’ve met so many incredible people, like Tess.”

Jim and Lyn have also made quite the impact on Tess. “They are a role model for how to face an incredibly challenging diagnosis without losing dignity, gratitude, humor, and love,” she says.

Lyn wants more Vermonters to be aware and take advantage of our case management benefit. “People are ill with all sorts of things but it’s so good to know that at the end of the day you have someone to talk to when you need help,” she says. “It’s almost like magic. You never know when you’re going to need it.”