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Geriatric Care Managers Advocate for Older Adults — and Their Caregivers
When caregiving becomes overwhelming, these professionals can help families navigate the maze of medical services and difficult care decisions
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Key takeaways
- Geriatric care managers assist caregivers facing complex medical, financial and emotional challenges.
- Through in-home assessments, they identify safety risks, evaluate care needs and recommend appropriate services.
- Hiring a care manager is like hiring any trusted professional: Request information about credentials, experience, fees, references and more before making a decision.
Caring for a loved one can quickly become a full-time job. Caregivers find themselves managing, among other things, medical appointments, insurance questions, hospital discharges and home care, while juggling their own personal lives and, sometimes, jobs outside caregiving.
That’s the reality Mitch Falter, 53, has faced since his father suffered a stroke in 2019. Over the past several years, Falter, a financial planner in Clifton, Virginia, has helped care for both of his parents, who each have their own health challenges. His 80-year-old dad, Steven, who has diabetes, had a second stroke and broke a hip after moving into assisted living in 2019. Meanwhile, his 78-year-old mother, Nancy, recently underwent surgery for colon cancer, requiring a new level of care and medical coordination.
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Because his parents have been divorced for decades, he and his sister, Bethany, have been managing two separate care plans while balancing demanding careers. Falter turned to a local life-care management practice, LionHeart Eldercare & Consulting, which helps his family navigate the maze of medical decisions, coordinate care and advocate for his parents.
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"They let you keep the relationship you want with your parents and take care of the health care bureaucracy that is so confusing,” he says.
What geriatric care managers do
These professionals act as advocates and guides for family members who want to ensure their loved one is in the best possible hands, and they generally serve clients and families whose incomes are too high to qualify for publicly funded services.
They go by different titles — most commonly geriatric care managers, eldercare consultants and, for those who are members of the Aging Life Care Association, aging life care managers. Usually licensed nurses, social workers or therapists trained in caring for older adults, they generally serve clients and families whose incomes are too high to qualify for publicly financed services. These clients often reach out in times of crisis, “when a diagnosis or complex medical situation has turned their world upside down,” says Nina Herndon, president of the Aging Life Care Association in Tucson, Arizona. “Our purpose is to bring calm to the chaos.”
Establishing a human connection with both the family caregiver and their loved one is one of the most important parts of a care manager’s job. An in-person assessment gives them the opportunity to observe the home environment, understand family dynamics and identify potential problems that might not come up during a phone call or video visit. They may notice loose rugs that increase the risk of falls, unopened mail piling up, an empty refrigerator or subtle signs that memory or mobility has declined. Those observations help ensure families hire the right type of help rather than paying for services they don’t need.
"A lot of families will say: ‘We need to hire a nurse for mom.’ I always stop and ask them why they think that,” says Colleen Duewel, founder of LionHeart Eldercare & Consulting in Falls Church, Virginia. “Maybe they don’t need a nurse, which will be costly over time. Instead, maybe the individual needs a personal companion to spend time with them and ensure they are safe.”
Along with assessments, other care management services may include:
- Evaluating, arranging for and monitoring hired caregivers, such as home health aides.
- Coordinating medical appointments and arranging transportation.
- Identifying social services and programs that could help the care recipient.
- Making referrals to financial, legal or medical professionals and suggesting ways to avert problems.
- Conducting home safety inspections to help identify potential hazards and suggest modifications.
- Explaining complex or difficult topics to care recipients and their families.
- Creating short- and long-term care plans that could include assisted living or nursing homes.
- Coordinating hospital discharge plans to return home or move to a rehab facility.
- Acting as a liaison to families who may be hundreds of miles away.
- Answering questions and addressing emotional concerns of caregivers and their loved ones.
- Arranging for relief or respite care for stressed-out caregivers.
“We’re the project managers for care. We start by asking what’s important to the caregiver, and then we bring together all the right professionals and make sure everything works together,” says Duewel. “Our specialized experience and local connections can speed families through the roadblocks they often encounter.”
Count on paying out of pocket
Professionals charge by the hour, ranging from $150 to $300, depending on the geographic region. Many begin with an initial assessment of 4 to 6 hours, which may require a one-time charge. Some also charge for mileage and travel time. Be sure to review these billing details and get them in writing before you agree to the services.
Al Whitney, 77, budgets $650 to $900 a month for care management services for his wife, Sue, who has dementia. He realized he needed help after two years of caring for her at home and her condition had progressed, making it difficult for him to manage alone. With guidance from life care manager Jennifer Crowley, he transitioned Sue into a memory care community near their home in Kalispell, Montana.
Crowley and her team provide social health engagements, where a specially trained staff member visits twice a week to take Sue on outings, such as visits to nearby parks, a cat shelter and local shops. Crowley also coordinates appointments with specialists and visits her regularly to check on her — keeping Whitney involved in her care but lightening his caregiving load.
“Jennifer knows how to take care of both the person with dementia and the caregiver,” says Whitney. He felt good that Sue was getting the care she needed, he adds, while he “got the time back to take care of myself again.”
Neither Medicare nor Medicaid typically pays for care management services. Long-term care insurance may cover some of the costs of care coordination, but most private insurance policies, including Medigap and Medicare Advantage plans, do not.
Employee assistance programs may cover some care management fees because the services can help family caregivers stay focused on their paying jobs and miss less work time.
9 questions to ask before you hire a care manager
Be clear about your expectations when hiring a geriatric care manager. That starts with asking the right questions, including:
- Resources: What care management services does your company provide?
- Size: How many care managers do you have on staff?
- Qualifications: What credentials and professional licenses do you and your managers have?
- Longevity: How many years have you been providing care-management services?
- Initial costs: What fee, if any, do you charge for an initial consultation?
- Continuing costs: What are your ongoing fees, and may I get them in writing?
- Communication: How will you keep in contact with us?
- Flexibility: What happens if my family member has an emergency? Will you be available?
- References: Who has used your services, and may I contact them?
Source: Aging Life Care Association
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