Feeling anxious and overwhelmed as a family caregiver? A geriatric care manager can relieve your stress by helping you make caregiving decisions, navigate the elder care system, and supervise care.
Occasionally on this blog I write about things I wish I had done differently as a care partner for my mother, Judy, who lived with vascular dementia and probable Alzheimer’s disease. Today I’d like to talk about geriatric care managers—what they are, and why I wish I had hired one.
Even though I felt acutely stressed as a “sandwich generation” caregiver (caring for my children as well as my mother), I rejected the idea of hiring a geriatric care manager (a GCM). I was trying to stretch my mother’s modest savings, and thought that hiring a GCM would be too extravagant.
Looking back, I wish I had hired a GCM, even before Mom moved into my home. A GCM would likely have had a real impact on the choices I made and the quality of my mother’s life, my life, and that of my husband and children. Below I’ll outline some of the ways we could have benefited, and discuss the main reason people decide not to hire a GCM.
What is a geriatric care manager?
Geriatric care managers are health care professionals with a background in nursing, social work, gerontology or psychology who specialize in elder care issues and are trained to help family caregivers by
- assessing the particular needs of a family, the level of care needed, and the living situation;
- helping them navigate the medical system; and
- planning and supervising care, among other services.
Five reasons to hire a geriatric care manager, and one reason perhaps not to
First, let’s cover the reason a person might not want to hire a GCM (besides the fact that many caregivers do not know that GCMs exist):
Geriatric care management services are not covered by most private insurance and at this time are not covered by Medicare or Medicaid. Services cost between $50 and $200 an hour, depending on the geographic area, with initial assessment visits of an hour and a half often charged at a higher rate. While many people find it helpful to hire a GCM for just a handful of hours—for the initial assessment, for example—many other people find that the cost, even for a few hours, is beyond their reach.
Benefits to hiring a geriatric care manager
Geriatric care managers can help you:
1. Save money
It’s counter-intuitive, but true for many people. Hiring a GCM either for a one-time assessment or for ongoing support is likely to lower your expenses in the long run by helping you plan ahead and avoid hasty decisions that might prove unnecessary or overly expensive.
If you care for a loved one at home, for example, a GCM can help you decide which home care services may be necessary, and help you supervise that care. A GCM may help with financial planning for future care, working as a liaison with a person’s power of attorney, elder law attorney and financial planner, perhaps helping caregivers avoid costly mistakes (such as I made when applying for Medicaid for Mom). GCMs should also be able to give you information about entitlement programs and benefits for veterans.
2. Make better decisions
A GCM can assess a person’s living situation and recommend changes such as modifications to their home or a move to a facility. I know now that a GCM could have assessed my mother’s ability to care for herself when she still lived alone, assessed her ability to drive, and offered us suggestions for the next steps to take. With the benefit of a professional’s insight, surely I would not have been able to deny my mother’s dementia as long as I did.
I also might not have rushed into moving Mom into my house. I may have paid for aides to help my mother in her home, or convinced my mother to move directly to assisted living, or questioned why I felt confident caring for Mom in my own home, given our challenging history as mother and daughter. Later in my caregiving journey, a GCM could have helped me navigate the rocky transitions between assisted living, the hospital, rehab, memory care, and nursing home care.
3. Navigate the medical system
Geriatric care managers may attend doctors’ appointments, help you communicate with health care professionals, and make sure doctors’ orders are understood and followed. In addition, according to Nataly Rubinstein, a geriatric care manager and author of the book Alzheimer’s Disease and Other Dementias: The Caregiver’s Complete Survival Guide, if you need help getting an accurate diagnosis for your loved one, a geriatric care manager can help you find the right specialist and then walk you through the evaluations necessary for receiving a diagnosis.
An ongoing relationship with a GCM should also help you avoid unnecessary hospitalizations for your loved one.
4. Supervise care and advocate for your loved one in a facility
A GCM can coordinate all aspects of a loved one’s move to a facility, or simply serve as an extra and discreet pair of eyes and ears to visit the facility at odd hours and check on a client’s physical care, emotional state, activity level, and social engagement. A GCM can also help facilitate communication between family caregivers and facility staff.
5. Find caregiver support
A GCM can help save your sanity as a caregiver. Family caregivers often try to take on too much—either out of guilt, a feeling of being obligated, or just love and good intentions. A GCM can not only share the burden of weighty decisions, but gently suggest ways you can pay attention to your own needs. GCMs should be able to recommend sources of caregiver support in your area such as respite care, caregiver counseling, and adult day service centers. GCMs may also be able to guide you through the process of building your own “circle of care” in which you let other family members, friends, and community members help with caregiving duties such as driving, grocery shopping, or just spending time with your loved one.
How to find a geriatric care manager
If your loved one lives with you or in your county, contact your county’s Office for the Aging (find yours here) for their recommendation of a local GCM. If your loved one lives farther away, you can contact the Office for the Aging in that area, or find a GCM through the National Association of Professional Geriatric Care Managers. Make sure the GCM is certified through the Commission for Case Manager, the National Association of Social Workers, or the National Academy of Certified Care Managers, and ask for references.
Free Alternatives to Geriatric Care Managers:
If you cannot afford the cost of a GCM—or even if you can—I recommend contacting your county’s Office for the Aging to speak with a free counselor or to join a caregiver support group. I found my local OFA to be invaluable over my eight years of caregiving. OFAs specialize in supporting care partners who need help navigating long-term care, and they are usually warm places with helpful, knowledgeable staff. (You can find your local OFA here.)
There is no substitute, however, for having an expert on call who knows your family well and can target his or her recommendations to your specific needs and situation. Although I received credible advice along my caregiving journey from various sources (other caregivers in my Office for the Aging’s caregiver support group, my city’s Family and Children’s Services caregiver counselors, a social worker, an elder care psychologist, and various staff members at Mom’s facilities), none of the advice I patched together over the years could have equaled in breadth and depth what I would have learned from an experienced GCM familiar with all aspects of my mother’s life.
For more information about geriatric care managers, visit the National Association of Professional Geriatric Care Managers.
“Why Hire a Geriatric Care Manager?” Jane Gross, New York Times New Old Age blog
“Geriatric Care Management: Questions and Answers,” Alzheimer’s Association
Have you hired a geriatric care manager, and would you do it again? Please share your experiences here.