Photograph by Kathy De La Torre
Sally Hedman, R.N., a private geriatric care manager, talks with Saratoga resident Imogene Blatz about her 84-year-old mother and her 97-year-old father-in-law.
Geriatric care managers help assess need for care
By Rita Baum
'If I weren't so exhausted, I could write a book about do-it-yourself geriatric care management," Saratoga resident Imogene Blatz says. Blatz was faced with the need to find help for her 84-year-old mother and 97-year-old father-in-law, who both experienced difficulty living independently at about the same time.
She decided to take matters into her own hands. "I read books, made dozens of phone calls, checked the web and met with a number of individuals to learn about the resources and options available to these two dear people," she says. "It's an all-consuming job for a family member, but it's done out of love and it's worth it. The problem is that once a person has done all her homework and has what seems to be a perfect plan in place, there's a change and you have to start over, putting whatever is going on in your own life on the back burner."
Matt, a 53-year-old East Coast executive with demanding travel, work and family schedules, took a different approach to finding help for Elsie, his 86-year-old mother. Elsie's pastor called Matt to tell him about some alarming changes in Elsie's health and well being--weight loss, missing church services and other appointments. Matt thought about his visit to California three months earlier. The refrigerator had been well-stocked; she was taking her heart medication; all seemed well. However, he had noticed one unusual thing: Elsie, a prolific potter, had left a lump of clay to harden on her potter's wheel, apparently untouched.
The human resources department where Matt worked put him in touch with an elder services consultant, who discussed options and gave him some phone numbers for elder care services in Santa Clara County. Within days, Matt and Elsie had an appointment to meet with a geriatric care manager (GCM) for an assessment and consultation.
Elsie insisted she would accept help only if she could continue to live in her apartment. Fortunately, the GCM thought she was functioning well enough that a few support services, such as home delivery of a daily hot meal, a volunteer visitor, transportation and daily phone calls from a senior services agency to remind her to take medications, would be all she would need.
As Matt learned, a geriatric care manager is a professional who specializes in assisting older people and their families with long-term or short-term care arrangements. GCMs have a bachelor's degree or substantial equivalent training in gerontology, nursing, social work or counseling.
There are five elements to geriatric care management: assessment and consultation, care plan development, service arrangements, monitoring, and reassessment at periodic intervals. The assessment encompasses all areas of the older person's life--physical, cognitive, psychological and economic--and includes a functional appraisal. The appraisal would determine the elder person's ability to carry on the activities of daily living necessary to remain at home safely.
A geriatric care manager can take total responsibility for the five elements of geriatric care management, or, he or she can help the family only with the assessment/consultation, care plan, and referrals for services, letting the family set up and monitor services.
In Elsie's case, a reassessment revealed that a change was in order. Within six months, it was clear that she was not eating to supplement the daily delivered meal or taking her medicine, despite the reminder phone calls. Matt returned to help his mother choose among three assisted-living facilities recommended by the GCM. To his surprise, his mother offered no resistance, and Matt left town with the assurance that Elsie would have three meals a day, administration of medicine, arrangement of and transportation to doctor's appointments--and plenty of company.
The professional geriatric care manager might be a consultant in private practice, such as Sally Hedman, R.N., or may be connected to one of the social services agencies or a private home-care agency, such as Laurel Home Care or Lifespan, who provide geriatric care management services as well as in-home care, bill payment and other services.
The Council on Aging of Santa Clara County (COA) offers a variety of support services for older people, including a nurse/social worker team approach to case management for older people, as well as younger adults.
For information about these and a variety of other services call 408.296.8290 or their information line, 800.510.2020. Blue Shield of California, 800.445.2520, has a free resource line staffed with geriatric care managers for its Medicare members. These consultants conduct assessments by phone, suggest appropriate local services, and answer questions about senior care. Older veterans can obtain case management services through the Palo Alto Veterans' Administration, 800.455.0057.
For Santa Clara County residents like Imogene, who prefer the do-it-yourself approach, Information and Referral Services Inc., 408.345.4532, is a good local resource. The Older Adult Resource Center in Cupertino, 650.988.7622, will conduct a rudimentary assessment by phone or in person, discuss eldercare issues and services and lend informational books and tapes.
The U.S. Administration on Aging provides Eldercare Locator at 800.677.1116. Anyone in the United States can call for the phone number of an area Agency on Aging and Information and Referral service for any county in the country.
Help online is available at www.extendedcare.com, which offers an online questionnaire assessment tool, and then lists local resources. www.careguide.com provides assistance locating and paying for services.
There are many choices for those who want to go the self-help route. Book stores and libraries have a variety of books and tapes on aging. How to Care for Aging Parents, by Virginia Morris, is a steady seller. The best way to start may still be to make an appointment with a social service agency or private case management professional. During a 1 1/2-hour consultation, these professionals supply a wealth of experience that would take many hours to collect on your own. The old saying, "Well begun is half done" rings true here.
Los Gatos resident Rita Baum has a master's degree in gerontology.
Saratoga, California Since 1955
