Geriatric Care Management
If you have clicked here, I will assume that you are looking for more in depth information about Geriatric Care Management. This section will offer detail on the following:
- What is a Geriatric Assessment?
- What is a Care Plan?
- When is a Geriatric Assessment Needed?
- What is a Geriatric Care Manager?
- Fees for Care Management Services
- Resources
What is a Geriatric Assessment:
A professional examination of the older person's current status encompasses the following items. When these items are looked at together, a comprehensive evaluation is provided that is a significant benefit in both understanding what is happening and in decision making and planning for that individual. The report is written and provided to family and/or significant others. .
- Physical, mental, and psycho-social health are carefully assessed with both validated psychological instruments and in-depth questioning
- Assessment of their ability to function well and to independently perform the basic activities of daily living (known as ADL’s) . Examples include: dressing, bathing, meal preparation, medication management, etc.
- Living arrangements, their social network, and their access to support services are each critically important in helping an individual to retain as much independence outside a facility as possible.
From gathering this information, a clear identification of current problems or anticipated future problems in any of these areas can be made.
What is a Care Plan?
The next step is to create a Comprehensive Care Plan that goes beyond the Geriatric Assessment and both addresses the identified problems and also offers specific interventions or actions required immediately and perhaps in the future, on the senior’s behalf. Specific recommendations regarding resources that will be needed to provide the necessary support services are also included.
This plan also addresses how I could assist you to:
Manage a successful linkage between the recommended resources and the older person and that person's family so that provision of the necessary services is assured.
Ongoing monitoring of this linkage to insure that the problems identified, are being properly managed and re-evaluations are conducted to determine when modification of the Care Plan are needed.
When is a Geriatric Assessment Needed?
A request for a geriatric assessment would be appropriate when there are persistent or intermittent symptoms such as:
- Memory loss,
- Confusion,
- Other signs of possible dementia
- Inability to live alone or take care of activities of daily living without additional care
- When a family that may live at a distance is concerned and wants a thorough evaluation of the senior’s well-being.
Often, what looks like Alzheimer's or dementia can be the result of medication interactions or other medical or psychiatric problems. Because of the thoroughness of the geriatric assessment, it is one of the best ways to determine what the actual problem and cause is or is not.
What is a Certified Advanced Geriatric Care Manager?
Advanced Social Work Care Manager (C-ASWCM), the credentialing I hold, is a professional social worker with specialized knowledge and expertise in senior care issues with an advanced degree in social work who has been credentialed by The National Association of Social Workers (NASW), as having the required years of experience, expertise and professional ethics to qualify for this specialty credentialing beyond their designation as a Licensed Clinical Social Worker (see About Leslie section).
The National Association of Professional Geriatric Care Managers recognizes the C-ASWCM for a "Certified Care Manager. To maintain my credential I am required to undergo testing and continuing education.
I am a guide and facilitator to evaluate your elder’s situation as well as the resources that exist within the elder’s support network (i.e. financial, geographic proximity, culture, quality of relationship, etc.) and I identify solutions, and work with you to design a plan for maximizing your elder's independence and well being while providing you with the highest possible level of security and peace of mind.
Not only do I develop your care plan but, I can also be contracted to arrange for services, and follow up or monitor care.
Of course, you aren't obligated to implement any part of the suggested Care Plan, but most often I can suggest potential alternatives you might not have considered, I am familiar with community resources as well as have knowledge of any benefits to which they are entitled.
My service is invaluable for family members who live at a distance from your elderly relatives, but also if you live nearby but lack the knowledge of how to tap into the appropriate local services.
As a Geriatric Care Manager, I can either provide a single, specific task, such as helping you find a daily caregiver, or oversee, manage and quality assess the entire caregiving process. As situations change with time, it is always good practice to schedule re-evaluations to determine the current level of functioning and any revisions to the Care Plan that may be required.
When re-evaluation is necessary: A perfect example is memory. When first seen, a senior may have some moderate memory loss, but nothing that is potentially threatening. Six months later those memory issues may have worsened or be episodic with unpredictable good and bad days. When this occurs, an assessment should take place to determine the extent of the memory loss, the potential consequences of the loss, and what can be done to compensate for it.
You are very important in this process. I will partner with family members to make the best possible decisions. Since I am not in the home/facility on a daily, or weekly basis, if you have concerns it is important that you bring them to my attention. But, as a professional, I can spot what is occurring and help address small problems before they escalate into big ones.
I am at my best when I am communicating with you, the senior, healthcare providers and others involved in the senior’s care.
When to contact me. Are you…
- new to elder care or uncomfortable with making important elder care decisions;
- experiencing difficulty with any aspect of elder care – such as home care, getting straight answers from doctors or other healthcare providers;
- Must make a sudden decision or major change, such as a health crisis or a change of residence;
- Or perhaps dealing with a very complex situations such as a psychiatric, cognitive, health, legal, or social issues.
I can also act as your informed connection with a range of other professionals who are part of your elder care support system, including any of the following service providers:
- Attorneys or trust officers. A care manager can serve as both elder advocate and intermediary with financial and legal advisers. Often, I can be a good source of referrals if you require services from these professionals.
- Physicians. A Geriatric Care Manager is an ideal liaison between doctors and other health professionals, and the elder patient and family members. Because I understand both the physical issues as well as the emotional and familial ones.
- Social workers. Many hospital and nursing home social workers and discharge planners welcome having another professional who represents the elder and family, to coordinate care and assist them on a long-term basis. Recently, many hospitals have downsized the social work departments and discharge planners often have large caseloads of people and very little time to address their needs, making a Geriatric Care Manager an important part of your “team”.
- Home care companies. I either have a relationship with local agencies or can research and connect with them and can then share with you the options, costs, and oversight of home care workers. I can also help deal with the elder’s social issues, help link them to other community resources, and/or suggest possible placement options.
- Residential facilities. I can help identify care facilities and assist you in selecting an appropriate one for your situation. I often can expedite and ease the transition into or out of a senior community, for both the elderly resident, family members and staff.
Costs of geriatric care management
As of 2010, my hourly fee is $ 160 an hour with an initial intake fee between $750 - $1000 for the initial visit, which is when the initial assessment takes place and a report is written. If you wish to engage my services for a longer term, to develop a Care Plan, engage other resources, etc. we will clearly spell out the details and go from there.
When I am engaged for a longer length of time, I ask for a retainer that will cover up to 10 hours of work and any related costs. I provide statements of hours spent with details about how they were used which you will receive on a monthly or more frequent basis.
While this may seem costly, realize that a professional service such as this will save you money in the long run, by assessing your precise needs and helping you choose the specific services that will best serve you now. As most people require geriatric care management only intermittently once support services are in place the fees will not run as high over time.
Not only do you Save Money, but what you gain in time not spent away from family and work, and relief from constant anxiety and emotional distress,is considered by most to be more than worth the expense.
Although geriatric care management fees are not covered by Medicare or Medicaid, some employers, insurance companies, health plans and financial service providers are beginning to subsidize or cover these services for their members and clients. Long-term care insurance often includes care management.
If you are unable to afford private care management, call your local Area Agency on Aging (call 1-800-677-1116 for the AAA in your area). They may be able to refer you to a city, county or agency source.
In addition, most states offer a Medicaid waiver program that provides geriatric care management and in-home services for individuals 65 and older, who are eligible for both nursing home placement and Medicaid.
References and resources about geriatric assessment
Other related links
The FHA Physician Referral Service – Provides an online form for you to request a list of geriatric specialists in your area. Includes a brief listing of additional resources to assist you in locating a doctor nearby. (American Geriatrics Society)
What Is Geriatrics? – Defines geriatrics and the role of a geriatrician. Describes the team approach and who should see a geriatrician. (American Geriatrics Society's Foundation for Health in Aging)
Eldercare Locator – Call 1-800-677-1116 Monday through Friday, 9:00 a.m. to 8:00 p.m. Eastern time for more information on care managers and referrals. (US Administration on Aging)
Additional online resource for geriatric care management
