Geriatric Care Managers: What to expect
Prepared by:
Raymond Zakhari, NP founder of web based primary care medical house calls solutions that take the hassles out of going to the doctor.
When someone is looking for a geriatric care manager they are often left wondering exactly what is it that they are paying for? The Geriatric Care Manager can be as hands on or hands off as you would like. The easiest way to conceptualize the concept of a geriatric case manager is the following: these are the available and responsible rent an adult child to care for the elderly person who is declining in function.
The Geriatric Care Manager will check in and facilitate the incidental activities of daily living (IADLs), make sure food is in the fridge, arrange for home attendants as needed, coordinate doctor appointments, arrange transportation, serve as a point of contact between concerned family members, health care providers and other parties as needed, and develop a therapeutic relationship with the client over time. They should be able to tell you if the living situation is safe or if a change is needed as well.
Cost:
Usually this person is paid on an hourly rate much like a lawyer which can range anywhere from $75-400 per hour. Often times a retainer is paid prior to starting the assessment. A good way to help you get the most for your dollars spent is to prepare the following items listed below in a clear and easy to follow format before contacting a geriatric care manager otherwise you will have to pay for them to do it.
Financial and Legal Preparation:
- Wills up to date in state of residency
- Trusts considered
- Durable Power of Attorney of person or HealthCare Proxy
- Durable Financial Power of Attorney
- Banking co-signatures
- Asset/Income list – sources, contact info, acct #’s
- Deeds available and up to date
- Burial account set up
- Funeral arrangements specified
- Advance directives or Living Will discussed and/or written
Insurance:
- Medicare status
- Secondary health insurance
- Medicaid coverage for health care or Skilled Nursing Facility care
- Long-term care insurance
Medical Care:
- Primary Care Provider
- Geriatric Consultation
- Dementia evaluation
- Vision, hearing, mobility, pain management at optimal levels
- Substance abuse or psychiatric special needs
- HIPPA or Release of Information forms on file with the MD and the Healthcare Proxy
- List of prescriptions, diagnoses, physicians in the hands of pertinent people
- Transportation to/from
Leisure and Socialization:
- Transportation
- Physical activity/recreation
- Senior Center
- Large print books
- Pet care
Housing Issues:
- Accessibility to stairs, bathroom, bedroom
- Personal safety: wonder alerts, smoke detectors, spare keys
Equipment Needs/ Safety inspection:
- Commode chair
- Grab Bars
- Shower chair
- Mobility aids
- Reaching tool
- Visual or hearing aides
Discussion Points with Significant Others:
- How to know when to stop driving?
- Age in place preferences vs. relocation: How to know when it is time to move?
- Care preferences, Advance Directives: how do you want to be cared for if frail or dying?
- Financial Management, who will do it and how?
Personal Attendants:
- Medical Alert System
- Home-delivered meals
- Home safety inspection/modifications
- Senior Transportation
- Non-medical home companions
- Adult day care
- Respite care
Many of the above listed service are not covered by Medicare or Medicaid. Also, if the above service are going to be covered the patient has to abide certain rules i.e. medically homebound, or require personal care, or have a change in a medical condition that can be expected to benefit from rehab but not maintain current function etc. If these strict criteria are not met then these services will have to be privately paid.
The benefit of privately paying is it allows for the highest degree of flexibility in utilizing resources. It also helps facilitate a rapid implementation of resources and can bypass long waits for agency rendered services.
If you are interested in learning more about geriatric care management for residents living in Manhattan log on to MetroMedicalDirect.com and arrange an appointment.
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