Sometimes You Need An Ace
To families struggling with the needs of aging relatives, the geriatric care manager can be a godsend. This emerging breed of specialist can assess a senior's physical, social, and financial needs and stitch together a patchwork of services to address them. The cost: about $300 to $800 for an initial assessment, and $50 to $150 an hour after that.
If you're in the market for such a person, be aware that the profession is virtually unregulated: The feds don't monitor it, and only one state, New Hampshire, requires licensing. As the demands of the older population grow, the field is wide open to practitioners with little experience in dealing with the variety of issues the elderly face. Cathy Cress, president of Cresscare Case Management Agency for Elders in Monterey, Calif., says accounting and financial-planning firms and home-health agencies are starting to offer geriatric care management, too. Although these professionals may be trained in some facets of elder care, she says, families need to check credentials carefully. "These are incredibly complicated problems, and geriatric care managers must be experts in multiple domains," explains Cress, who teaches courses on geriatric care management for San Francisco State University's master's in gerontology program.
In short, a skilled geriatric care manager is a "jack of all trades," says Tara Eisner, who works for LivHome Corp. in Los Angeles. You can hire one to supervise home-care aides, retain an attorney for legal problems, arrange for transportation for visits to doctors and shopping trips, fill out endless forms for benefits programs, and act as a family's advocate with hospitals and physicians. Adult children who live far away look to care managers to visit their parents regularly and to keep them informed, she says. Although she will help place a senior in an institutional setting, Eisner says her goal is to keep an older person at home: "We want them living an independent life so they can age gracefully."
GETTING INSURERS TO BUDGE
That's what Niki Martin, 50, of Sunnyvale, Calif., is trying to do for her 78-year-old father, Nick, who lives with her. She turned to Cresscare in early April for help with her father, who had suffered several strokes. He had also been diagnosed with a brain tumor that was causing violent behavior. The care manager, Stephen Kutchko, found a daily outpatient treatment program for her father, persuaded a reluctant insurance company to pay for a home-care aide, and arranged for a wristband transmitter in case her father wandered off. Kutchko plans to spend an hour and a half a week on the Martin case. Martin, who works full-time as an executive assistant at Agilent Technologies (A ), says the service provides her with the "expertise to navigate a very complicated, cumbersome system." She signed a contract, which included a $500 deposit and an hourly fee of $85, although there might be some other costs depending on her dad's needs.
Like Martin, relatives usually seek help during a crisis when they do not have time for an in-depth probe of a care manager's training. So if you think you may need this sort of help, start looking ahead of time (table).
Make sure the manager is licensed as a social worker, a registered nurse, a therapist, or care-related professional. The best place to start is the National Association of Professional Geriatric Care Managers, whose members must meet certain standards. Anyone you pick should have several years' experience in providing assessments of and services to the elderly and a list of recent references.
Also inquire how the manager would handle family squabbles over care. Marsha Pierson, a care manager with Iona Senior Services in Washington, says she will mediate disputes among siblings. "We try to neutralize the family dynamics of guilt and anger and meet the needs of the senior," she says.
Although costly, a geriatric care manager may offer something money can't buy. By lightening the burden of having to unravel the perplexing web of elder-care services on their own, families will be able to make the most of those last years with their aging relative.
By Susan Garland