Contributed by Steven Barlam, MSW, LCSW, CMC. Steve is an active member, and former President, of the National Association of Professional Geriatric Care Managers (now Aging Life Care Association).
Are you feeling overwhelmed by the difficult challenges associated with aging? Is your responsibility to care for a loved one becoming unmanageable? You are not alone, as it is normal to encounter medical, legal, financial, and psychological complications related to aging that eventually points you in the direction of a geriatric care manager.
A geriatric care manager is a social worker, nurse, gerontologist, or mental health professional who acts as a guide for families with specialized care needs. Geriatric care managers provide expertise in the assessment, plan development, coordination, and monitoring of elder care services to ensure the highest quality of care.
Countless families hire a geriatric care manager to alleviate their stress, worry, and fear that can accompany aging—and most importantly—give them a greater sense of stability, clarity, and peace of mind. According to research conducted by the Florida Chapter of the Aging Life Care Association, ninety-nine percent of families said a geriatric care manager had a positive effect on their own lives.
Background and Training
A professional geriatric care manager has an advanced degree in gerontology, nursing, social work, psychology, or another related field. He or she is trained to understand the needs, wants, and risks of an aging adult, quickly pulling together all needed resources, services, and technology.
A certified geriatric care manager, now an Aging Life Care Professional, is a member of the Aging Life Care Association. To retain an ALCA membership, each Aging Life Care Professional must meet the rigorous education, experience, and certification requirements of the organization.
The cost of hiring a geriatric care manager can vary greatly. Hourly rates and fees range from $100 to $250, and an initial assessment can run from $150 to $750 depending on the scope of work. Some practitioners may charge a flat monthly fee for agreed upon services to make the planning of expenses and allocated time more manageable.
Knowledge of a Geriatric Care Manager
A professional geriatric care manager has extensive training and expertise across eight distinct bodies of knowledge. They can lay out the best options, balancing the needs and wants of your elderly loved one with the requirements of your whole family.
Health and Disability
Geriatric care managers understand aging and the associated conditions and diseases. As a result, they can help seniors and their families make informed decisions relating to physical health and disability. When you need services, products, or education about a specific condition or diagnosis, you can count on a geriatric care manager to help guide you to the right information and services which can serve you best. They can help you formulate the questions you need to ask to be the best-informed consumer.
Geriatric care managers can help ease your financial worries about the aging process. They know how to create viable and sustainable care management plans based on affordability and value. They understand the criteria for public benefits, so you can receive all you’re entitled to, and they will appropriately refer you to financial professionals as needed to assist with financial planning.
A geriatric care manager knows what housing options are available in your local community and the associated costs and benefits. Also, if your loved one prefers staying in the comfort of their own home, a geriatric care manager will work with you and your family to develop a care plan that identifies which services and home adaptations are required to ensure safety.
Sometimes, “unfinished business” gets in the way of addressing a senior’s needs. A geriatric care manager can help families work through their unresolved family issues, or at least help them to work as civilly as possible with one another throughout the care management process.
Geriatric care managers have experience working in their local communities. They know the ins and outs of local resources, including prices, fees, and level of services. Most importantly they understand the subtle nuances of a program which allows the care manager to make “just right” recommendations.
Geriatric care managers are qualified to advocate for seniors. Due to their expertise and experience, geriatric care managers work effectively with hospitals, assisted living and nursing facilities, and local, state, and federal agencies to make sure that the senior receives all the help and support to which they are entitled. Advocacy like this is especially critical for seniors who can’t speak up for themselves (due to illness or cognitive conditions), as well as for those who are at risk of financial misconduct, neglect, undue influence, and other forms of elder abuse.
Professional geriatric care managers know what documents should be in place to ensure the proper protection. These may include advanced directives, wills, trusts, and other estate planning documents. During the initial assessment, the geriatric care manager will help make sure you have all the necessary legal tools in place. If something is missing, they can offer referrals and other resources to get you what you need.
Aging is complicated, and at times it can even be traumatic. When a crisis arises, it can be tremendously beneficial to lean on the training and expertise of a professional geriatric care manager. Geriatric care managers can help you during a crisis and intervene when necessary, such as when confronted with a new diagnosis, loss of a family member, or a behavioral change.
Role of a Geriatric Care Manager
The role of a geriatric care manager is to help families navigate the transitions of aging and ensure the proper guidance, resources, and support is in place. The best geriatric care managers act like the “coach” or “concierge” to lead the family down the right path to aging well.
Navigate Healthcare System
Healthcare systems are highly complex, and it’s not easy to get the answers you need. An experienced geriatric care manager can help you schedule appointments with specialists, clarify what physicians communicate, get second opinions, find recommended physical therapists, or solve some other healthcare-related problems.
Support Family Decisions
Geriatric care managers are not decision makers. Instead, they work with seniors, family caregivers, and other advisors to prioritize critical concerns, review care options, and determine a path forward. In other words, a geriatric care manager offers expert decision support. While you remain the decision maker, the geriatric care manager helps you stay on track which leads to better outcomes.
Evaluate Housing Options
One of the most pressing concerns is, “Where will I live?” A geriatric care manager can help answer that question by assessing a senior’s needs, resources, and preferences. They understand that, while people enjoy the best quality of life where they are the happiest and most comfortable at home, there may be a time when an alternative living arrangement is advantageous. So, whether your loved one wants to stay in the comfort of their own home for as long as possible, or consider a move, a geriatric care manager is your best resource.
Advocate for the Senior
Geriatric care managers are trained to advocate for their clients’ quality of life and well-being. They offer your family a professional perspective, making sure your loved one’s voice is heard and understood. They are sensitive to a senior’s vulnerability and maintain a close eye on the situation at all times, especially when a senior is at risk of elder abuse.
Manage Resources Wisely
As individuals age, they may need to consider in-home care, home modifications, or maybe even a new home altogether. A geriatric care manager can work closely with a financial planning professional to ensure your family is investing your resources wisely and within your means. They know how to access all needed resources—and they can do so quickly and efficiently while keeping an eye on the budget.
Reduce Avoidable Risk
When a geriatric care manager starts working with an older adult, the relationship begins with an assessment that focuses on three distinct areas: needs, preferences, and risk factors. Often, there are risk factors that require immediate attention, since they can pose a direct threat to health and well-being. The list of possible risk factors for seniors includes falls, abuse, home safety, nutrition, medication, depression, social isolation, caregiver burnout and more.
When to Hire a Geriatric Care Manager
Geriatric care managers offer holistic support for senior adults and family caregivers who are navigating the challenges of aging. You should consider hiring a geriatric care manager if you or your loved ones are feeling overwhelmed with:
Changes in Ability
Many older adults need assistance with basic functional tasks such as bathing, walking, transferring, grooming, toileting, dressing, using the telephone, managing medications, and handling money. Professional geriatric care managers are skilled at introducing personal care services which align with the senior’s needs and help to improve their quality of life.
Above all, most geriatric care managers employ a positive strengths-based approach to the care management plan that will focus on helping the client achieve a sense of greater independence for a more extended period – which, after all, is what most seniors want and deserve.
Family Living at a Distance
Often families live far away, and they find it challenging to provide the necessary help and support the senior needs. By hiring a professional geriatric care manager, they can help:
- Develop and implement a care management plan
- Oversee progress and communicate with family
- Provide ongoing supervision 24/7 in case of emergency
- Be your professional local eyes and ears
When adult children talk to their elderly parents about driving safety, the conversations often become emotional, ending in stalemates. That’s because most seniors resent being told what they can’t do, primarily by their children. Also, many older adults feel that giving up their car is like giving up their legs; they believe that if they can’t drive, they are no longer mobile. Fortunately, a geriatric care manager can provide a fresh perspective. Professional geriatric care managers, such as a social worker, understands how to broach the subject of driving in a less emotionally-charged way. They can offer real-world solutions that address any concerns about safety and provide transportation resources to help the senior experience life outside of their own home.
Medication Adherence Issues
Taking medications as prescribed is vital to good health. However, it can be difficult to know if a loved one is taking the right medications at the right times, and in the proper dosage. A geriatric care manager can help ensure maximum adherence to a medication plan due to:
- Confirming the medication list with a primary physician
- Establishing a prescription fulfillment schedule
- Organizing the medications in an easy-to-access system
- Setting up a system to remind, verify, and document the medications as prescribed
The AARP Foundation’s Connect2Affect calls social isolation a growing health epidemic among older adults. It has a wide range of adverse health effects, including falls, dementia, depression, anxiety, and increased risk for hospitalization. One study even concluded that the health risks of prolonged isolation are equivalent to smoking 15 cigarettes a day.
A professional geriatric care manager can mitigate the effects of social isolation by helping your elderly loved one stay connected to the people they love and the activities they most enjoy. A geriatric care manager will understand what hobbies and pastimes were once important, the obstacles that are getting in the way, and how, through adaption, the senior can re-engage in purposeful and meaningful activities that once gave them joy.
Sometimes family members don’t agree on how best to provide care for an elderly loved one. The conflict that arises can become an obstacle that gets in the way of the senior receiving quality care. A geriatric care manager can provide an objective professional assessment of the circumstances and facilitate the discussions that lead to a sustainable care plan. Geriatric care managers with a social work background have the training and experience to understand and deal with complicated family dynamics with a goal of de-escalating emotionally-charged situations while keeping everyone focused on the senior’s needs.
When an elderly loved one is in the hospital, you know they’re in good hands. But what happens when it’s time for a hospital discharge? Where will your loved one go? How can you be sure they’ll receive the appropriate follow-up and the needed rehabilitation care?
Unfortunately, developing a post-discharge plan can be stressful, confusing, and rushed. Often, family caregivers may be handed a list of facilities or caregiver agencies and then told they only have a few hours to make decisions.
A geriatric care manager can coach you through the discharge process to help with making decisions and facilitating access to all needed services. Geriatric care management services can attend to medication oversight, setting appointments with physicians, and confirming all supplies, equipment, and services are initiated.
Caring for an elderly loved one isn’t easy. If you’re an adult child, you may be finding it challenging to balance your elderly parent’s care with the needs of your own family and your job. If it’s your spouse who is in declining health, it would be understandable and expected that you might be starting to fray around the edges, as well. Caregiving is unpredictable, stressful, and never-ending. No wonder family members are so susceptible to the physical and mental strain that stem from caregiver burnout.
Geriatric care managers can alleviate caregiver burnout because they focus on solutions that benefit the senior and involved family members, as well. For example, they can help schedule regular respite care so that you can take a nap, socialize with friends, or do something else unrelated to caregiving. A geriatric care manager can also access other supportive resources, such as support groups and counselors.
When someone gets a new diagnosis, it’s as if their world gets turned upside down. Their thoughts race with questions and concerns about what lies ahead. Having a certified geriatric care manager, or Aging Life Care Professional, close at hand can be a tremendous comfort, providing not only emotional support but also a professional perspective to help process the news.
Geriatric care managers are experts in navigating the medical system and can provide you with education to better understand what may be going on with your aging family member. They will also work with you to get your questions answered, schedule a second opinion, if desired, and begin the treatment plan, coordinating all needed services and resources to ensure timely implementation.
Caring for a senior with impaired cognition creates unique challenges for family members when they are not able to be an active partner in the process. The problems include lacking the ability to help physically, acknowledging that the help is necessary, or making plans and decisions about the care. It has been referred to as the 36-hour day due to the daunting level of care and the diligence required. Having a geriatric care manager involved can ensure that you don’t feel so alone in the process.
Geriatric care managers identify viable housing options based on their clients’ needs, preferences, location, financial resources, and service offerings. Once your family has chosen a facility, a geriatric care manager can help ensure a smooth transition, from scheduling a moving service to coordinating with new local physicians, pharmacies, and other healthcare services.
A geriatric care manager can also develop a transition plan to ease emotional concerns about the move, as well as deal with all aspects of the logistical support needed to ensure a smooth transition.
Resistance to Care
Some older adults have trouble accepting the care they need. Professional geriatric care managers are skilled at working with seniors who may be resistant to care. Their training helps them to understand the reason for the resistance and determine effective strategies for working through it. The goal is to help seniors accept changes to their lives while remaining as active, purposeful, and independent as possible.
Loss of Spouse
Spouses support one another in innumerable ways, and when one passes away, it can be difficult for the surviving spouse to continue to live as independently as before. Immediately after a significant loss like this, it’s natural for family caregivers to step in and make significant decisions quickly out of the desire to be responsible family. However, it’s better to slow down and make decisions only after careful consideration.
Helping the surviving parent achieve a sense of stability in the midst of a significant loss is critical. You will need to know if it’s safe for your elderly loved one to live alone in their own home. You may also want to explore other possibilities, such as assisted living or different types of senior housing.
What a Geriatric Care Manager Does
Geriatric care managers work with older adults and family caregivers to meet their emotional, cognitive, social, and safety needs. They can quickly develop a care management plan and coordinate all activities, seeking first and foremost, to maximize the individual’s quality of life.
Understand Care Needs
A geriatric care manager typically begins with an assessment that addresses three distinct areas: needs, preferences, and risk factors. A professional evaluation serves as the basis for a comprehensive, individualized care management plan. It identifies issues that require attention, goals to be achieved, and the specific resources, services, and people needed to accomplish those goals.
Implement and Coordinate Care
After the creation of a care management plan, a geriatric care manager moves into the implementation phase. By using phone calls, emails, interviews, home or office visits, he or she can quickly initiate all of the needed services, keeping the senior and involved family members and professionals apprised of progress along the way.
Monitor Quality of Care
A care management plan must be consistently monitored and periodically updated to be effective. A geriatric care manager monitors progress using phone calls, emails, video calls, and in-person visits to ensure that all initiated services are meeting the needs and preferences of the senior and family caregivers.
Re-Evaluate Care Plan
Geriatric care managers know how to advocate for the elderly. They have the training and expertise to speak for seniors who can’t speak up for themselves (due to illness or cognitive condition), as well as for those who are at risk of financial misconduct, neglect, undue influence, and other forms of elder abuse. A professional geriatric care manager will continue to monitor and re-evaluate the situation, taking note of any changes that require fine-tuning of the care management plan.
Selecting a Geriatric Care Manager
When you first set out to find a geriatric care manager, all the options may seem daunting. For example, some geriatric care managers are licensed as nurses and have expertise in specific areas of medical care. Others are credentialed as social workers and focus more on quality of life. Still, others may specialize in psychology or some other related field.
Be a savvy consumer and take the search process step-by-step. When interviewing candidates, if possible, make sure you follow this proven process to find and select the right geriatric care manager for your family.
Confirm that the geriatric care manager has certifications issued by recognized and respected agencies, such as the National Academy of Certified Care Managers (NACCM), Commission for Case Manager Certification (CCMC), and National Association of Social Workers (NASW).
Question Local Knowledge
Geriatric care managers must know how to access local health and disability services so they can get their clients the help they need quickly and efficiently. Before hiring a geriatric care manager, ask how long they have worked in the area, which local resources they rely on, and where they turn for answers to questions that lie beyond their area of expertise.
Ask About Associations
Most geriatric care managers have advanced degrees and licensed in social work, nursing, or a related human services field. Anyone you hire should be in good standing with the Aging Life Care Association.
Aging is unpredictable, and questions and concerns can arise at any time. That means your geriatric care manager needs to be available 24 hours a day, seven days a week—by mobile phone, email, or an answering service. Some geriatric care management companies offer a team approach so that if the geriatric care manager is not available to return your call, another nurse or staff member will.
Evaluate Personal Chemistry
Geriatric care managers work very closely with their elderly clients and other involved caregivers. For the relationship to work, there have to be mutual feelings of respect and a comfort level that inspires open communication. It seems simple, but it’s worth stating: Be sure you get along with the geriatric care manager you hire and trust your gut.
Review Specific Services
Professional geriatric care managers assist with a variety of roles. Before hiring someone, review the terms and conditions of their service agreement carefully. Make sure you know precisely which care management services will be provided, how much those services will cost, and when the contract will expire.
Determine Cost and Value
Geriatric care managers usually save families time and money by helping to make essential decisions about long-term health care, housing, and personal care needs. In collaboration with a trained professional, you can be confident that you are investing your resources wisely. A geriatric care manager will help you prioritize your needs, review options, and determine an optimal course of action.
Talk to References
Before hiring a geriatric care manager, be sure to talk to references—these references could be from past clients and their family and professionals in the community. Ask about the pros and cons of their experience, including the beneficial aspects of geriatric care management and how they have settled disagreements.
Please note, some geriatric care managers do not share client/family references due to reasons of confidentiality, but instead, they share testimonials written by current or past clients, their families, and esteemed professionals.
Conduct a Thorough Interview
There are many things to consider before hiring a geriatric care manager. You should create a list of expectations so the conversation is succinct. Then, properly vet each provider of geriatric care management by asking these important questions in detail.
Find a Geriatric Care Manager
If you’re feeling overwhelmed by the challenges of geriatric care, it may be time to hire a geriatric care manager who can help you cut through the confusion and regain peace of mind.
Please call LivHOME today to discuss how our “whole person” and “whole family” approach distinguishes us from other geriatric care management companies. We’ll start with a personalized care assessment and work with you to customize a care management plan that will provide your elderly loved one with the services and support they deserve.