January 9, 2007

Aging Connection

Care managers can be invaluable intermediaries between
elderly and their caregivers and the services they need

By Vivian I. Silva
MSW/Gerontologist
Special to the Times

A son comes home for the holidays to find his mother needs full time care but her funds are dwindling. His time is limited because he has to go back to work on the East Coast, but he wants to help his mother remain at home for as long as possible. He worries, what if he has to leave before all the resources are in place?

A daughter panics because the hospital plans to discharge her father and she is handed a three-page list of home care agencies. Where does she start?

If you are asking yourself the following questions, a geriatric care manager may be the answer:

If you are the person in need of help:

- Where do I find someone to help me with bathing and cooking?
- Where can I find someone to install a grab bar for my bathroom?
- My children want me to live with them out of state, how to assure them I’m fine where I am?
- Should I move to a retirement home?
- When is it time to go to a nursing home?

If you are the caregiver:

- My husband is getting forgetful; does he have Alzheimer’s disease?
- Are my parents safe at home?
- Are my parents’ health concerns taking me away from my family?
- What kind of help would increase safety while maintaining my parent’s dignity and independence?
- Are my mother’s bills being paid on time?
- My siblings are in denial about my parents need for care, who can we talk to?
- How can I find help for my father when I live so far away?
- Where do I find a caregiver support group?

A geriatric care manager is a health and human services professional. They can be a geriatric nurse, social worker, or even a psychologist with a specialized focus on issues related to aging and elder care.

Care managers can be described as problem solvers. Whether a one time consult or a long-term advocate, they know the resources in the community. And, they are a resource regarding various aging issues.

Sometimes a one time consult helps to clarify the issues, concerns or provide adequate resource information. But, many times, long-term care management works best.

One of my clients, for example, didn’t have any adult children living nearby. The children engaged my services because they wanted someone to be an advocate for their parents with their hospital plan and any physician contacts. They wanted me to oversee their move into a retirement facility as well.

Another client’s dementia progressed and the daughter didn’t want her father living alone so we met to discuss a plan and resources to keep her father eating, safe and to help prevent him from getting lost.

Long-term care management usually involves five components. A brief description of each follows:

- Assessment: compiles an assessment of the older person’s needs and situation. This involves a holistic approach by examining the psycho-social, economic, spiritual and environmental needs of the individual.

- Care Plan: provides a ‘plan of care’ with specific recommendations and, when needed, encourages the person to accept help. Often this stage includes discussion of what the care manager sees as an option, which might be different from what the person or family member sees as a need.

- Linkages: finds and secures services such as legal counsel, home maintenance or home care. If the person is unable to follow through with telephone calls, for example, the care manager will do this for them.

- Monitors: once services are in place, sometimes there is a need to check to make sure the services are working, appropriate or if the situation changes all is in place. Counseling and supporting family members during this time may be necessary.

- Termination: when services are no longer necessary, termination may be agreed upon. A person’s ability to handle their own care may improve so they no longer need an advocate, or perhaps they’ve moved out of the area.

Geriatric care management is a growing field and an important one. Many clients state how relieved they are to have found someone to talk to about aging issues or their loved one’s care.

When I speak in the community about my work, some have said, “I wish I would have known about you when I was caring for my mother!” Help your friends and family by educating them about geriatric care managers.
Services and fees (include a sliding fee scale) may be discussed in my office or on the phone. Consults are available in my office or in the client’s home. I look forward to answering your questions.

Happy New Year and look for the announcement regarding the next caregiver support group.

Vivian I. Silva, Gerontolo-gist / MSW is the director of Geriatric Advisory Program at Almaden Valley Counsel-ing Service. The service educates and advises adult children and elders on aging issues and provides individual and family consultation. For more information call (408) 975-2988 or e-mail vivsilva@aol.com.