It’s a familiar story: Mom and dad are in their eighties and everyone is worried. Mom’s been caring for dad’s illness for the last three years, and it has put her in the hospital with pneumonia. She believes she can still do it all, but just doesn’t remember things well enough to be safely left in charge at home. Now the children are taking care of both of them while juggling jobs, their kids, and their homes. Perhaps, very soon, one or both of them is going to need lots of care, and you, their caregiver, are going to need a clone! Suddenly, you realize that you have no idea how they’ve planned – financially, legally, or emotionally – for their twilight years. The planning falls to you, and you are caught not knowing where to turn.
Almost without notice, there have been vast upheavals in the health care system, especially when it comes to long-term care. Hospitals, nursing homes, home care agencies, rehabilitation centers, assisted living facilities and hospice programs have been struggling to keep up with the pressures of managed care and government cutbacks. In the past, families received lots of help from hospital social workers, discharge planning nurses or home care assistants. Recently, these positions have been reduced, and the effect has been the loss of comprehensive planning assistance for families and follow-through services for older persons discharged to home. At the same time, the numbers of those people aged 65…75…85… have dramatically increased, and this trend will continue for 30 more years.
If there is one bright side to all of this, it is that the lack of help at the time of crisis has caused some forward-thinking families to plan sooner. Word is getting out that the “system” is flawed, and that early financial and legal planning for long-term care pays tremendous dividends.
This is also where the value of a Geriatric Care Manager (GCM) becomes apparent. In consort with the attorney and the physician, the professional Geriatric Care Manager conducts a highly skilled clinical assessment of the long-term care needs of an older adult. This includes consideration of all financial and other resources available to sustain an older person at the highest possible level of independence. After a thorough assessment, care management is coordinated by the GCM.
Very often, anticipating guardianship issues and loss of cognitive capacity are paramount in managing the long-term care needs of a loved one. Geriatric Care Managers work with attorneys specializing in Elder Law to avoid guardianship altogether, by compensating for loss of capacity with proper planning documents. Professional Care Management includes coordinating home care services via agency or private arrangements, medical and psychological services, and physical supports such as assistive devices, home modifications, transportation etc. The goal is to prevent, through early intervention, any further deterioration, and to relieve the burdens of caring by family members. By working closely with the attorney, the transition from facility to home and the establishment of eligibility for insurance or government benefits is seamless, quick, and less costly. Families are able to shelter a lifetime of hard earned assets, control long-term care costs, minimize risky home care situations and improve the quality of life for all concerned.