Is a Geriatric Care Manager the Right Decision?

Sooner or later, most families will have an older family member with a disability who will need some degree of help with daily living activities in such areas as medication, meals, and other functional needs. When this type of need arises, the immediate instinct is usually to respond by having willing and available family members personally provide what is necessary to keep their relative safe in his or her living environment. But for seven million Americans, according to the National Alliance of Caregiving, family members are arranging for care from a distance. For them and others who are simply unable to manage the care of their elderly relative with a disability, the solution is to retain the services of a Geriatric Care Manager (“GMC”).

A GCM is a professional who coordinates services and supports for an older adult or an individual with a disability in order to maximize the potential of the person served to maintain autonomy in his or her living environment. The GCM may have specialized knowledge in one or more areas related to care management, including, but not limited to, Mass Health and other government benefits, nursing, gerontology, social work, bill paying or counseling.

The decision to hire a GCM is unique to each family. Some families resist bringing in an outside person to help with the care of a relative because they consider it their family duty to handle things themselves. It is sometimes considered a private family matter. These considerations are often outweighed, however, when the realities of life begin to negatively affect their aging relative with a disability. For instance, when the demands of one’s job, children and other obligations prevent one from having the time to check, for example, whether medication is being taken, whether meals are being prepared and eaten, or whether the laundry is being done, it is probably time to enlist the assistance of a GCM. The National Association of Professional Geriatric Care Managers (“NAPGCM”) (www.caremanager.org) suggests that family members ask themselves the following questions when deciding whether to hire a GCM:

• Are the problems that you or your loved ones are facing becoming larger and more complex than you can comfortably manage?
• Are other demands and responsibilities now so great that you are not able to provide the desired level of supervision and attention to your loved one’s problems?

Once the decision is made to hire a GCM, there are some simple steps to locate one who is right for your family. There are many places to find a GCM. The NAPGCM website can provide you with a list of local referrals. Also, your aging family member’s health care providers or local elder law or special needs attorneys are likely to be excellent referral sources.

Once a GCM is retained, the scope of services needs to be determined. The most logical first step is to conduct a care- planning assessment to identify problems and to set forth solutions. After this assessment is completed, the GCM can screen, arrange and monitor direct services such as home-health aides, personal care services, and counseling and support. An invaluable service can be crisis intervention in the event of a fall or acute health emergency requiring personal intervention. GCMs are usually quite familiar with local resources. As such, they are in a unique position to offer assistance in evaluating and selecting an appropriate continuing care retirement community, retirement complex, assisted living environment or long-term care health care facility.

Before you retain the services of a GCM, you should evaluate whether the GCM meets the needs of your family member. You should find out her/his areas of expertise. The NAPGCM suggests the following questions when selecting a GCM:

• What are your professional credentials?
• Are you licensed in your profession?
• Are you a member of the National Association of Professional Geriatric Care Managers?
• How long have you been providing care management services?
• Are you available for emergencies?
• Does your company also provide home care services?
• How do you communicate information to me?
• What are your fees? (These should be provided to the consumer/ responsible party in writing prior to services starting.)
• Can you provide me with references?

A GCM is a fee-based service. Before hiring a GCM, you need to determine the hourly rate you will be charged. Hourly rates range from $80 to $250. Find out how frequently you will be billed for services. These matters should be discussed upfront and confirmed in writing to avoid unpleasant surprises later on in the engagement. Also, in addition to fees, you need to understand what expenses, such as mileage, supplies and other incidental costs, will be your responsibility. A written agreement covering fees and expenses should be entered into before the commencement of services.

Once you’ve hired a GCM, it is reasonable to expect that your concerns are responded to professionally and personally.  If you don’t like the answers to your questions, if you don’t like the GCM’s performance, or if the chemistry between the GCM and your family doesn’t fit, terminate the relationship. Ongoing communication is crucial to a successful engagement. With good communication and respect for everyone’s concerns, the experience your family has with a GCM should be a productive experience, giving you peace of mind and your family member the highest quality of life possible. And, after all is said and done, isn’t that what our family member deserves?