Do You Need a Geriatric Care Manager?

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Caring for an elderly parent often feels similar to parenting. I remember taking my parents to many medical appointments, managing paid caregivers, making sure they had nutritious food to eat, and ensuring that their living environment was safe. But, what happens when you encounter critical situations where you just don't know where to turn? It might be beneficial to hire a geriatric care manager.

The National Institute on Aging defines a geriatric care manager as "usually a licensed nurse or social worker who specializes in geriatrics, is sort of a 'professional relative' who can help you and your family to identify needs and find ways to meet your needs."

I first turned to a geriatric care manager when I moved my Dad to a memory care facility and it turned out to be a disaster. He was receiving minimal personal care, staff turnover at the director and nursing level was ridiculous, and he was miserable. It felt like we could do a better job caring for him at home, with outside help, but I wasn't sure where to begin. I decided to hire a geriatric care manager to evaluate the situation objectively and provide recommendations. The geriatric care manager evaluated my Dad's needs, consulted with my Mom and me about our wishes, developed a schedule for outside aides, and worked with the in-home care agency to put it into action.

Over several years, I hired this same geriatric care manager to help me in various situations. Based on this experience, here are four observations which may help you decide if this type of service would be helpful to you:

  1. Geriatric care managers understand the local elder care landscape. When it became clear that my parents needed to move from their home, the geriatric care manager gave me insight into the different memory care and assisted living facilities in the area. Because she had clients in various locations, she had first hand experience with what the care was like. I used this information as I decided which places to tour.

  2. Geriatric care managers can help you navigate when you feel overwhelmed. As my Dad's dementia progressed, it became clear that memory care assisted living was no longer the right solution for him. The stroke that he experienced during his heart surgery affected the part of his brain which controlled emotions. He was prone to crying a lot which was difficult for my Mom and me to see. At one point, he began yelling at me that I had "shown my true colors" and had "ruined our family." The memory care facility wasn't sure what to do with him and I was at wits end. I asked my geriatric care manager to step in. She knew that no skilled nursing facility would accept my Dad without first having a geriatric psychiatric evaluation. She navigated that process for me, as I was completely unable to cope with it emotionally. I am ashamed to say that, but it's the truth.

  3. Geriatric care managers understand the realities of elder care. Once we got through the geriatric psychiatric evaluation process, it was time to move my Dad to a skilled nursing facility. The geriatric care manager and I worked together to identify places that I would be comfortable moving him. She made the first contact with the admissions teams to explain the situation (i.e., that both my parents would be moving to the facility and she explained my Dad's medical history and background). Then I made my visits to see the facilities in-person and to complete the application paperwork. I have to commend the geriatric care manager for her negotiation skills. The sad reality is that private pay skilled nursing care is highly lucrative for facilities – the geriatric care manager knew that and emphasized to the admissions departments that my family would be paying for two residents. This represented a significant revenue opportunity for a nursing home.

  4. Geriatric care managers enable family members to take much needed breaks. Throughout my parents' journey – while they still lived at home, while they were in assisted living, and once they moved to a skilled nursing facility – I turned to my geriatric care manager to keep an eye on things, so my husband and I could go on vacation or go out of town for work.

Geriatric care managers typically charge on an hourly basis for their services. Their rates vary, but they are usually similar to other professional services such as accountants or some lawyers. While the fees may seem high, they often have knowledge and contacts that would take you weeks or longer to accrue. In some cases, the time saved is well worth the money spent.

For children who live far from their elderly parents or who have to travel for work, I think a geriatric care manager can be a great resource. My Mom was hospitalized after breaking several ribs, for example, while I was out of town for work. I had our geriatric care manager meet her at the hospital and serve as a liaison between the medical team and me until I could get back home.

If you would like to engage a geriatric care manager, here are three resources:

  • Aging Life Care Association. This organization has a searchable database of geriatric care managers. I'd suggest contacting two or three in your area and interviewing them. In addition to the geriatric care manager's professional credentials, it's important to find someone who you feel comfortable interacting with on a personal level.

  • The National Institute on Aging offers several interview questions you could use as a guide when evaluating care managers.

  • For families in the Merrimack Valley area of Massachusetts, I'd highly recommend Pro-Active Elder Care.

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