Senior moments: Geriatric care managers can oversee elderly support

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By Jackie Byrd
A column for seniors and those who love them

Three things in human life are important: The first is to be kind. The second is to be kind. And the third is to be kind. – Henry James (1843-1916) writer

Imagine a middle-aged woman who has a husband, two school-age children and a full-time job. She lives a thousand miles from her widowed mother, who recently celebrated her 80th birthday. When she visited her mother for the birthday events, there was an unpleasant discussion (again) regarding the child’s concern about her mother living alone in a house with 27 steps up to the front door, and steps down to the basement washer and dryer. Our heroine is also aware of her mother’s increasing forgetfulness. She knows that her mother needs documents she doesn’t have: a will and various powers of attorney. She worries that her mother doesn’t eat right and doesn’t have access to groceries or help in bad weather.

Are there options that will allow the mother to stay in her home? What about Meals on Wheels and adult day care for some days? The child considers things that must be done: visit and research assisted living residence centers, ensure that her mother’s legal affairs are in order, etc. But the distance is great, and she has commitments to family and work.

What if there is a fairy godmother who could rescue this daughter? Amazingly, perhaps there is. The explosion of the aging population has resulted in changes and advances in the way we provide elder care. Among many pleasant developments in recent years is the advent of a profession whose members are called geriatric care managers and whose stated purpose is to “promote the advancement of dignified care for older adults.” For our long-distance child, a GCM could be her eyes and ears: arranging and monitoring services and providing regular updates by phone. GCMs can serve as a source of information about community resources, the process of setting up services and how to pay for them. GCMs can arrange family meetings and help build stronger support networks.

Calling a GCM can be a wonderful solution when you or someone you love needs help with chores of daily living, paying bills, taking medication, coordinating medical care, addressing legal concerns or obtaining social services. The GCM can help meet the challenges of long-distance care-giving, put together a comprehensive plan for present or future needs, provide extra assistance for a relocation or monitor your relative during your vacation.

GCMs are knowledgeable about local facilities for senior care, and they will work with you and your family to look at all the options and make recommendations for your situation. They have the training and skills needed to develop rapport even with difficult clients. They know how to suggest creative alternatives and different approaches for dealing with the myriad challenges facing the senior and his or her family.

As you can see, GCMs provide a wide array of services for older adults and their family. Most GCMs initially provide a home assessment and then create a recommended care plan based on the interview. A GCM can be a social worker, counselor or nurse. Their qualifications vary, but most have at least a degree in social work, psychology, nursing, counseling or gerontology. Some have advanced degrees, and many have spent years in the field of gerontology and social services.

GCM services can be broken down into four phases: Conduct an assessment. Make a care plan. Arrange services. Provide ongoing care management. If a senior is living at home, the goal of the GCM is to set up services that will allow the individual to continue to live at home for as long as possible, at the highest level of independence.

When services of this nature are being discussed, nearly everyone’s first question is “How much will it cost?” Fees vary, of course, but in this geographic area they range from $75 to $165 an hour. Services can be very short term or ongoing. Individual GCMs will explain their fee structures to you. Some public and nonprofit agencies use a sliding-scale system based on income to set fees for the services. Unfortunately, Medicare and most health insurance plans do not cover the cost of care management at this time. Some long-term care insurance plans will reimburse for care management services.

However, the National Association of Professional Geriatric Care Managers has established standards of quality and a code of ethics for GCMs. Make it a point to personally interview any GCM that you’re considering. Ask questions such as the following during your interview: Are you with a firm? Are you a member of any national organizations such as the National Association of Professional Geriatric Care Managers, Children of Aging Parents, National Guardianship Association or American Association of Critical Care Nurses? How many years have you been a GCM? Can you provide client references? What are your educational and professional credentials?

To locate a GCM in Maryland, Virginia or Washington, contact the Mid-Atlantic GCM Chapter at Contact the National Association of Professional Geriatric Care Managers at or 520-881-8008.

Thank you for reading. Stay well. See you next week.

The writer, a longtime resident of Bowie, is secretary of the Maryland/D.C. chapter of the National Academy of Elder Law Attorneys and a member of the Elder Law Section of the Maryland State Bar Association. You can e-mail her at [email protected].

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