The inevitable question I am asked when I speak to a prospective client is “Doesn’t Medicare pay for that?!” In an ideal world it would. But the reality is different, as there are clear limits on what Medicare will pay and how much Medicare will pay.
For example, estimated for a typical live-in caregiver is at $275 per day. If care is needed during the hours of sleep, you then need 2 – 12 hour shifts which are estimated at $500 per day. Roughly $180,000 per year. Unsustainable for most.
The answer to this problem is “Long Term Services.” Which are paid through one or more of these possible sources: 1) personal savings 2) support from family 3) privately purchased long term-care insurance and/or 4) Medicaid for those with limited income and assets. But a client
needs help in navigating and managing all of these options. The solution is a Geriatric Care Manager.
What is a Geriatric Care Manager?
A Geriatric Care Managers are health care professionals with a background in nursing, social work, gerontology or psychology who specialize in elder care issues and are trained to help family caregivers by:
- Assessing the particular needs of a family, the level of care needed, and the living
- situation;
- Helping the family and client navigate the medical system; and
- Planning and supervising care, among other services.
Successful care coordination maximizes the use of medical care, resources and community services. Medication management, home visits, care giver education/support and use of technology are all key factors to reduce exacerbations of medical issues, improve outcomes while reducing overall costs. Hiring a Geriatric Care Manager – either for a one-time assessment or for ongoing support – will lower expenses in the long run by helping the client plan and avoid unnecessary or expensive decisions.
It starts with working with your Geriatric Care Managers during an initial assessment to evaluate your immediate, short term and long term needs. As a community-based leader, Geriatric Care Managers are knowledgeable about needs, community resources, health care providers. From the assessment comes a rational plan that puts the person needs, values, and preferences first.
Case Review 1:
Ben and Margaret have been married for 55 years. Hard working, frugal people, they never saw the importance of purchasing Long Term Care Insurance. Ben was diagnosed with Parkinson’s 5 years ago. All along they have been managing Ben’s care needs with some supplemental caregiver help. Margaret feels she is the only one who can properly take care of Ben. Unfortunately, Margaret’s memory has been failing lately and she is finding it difficult trying to keep up with their needs. Appointments are missed, medications have not been refilled, and the home is in disrepair. Margaret is still driving.
In a Geriatric Care Management Assessment we would create a plan that works with both Ben and Margaret. Assisting with medication management, coordinating medical appointments and caregiver schedules to maximize hours with safety needs.
Case Review 2:
Susie and Irv have been married for 15 years. Second marriage for both. Through the course of time, Susie has had 3 back operations that have left her legs weak, resulting in several recent falls. Subsequently, Susie takes multiple pain medications that have altered her personality. After a particularly difficult day Susie’s behavior became erratic… she was Baker Acted. It is stated by the medical professionals that for Susie to go home she will need 24 hour supervision and medication management.
As a Geriatric Care Manager, we would advocate for Susie throughout her hospital stay. Transition home with the right team of caregiver’s and medication management for a successful outcome.
Conclusion
Geriatric Care Managers improve health, functional outcomes and provide financial savings.
Without accessible and appropriate Long Term Care Services to meet daily living needs, chronic health conditions can worsen and create a spiral of functional decline.
Why Bridge Long Term Care Planning and Geriatric Care Management? By assembling your team of professionals that include a Geriatric Care Manager, along with medical care professionals, a Financial Planner and legal counsel, you create your specialized plan that works for you and your family.
Be Proactive. Not Reactive.
Karen Partelow founded Hired Hearts, Inc., a Geriatric Nurse Care Management and Nurse Consulting service 18 years ago. She recognized the many gaps in care for our most vulnerable citizens and since then, has helped improve the quality of life for many in southeast Florida. Karen has lent her considerable experience to the industry as the recent Florida State Guardianship Association President, as well as serving six years as the President for the local Palm Beach County chapter. Karen is nationally recognized, having served as the Co-Chair of the NGA conference and FSGA Annual Conferences 2010, 2012, 2013 and 2015. Karen is also a Certified Examining Committee Member for the State of Florida.