Aging Parents and Adult Children Together

Aging Parents and Adult Children Together (A/PACT)

Your elderly aunt is widowed and lives alone. You’re the only family member she has to care for her. Her long-time health problems have become debilitating. You know she needs help but, because you live far away, you don’t know exactly what she needs or where to look for help. Someone suggests that you contact a geriatric care manager. What is a care manager and how can you find a good one?

A geriatric care manager (GCM) is a professional who specializes in helping older people and their families with long-term care arrangements. GCMs often have training in gerontology, social work, nursing or counseling. They also have extensive knowledge about the cost, quality and availability of services in an older person’s community. As a result, GCMs can help:

• Conduct care-planning assessments to identify problems and determine eligibility for assistance and the need for services;
• Screen, arrange and monitor in-home help or other services;
• Review financial, legal or medical issues and offer referrals to geriatric specialists to avoid future problems and conserve assets;
• Provide crisis intervention;
• Act as a liaison to families living away from the parent, making sure things are going well and alerting families to problems;
• Help move an older person to or from a retirement complex, care home or nursing home;
• Provide consumer education and advocacy; and,
• Offer counseling and support.

Choose a GCM carefully. The field of geriatric care management is relatively unregulated and many people without specialized training identify themselves as care managers, care coordinators or care advisors. Therefore, it’s wise to screen candidates to ensure that you’re working with a person qualified in this new profession.

• Ask about candidates’ training, education and background in care management and geriatrics. Ask how long they’ve been a GCM and whether they belong to the National Association of Professional Geriatric Care Managers or any other professional associations.
• A care manager’s ability to be responsive is important. Ask candidates what their average response time is to return calls from clients and their families. Have them describe their communication system: Do they use pagers, portable phones, an answering service or voice mail? Learn about their agency’s size, hours and staff composition. How are after-hours emergencies handled? What are the back-up systems for covering vacations and days off? Will you and your parent work with one GCM or several?
• Determine the scope of the GCM’s practice. Some GCMs or agencies specialize in assessments and care consultation but typically don’t follow people on an ongoing basis. An assessment is a thorough review of the client’s physical, medical and mental status, and financial resources. It serves as the basis for a comprehensive plan for the client. Other GCMs offer psychotherapy, money management, or home care. They also can act as conservators, appointed by a court to manage the financial and/or personal affairs of someone unable to manage his or her own affairs. It’s important that the GCM’s practice setting and specialties meet your needs and your parent’s.
• Investigate the GCM’s track record and reputation. Ask for letters of reference or names of previous clients you may contact. Is the GCM active in professional associations? Does the GCM perform volunteer work?

While there are no licensing requirements for GCMs, there are certification programs. Ask each candidate you interview if he or she is certified, and by whom.

Confusion about fees and billing can be a problem. Be sure you understand the GCM’s billing rates and how charges are calculated. Fees vary depending on the GCM’s work setting — private practice, public agency or private non-profit agency. Get a written service agreement that outlines the fee structure and practices.

Finally, ask GCM candidates if they subscribe to a code of ethics or are guided by professional standards of practice. Get a copy of the standards. They should deal with the right to privacy, fiduciary responsibilities, full disclosure, fostering self-determination, fees, continuing education and professional relationships. Ask how complaints are handled.

For More Information

You can find GCMs through:

• The Area Agency on Aging in your parent’s community
• Hospitals, senior centers, geriatric assessment centers and charitable organizations, such as the Alzheimer’s Association
• The National Association of Professional Geriatric Care Managers at (520) 881-8008
• The Eldercare Locator Service at (800) 677-1116

Private non-profit organizations that promote standards for geriatric care managers include:

National Association of Professional Geriatric Care Managers
1604 North Country Club Road
Tucson, AZ 85716-3102
(520) 881-8008; Fax: (520) 325-7925

National Council on Aging
409 Third Street, SW
Suite 200
Washington, DC 20024
(202) 479-1200; fax: (202) 479-0735

Case Management Society of America
8201 Cantrell Road, Suite 230
Little Rock, AR 72227
(501) 225-2229; fax: (501) 221-9068

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