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What to Do When a Senior’s
Care is Too Much for the Family
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Families who are dealing with a senior loved one’s chronic care needs
are constantly tested in their resolve. It takes a special person to
continuously provide care and find resources for support while also
managing their own responsibilities. Often it is an adult child who is
charged with this task and often that adult child has a family and job
of their own to contend with as well.
Additionally, emotions can run high for the senior and the family
members involved in the decision-making. Determining the best course of
action can be challenging in this situation. Researching and locating
appropriate care options, and then agreeing on which route to take, can
create a lot of tension between family members. The decisions that need
to be made are usually tough. It can be difficult for an adult child to
be in the position to parent a parent and make decisions in their best
interest. To counter that, senior parents may not like that their
children are telling them what they need to do. If cognitive impairment
is involved, the discussions go down a very complicated avenue to
solidify the appropriate care and find agreeable solutions for all
parties.
A solution that can ease the stress for the whole family is enlisting
the guidance of a professional who is trained and perhaps even
certified to work with seniors and their families in a health and human
services role. Families are busy and can often overlook or
misunderstand the extent of the available resources that can combine to
provide a solid plan for care and support. A professional can help a
family make sense of these available resources. This third party
presents a professional view of the situation and frequently helps
diffuse the high emotions and stay on track for finding a solution.
These professionals are focused on helping seniors and their families
access resources and care. The need for these senior care professionals
has paralleled the explosion in the senior population and will continue
to grow in the coming decades as Baby Boomers age into senior status at
the rate of 10,000 per day. They have different titles and vary in
their level of training and certification. While many titles exist for
this type of professional, two common professionals who practice these
types of service are:
Geriatric Care Manager (GCM) – The GCM is trained and carries a
specific certification. Work experience of the GCM will include any of
several fields related to care management, including, but not limited
to nursing, gerontology, social work, or psychology, with a specialized
focus on issues related to aging and elder care. They assist older
adults and persons with disabilities in attaining their maximum
functional potential. In addition, the GCM is an experienced
guide and resource for families of older adults and others with chronic
needs, including helping those suffering from Alzheimer’s Disease or
Parkinson’s or exhibiting symptoms of dementia ( www.caremanager.org).
Patient Navigator (PN) – The role was originally created to assist the
poor, uninsured, and those with low literacy levels, but has developed
to now include helping patients who find the healthcare system
confusing or who are dealing with complex health issues such as
diabetes or cancer. The responsibilities may involve coordinating
doctors' visits, maintaining telephone contact between patients and
physicians, arranging rides to and from the hospital, helping with
insurance forms, and even suggesting what to ask at your next
appointment. PNs can be former nurses, social workers, or community
health workers. There is no formal training or certification for this
category of care assistant. Generally a PN has work experience in a
related field such as social work or healthcare
administration.
Services that Senior Care Professionals provide include:
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Conduct care-planning, in-person
assessments to identify problems and to provide solutions.
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Make a care plan.
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Screen, arrange, and monitor in-home
help or other services, including assistance in hiring a qualified
caregiver for home care.
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Provide short- or long-term eldercare
assistance for those engaged in local or long distance caregiving.
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Review financial, legal, or medical
issues and offer referrals to geriatric specialists.
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Provide crisis intervention.
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Act as a liaison to families at a
distance, overseeing care, and quickly alerting families to problems –
especially important when families are engaged in long distance
caregiving for a loved one.
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Assist with moving an older person to
or from a retirement complex, assisted care home, or nursing home.
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Provide consumer education and advocacy.
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Offer eldercare counseling and support.
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Arrange services for crisis
intervention; educate consumers on options for senior housing, power of
attorney, and guardianship money management; and provide referrals for
family or individual therapy and/or caregiving support services.
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Monitor the services and arrangements
that have been made and conduct periodic re-evaluations to see if any
adjustments are needed.
Sources: National Association of Professional Geriatric Care Managers,
2011, www.caremanager.org and Alzheimer’s Association, 2011,
www.alz.org
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More About
Care Management Professionals
Geriatric Care Managers (GCM)
– They are certified through various programs. Universities and other
organizations offer senior care focused education that can supplement a
career in those areas or stand on its own as a specialized
career. The GCM certification may include but is not limited to
these certifications:
Certified Geriatric Care Manager (CGCM)
The National Association of Professional Geriatric Care Managers www.caremanager.org Care Manager Certified - CMCNational Academy of Certified Care Managers (NACCM) (800) 962-2260 www.naccm.netCertified Case Manager - CCMCommission for Case Manager Certification (CCMC) (651) 789-3744 www.ccmcertification.orgCertified Advanced Social Worker in Case Management (C-ASWCM) www.socialworkers.org Certified Social Work Case Manager (C-SWCM)* National Association of Social Workers (NASW) (800) 638-8799 ext. 409 www.socialworkers.org/credentials
Patient Navigators (PN) – They are employed by hospitals and public agencies and other organizations like cancer centers. Many
hospitals in the U.S. and Canada employ navigators to help patients
manage their hospital stays. The National Institutes of Health is
funding several Patient Navigator pilot projects across the U.S. in
underserved and minority areas. (www.patientnavigator.com).
The National Association of Healthcare Advocacy Consultants (www.nahac.com)
is another organization that is interested in promoting the wellbeing
of the public through healthcare advocacy. Its members represent many
fields of experience and training, but all have the goal of ensuring
consumer protection through development of professional standards and
best practices.
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The Tipping Point
Guidance by a GCM or PN can make all the difference during very
challenging health issues and transitions for the senior and the
family. The point at which a person realizes he needs help managing and
providing the care for a loved one is often not the same point at which
that person actually begins working with a senior care manager. Most
often, families realize their need for this type of professional help
far after they have reached their own limits. Families who are out of
state will pursue professional assistance sooner than families who are
in the same community as their senior loved one because they are not
there to provide any of the care themselves. Families often bring
senior care professionals into the picture out of necessity, and
sometimes exhaustion.
A couple of considerations help to quantify that tipping point for your
family:
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Are the problems and care needs of
your senior loved one becoming larger and more complex than you and/or
your family can manage?
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Do you have the time, inclination, or
skills to effectively manage the challenges of the necessary geriatric
care?
If you are not sure, you can always ask for a consultation first before
fully enlisting the services of a GCM or PN. Evaluation services are
also part of this professional’s offering. He or she can come into the
senior’s home, observe, and assess the needs and available support for
that person. Getting an evaluation and a complete report with
recommendations for appropriate care moving forward may be all that a
family needs to regain control and embark on a more directed path for
helping the senior and the family.
Researching a Senior Care Professional
Of course, before working with a professional in this field, you’ll
want to get to know that person by asking good questions from the
start. It is a good idea to ask for references and follow up by talking
to those references. Start with this list of questions:
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What are your professional credentials?
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Are you licensed in your profession?
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Do you have special training in aging,
geriatrics, or related senior areas?
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How long have you been providing care
management services?
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Are you available for emergencies?
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Does your company also provide home
care services?
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How do you communicate information to
me?
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What are your fees? (Provided in
writing before services begin.)
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How do you bill – monthly, weekly?
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How often do you re-evaluate the
situation?
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Can you provide me with references?
The cost of these professional services varies by offering and by
geographic area. Depending on the size of the job, some will provide an
hourly rate while others my offer a contract rate. While some public
agencies and hospitals may provide the assistance of a care manger,
Medicare, Medicaid and health insurance policies do not cover the fees
associated with this kind of assistance. Any fees related to working
with a professional with this training fall under the private pay
option. Families are typically responsible for all costs. The
specialist you decide to work with can help outline the cost related to
the services provided and help figure out the best way to provide
affordable services for your specific situation.
These senior care specialists pave the way for seniors and their
families to positively manage chronic care issues and provide comfort
in knowing that their senior loved one is receiving the best possible
and most comprehensive care available. Families receive benefit in the
form of compassionate and personalized service that focuses on the
individual’s situation, care that is accessible 24 hours a day, and
continuity in care management by an expert. Ultimately, families are
relieved of the burden and daily stresses of providing care.
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