Care Coordination at Work: Mike E., Mike M., Rob and Abby

Care Coordinator Abby sitting with Mike M, Mike E and Rob on the couch of their group home.
Mike E and Mike M sitting at a table for dinner next to their Care Coordinator Abby.

Abby says that by building strong relationshpis with people you can learn how to be a better advocate for them.

The care coordination model is all about building a life plan that is centered around each person’s specific, individual goals and needs when it comes to the care and services they receive. Life plans help people with intellectual and developmental disabilities connect the dots between all aspects of their care so that they can live fulfilling lives.

Care coordinator Abby Starkey uses this person-centered approach daily, as she has the unique opportunity of working with three men, Mike E., Mike M. and Rob, who live in the same group home but want and require different resources.

Visiting often with the people you serve is key in being a strong advocate for each individual when it comes to care coordination, Abby says.

“By building a relationship with people and getting to know them you’re able to do your job to the fullest,” says Abby. “When you know someone better you can advocate for them more effectively.”

Before she became their service coordinator four years ago, Abby worked as their behavior specialist. Over the years she’s built a close relationship with each of them and watched them grow and succeed. She’s seen their coping skills, self-advocacy skills and friendships blossom.

Mike E sitting in a recliner chair in his room wearing a Buffalo Bills hat.

Mike E. is described by Abby as friendly, compassionate and determined

Mike E., is friendly, compassionate and determined, Abby says.

“He’s always excited to see me,” says Abby. “We even have a special fist-bump handshake we do whenever we see each other.”

She’s seen Mike E. grow tremendously since beginning to work with him. In the past, he struggled when he was upset and would become aggressive, but Abby says now he’s able to talk with staff and use other coping skills when he’s stressed to control his behavior.

Abby and Mike M., who she describes as being smart and a wordsmith, have bonded over their mutual love and interest in words. The two enjoy playing a game to find out the past and present tenses of different words. She says Mike M. has also learned how to utilize his coping skills to calm down in situations where he can become overly anxious.

“Rob always has a smile on his face, so you can’t help but smile too when you’re around him,” Abby says.

Mike M smiling in the kitchen.

Mike M. and Abby have bonded throughout the years over their mutual love of words.

Rob is described by Abby as the comedian of the group and she says he’s really grown in advocating for himself over the years. In the past, he wouldn’t stand up for himself, but now he’s able to communicate with staff and remove himself from situations that he doesn’t want to be in.

Aubrey Sedor, Abby’s supervisor, has seen the power of Abby’s commitment to building relationships with and advocating for the people she serves.

“Abby really gets to know each of the people on her caseload and strives to make sure that people are living to their full potential,” Aubrey says. “Abby is an excellent person to have in your corner.”

One of the group’s most valued accomplishments in self-advocacy was registering to vote. Abby lent a guiding hand throughout the process, giving them information on registering as well as how to vote.

“This had a positive impact on all of them because they were able to advocate for themselves by voting for someone they wanted to represent them.”

Care Coordinator Abby posing with Rob side by side.

Rob is always smiling, says Abby.

Living together in a group home through Autism Services Inc., Mike E., Mike M. and Rob have developed friendships with one another.

A typical day for the guys consists of attending their day program, which Abby visits often, then coming home watching TV in the living room before preparing the next day’s lunches and getting ready for dinner. Everyone eats together at the dinner table and cleans up together once the meal is finished.

“Mike E. and Rob have always been close, best friends,” said Abby. “But Mike E. has developed a closer relationship with Mike M. over the years, and even invites him to the annual train show he likes to attend.”

Together the group also celebrates special occasions, like birthdays, by going out to dinner.

As their care coordinator, Abby checks in at least once a month with the group and their support staff to see how things are going, which includes meeting with the site manager, nurse and behavior specialist.

Mike M and Abby talking with each other at the table in the dining room going over paperwork.

Abby checks in often with the guys and their support staff to see how things are going.

She continues to keep a person-centered approach to ensure that each person is receiving the best care, support and resources that can help them to live a fulfilling life.

“They inspire me every day because they’ve come across many challenges but have been able to overcome them,” Abby says. “I’m really proud of how far they’ve come in the years that I’ve known them.”