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Geriatric Care Management

Geriatric Care Management

Sometimes an overwhelmed family member needs a professional guide

by Barbara Moroch, AARP

With changing times comes a change in the way we care for our elders.

In the past, extended families often shared the job of tending to their senior loved ones. These days, families may live farther apart, and the responsibility for care can fall on one overwhelmed family member.

The good news is that geriatric care managers can help.

These professionals, sometimes called “aging life care managers,” are usually licensed nurses or social workers trained in senior care. They act as private advocates and guides for family members who want to ensure their loved one is in the best hands, and they generally serve clients and families whose incomes are too high to qualify for publicly financed services.

"Caring for a senior can often be an overwhelming process,” says Cathryn A. Devons, assistant clinical professor of geriatrics and palliative medicine at Mount Sinai Hospital in New York City. “Geriatric care managers seek to make the process easier by serving as an advocate or counselor — taking the pressure off of family members who often have other commitments, such as parenting and workplace responsibilities.”

The number of caregivers who need help will continue to increase.

People 65 and older now make up about 16 percent of the U.S. population, according to the Washington, D.C.-based Population Reference Bureau. By 2060, that share is expected to rise to 23 percent, and the number of seniors is projected to nearly double to 95 million, in part because people are living longer.

Count on paying out of pocket

Neither Medicare nor Medicaid will pay for a geriatric care manager's services. Some employee assistance programs have started covering some fees because the advice a geriatric case manager provides can help family caregivers stay focused on their paying jobs and spend less time away from work, says Julie Wagner, vice president of operations and administration at the Aging Life Care Association.

That may be because 3 out of 5 caregivers work full or part time at a paying job and spend the equivalent of another part-time job as caregivers, according to a 2015 AARP study.

Wagner's nonprofit professional organization, which formed in 1985 and has its headquarters in Tucson, Arizona, has more than 2,000 geriatric care managers as members.

The cost of a geriatric care manager's initial assessments of a care recipient can range from about $300 in more rural areas to more than $800 in large urban areas, based on a 2017 survey of association members, Wagner says. Ongoing hourly rates range from $100 to $200.

Some care managers also charge for long-distance calls, mileage and travel time. Be sure to find out about these billing details and get them in writing before you agree to the services.

If your loved one already has long-term care insurance, the policy may cover some of the costs of care coordination. But most insurance plans, including Medigap and Medicare Advantage policies, do not cover these expenses.

Find a geriatric care manager

Keep in mind that many people can refer to themselves as care managers without having the proper qualifications, so check carefully.

  • Aging Life Care Association expert search
  • Eldercare Locator support services (enter your location information to find the nearest Area Agency on Aging — they often have lists of local providers)

How geriatric care managers can help

For caregivers juggling paying jobs and their responsibilities to loved ones, geriatric care managers can offer a more efficient path forward, in the same way you might hire a guide to help you climb a mountain.

Many care managers started their careers in geriatrics, nursing, occupational therapy, physical therapy or social work and decided to become geriatric care managers later, having seen such a need for their clients, Wagner says.

What they do now is a range of assessments and coordination of care. Among the services geriatric care managers can provide:

  • Evaluating, arranging for and monitoring in-home personnel and care needs.
  • Coordinating medical appointments and arranging for transportation.
  • Identifying social services and programs that could help the care recipient.
  • Making referrals to financial, legal or medical professionals and suggesting ways to avert problems.
  • Explaining complex or difficult topics with the recipient of care or family members.
  • Creating short- and long-term care plans that could include other living arrangements.
  • Acting as a liaison to families who may be hundreds of miles away.
  • Answering questions and addressing emotional concerns of caregivers and their loved ones.
  • Arranging for relief or respite care for stressed-out caregivers.

"The manager ensures that the senior's personal and practical needs are met and can help with more mundane tasks, freeing up family members so that they can enjoy more quality, stress-free time with their loved one,” Devons says. “Very often, we see geriatric care managers become a much-valued part of the family."

Check references and credentials

Unlike medical doctors and registered nurses, geriatric care managers don't have state-level license requirements.

But because many care managers started in health care, they often continue to keep their certifications in their original field. Many states also require social workers to be licensed.

Two organizations — the Commission for Case Manager Certification (CCMC) in Mount Laurel, New Jersey, and the National Academy of Certified Case Managers (NACCM) in Tucson — offer certification programs. Both organizations require specialized degrees, experience and successful completion of an examination.

Those who fulfill CCMC requirements become a certified case manager (CCM) and must renew the certification every five years, which includes continuing education requirements and another exam. Those who satisfy NACCM requirements become a certified care manager and must renew the certification every three years as well as complete continuing education requirements.

Barbara Moroch is an independent writer specializing in health care and lifestyle topics. She previously worked 21 years for the Gannett Co./USA TODAY Network in its New York office.

9 questions to ask before you hire

Be clear about your expectations. That starts with asking a prospective care-management provider the right questions.

1. Resources: What are your business's main services, and do they include in-home care?
2. Size: How many geriatric care managers do you have on staff?
3. Qualifications: What credentials and professional licenses do you and your managers have?
4. Longevity: How many years have you been providing care-management services?
5. Initial costs: What fee, if any, do you charge for a consultation?
6. Continuing costs: What are your ongoing fees, and may I get them in writing?
7. Communication: How will you keep in contact with us?
8. Flexibility: What happens if my family has an emergency — will you be available?
9. References: Who has used your services, and may I contact them?

Source: Aging Life Care Association

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