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Geriatric Care Management

You may also be in need of Geriatric Care Management (GCM) for you or a loved one. Some agencies have both caregivers and GCMs while other organizations provide only care management. Starfish Resources works with some of the best GCM's in the County.

To Locate a Care Manager in Greater San Diego, call Starfish Resources at 760-522-6478 or contact The National Association of Professional Geriatric Care Managers at (520) 881-8008 or www.caremanager.org

What Is Geriatric Care Management?
By Linda Colling of A Servant's Heart Senior Care

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 care?
Needing to be managed?

Nonetheless, the term is an industry standard and so for now we'll stick with 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.
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. Occasionally, though, 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 of the situation and make sure that the client's needs and concerns are taken care of in an appropriate and timely manner. That is what "advocating for the client" means.

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.

About Us
This information was provided by:
A Servant’s Heart Senior Care< br> Office: 800-777-4750
Fax: 760-874-2870
Web site: www.TrustworthyCare.com
Email: info@TrustworthyCare.com

With A Servant’s Heart Senior Care, older adults and their families can navigate through the next steps in aging with expert care and advice while enjoying The Servant's Heart Difference.
Whether it’s providing caregivers so that your loved ones can remain at home, resolving an immediate crisis, help with finding an appropriate retirement home or assisted living facility for them, taking them to the doctor, or just providing expert answers and advice and looking in on your loved ones from time to time to make sure that they’re ok, our full-service, CAHSAH-certified company can help.

For more information call us toll-free at 1-800-777-4750 today!

How Do I Select a Geriatric Care Manager For My Parents?
By Linda Colling of A Servant's Heart Senior Care

Introduction
Why not just rely upon the government to protect us through regulation?

Most people believe that the state of California licenses and oversees professional Geriatric Care Managers (GCMs). After all, California regulates everything , doesn't it? Well, not in the case of professional Geriatric Care Managers. California does not provide any type of licensing, regulation, oversight, minimum standards, or any other sort of controls over the GCM industry.

In effect, the state is leaving it up to older adults and their families to protect themselves and leaving it up to them to think about all the right questions to ask and the things to watch out for. Caveat emptor!

In this article we'll provide information about what to look for and what to watch out for so that you can make well-grounded assessments regarding the GCMs that you select to work with you and your loved ones.

Criteria for Selecting a Geriatric Care Manager

Get a Little Help from Your Friends
Referrals from people you know are often the best starting point. If someone you know gives a strong endorsement to a GCM with whom they have worked regarding their own loved ones, that is a valuable starting point.

The Most Important Qualifications

You should look for professional GCMs who are:

Competent

They know what to do, and how to do it. That’s important in order to make sure that your parent will get the types of help that they need without mistakes or waste.

Trustworthy

They are reliable and keep their promises. That’s important in order to make sure that you can depend on the GCM to deliver the help that your parent needs, when the GCM says that it will be delivered.

These are the two absolutely essential criteria. If the GCM you choose to help your parents doesn’t meet these two criteria, you’re just wasting your time and money and putting your parent at risk.

Determining Competence
Since we don’t have licensing and regulation of GCMs in California, how can you tell whether or not a GCM has the knowledge and experience that it takes to provide excellent help to your parents? Here are some important tools to use to assess GCMs’ competence:

Education
Certification
Membership in NAPGCM

Education
Does the GCM have a college degree, preferably a graduate degree, in a relevant field of study? This is important because the GCM’s educational background should include study on topics that matter to your parents’ care needs.
Most GCMs have a masters degree in Social Work, Gerontology or similar fields involving social work and psychology because their studies in those fields prepare them to understand “the needs of the person” as a whole including psychological, health, social, financial and spiritual needs.

Note: Sometimes nurses practice as GCMs. Because nurses are not required to have a bachelor's degree, many nurses only have the equivalent of a community college “Associate’s” degree or no degree at all. If your parent has a nurse as a GCM, ask whether the nurse has a college degree and if so, what type of degree it is.

When you are considering a nurse who offers services as a GCM you must ask yourself whether your loved one’s primary needs are:

Psycho-social needs, in which a social worker might be the best choice. Examples of psycho-social needs that your parent might have include these:
- Loneliness
- Lack of socialization
- Need for advocacy such as with doctors or authorities
- Need for supervision or observation
- Care needs assessment
- Gero-psychological issues

Medical needs, in which case a nurse might be a good choice (if properly qualified with geriatric care experience). Examples of medical needs that your parent might have include disease issues and wound care.

Both needs, in which case your parent might need help from both social workers and nurse case managers. Some care management firms have both social workers nurses available so that clients have access to both disciplines.

Certification
There are several different certifications available for GCMs that are broadly recognized and accepted as authoritative. The one most widely recognized is the “CMC” certification, granted by the National Academy of Certified Care Managers. “CMC” stands for “Care Manager, Certified” and is granted after a comprehensive examination based upon knowledge of care management issues, laws and practices.
Certification is important for your parents’ sake because legitimate certification demonstrates that a third party has made a well-grounded assessment of the GCM’s knowledge and ability to provide care management services.
Membership in NAPGCM
The primary professional association for GCMs is the National Association of Professional Geriatric Care Managers (NAPGCM). If you are considering a prospective GCM who is not a member of the NAPGCM ask yourself why they aren't a member and what that says about their qualifications. NAPGCM has strict standards for membership and full members must possess at least one of the recognized care management certifications to qualify for membership.
Membership in NAPGCM matters because they have independently verified the GCM’s experience and certification and because they provide ongoing continuing education and training for GCMs. Your parents will benefit from their GCM’s having up-to-date training, information and knowledge about the ever-changing landscape of laws and technology that affect older adults and their families.

Determining Trustworthiness

There are several ways to assess the GCM's trustworthiness, including:

Experience
Client References
Professional References
Interview Impressions
Better Business Bureau Reports

Experience
How many years has the prospective GCM been working as a professional GCM? Before that, did the GCM have other experience that is truly relevant to GCM work, such as working in a hospice organization or a geriatric medical group? If the GCM has significant professional experience, they are more likely to know what to do to assess and provide for your parents’ needs and help your family.
Client References
Ask the GCM to provide at least three client references who will attest to the GCM's performance and reliability. Ask the references questions like,
- "Tell me about a time when the GCM really came through even though circumstances were difficult."
- "Tell me about the times when the GCM failed to keep the promises that he or she made to you."

By asking for references you are more likely to find out whether or not the GCM really has the experience that he or she is claiming. That way, you can make sure that the GCM that you select for your parents is going to be a good choice to help them.

Professional References
Can the GCM provide at least three references from professionals who have referred clients or patients of their own to the GCM and who are satisfied with the results?
This is important because other professionals like doctors, attorneys, fiduciaries, hospice case managers and other are very careful to only refer to GCMs who they know will do a good job. By asking for professional references you will ensure that your parents’ GCM is someone who is respected not only by former and current clients but also professionals in the community who can make well-grounded assessments of the GCM’s skill and ability.
Interview Impressions
It may be wise to conduct phone interviews with several prospective GCMs before selecting one to work with your loved ones. Most GCMs will do this at no charge as an initial consultation.

After initial phone screenings with prospective GCMs, it may be wise to conduct a final interview with your first choice in the GCM's office before committing to beginning service.

At the end of the interview, how do you "feel" about the GCM? Although this is not a precise measurement, you should ask yourself whether someone who makes you uncomfortable or about whom you have post-interview doubts is going to be the best person to trust with the care of your loved ones. Your parents’ care depends upon your making a choice that you have a real peace about.

Beware of Pretenders
One last thing to watch out for: Some companies call some of their employees "care managers" who really aren't professional Geriatric Care Managers. Often these so-called "care managers" are people who are staffing or scheduling coordinators for non-medical in-home care companies.

Scheduling and staffing coordinators are different from true professional Geriatric Care Managers, but there is currently no law preventing them from being called Care Managers in California.

When a company tells you that they provide "care managers", ask questions using the information in this article to make sure that you know what those "care managers" really will be doing. If they’re not real professional GCMs as described earlier in this article, you can’t count on them to provide excellent GCM services to your parents.

Summary
As you can see, there a re many factors to consider when selecting a professional Geriatric Care Manager, especially in a state like California where there are no consumer protection laws that apply to this type of professional service. By following the suggestions in this article, you will be able to select a great GCM to work with in protecting your loved ones and providing for their care in the best possible way.

About Us
This information was provided by:
A Servant’s Heart Senior Care
Office: 800-777-4750
Fax: 760-874-2870
Web site: www.TrustworthyCare.com
Email: info@TrustworthyCare.com

For more information call us toll-free at 1-800-777-4750 today!