On a Monday night in late January, Michael Mann, who lives three hours away from his father, got a call every child with an elderly parent hopes not to receive. His 82 year-old father, who suffers from dementia and other medical problems, had fallen outside his home and was being transported to the hospital by ambulance.
Ordinarily, Mr. Mann would be worried that he couldn’t get to the hospital quickly to talk to his father’s doctor and hospital staff. Instead, he was reassured that his father would not be alone because, on a recommendation from his father’s physician following a previous hospitalization, he had hired a care manager. The geriatric care manager would meet Mr. Mann’s father at the hospital and take control of the situation, ready with medical history and the patient’s medication regime. The care manager would also act as a familiar person, providing company and comfort for the elder Mr. Mann until his son could arrive.
The National Association of Professional Geriatric Care Managers defines a care manager as “a health and human services specialist who assists families caring for older relatives.”
The geriatric care manager is trained and experienced in any of several fields, including but not limited to nursing, gerontology, social work or psychology, but with a special focus on issues related to aging and elder care. Increasingly, physicians and other health care professionals are recommending geriatric care managers to allow patients to stay in their home environment for as long as possible, while alleviating many of the challenges for family members that come with caring for an ailing loved one, especially from a distance.
The process takes organization and teamwork and entails calling on family members, using community resources and support and communicating with a long line of medical and legal professionals. Often, people find that the tasks and problems they encounter are more than they can comfortably manage and their other responsibilities interfere with the level of care or supervision a family member or loved one needs. And since these concerns aren’t limited to the geriatric population, care managers serve other medical populations as well.
A care manager initially provides a full assessment of the client’s status, identifying problems and developing a plan of care in conjunction with the patient, his or her physician, family and any other members of the health care team.
The care manager oversees the plan of care, implementing and monitoring services related to medical equipment, therapies and skilled facility and rehabilitation placements. The care manager can offer referrals to geriatric specialists, accompany the patient to doctors’ appointments and provide ongoing education related to the patient’s condition, medication regimen and physician care plan. The geriatric care manager is usually very familiar with resources within the local community and/or resources specific to a disease and can assist with Medicare and Medicaid issues and/or direct clients to appropriate resources for financial assistance for which they might qualify.
As an acting liaison to physicians and other members of the health care team, the care manager alerts families to problems — a particularly important link when family members live at a distance. The manager also monitors and reassesses the care plan regularly to ensure an optimal outcome for the client.
When choosing a care manger, ask about past experience and request references from prior clients. Be sure the care manager is properly certified to ensure they have the necessary skills. You can contact the National Association of Professional Geriatric Care Managers at www.caremanager.org for additional information. The website has a locator that can help you find a case manager in your area. An additional resource is the Case Management Society of America at cmsa.org.
Caregiver overload is a pressing issue today, particularly common among the sandwich generation — those caring for both their own children and aging parents. The stress of demands can lead to depression, anxiety and feelings of guilt as caregivers try to balance care for their own families and the loved one in need. In today’s environment, there’s no need to go through caregiving alone. Consider joining a support group, asking family members for assistance and/or hiring a case manager.
Julia Graziano is a registered nurse with a degree in case management and is a certified case manager and president of Care Management Associates in Southold.