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Your mom’s been admitted to the emergency room for the fifth time this month. Your dad is forgetting to take his medications and his fridge is mostly empty. You’ve been on the phone with the doctor’s office three times this week, trying to get your elderly aunt’s test results sent to the specialist. Meanwhile, you’re dealing with your own busy job, your kids’ sports schedules, and battling sleepless nights worrying about your aging parents.
Sound familiar?
Enter the geriatric care manager. This licensed professional, usually a nurse or social worker, can help you and your family identify care needs and find ways to meet them. A care manager not only intervenes as a knowledgeable third party to get things done more quickly and professionally, but just as importantly, these specialists—also known as aging life care managers— provide family caregivers with priceless peace of mind.
The hitch: that peace of mind can come with a hefty price tag. Fortunately, there are some options.
Dan Mines, who lives just outside Philadelphia, hired an aging life care manager to help with his elderly father, who lived in Queens, N.Y. His dad had several chronic health conditions, along with neurological issues that caused problems with his hands and legs.
Although there were home health aides around the clock to help with daily tasks like bathing and dressing, Mines says neither he, nor his three siblings, could be on hand regularly to oversee the care. That’s where Marjorie Goldstein came in.
Goldstein, a licensed social worker and certified care manager, provided a combination of problem-solving, networking, and boots on the ground.
“Having someone there in person was very reassuring because my siblings and I couldn’t always drop everything and get there,” Mines says.
Goldstein coordinated care, arranged transportation to doctors, ensured the home care aides were doing their jobs well, and handled other care issues as they arose.
“She was very, very good in helping to figure out what our needs were and plug in where there were unmet needs while also respecting the structure we already had in place,” Mines says.
His father, a retired physician, spent the last year of his life in and out of the hospital. He was adamant about not being moved to a nursing home.
Hiring Goldstein “allowed my dad to stay home until he died,” Mines says.
What they do
Many elder care professionals, like Goldstein, are certified through the Aging Life Care Association, a national organization that sets standards and ethical practices for their members. Members are knowledgeable in eight areas of expertise: case intervention, health and disability, financial, housing, family, local community resources, and client advocacy, according to ACLA president Tanney Hamill.
“If the senior in the family is not aging well, not having good results, then the rest of the family is stressed and not well either,” she says.
These specialists sit down with the family, talk about what the adult wants, whether it’s staying in their own home or moving to a facility, conduct a thorough assessment, coordinate all the services, and help them take all the steps necessary to execute that care plan.
The organization helps families find a certified care professional almost anywhere in the U.S. Since they’re tapped in to local community resources, care managers can also connect families with other professionals, like financial planners or elder lawyers, or with local programs to help alleviate social isolation, deliver meals, or provide transportation.
The cost
Caregivers spend huge amounts of time problem solving, must often take time off from work or often travel long distances to check up on their loved one, incurring more time and expense. According to AARP, approximately 40 million Americans provide 37 billion hours of care and help each year to family members and friends. On average, caregivers spend nearly 20% of their income providing care for a family member or other loved one.
“A much better use of their time and money is to outsource that,” says Anne Sansevero, an aging life care manager and nurse practitioner, who has run her own agency for the past 14 years
However, hiring a care manager is not cheap. Depending on geography and level of experience, they may charge anywhere from $50 to $200 an hour, or more. These services are not covered by Medicare, Medicaid or private insurance, So the costs are out of pocket. On the other hand, you know they’re looking out for your interests.
“A professional geriatric care manager is your advocate, your person that’s going to work for you, not the payer, not the insurance company, not the physician’s office and not the hospital,” Hamill says.
Some alternatives
Additionally, many care managers are willing to be flexible and tailor services to align with a family’s budget, or will bill on a sliding scale, depending on need, she says. As the population has gotten older, many cities and states have implemented programs that provide some care coordination at little to no cost, usually through the state or local department on aging or family services.
Families can also tap into some services directly, such as Meals on Wheels or ride-sharing. The trade-off is in the scope of services provided, as well as time spent on administrative tasks and follow-up.
Regardless of who is actually paying the bill, the “client” is always the person being cared for.
“That’s whose interests we’re looking out for,” Sansevero says.
Even if you can only afford an initial consult and development of a care plan, it can be worth it, she says. “It’s really kind of a strategic investment.”
Geriatric care managers can be especially helpful when family members live far apart, but even if you live around the corner, they will develop an action plan and make sure your loved ones have the services they need.
An objective eye
“Anne saved my life,” says Raleigh Mayer, a Manhattan-based executive consultant. Her mother, a retired assistant commissioner for New York City, was diagnosed with mesothelioma at age 90. Until then, she’d been vibrant, active, and very independent—even traveling to India at age 89.
“What made the situation so difficult was that my mother and I had to negotiate the type of support service and care she needed, to have the most optimal transition from a healthy life into a very medically managed life,” Mayer says.
After a career of being in charge and helping others, Mayer’s mother was quite resistant to what she considered interference, she says. So Mayer called Sansevero.
“Having someone external, who understands the medical community, who understands the aging issues, and who understands the psychology as well, made it an absolute must that I involve Anne,” Mayer says.
Sansevero successfully forged a partnership with Meyer’s mother and together, they developed a care plan. She also acted as a sounding board to evaluate medical issues, help Mayer cope with the mounds of paperwork, and was “a voice of reason” when Mayer would get frustrated or upset.
She also reminded Mayer that her mother’s mind was still sharp.
“Mom was still the one to make decisions, and I had to be respectful of that,” Mayer says.
How to hire
When is the best time to call in an aging life care professional?
“When you’re feeling overwhelmed,” Hamill says. “Call when you start to see a change in your loved one and you don’t know which direction to go.”
However, you can call in a care manager to help at any point. They are also excellent at crisis intervention, or in being proactive, before situations spiral downward, she says.
However, many people wait to call until a crisis happens—a fall, health emergency, a visit from an out-of-town son or daughter who suddenly realizes that the current situation is unsustainable.
Once you do reach out, the first step is a comprehensive, holistic assessment which encompasses a person’s whole life, not just the immediate need, Sansevero explains.
That means looking at how well they function, what the home environment is like, whether there’s family support available, how finances are handled, and whether any government or community resources are available.
What to look for
After a plan is developed, it’s often easier for the care manager to make changes happen, given different family dynamics.
“We’re the objective third party,” Sansevero says. “When you’re dealing with care for an older person, they take advice from their children differently than they would from an outside professional. They will listen to us.”
It can be scary letting a virtual stranger into your life to care for your aging parent. But, evaluating a geriatric care manager is much like evaluating other professionals like doctors or lawyers.
According to Hamill, the best geriatric care managers
- Are good listeners, patient, and diplomatic.
- Have a background in nursing, social work, geriatrics or a related field.
- Take continuing education courses to keep their skills and knowledge levels current.
- Are certified, through the Aging Life Care Association, or another organization that offers professional training
- Offer multiple references
Don’t be afraid to call around, or ask a geriatrician for recommendations.
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