Introduction
First of all, let’s deal with the name itself, “Geriatric Care Management”.
To tell the truth, we don’t really like the term “Geriatric Care Management”. After all, what client wants to be thought of as:
- Geriatric?
- Needing help?
- Needing to be managed?
However, for now the term is what everyone calls it, so we’ll use it. Perhaps some day we’ll find a better term for this profession. For now, we’ll forget about the name and talk about what it IS.
So, What Is Geriatric Care Management?
Geriatric Care Management (often referred to by its acronym, “GCM”) is a set of services performed by trained professionals, usually social workers or nurses. Those services include, but are not limited to, the following:
- Assess the care needs of older adults and their families by conducting a geriatric nursing assessment.
- Create care plans for the acquisition of services to take care of those needs, subject to agreement by family members or trusted advisors such as elder law attorneys or trustees.
- Implement the care plans.
- Advocate for clients when needed, which often occurs when other service providers or are unresponsive,
- Monitor the results and make changes as needed, and,
- Report as required to family, referral sources, and other authorized persons.
This series of steps all sounds very tidy and orderly. Actually, it almost never happens that way in real life.
In fact, most GCM cases begin with some acute problem or crisis which requires immediate fixing and action.
After the acute problem is solved, in most cases the family chooses to have the GCM continue to be involved to monitor the client’s status and needs on an ongoing basis. Sometimes, the client’s family or friends resume control of the day to day care needs of the client and the GCM is not involved after that unless a new problem arises.
Most GCM clients are older adults who live within the GCM’s service area and whose family or friends are either:
- Not living nearby and therefore are not able to help as much as they would like to, or
- Working full time and therefore not able to help as much as they would like to.
The family or friends ask the GCM to begin providing GCM services to solve the acute problem, if there is one, and then to monitor and provide “family assurance visits and reports” on a periodic basis if they so desire.
Advocacy
Note number 4 in the list above, “Advocate for the client when needed, which often occurs when other service providers are unresponsive”. Although this may not sound important, it can sometimes be critically important when considering the needs of elderly persons.
Many seniors are too “polite” to be assertive and insist upon the service and attention to which they are entitled. This often occurs in medical settings where the staff is overwhelmed with large numbers of patients and demands for their time.
It can happen in other contexts as well, such as when dealing with insurance companies or governmental agencies, where the staff attends to the needs of the “squeaky wheel”. This outcome may not be intentional, but it nonetheless does happen and results in the senior being marginalized and the senior’s needs being neglected.
An experienced professional GCM is able to recognize such situations. The GCM can take charge and solve the problem. When we say, “advocating for the client”, that’s what we mean.
Should You Wait Until A Crisis Before Contacting A Geriatric Care Manager?
No! Many times, that is what families do, but, No!
When a situation reaches the crisis stage, it may be impossible to completely undo the damage that has been done. For example, it may be difficult or impossible to overcome or recover from for the effects of:
- Falls
- Inability to call for help when needed
- Changes in condition that are not detected promptly
- Theft by dishonest friends, family members or caregivers
- Accidents arising from driving when the person is no longer safe to drive
Even if the physical effects of some problems can be reversed, the emotional and financial consequences are often never completely overcome.
Therefore it is best to anticipate problems and avoid them or plan for them before they occur. This is exactly what we mean by “assessing care needs” and “creating a care plan”.
How is Geriatric Care Management Paid For?
Most GCMs charge for their services on an hourly fee basis. Usually, GCM services are privately paid for “out of pocket” by clients and their families, because they are not covered under health insurance or Medicare. In some cases, long-term care insurance policies may cover part of the cost of GCM services, but that is not always the case.
Summary
Professional GCM services can be a valuable source of help for both crisis resolution and for ensuring that the long-term care needs of older adults and their families are taken care of in a thoughtful and thorough manner. Professional care managers who are experienced and educated in the needs of older adults can help families anticipate and avoid breakdowns and minimize costs of care through needs assessment, planning and monitoring.
We welcome the opportunity to help you and your loved ones within our GCM service area, which is North San Diego County. You can find out more about us by visiting our website at A Servant’s Heart Senior Care.