WHAT ARE GERIATRIC CARE MANAGERS?
· Relationships in Jim’s close knit family were frayed. They all cared about their ill father, but disagreement over his care was creating conflict and factions among his siblings. They all wanted the “best” for their dad, but misunderstandings created struggles and arguments about what was “best.”
· Martha’s mother-in-law was increasingly reclusive and forgetful. She pinned her clothes to fit her shrinking frame and her home was cluttered and dirty. While her mother-in-law accepted Martha’s help and increasingly relied on it, she denied any need of assistance and refused outside help. Martha was doing all she could do, but it wasn’t enough. She was exhausted and frustrated.
· Ron called his attorney when his sister put his mother in a facility. “Mom doesn’t want to be there. She calls me every day begging me to get her out. I don’t see why she can’t be at home where she wants to be.”
While these situations vary, a common awareness is “we can’t do this alone.” Geriatric care managers are increasingly called upon to help families and professionals who are struggling with complicated care situations, from resistant elders to feuding families.
What are Geriatric Care Managers?
Geriatric Care Managers (GCM) are health and human service professionals, such as a registered nurses or social workers, who have specialized knowledge and experience in the field of gerontology or geriatrics and disability. GCM serve as consultants to guide families and advise professionals.
Who Needs a Geriatric Care Manager?
Individuals call upon a GCM when a care situation requires more time, skills and/or resources than they possess or can offer. Some are in crisis due to a life threatening diagnosis; others need help to resolve conflicting interests among family members.
Common instances include:
· an only child who has little or no family support
· a family with limited time to understand and explore available resources
· “burn out” because of multiple medical or emotional issues
· dissatisfaction with a current care situation
· confusion about solutions when mom and dad have different or competing needs
Why a Geriatric Care Manager?
A professional geriatric care manager offers expertise to families to help them understand and respond to the complex care needs of older adults who are facing chronic and often lingering illness.
The level and extent of a care manager’s involvement is determined in partnership with the family and tailored to the needs of the particular family situation. Services may be limited to a one time consultation to help prioritize issues and develop a plan for care or a GCM may be involved over the long term to select and direct caregivers; coordinate medical care and make adjustments in care as needs change; and provide education, counsel and support.
The Geriatric Care Management Process
Typically an initial meeting involves designated responsible family members and the older adult in their home environment. The meeting serves to establish a sense of trust with the older adult and to make an assessment of the living situation and the particular needs of the older adult. The assessment will provide a “soup to nuts” review, including physical and emotional health, housing needs, family and community resources, financial status and legal considerations. A care plan is then drafted that includes a comprehensive review of the current situation and specific recommendations.
Recommendations may include specific services, such as adult day care; facilities, such as nursing homes or senior housing; or providers, a physician or therapist. The recommendations often include specific behavioral approaches to take to avoid and/or deal with resistance and conflicts.
Once the assessment is completed, the care manager may direct and coordinate care. Their roles and responsibilities can include:
· find and supervise in-home care givers
· oversee and adjust care plans as needs change
· make regular nursing home visits to provide input into and review of care
· consult with medical and other providers to ensure sound communication and coordination of care
· oversee a move from home to another setting or vice versa
· offer education and counseling to resolve family conflicts or resolve life losses
· educate family members on how to negotiate the health care and legal system
The involvement of a geriatric care manager can bring families, services and providers together to ensure that the needs of the older adult are addressed with expertise and compassion. Care of an older adult can be a satisfying, life giving experience when resources are used properly. The use of a geriatric care manager can replace frustration and fear with peace and pleasure in caregiving.
Signe Gleeson, R.N.C., M.S., C.C.M., R.G. is co-founder and president of ElderCare Solutions, a nurse run Geriatric Care Management company that has been serving the greater Chicago land area since 1996. For more than 30 years, Ms. Gleeson has been working with older adults and their families in hospital, nursing home and community settings.
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