Sometimes an overwhelmed family member needs a professional guide
by Barbara Moroch, AARP, Updated October 28, 2022
With changing times come changes in the way we care for our elders.
In the past, extended families often shared the job of tending to older 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. [We prefer the term “Elderly Care Managers.”]
These professionals, sometimes called aging life care managers, are usually licensed nurses or social workers trained in caring for older adults. 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, an 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.”
As the population ages — the number of Americans age 65 and older is projected to nearly double to 95 million by 2060, according to the Washington, D.C.-based Population Research Bureau — the number of caregivers needing help will likely increase as well. The COVID-19 pandemic accelerated the trend, according to geriatric care managers, who report more families turning to them for assistance.
“Seniors were in their homes and not getting out and about, and their functioning really declined,” says Debra Feldman, board president of the Aging Life Care Association, a professional organization for geriatric care managers. “What we’re encountering now are the adult children seeing their parents who declined so much.”
The association, formed in 1985 and based in Tucson, Arizona, has more than 2,000 care managers as members.
How geriatric care managers can help
Many care managers started out in nursing, occupational therapy, physical therapy or social work, often with a focus on geriatrics, and decided to switch careers to meet clients’ needs for broader care services, Wagner says.
What they do now is a range of assessments and coordination of care. Initial assessments of clients and their living situations largely moved online when the pandemic struck, but that was far from ideal, Feldman says, and managers have mostly resumed in-person visits.
Establishing a human connection with care recipients and caregivers is a big part of what care managers do, she says. Plus, an in-person assessment can reveal details that aren’t always captured on a screen, such as rugs that might be tripping hazards.
Along with assessments, other care management services may include:
- Coordinating medical appointments and arranging 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 to care recipients and their families.
- Creating short- and long-term care plans that could include assisted living or a rehab center.
- 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.”
Count on paying out of pocket
The cost of an initial assessment can vary widely by region but will generally run from about $800 to $2,000, says Julie Wagner, CEO of the Aging Life Care Association. Hourly rates for ongoing services range from $90 to $250.
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.
Neither Medicare nor Medicaid will pay for geriatric care management services. Long-term care insurance may cover some of the costs of care coordination, but most private insurance policies, including Medigap and Medicare Advantage plans, do not.
You may be able to get help from your workplace, Wagner says. Some employee assistance programs cover some geriatric care management fees because the services a manager provides can help family caregivers stay focused on their paying jobs and miss less work time.
Roughly 3 out of 5 family caregivers work full or part time, and of that group, more than half report having to go in late, leave early or take time off from their job to attend to caregiving responsibilities, according to a 2020 study by AARP and the National Alliance for Caregiving.
Check references and credentials
Unlike medical doctors and registered nurses, geriatric care managers don’t have state-level license requirements. But because many started in health care or social work, they often maintain certifications in their original field.
Two nonprofit organizations, the Commission for Case Manager Certification (CCMC) in Mount Laurel, New Jersey, and the National Academy of Certified Case Managers (NACCM) in Tucson, Oklahoma, offer certification programs. Both require specialized degrees, experience and successful completion of an examination.
Those who fulfill CCMC requirements become certified case managers and must renew the certification every five years, a process that requires continuing education and another exam. Those who satisfy NACCM requirements become certified care managers. They must renew every three years and meet continuing education requirements.
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