Helping older family members through the aging process is an overwhelming experience for many of us. It is even daunting for me and I am in the home health care business!
Fortunately, specialists in geriatric care management or care management are available to help us help our parents make the transition from an independent lifestyle to one that incorporates varying degrees of assistance.
Geriatric care managers (GCM) or care managers (CM) are professionals with the experience, education and training to advise families as they navigate the maze of resources and questions that make providing the best home health care possible.
Indeed, for most of our lives Mom and Dad have lived independent, interesting lives as the capable matriarch or patriarch of the family. But now in their elder years, these same parents often experience diminished physical, mental and social capacities. I have experienced this role reversal with a number of my older family members, including my mother. Now, I must take on the job of the responsible adult or the “parent.”
As a result, many of us feel lost, angry and even at odds with our siblings on how to provide the best home care for our aging parents. That’s when a skilled care manager can make a big difference.
What is a Geriatric Care Manager?
As John W. Gibson, DSW, says in his book “Health Care Issues of Aging Families: A Handbook for Adult Children,” a geriatric care manager is an elder expert who can, “Help you take stock, develop a plan, identify resources needed, implement the plan, and monitor the progress of the plan, modifying it as needed.”
He explains that geriatric care managers are often nurses or social workers or others with years of experience in the home health field. They are trained in family dynamics, family communication and family conflict.
We like how he describes a GCM as a coach or a guide. Dr. Gibson describes that an experienced care manager who someone who is able to see the big picture. As a result, in the role of advisor this disinterested third party can help coordinate the many details that range from locating senior housing to offering emotional support and family mediation.
What Geriatric Care Managers Do
Geriatric care managers perform all kinds of tasks. They can assess needs, handle crises, refer to a long-term facility, mediate family differences and find community resources. For out-of-town families they often act as surrogate family caregivers at doctor appointments and even assist with caregiving.
When geriatric care managers are brought on board, they usually meet with your loved one (and family members, if appropriate) to evaluate the current situation. They assess your loved one’s physical environment and mental, social, and emotional functioning and independence. Based on this assessment and conversations with family members, GCMs identify your loved one’s care needs.
• Plan of care
Once the assessment is complete, GCMs will make recommendations about the types of care your loved one needs. They meet with you to review these recommendations in detail and get your feedback. They note recommendations in a written plan of care. As care progresses or as care needs change, care managers note progress and make updates as needed.
• Coordination of services
Geriatric care managers can be as actively involved in the care of your loved one as you need them to be. But you need to clarify expectations at the outset. Most GCMs know all the senior care providers in your area and are well prepared to help you find the best match for your loved one. You can use them to help you find agencies such as Andelcare to provide in-home care, hospice, or skilled nursing care, as well as to coordinate the comings and goings of the caregivers. If your loved one needs residential care, the GCM will help you find the best assisted living or nursing home that meets your loved one’s needs and fits within your budget. Some GCMs will also help with day-to-day care for your loved one — picking up prescriptions, taking your loved one to doctor appointments, or visiting for regular check-ins.
• Family support
GCMs also provide invaluable support to family members as they cope with a loved one’s decline or illness. They can help smooth communication and mediate disagreements.
• Ideas, products, and innovations
GCMs are always on the lookout for new types of services and tools to make caregiving easier and to help keep your loved one stay safe, mobile and as independent for as long as possible.
How to Find and Select a Geriatric Care Manager
As with so many personal services, it is important to do your homework when selecting a geriatric care manager. First, we suggest families ask around. Ask friends and doctors for personal recommendations. Then, search by zip code in the Geriatric Care Manager Directory. Also, take the time to checkout reviews of GCMs posted by family caregivers. Be sure to ask about education, training and certification.
Who Pays for GCM?
Families need to know that geriatric care management is strictly private pay. Medicare, Medigap, Medicaid and managed care and long-term care insurance do not cover the service.
Some local government agencies and charitable groups offer consulting services free or on a sliding scale according to income level. If you hire a geriatric care manager, however, be prepared to pay from $60 to $250 an hour.
If you are a veteran you need to know that VA benefits do not cover the service. However, veterans’ benefits do cover geriatric evaluation and management (GEM), a similar service that includes a comprehensive assessment of the vet’s physical, medical and emotional needs. For more about GEM, see VA Nursing Home and other Long-Term Care Benefits.
A geriatric care manager for more than 30 years, Dr. Gibson encourages families to consider utilizing a geriatric expert. “Our experience has been that even a single consultation with one or more of these experts can provide much-needed information and insights that will help adult children continue to prepare for the changes and challenges ahead,” explains Dr. Gibson. “Remember to take notes and keep track of professionals’ recommendations.”
How Andelcare Care Managers Provide Elder Care Management
At Andelcare we have a number of care managers (CM). I am a Certified Senior Advisor (CSA) and Eileen is currently earning this highly regarded designation. Carol has earned her CM stripes in the trenches, helping not only her parents but scores of our clients and their elderly parents through the aging process.
In our day-to-day work at Andelcare we always ask questions and help solve problems. But through the years this service has evolved into a more formal and deeper role as care manager. We started offering this service because we care and because our client families need help. Our job could be as simple as helping resource a wheelchair or sit-to-stand chair for the parent of an out-of-town client.
On the other hand, our role may be one of leadership. We sometimes serve as the leader who coordinates with all the different players involved in Mom or Dad’s care from social workers to nurses, trusted advisors to professionals such as doctors and therapists. We also work with other groups such as rehab centers and senior housing facilities. As care managers we are also experts at researching and finding resources to deal with insurance and Medicare or Medicaid questions.
Not only do we serve as a leader or guide, we provide important services that range from developing a care plan to physically checking in with the elder on a scheduled basis. We also communicate regularly with all parties in the care loop.
Example of Andelcare Care Management Services
Sometimes clients have crisis or complicated family situations and need guidance dealing with a jumble of factors. We recently worked with a client who had both parents in need of services at the same time. They ended up at different facilities and lots of coordination was required to help everyone navigate multiple and difficult transitions.
In this case the client’s father had Alzheimer’s and the mother suffered a stroke as a consequence of trying to provide all his caregiving at home. After her hospital stay and rehab, the mother used Andelcare caregivers for around-the-clock care to expedite her respite and rest. Although it was hard on her emotionally to have her husband at a different facility, with this plan she was able to go home and recover her health. Her husband continued to decline and needed 24/7 care at the nursing facility.
As the mother regained her strength, the client reduced the Andelcare caregiver’s hours. But those hours were very important. The caregiver provided companionship, drove the wife to visit her husband, helped decorate his quarters and even took the couple on outings. The caregiver also worked with the mother on art projects and encouraged the woman to resume painting and crafts. The father passed away recently and the mother is now mostly independent.
Currently Andelcare provides eight hours a day of caregiver services to the woman, mostly for companionship purposes. The client appreciated and respected the Andelcare care manager’s input and suggestions through a difficult time as her parents’ needs evolved.
How Do Andelcare Care Managers Work with Partners?
For starters, we are absolutely ace communicators. We coordinate with facilities such as hospitals, assisted living and rehab centers. Our care managers or our nurses keep them informed with reports of any changes. We know facilities’ different policies, our caregivers respect their authority and we are careful to work within each facility’s guidelines.
Andelcare as Care Manager Mediator
Serving as a mediator is one of the core, care manager services. When family members disagree, we can serve as the disinterested third party or middleman to help them work through varying opinions and strong emotions. One of the benefits of this role is that it sometimes shifts some of the issues onto the care manager’s shoulders. This often reduces stress and helps the family to focus on what is best for the loved one’s home health care.
Nearby or Distance Care Management Services
Whether they live next door or thousands of miles away, adult children appreciate how care managers can act as “eyes and ears” for them. You see, our care managers are experts at visiting with elders and assessing “what is really going on.”
Our care managers are perceptive and pick up details. Is the elder losing weight? Do they have bruises that might indicate falls? Is the food in the refrigerator our-of-date? In addition, often the parent will respond more positively or disclose more details to the care manager than they would to an adult child. Along those lines, sometimes the elder will respond more positively to the care manager’s suggestions than they would to a son or daughter. It’s only human nature.
What Clients Need to Know about Health Care Management
In general, we want clients to know that care management is not that expensive and it can offer great benefits. We suggest that it is easy to work with us and our experienced care managers. We are affordable ($60 per hour) and we can help shoulder the responsibility. We totally tailor care management to the client’s needs and pocketbook.
One thought is that if we already provide caregiver services for your loved elder, it is easy for us to add another level of guidance or leadership to home health care services. We have access to your caregivers 24 hours a day and we can respond to changes quickly. Our flexibility makes us more efficient.
• Locate good local resources
• Help coordinate care if your parent has other medical issues
• Advise you on how to handle symptoms and behavioral issues
• Help you safety-proof your loved one’s home — or your home
• Track routine care, from appointments to prescriptions
• Mediate family disagreements
• Make home visits
• Refer you to specialists
We would like to hear about your experience working with a geriatric care manager. How did the CM reduce your stress or help you find resources? Was it worth the money? Why?
For more information about geriatric care managers, please visit Andelcare’s website, the National Association of Professional Geriatric Care Managers or the Geriatric Care Managers Association.
Photo courtesy Harabugsmannen