Using Geriatric Care Management
Written by Chris Austin, MA, BS, LSW, CSWCM and
President of My Life, LLC Professional Geriatric
While the concept of Geriatric Care Management has been around for the past 20 years or so, it is becoming a rapidly growing senior service. Geriatric Care Management is the art of supporting an elderly individual to remain in the least restrictive environment for as long as possible while anticipating future needs and preventing crisis situations. A Geriatric Care Manager is a professional who assesses the physical, cognitive, social, spiritual and economic needs of an aging person, and coordinates a network of services to address those needs. This ultimately reduces or eliminates unnecessary costs and improves quality of life for seniors and their families.
To best illustrate the work of a Geriatric Care Manager, consider the story of Rosemary, a client who was referred by her social worker to Chris, a Care Manager. Rosemary was a 72-year-old woman who was profoundly deaf and diagnosed with a personality disorder. She had outlived her husband and 3 adult children. She had no living relatives and only one close friend, whose health was failing. Rosemary’s apartment was cluttered and filled with boxes she had never unpacked from a move several years prior. Her mood was unstable, and she often became aggressive and hostile towards her neighbors, landlord and local store clerks when they failed to understand her. Because of her unhealthy living condition and inappropriate behaviors, she was at risk for eviction and banned from the neighborhood grocery store and pharmacy. Despite the decline in her physical and mental status, she refused to attend medical appointments for fear of not understanding what was being said to her. She neglected to pay some of her monthly bills, and others she paid more than the total due. She was mistrusting of people, isolated, lonely and depressed.
Chris, her Care Manager, began visiting Rosemary weekly. At first, Rosemary was suspicious and resistive. Many of Chris’s first visits only lasted long enough for her to gesture ‘hi’ and ‘thank you’. Chris persisted and quickly learned enough sign language to carry on brief conversations with Rosemary. This helped Rosemary to develop trust. Within a few months, Rosemary allowed Chris to accompany her to the grocery store and run errands with her. Eventually, Rosemary and Chris unpacked her boxes and organized the apartment. Chris assisted Rosemary in obtaining a new Teletype (TTY) machine so that she could communicate with creditors and healthcare providers. Together they developed a bill paying schedule and put Rosemary’s finances back on track. Chris coordinated interpretive services with her healthcare providers, and Rosemary began seeing her physician regularly. She also agreed to take an antidepressant and high blood pressure medication.
As Rosemary’s trust for others grew, Chris connected her with new providers who assisted her in maintaining her independence. After several months of work together, Rosemary began attending social groups at her local community Senior Center for the first time ever. Rosemary and Chris developed a deep caring relationship that created a bridge from Rosemary’s previous life of isolation to one that was fulfilling as well as physically and emotionally healthy. One day while grocery shopping together, a clerk pulled Chris aside and commented, “Rosemary is a completely different person today than she was several months ago. She used to be angry and make scenes in the store. We were even afraid of her. Ever since you started coming here with her, I’ve noticed big changes in her personality. Now she is pleasant and patient and delightful to serve. I don’t know how you did it, but it’s like seeing a miracle!”
Geriatric Care Management can enhance an elderly person’s life by providing them with advocacy and support. Care Managers very often save individuals money by eliminating unnecessary costs, securing appropriate services at the best possible prices and providing oversight of their client’s healthcare. Geriatric Care Management can benefit families of elderly individuals by helping them to navigate through difficult life decisions related to aging. Care Managers can eliminate the stress that caretaking brings to family members. This allows adult children to cease being the care provider and enjoy being the kid again. Families often save money by not having to take extra time off of work to provide care or attend to emergencies. Geriatric Care Management can also benefit professionals by filling in the gap that is created when a client’s needs extend past the services that they can provide.
Many Geriatric Care Managers are certified by the National Association of Professional Geriatric Care Managers (NAPGCM). A care manager certified by the NAPGCM must have a formal education in human services or a related field, and must demonstrate work experience both with the elderly and as a case manager. Additionally, certified NAPGCM members must undergo credentialing by organizations such as the National Board of Social Work, National Academy of Certified Care Managers, or the Commission for Case Manager Certification. While there are currently no formal requirements to become a Geriatric Care Manager, most professionals who practice Geriatric Care Management have a related license, educational degree or certification.
Geriatric Care Management is most often billed by the hour and paid for privately, as these services are not covered by Medicare or Medicaid dollars. However, many long term care insurance policies include coverage for Care Management services if the insured meets eligibility requirements. To find out more about Geriatric Care Management, or to locate a Certified Geriatric Care Manager anywhere in North America, visit www.caremanager.org.