When older adults can no longer care for themselves, it’s usually up to their family members to take over the responsibility. But it’s hard to know where to begin managing the care of someone who has chronic health conditions, requires frequent doctor visits and needs assistance at home — which may be in another town. “Families are often overwhelmed and ask, ‘What do we do? How do we handle this?'” says Nancy Avitabile, president of the board of directors of the Aging Life Care Association.
Avitabile is an aging life care manager (also known as a geriatric care manager), a type of elder care professional trained to jump into these challenging situations and offer solutions, guidance and hands-on management.
“It’s not uncommon for adult children to involve a geriatric care manager when things are getting complicated with a new diagnosis or a change in function or cognition, especially when the family lives far away and they need guidance on which options are available,” says Dr. Christine Ritchie, a geriatrician, palliative care physician and professor at the University of California–San Francisco School of Medicine.
[Read: How to Be a Great Caregiver.]
What Do Geriatric Care Managers Do?
Think of a geriatric care manager like a corporate consultant hired to stabilize a struggling company. The job typically involves a thorough evaluation of a family’s situation and then the creation of a plan to get an older adult’s care back on track. “When I meet with a family, I’m assessing the person’s condition and lifestyle, looking at the available resources and coming up with recommendations most suitable to that family,” Avitabile explains.
Sometimes a geriatric care manager’s role is short term, limited to developing the care plan, coaching the family on how to implement the plan and suggesting agencies or services (like private duty care, food services, transportation or adult day care facilities) that the geriatric care manager knows to be reliable. (The geriatric care manager should not receive a referral fee for such services, Avitabile points out.)
In other cases, the relationship is long term, with a family asking the geriatric care manager to carry out and manage the plan. That may involve vetting and arranging all services and overseeing all care of the older adult. “They may ask that we visit weekly, monitor home care, assist with social activities, coordinate doctor appointments and then provide necessary follow up,” Avitabile says.
Geriatric care managers may also accompany older adults to doctor appointments and serve as a liaison between the family, patient and health care team. “What’s wonderful is that they have the savvy to translate the medical terms to the family,” Ritchie says. “Most health providers are appreciative of that.”
[Read: What Are the Secrets to Aging Well?]
Finding a Geriatric Care Manager
You may feel as confused about hiring a geriatric care manager as you do about taking over a loved one’s care. “Care management is an unregulated field, and many people refer to themselves as care managers. But that doesn’t mean they’re qualified,” Avitabile says.
Qualified geriatric care managers typically:
— Have completed education in nursing, social work, gerontology or psychology.
— Have been certified as a care manager by the National Academy of Certified Care Managers, the Commission for Case Manager Certification or the National Association of Social Workers.
— Are members of a professional nonprofit association, such as the Aging Life Care Association or the National Association of Social Workers. These organizations have requirements for education, experience and certification as well as strict ethics and practice codes.
To find someone who meets these requirements, check the websites of these organizations, which enable you to search their databases for professionals. Other organizations and agencies also offer search tools, such as the Alzheimer’s Association and the U.S. Administration on Aging (which features a tool called the Eldercare Locator).
The Next Step
Avitabile and Ritchie recommend interviewing several geriatric care managers before hiring one. “Go to their websites. Get a sense of their background, who they are and if that matches what your loved one needs. Give them a call and have a phone interview if nothing else,” Ritchie suggests.
“Ask about their credentials. Ask if they offer 24-hour coverage if that’s important to you and when you’ll get a written action plan. Communicate how much time you’ll want the aging life care manager [geriatric care manager] to work. Everyone needs to be on the same page so that the manager won’t make superfluous recommendations,” Avitabile says.
Other questions to ask:
— How much and what kind of experience does the geriatric care manager have?
— How will information be communicated to you?
— Can the geriatric care manager provide references you can talk to?
— What are the fees involved, how will they be tracked and when will payment be expected?
— How long has the care manager been in your loved one’s community? “It’s valuable for the geriatric care manager to have been in the community for some period, so they know the relevant service agencies,” Ritchie says.
[Read: Doctor Shortage: Who Will Take Care of the Elderly?]
Fee for Service
Geriatric care management can be pricey. Medicare and Medicaid do not cover the fees, which can include an initial assessment fee, a monthly retainer or an hourly rate. “The hourly rate varies geographically,” Avitabile says. “Probably now nationally it’s $100 to $250 per hour.”
She recommends that you get a contract with all services spelled out and that you keep an eye on the clock when it comes to utilizing hourly services. “It’s customary to invoice in increments of as little as six or 10 minutes, similar to an attorney, for a conference call or communicating with a physician or setting up appointments. Think of it like a time clock. Try to be concise.”
Before signing a contract, you may consider consulting with a local senior center to see what the going rate for geriatric care management is in the area.
Tips for Success
One of the most important keys to working with a geriatric care manager is being clear about your expectations. “Determine what they’re allowed to know and who will communicate that information with whom and when,” Ritchie advises.
Ritchie also stresses that it’s important for everybody, including the health care team and the older adult, to understand the geriatric care manager’s role and communication lines.
Avitabile says that families soon recognize and rely on the help of a manager, whether it’s for the short or long term. “Even just getting the initial consultation or coaching for a few weeks can make a big difference,” Avitabile explains. “If there’s a care manager in place telling you how it should be done, how to advocate for your loved one and how to make sure the situation is set up with caregivers hired from the right agencies, then all kinds of problems can be prevented.”
More from U.S. News
What Are the Secrets to Aging Well?
5 Anti-Aging Secrets That Don’t Involve Diet or Exercise
What to Look for in a Geriatric Care Manager originally appeared on usnews.com
