Geriatric care managers can solve problems
care givers often can't deal with themselves

BY STAFF WRITER —
Of all the changes brought about by the large population of aging Baby Boomers, one of the most significant will likely be the rise of the geriatric care management profession.

According to AARP, more than one in four American families are caring for an elderly relative. As more children find themselves in this position — often living many miles away — care managers can offer solutions to problems many Boomers are ill-equipped to handle. And as the Boomers themselves move on to become the frail elderly, a virtual, full-employment act for care managers will take effect.

Multi-disciplinary backgrounds

Care managers are professionals with backgrounds in elder care, often with experience in specific roles, like social work or nursing, who coordinate an elderly patient's care. They step in to provide expertise in managing all aspects of senior care, filling in the gaps by calling on other professionals in the home care, housing, legal, and financial areas. Some care managers will even coordinate a cross-country move for a client, if that's what it takes to provide a better living arrangement.

For a list of care managers in Minnesota, click here.

The process of care management starts with an assessment of the person's current situation and future needs. For example, a care manager will often evaluate whether the current housing arrangement is adequate for the patient's physical and mental abilities. This might result in a recommendation to start home care, a move to an assisted living community, remodeling the current home to make it safer, subscribing to a lifeline service, or using adaptive technology.

They'll take a look at the patient's finances (or have a financial consultant do it) to determine that financial matters are being handled competently. Some care managers are knowledgeable enough on Social Security and Medicare to provide counseling and help with routine medical paperwork. If legal experts are needed, they'll call them in as well.

Power of persuasion

Perhaps the most important role played by a care manager is to establish a relationship with the elderly person that enables them to persuade the person to accept help through a care plan.

Children of elderly parents, even those who are rather old themselves, are often unable to step out of their role as children to convince stubborn parents to accept changes in their living situation. Being able to persuade an elderly driver to give up the car keys, for example, can be a live-saving achievement. Since most elderly people were brought up to respect authority (far more than most Boomers themselves!), a professional care manager can be more persuasive than the son or daughter. They also support and counsel family members.

Given the wide range of professionals who practice various aspects of care management, it is difficult to estimate the cost of care management. Some government agencies and social service non-profits offer components of care management at no cost or on a sliding scale. Privately purchased care management ranges from $75/hour to $250/hour nationwide.

While some professionals charge a high hourly rate, their ability to achieve cost containment, through eliminating inappropriate placements, duplication of services, and unnecessary hospitalizations, can more than pay for the service. Some long-term care insurance policies may cover these costs, but Medicare does not.

Care managers are not all created equal. Some companies offering this service are also engaged in other activities, like home care or real estate. These people may do an excellent job, but if you hire someone affiliated with another industry, you might want to get a second opinion from someone without this potential conflict of interest, if you suspect their recommendations aren't objective.

Care managers are not licensed by the state of Minnesota or the federal government. However, those care managers who come from nursing or social work are usually licensed in those fields, so they are subject to disciplinary action if standards in those professions are violated.

Many geriatric care managers are members of the National Association of Professional Geriatric Care Managers. NAPGCM requires all their members to hold at least one of the following certifications: Care Manager Certified, Certified Case Manager, Certified Advanced Social Worker in Case Management, or Certified Social Work Case Manager.

What to look for in a care manager

If you're looking to hire a care manager — either for an older relative or for youself — look for these things:

Are they certified? Do they belong to any professional associations?

What experience, education, professional licenses to they have? Ask for references. Call them!

What is their care philosophy? How will you work with the care manager?

Are they (or their staff) available 24-hours a day? What are their backup systems?

What are the range of services they provide? What are their rates for each service?

Doing your research in selecting a care manager before a crisis develops is sound advice.

(Posted December 23, 2008)