Geriatric care managers bring ease to elderly needs
by Rosalyn Demaree
Lee Fiedler found reliable advice through a geriatric care manager when she needed it most: as her stepmother, Alice Fiedler, approached 95 and her health was declining. Lee plans to use highly rated Elder Advocates again when her husband, Ed Milam - 15 years her senior - needs additional care. "What I learned was invaluable," says Lee, a retired journalist in Orlando, Fla., where Elder Advocates is based. "I did my homework, and they were still able to help."
GCMs assess a senior's situation to determine what kind of care is needed, and either provide those services or make referrals. Lee got help as wide-ranging as choosing a walker that Medicare would cover to selecting a skilled-care facility appropriate for Alice's needs and determining end-of-life care.
Care managers' backgrounds are diverse - from nurses and neurologists to elder attorneys and social workers - and they can help identify health, legal and financial resources. The GCM who Lee hired, a nurse, monitored the nursing home care, visited Alice weekly and advocated for her when she was hospitalized after a fall. "The advice they gave me was always good," Lee says. "They told me to 'Check things out. Don't just do what we tell you.'"
Elder Advocates owner Patty Antony describes her agency's job as evaluating immediate needs, forecasting future ones and creating a Plan C, "in case all of that falls apart." Her clients are overwhelmingly adult children who live out of town and suddenly need help when their parent faces a crisis, often on a weekend. "We can check in on Mom, make sure durable medical equipment arrived and that she's taking the right medicine," says Antony, who once dog sat for a client who refused hospitalization until Rover was cared for.
Costs vary widely. The American Elder Care Research Organization says clients typically pay $50 to $200 per hour. Lee paid $600 for an initial assessment and $200 per month for ongoing care, which wasn't covered by her insurance. Some long-term insurance plans cover GCM advisory services, but most general health policies don't, Antony reports, so her agency also helps clients identify potential benefits from government and community programs.
The way GCM agencies operate also vary. Elder Advocates has caregivers on staff. Other GCMs, such as the highly rated nationwide A Place for Mom, give clients a free list of providers, which pay the agency when clients hire them.
Michele Viehman of Lake St. Louis, Mo., found this clearinghouse arrangement ideal when her mother needed a home aide. "They helped me determine what services were needed and offered all levels of assistance," she says.
The demand for GCMs is rising dramatically as the number of senior citizens increases, says Susan Fleischer, president of the National Association of Professional Geriatric Care Managers. She advises to look at a GCM's certification and professional licenses before hiring. NAPGCM requires members to be certified by the National Association of Social Workers, the National Academy of Certified Care Managers or the Commission for Case Manager Certification.
Alice Fiedler's care evolved over six years and involved two nurses because the first one moved from the area. "I never, ever felt it was a waste of money," Lee says. "It gave us peace of mind that we were getting the best care we could give her."