- The Washington Times - Saturday, October 25, 2003

When Jane Pugh, 82, fell ill recently, she needed help with everything from getting her house ready to sell to finding an assisted-living facility in which to live. Miss Pugh, of Bethesda, also needed someone to coordinate her doctors’ appointments and help her get to them.

With her nearest relatives living hundreds of miles away, that transition threatened to be stressful, complicated and a step into unknown territory.

Enter Susy Murphy, a geriatric care manager hired by Miss Pugh’s nephew, Pete Bambey of Cincinnati. Mrs. Murphy is a specialist in a field that is growing as the American population is living longer. A geriatric care manager is someone who can assist an elderly person with all facets of care — from coordinating home health aides to dealing with Medicare to evaluating clients’ health and mental status and bringing in groceries.

“She takes good care of me,” Miss Pugh says, pointing out the TV and recliner her geriatric care manager picked out for her new apartment. Mrs. Murphy, meanwhile, is synchronizing her datebook and Miss Pugh’s calendar to reflect the upcoming dentist and eye-doctor appointments.

A geriatric care manager usually has training as a licensed clinical social worker or registered nurse. However, more important than advanced training are knowledge, resources and experience that can help an elderly person, says Debra Levy, a licensed clinical social worker and geriatric care manager based in Silver Spring.

A knowledgeable geriatric care manager has resources the average person might not. He or she will know, for instance, the right physical therapist to bring in or a top-notch housekeeper to hire. This will save a family time — and potential confusion — particularly if a relative gets into a crisis situation.

“We work for the family,” Ms. Levy says. “We coordinate and evaluate the care an elderly person gets, and we can be objective. We can evaluate their mental and physical functioning, look at their home, assess their legal affairs and financial situation, and work with their adult children to suggest a care plan.

“People are living a lot longer, and they can live 10 or 20 years with Alzheimer’s,” she says. “That can be very draining for a family. Families are scattered, families are smaller, and more women are working. Family members can’t always be the caregiver.”

Indeed, the National Council on the Aging, a nonprofit advocacy group, estimates that the number of long-distance caregivers will double in the next 15 years. Nearly 7 million Americans currently provide or manage care for an elderly relative who lives at least an hour away, says Scott Parkin, the council’s vice president of communications. This results in about 15 million missed workdays for adult children of aging parents or other relatives.

“A geriatric care manager can provide a very valuable service for adult children struggling with care issues,” Mr. Parkin says. “When you are faced with a crisis situation, you don’t always have a lot of time to try and find out all you need to know. It is helpful to find someone with expertise. It is hard to navigate and know about all the options that exist.”

District lawyer Anne Sullivan knows that all too well. When her father suffered a stroke while visiting here from Mexico three years ago, she was referred to Washington-area geriatric care manager Pearlbea LaBier. Ms. LaBier gave Ms. Sullivan objective advice on everything from medical specialists and nursing care to whether Medicare would pay for a hospital bed.

“It was the most significant relief I had in a long time,” Ms. Sullivan says. “It was an informed, independent person to give you input.”

The cost of care

Geriatric care management does not come without a price tag. It typically costs about $100 an hour and usually is not covered by Medicare or private insurance.

However, hiring a geriatric care manager does not have to be the start of a long-term relationship. Though many care managers do work for families for years, sometimes they are hired for one or two meetings just to coordinate a care plan, Ms. LaBier says.

“The good news is that there are so many options out there if someone is in a crisis situation,” she says. “The bad news is, they don’t know what the options are. So it is a good value if in a few hours I can point them in the right direction.”

Joy Loverde, author of “The Complete Eldercare Planner,” agrees.

“A super tip I have given is to ask a geriatric care manager, ‘What can you do for me in an hour?’” Ms. Loverde says.

There are many questions to ask before hiring a geriatric care manager.

The National Association of Professional Geriatric Care Managers, an Arizona-based trade organization, counts nearly 1,800 members (up from 600 eight years ago), but there is no formal licensing procedure for the field. That is why it is important to ask about the qualifications and certifications of the geriatric care manager. This can be in the form of formal training (such as being a licensed social worker) or experience (such as several years as a hospital patient advocate or nursing-home manager).

“You should interview a care manager just as you would any other contractor you would hire,” says Jihane Rohrbacker, communications manager for the association. “Ask if they are a member of the National Association of Professional Geriatric Care Managers. Ask for references. Go along with them to see how they deal with other clients.”

Almost as important is the care manager’s personality, compassion and compatibility, Ms. Levy says.

“Credentials and education are only a piece of the puzzle,” she says. “You want to feel the chemistry is right.”

Ms. Levy also recommends discussing how the manager will communicate with you on a regular basis. Will it be in writing, by phone or e-mail? How often will the care manager communicate?

Ms. LaBier says sharing the same philosophy is also important. Find out the manager’s opinions on independence versus home care, she says, adding that the goal for many people is to stay in their own home as long as possible.

“I’m not a general contractor, but I take care of people in their home,” Ms. LaBier says. “I have helped them put up satellite dishes and replace roofs. It is our job to get those [contractors] in there.”

Making contact

A thorough evaluation usually begins in the elderly person’s home, Ms. Levy says. Sometimes the biggest hurdle is developing the trust of a client who is not thrilled with having a virtual stranger sort out his personal affairs.

Ms. Levy then does a medical history and looks at mental functioning by doing a standard memory-loss evaluation. She looks for signs of depression and gathers more information by talking to doctors and family members.

A look around the home can offer a lot of information, Ms. Levy says. She checks for safety issues and hazards. She looks in the refrigerator to see how the older person is eating.

Ms. LaBier takes a similar approach. She says a good geriatric care manager must be persistent, yet respectful.

“I had one case, a retired doctor whose relative from Chicago hired me, and I sat on the patio and watched the grass grow for two months before he would open the door,” she says. “He eventually began to trust me, and the case lasted five or six years. I like that kind of case.”

Mrs. Murphy and Miss Pugh’s relationship hit no such snags. When it was clear Miss Pugh needed to go to an assisted-living facility in July, Mrs. Murphy says, “We hit the ground running.

“We’re still cleaning out her house so we can sell it, and I am arranging to donate her car,” says Mrs. Murphy, who works for Debra Levy Eldercare Associates.

Says Mr. Bambey: “Susy has done shopping for Jane and is getting her back on schedule with her doctors’ appointments. She’s really indispensable. Without her, I don’t know what I would have done.”

MORE INFO:

BOOKS —

• “ELDERCARE 911: THE CAREGIVER’S COMPLETE HANDBOOK FOR MAKING DECISIONS,” BY SUSAN BEERMAN AND JUDITH RAPPAPORT-MUSSON, PROMETHEUS BOOKS, 2002. THIS BOOK IS A GUIDE TO ELDER CARE ISSUES, INCLUDING WHAT TO DO IF A PARENT DOESN’T WANT HELP AND HOW TO HANDLE LONG-DISTANCE CARE ISSUES.

• “THE COMPLETE ELDERCARE PLANNER: WHERE TO START, WHICH QUESTIONS TO ASK, AND HOW TO FIND HELP,” BY JOY LOVERDE, HYPERION, 1997. THIS BOOK FEATURES SECTIONS ON ALL TYPES OF ELDER CARE ISSUES, INCLUDING MEDICAL, FINANCIAL AND LEGAL MATTERS AND CAREGIVING.

M”HOW TO CARE FOR AGING PARENTS,” BY VIRGINIA MORRIS AND ROBERT BUTLER, WORKMAN, 1996. THIS BOOK IS A COMPREHENSIVE GUIDE FOR ADULT CHILDREN OF ELDERLY PARENTS.

• “TAKING CARE OF MOM AND DAD: THE MECHANICS OF SUPPORTING YOUR PARENTS IN THEIR TIMES OF NEED,” BY MIKE RUST, SILVER LAKE PUBLISHING, 2003. THIS BOOK IS MOSTLY ABOUT THE FINANCIAL ASPECTS OF AGING.

ASSOCIATIONS —

• NATIONAL ASSOCIATION OF PROFESSIONAL GERIATRIC CARE MANAGERS, 1604 N. COUNTRY CLUB ROAD, TUCSON, AZ 85716. PHONE: 520/881-8008. WEB SITE: WWW.CAREMANAGER.ORG. THIS PROFESSIONAL ASSOCIATION FOR CARE MANAGERS FEATURES INFORMATION ABOUT WHAT A CARE MANAGER CAN DO, TIPS FOR HIRING ONE AND REFERRALS TO MEMBERS IN YOUR AREA.

ONLINE —

• AARP’S WEB SITE (WWW.AARP.ORG) HAS ARTICLES AND WORKSHEETS ABOUT HOW TO PLAN FOR AGING PARENTS, WHERE TO GET HELP AND HOW TO ASSESS THE SITUATION.

• THE U.S. GOVERNMENT’S ADMINISTRATION ON AGING (WWW.AOA.GOV) HAS AN ELDER CARE LOCATOR ON ITS WEB SITE.

LOCAL RESOURCES —

• INOVA VNA HOME HEALTH IS STILL TAKING VOLUNTEERS TO PARTICIPATE IN THE ELDER COMMUNITY CARE PROGRAM. CLIENTS MUST BE OLDER THAN 65, HAVE CONGESTIVE HEART FAILURE, BEEN HOSPITALIZED AT LEAST ONCE IN THE PAST SIX MONTHS AND LIVE ALONE OR WITH A COMPROMISED CAREGIVER. FOR MORE INFORMATION, CALL 703/916-2987.

• SENIOR NAVIGATOR (WWW.SENIORNAVIGATOR.COM) IS A SITE SPONSORED BY THE VIRGINIA HEALTH CARE FOUNDATION. IT FEATURES HEALTH, FINANCIAL AND LIFESTYLE INFORMATION FOR SENIORS.

• LOCAL GERIATRIC CARE MANAGER PEARLBEA LABIER HAS A SITE, WWW.ELDER-OPTIONS.COM.

• LOCAL FIRM DEBRA LEVY ELDERCARE ASSOCIATES HAS A WEB SITE, WWW.CARE-MANAGER.COM.

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