GERIATRIC CARE MANAGERS:
WHO ARE THEY? WHAT DO THEY DO?

Over the past few weeks, I have been asked on multiple occasions to explain what a Geriatric Care Manager does.  Briefly, a geriatric care manager is a professional who develops and implements a plan to assist the elderly and their families with all aspects of long-term care. They often have have graduate degrees in social work and/or nursing and are certified and/or licensed.

The concept of a nuclear family is very common amongst our culture.  Families are often separated by many miles and many children find themselves juggling careers that are demanding, families, and the responsibility of caring for an aging parent. Survey after survey confirms that we are busier now than ever before.  Ideally, it would be perfect to live in a society where our parents and our elderly could be cared for easily, where extended families were in close proximity, and where both family members were not working full time. The reality is that for most of us this is not the case. There are many older people who live alone, far from children and other relatives. Even for those who live near children, family members may be working and may not be in a position to do all that is required.

When older people begin to have trouble coping with their daily lives, they often cannot turn to family members for help.  Even more importantly, they do not wish to burden those they love with their care. Under these circumstances a geriatric care manager can be crucial.

A geriatric care manager must perform an assessment and first evaluate an older person's needs, including physical and mental health, family and community resources, and medicines being used. The importance of an appropriate living environment cannot be over-emphasized. Will the client have the kind of services, companionship and surroundings that she or he wishes to have? The geriatric care manager must understand the people he or she is working with, what their values are, and come to each situation with no prescribed answers.

It is the care manager's job to make certain the client has what he or she needs to remains safe and comfortable. A plan is subsequently developed based on a close examination of a client's requirements and then implemented. Once these arrangements are in place, the care manager can coordinate all services to ensure the client's health, safety and general well being. There needs to be a continuous monitoring and re-evaluation process to make necessary changes as needed. A care manager can come in simply to advise a family on resources and help develop a plan or can come in as a long-term member of the care team.

Often care managers are brought into a situation by an adult child, spouse or other responsible person because there has been a change in health status or the time has come to plan for the future. Sometimes the older person who is aware that the daily tasks of life have become overwhelming will initiate the first call. Whether it is a bank manager concerned about a customer or a resident manager, or a lawyer concerned about his client, the first call is usually from someone who is expressing real concerns.

Developing a care plan and putting it into place can be a short-term process if there is family willing and available to do the follow-up work. When no family lives in the area, however, the process tends to be on-going. Each situation is different, and geriatric care managers are very flexible in working with individual families who have their own needs and concerns.

Families have different expectations about care managers as well.  Communication is key (as with any profession), to make sure that that expectations on both sides are met.  There needs to be a trusting relationship in order for the arrangements to work. A trusting relationship is at the core of any plan for long-term care.

Hiring someone to help look after a parent is a serious, but often a necessary, thing to do. You want to make certain that the person can be your eyes and ears, and can bring to your parent's care a wealth of resources, understanding, and compassion. A Care Manager should be willing to answer all your questions and should be concerned about the things you are. If a parent is vulnerable, everything from having valuable items in the house inventoried, and appraised, to arranging proper medical care should be as important to the care manager as it is to you. All aspects of an older person's life and well being, as well as easing the burden for family members and friends, are the concerns of a responsible and caring geriatric manager.