Diane is taking care of her aging husband at home. He has diabetes and is overweight. Because of the diabetes her husband has severe neuropathy in his legs and feet and it is difficult for him to walk. He also has diabetic retinopathy and cannot see very well. She has to be careful that he does not injure his feet since the last time that happened he was in the hospital for four weeks with a severe infection. She is having difficulty helping him out of bed and with dressing and using the bathroom. She relies heavily on her son who lives nearby to help her manage her husband's care.

On the advice of a friend Diane is told about a care manager, Thelma Richards, who helped the friend's family cope with the care of a loved one. The cost of an initial assessment and care plan from the care manager is $300.00. Diane thinks she has the situation under control and $300.00 for someone from the outside to come in and tell her how to deal with her situation seems ridiculous.

One day Diane is trying to lift her husband and injures her back severely. She is bedridden and cannot care for her husband. Her son, who works fulltime, now has two parents to care for. On the advice of the same friend he decides to bring in Thelma Richards and pay her fee himself.

Thelma does a thorough assessment of the family's needs. She arranges for Diane's doctor to order Medicare home care during Diane's recovery. Therapists come in and help Diane with exercises and advice on lifting. Thelma advertises for and finds a private individual who is willing to live in the home for a period of time to help Diane with her recovery and watch over her husband. Thelma makes sure the new caregiver is reliable and honest and that taxes are paid for the employment. Thelma enlists the support of the local area agency on aging and makes sure all services available are provided for the family. Thelma also calls a meeting with Diane's family and explains to them the care needs and how they need to commit to help with those needs. Thelma makes arrangements to purchase medical equipment for lifting, moving and easier use of the bathroom facilities. Medicare will pay much of this cost.

Thelma suggests using a geriatric care Physician she works closely with to help Diane in the care of her husband. The geriatrician meets with Diane and her husband and spends a great deal of time explaining the proper treatment and care of elderly with diabetes. He rearranges medications and puts Diane's husband on a new insulin regimen to better control his blood sugar. He starts a strict diet and insists on weight loss and exercise. The previous doctor seemed more interested in treating symptoms than in changing lifestyles. Besides, many Physicians reason that the elderly are going to die from one thing or another so there's no sense in trying to bring about a cure. The inevitable outcome of old age is death. In contrast to this philosophy, the geriatric Physician feels that Diane's husband has a chance of improving his health with proper treatment.

Thelma also works closely with an elder law attorney and a financial planner who specializes in the elderly. The attorney prepares documents for the family including powers of attorney, a living well and advice on preserving Diane's remaining assets. The financial planner recommends a reverse mortgage specialist to help Diane and her husband tap unused assets in their home's equity. In addition, an income vehicle is put into place to convert assets into income in order to provide for Diane for her life when her husband is gone.

With the help of the care manager, Diane's life and future have been significantly improved. Her husband as well, if he adheres to the care plan, may end up having a better quality of life for his remaining years.