Geriatric Care Manager
by Cheryl Ellis, Staff Writer

Caregiving can become an unexpected necessity if a senior experiences a sudden illness.  We expect the elderly to have special challenges with the passing years.  Yet, we may not be able to predict or assess just how challenging their lives may be.  This is where a Geriatric Care Manager (GCM) may provide valuable assistance to caregivers and the elderly client.

Geriatrics, a specialty branch of medicine dealing with elderly populations and their medical needs, was a blossoming field in 1989.  With Medicare cutbacks among the reasons, fewer physicians are specializing in this branch of medicine.  The American Board of Medical Specialties reports a reduction of about 440 less geriatric doctors between 2004 and 2006.  More of us are growing older, but there are fewer doctors for this specialty population.  Geriatric Care Managers can fill the needed gap, providing assessments and planning, as well as communicating with physicians.

Most GCMs will be degreed in social work, nursing, counseling, or psychology.  Like any professional, their experience and ability will vary.  Professional regulation is not required of a GCM in all states, and some individuals can earn a “certificate” via online programs. 

The National Association of Professional Geriatric Care Managers accepts members who have met specific criteria, and is a good resource for referrals to care managers locally and nationally.  Keep in mind that while the organization does check references and credentials, anyone with some affiliation or interest in geriatric care can apply to select an “affiliate” membership. 

Interviewing a care manager includes answering their questions, too.  Both parties must be sure that the senior’s needs are met.  The GCM’s responsibility is to the senior first.  Caregivers may be reassured of that, but must also be aware that the elder care professional has access to more information.  Once an evaluation is done, the caregiver may be surprised to find the current scale of care should be altered to fit changing needs that a non-medical professional will not recognize. 

Care management is exceptionally useful if seniors are being monitored from a distance by phone calls, or occasional visits from local family and friends.  The GCM can act as a medical advocate as well as spot imminent health conditions.  Since seniors living alone tend to accentuate the positive to retain their independence, an impartial third party can determine which services will help them retain that independence.

Families living away from their elders can utilize a GCM to keep up with their loved one’s needs, such as regular bill paying, doctor’s visits, and intervention with community or medical services.  The GCM’s role does not stop at assessment and recommendation, although it can, if a caregiver desires. 

In situations where one parent has a deteriorating condition, the GCM will assist with helping the caregiver-parent with much needed advice and social assistance.  Aging parents may be reluctant to move from their secure environment to live with family.  A care manager can accurately review the current living conditions, and if needed, act as an intermediary to discuss realistic living options.  In this way, family members are not seen as removing independence from loved ones by stepping in to alter their living situation.

In multi-child families, one child may have the role of caregiver fall to them, with too much or not enough input on the part of the other siblings.  A possible solution is through geriatric care management.  Hiring professionals to not only evaluate, but channel information about health and other issues is a clean way to break from being the sole decision maker.

The many service options offered by GCMs can also include assistance when a caregiver must relocate to be closer to the senior, or when the senior must relocate.  This not only includes assisted living or other long term care, but relocation to the caregiver’s home. 

The senior dwelling in Florida must deal with hurricanes and weather extremes like blistering summer heat.  The old saying of “you can’t change the weather” can stir up tremendous anxiety in long distance caregivers.  Worries about health and emergency needs amplify, but geriatric care, once in place, plans for these things, too.  Regardless of where one lives in the state, concerns for flu season, mosquito transmitted diseases and weather associated respiratory problems exist.  Again, care management takes these factors into consideration, developing solutions before problems begin.

Geriatric care professionals are connected by a network of professional associations, and they can connect the senior and family with a GCM locally to keep the service uninterrupted.

Attorneys, banks, and healthcare providers rely on geriatric care when there are no family members to step in.  In this way, the client’s affairs are kept in order according to the law, and the client is kept well attended.  In so many families where time and distance have separated people beyond reasonable bounds, geriatric management provides advocacy and consistency of a senior’s quality of life.

Costs vary from manager to manager, as well as the detail of service being provided.  Medicare and Medicaid do not cover these services, but when considering out of pocket expenses such as these, a caregiver must evaluate both senior and caregiver needs.  Overstressed caregivers will require more medical and psychological care of their own.  By relieving some of the natural pressure that comes with caring for another, stress levels fall, health levels increase, and doctors’ visits gradually diminish. 

Care managers may also find services that are low or no cost (such as respite care), that will reduce or eliminate the need for paying for companions or aides.  The ability to “find money” is part of a geriatric care manager’s skills.  They reduce the time expenditure in trying to find particular services, which also helps with caregiver stress.

Evaluating a care manager involves cost per hour, but only in part.  Years in the field, degrees currently held (LPN, RN or higher degree), and any additional specialty credentials (finance management or paralegal training) should be considered.  Caregivers must also be comfortable and able to communicate with the manager, because this is where information of all types can be obtained.  If the ability of the care manager to communicate with effectiveness and compassion is not present, it would be better to continue interviewing others, regardless of any credentials.  This individual will be a caregiver’s first line of hope, and help. 

Rather than viewing a care manager as someone who takes the family out of the senior care equation, they should be seen as a resource of information about the individual needing care.  Regular contact with the care manager creates a feeling of well being within the family structure because the constant anxiety of questioning how the senior is doing is subtracted. 

When a care manager steps in to assist client and family, a new dimension opens up in the relationship between senior and caregiver.  The deeper bonds of relationship are no longer submerged beneath stress, tension and fear of “doing the wrong thing.”  True feelings of love and compassion are free to surface.  Health of both senior and caregiver can improve dramatically when the right changes are made. 

One person is no longer “in charge” of another, and the feelings of resentment and/or guilt that can breed between caregiver and elder dissipate.  Individuals move to a new level of relating to one another, and the geriatric care manager can also guide this journey, too.

Caregiver and senior may have to adjust to new circumstances, but their relationship ultimately becomes renewed.

To find a Geriatric Care Professional near you, visit the National Association’s website at: http://www.caremanager.org/

 

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