by John O'Neill Attorneys who deal with elders through family law or estate planning often find that the elder presents a wide array of concerns that go far beyond issues of law. In fact, as the population in America lives longer, more people face confusing and difficult decisions about how to age safely and with dignity.
Most families are unaware of the many resources that are available and/or do not know how to access those resources. Families struggle over what to do when a parent becomes frail. They have to juggle work, children and other responsibilities in order to help solve their housing problems, attend conferences with physicians and deal with needs like grocery-shopping, house cleaning and making sure the bills get paid. The stress can often be overwhelming.
A new service has emerged over the past several years to help seniors and their loved ones navigate the eldercare options available to them. This service is known as geriatric care management. Geriatric-care managers may work independently or as part of a larger human services organization. They should be licensed social workers, nurses or mental health therapists.
Individual care managers and care-management organizations vary in the services they offer. Services can include assessment of needs, counseling and caregiver support, and coordination of activities of daily living such as personal care, transportation, shopping, laundry and escort to appointments. They can also find and oversee the construction/implementation of home adaptation; assist with the assessment, selection and transition to alternative housing; access eligible benefit programs; help select and coordinate healthcare and mental health services; and monitor the quality of short-term and long-term care provided to the senior.
Attorneys looking to recommend a geriatric-care manager to clients should ensure that the care manager is fully licensed and insured. They should also have extensive knowledge of and experience in the delivery of aging-related services and have access to detailed, wide-ranging databases. It is also extremely important that they have solid relationships with back-up services, such as nursing, social services, and nutrition programs. Attorneys should also ascertain that the individual or organization has no financial interest in the services recommended so that the care management organization will provide their clients with an objective opinion that is experience-based and tailored to each client's needs
The ability to recommend a quality care-management service to a client can help attorneys know that their clients are receiving all the services they need.
For example, when the elder father of a family in Newton died suddenly, the adult children worried about their mother's ability to live independently. Their mother, who is 90 years old, suffers from cognitive difficulties and inability to manage her affairs. The family was concerned about her ability to cook meals and manage the numerous medications she takes for high blood pressure, heart condition and osteoporosis. Two of the adult children live out-of-state and the one in-state son and his wife both work full time. In addition the in-state son's work routinely takes him to Cape Cod for several days at a time. The family was unsure where to turn.
They were referred by a hospice worker to an aging-services organization that offers geriatric care-management services. At a family meeting that was arranged quickly so that the out-of-state children could attend, the geriatric-care consultant was able to do a full assessment of the elder, determine her level of independence, outline options for addressing problem areas and explore means to allow her to remain independent in her own home.
"The service we received was outstanding. It was the single most important service we received at that time. We had no idea how to proceed and in just a few short days, the geriatric care consultant solved the problem of how to care for my mother. Besides recommending a course of action, the care consultant arranged for services to be provided in my mother's home," says the son. "This service helped Mom maintain her dignity and brought us peace of mind." John O'Neill is on the Board of Directors for ACCESS Community Care, Inc., an affiliation of 27 community-based home care agencies with more than 25 years of experience in managing services for seniors. ACCESS offers geriatric care management through its ACCESS Senior Options program.