Seniors | In aging crisis, who ya gonna call Start with an expert

Many years ago, before I was involved in aging services, a friend in California told me that she was concerned about her mother who was living alone in New York. Her mother was having problems walking and it was becoming in-creasingly difficult for her to handle daily activities. Since my friend wasn’t able to fly back and forth, she said she’d hired a geriatric care manager to help her mother.

“You mean someone to help her cook and clean?” I asked.

Rob Tufel

“No,” she said, “a professional who is trained in gerontology and helps coordinate all her care — things like doctor visits or getting her hooked up with a physical therapist, not just household stuff. ”

As it turns out, my lack of knowledge about the field of geriatric care management was not uncommon. That’s partly due to the fact that this field is relatively new. The main association representing geriatric care managers, the National Association of Professional Geriatric Care Managers, wasn’t established until 1985.

Though the field of geriatric care management has grown since then, there’s still a lack of awareness about it. This is borne out by many of the callers we speak to on our Senior Information Line who are unfamiliar with geriatric care management and how it can help in dealing with aging issues.

So what, exactly, is a geriatric care manager?

A geriatric care manager is a master’s-level-trained professional with a specialization in gerontology, and a background in social work, nursing or counseling. Some may be certified, others may be licensed social workers or nurses, but the common thread is that all geriatric care managers have expertise in aging services and working with older adults and their families.

A geriatric care manager can help an aging adult access services to address the common issues that people experience as they age. Care managers become the older adult’s advocate in dealing with medical and financial issues, living situations, health, and more. A care manager might accompany a client to a doctor’s appointment; facilitate a meeting with an elder lawyer to draw up a will; or help a family decide the services an older adult needs in order to remain in their own home.

Perhaps the best way to define a geriatric care manager is by giving examples of the day-to-day, practical help that care managers can provide.

For example, a Berkeley woman who is caring for her husband with Alzheimer’s disease recently called us looking for assistance. She met with one of our geriatric care managers, who helped her find a home care aide with experience caring for someone with Alzheimer’s. We also let the wife know about day programs for people with Alzheimer’s and got her enrolled in a special training for caregivers of those with Alzheimer’s.

Another typical situation involved supporting an adult child whose father was moving to the area from out of state. The son had questions about whether his father should live with him; the different types of senior facilities; whether his dad would be eligible for any financial programs; and how he would go about finding a good facility. A geriatric care managers worked with him and his dad to explain the different living options, including what would need to be done to modify the son’s home to make it a good living environment for his father, as well as how to go about finding the best place to live outside the son’s home.

In addition to this kind of practical help, a care manager can smooth out the tensions that sometimes arise among parents, siblings and children when having to make difficult decisions about moving, getting help in the home, accessing medical care, or stopping driving.

Generally, the process for working with a geriatric care manager starts with a home visit and assessment to determine major issues confronting the older adult. Care managers also assess the home environment, including making suggestions for modifying the home to reduce or prevent falls (a major risk factor for older adults).

The manager will then write a “care plan” (that’s social work talk for a plan of action based on the needs identified during the assessment). The older adult and family members can then decide if they want to implement the care plan themselves or need the care manager to coordinate services and monitor the care, to ensure that needs are being met. Each family also decides whether the relationship with the care manager will be short-term (one or two meetings) or an ongoing arrangement.

Unless someone is considered very low income, there is a fee for hiring a geriatric care manager. The fee will vary depending on whether the care manager is in private practice, works for a nonprofit organization, or works for a for-profit business. Many people start with a couple of meetings to get a good idea of what a care manager can do.

Even just one or two visits can help a family navigate the overwhelming world of older adult services. A care manager can help a family avoid having to visit many different skilled living facilities or wade through the confusing world of Medicare paperwork on their own. And because dealing with aging issues for both an older adult and their adult child or caregiver can be stressful, a meeting with a geriatric care manager can help reduce anxiety and provide assurance that the older adult will remain engaged and be well taken care of.

If you’re interested in hiring a care manager, most Jewish Family and Children’s Services agencies across the country have care management programs. You can also contact the National Association of Professional Geriatric Care Managers (www.caremanager.org) for more information.

I look at it this way — if you had a toothache, you would call a dentist. If you were depressed, you would call a therapist. So if you need help dealing with an aging issue for yourself or a parent, why wouldn’t you call an expert? n

Rob Tufel, MSW, MPH, is director of Adult Services at Jewish Family and Children’s Services of the East Bay. His columns appear regularly in j’s Seniors supplements. Have questions about your aging parents? Email rtufel@jfcs-eastbay.org or call (510) 558-7800, ext. 352.