There are two types of Geriatric Care Managers generalists and Care Managers with specialties. My specialty is dementia, so I am writing in regard to dementia. However, most generalists also follow the same type of procedures as specialists. Each Care manager has their own fee schedule and method of charging their clients. I also describe my fee schedule and the way I operate in this article. Again, business practices vary from care manager to care manager, but are reasonably similar to the way I work. Always ask about fees before hiring a care manager.
Families are referred to dementia specific geriatric care managers by doctors, home care companies, residential communities, attorneys, financial advisors, and others. We travel to where the person with dementia lives and do a complete geriatric assessment. Usually the rest of the family or others involved with the person’s care are there too. We generally spend at least an hour with the person with dementia in their home getting to know them, their personality, their preferences, their likes and dislikes, and often do a little cognitive screening testing on them. We also do a walk thru of the residence to look for safety issues. Then often we travel to another location to continue the conversation with the demented person’s children or caregivers to discuss things that many times are uncomfortable for the person with dementia to hear.
Things discussed include: income and assets available for care, the possibilities of discovering other possible income (such as VA benefits) or if needed, strategies to use in working assets down to Medicaid eligibility. Also discussed are things such as family dynamics and emotions generated by situations such as these. The assessment questions are completed. Caregiving issues are discussed, and ideas to help ease some of the most pressing issues and concerns are immediately given verbally. Resources to enable carrying out of those ideas are given verbally, or via email that same day. This is the instant education part of the initial meeting. References are given to other sources for additional education of the family.
Then, from all the information collected from the assessment and any other research that needs to be done, a written report is produced for the family. It contains findings from the assessment, specific resources to go to for best care (home care companies, memory care or other residential care facilities, eldercare attorneys, senior real estate agents, moving companies, consulting pharmacists, or anyone else needed to provide the best care for the individual). The report usually ranges from12-17 pages long. A copy of the report also goes to the neurologist and family doctor so they know what is going on with their patient.
Neither Medicare nor Medicaid covers us yet, so we try to keep prices reasonable for families. There is a flat fee for the assessment and report, including referrals. Some of the clients take the report, implement its findings on their own and there is no further cost to them. Others want the care manager to continue to guide them through the steps to best care. For example, prescreen in home caregivers for knowledge and personality fit with the demented person, or walk with the family through communities and ask the questions that the family doesn’t know to ask. Sometimes the care manager is asked to accompany the family to Social Security, Medicaid or VA offices to help in securing benefits. If the family lives out of town and wishes monitoring of their loved one with dementia on a regular basis that also is done. The point is we do as much or as little as the family wants us to do, charging by the hour. The families are always in control of the fees the care manager is paid.
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Carole Larkin MA, CMC, CAEd, QDCS, EICS is a geriatric care manager who specializes in helping families with Alzheimer’s and related dementias issues. She also trains caregivers in home care companies, assisted livings, memory care communities, and nursing homes in dementia specific techniques for best care of dementia sufferers. Her company, ThirdAge Services LLC, is located in Dallas, TX.
