One potential downside of care management is the cost.  Geriatric care managers charge between $80 and $150 an hour, so over time the costs can add up significantly.

Long-term care insurance policies often cover the costs of a geriatric care manager, but Medicare does not.

Despite the price Jan Collins, a South Carolina attorney who specializes in elder law, frequently recommends geriatric care managers to his clients.  "Dealing with the elderly is a multidiscipline event," he says.

He points out that a care manager may actually save money by connecting families to useful community resources, including free ones, and steering them away from expensive living arrangements where fees may quickly rise without warning.  "[Families] who have the least," Collins says, "have the most to lose."

EARNING TRUST IS KEY

For a geriatric care manager, "the most important job is to develop trust in the relationship," says NAPGCM's LaBier.  As an example she cites a retired physician she cared for.

Accustomed to controlling every aspect of his life, the doctor had retreated at age 94 into a life of "sitting in his sunroom watching the grass grow," LaBier recalls.

He was also trying to care for his wife, who had dementia.  Bills piled up on the dining room table, no one made meals and their home was a mess.

Furthermore, LaBier says, "stockbrokers were churning him left and right," talking him into buying and selling stocks at an alarming clip.

The couple had outlived their children and had no relatives nearby, but a nephew in Germany discovered their situation and hired LaBier.

Suspicious at first of LaBier, the physician eventually allowed her to bring in help to clean up the kitchen and cook some meals.  She gradually persuaded him to deal with the bills and call the investment firm that was hounding the doctor to report the broker.  The doctor was able to fulfill his wish of staying in his own home until he died.

Unfortunately, it's usually a crisis—a broken bone, a hospitalization—that prods families to plan for elder care.  Care managers say they are having some success, however, in getting families to have a plan before a crisis develops.

The NAPGCM reports that even retirement-age people who are still healthy are arranging for their own eventual care needs so their younger relatives won't have to.

Article By: Linda Greider
Published in: AARP, December 2001, Vol. 42 No. 11, Washington D.C. p 9-13.