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HanSolo Asked August 2016

Can I hire someone with relevant expertise to help my mom?

deal with complex bureaucracy? I want to find someone with relevant expertise who can help my mom deal with complex bureaucratic problems. If I need to pay them, fine, I'll do it, but I don't think this is something that should require $300-per-hour lawyer fees. For example, my mom said she was on both Medicare and Medicaid, then got kicked out of Medicaid because nobody told her she had to re-apply periodically. Then she has problems like she orders some forms and never receives them, or can't get the right person on the phone, or gets letters that contradict published rules and guidelines, etc., etc. There are other situations like this that I can't explain because I don't understand them. I don't have a lot of money to burn but I can help pay for incidentals, like this kind of assistance. From my mom's point of view, the various agencies make it as difficult as possible to deal with them, perhaps they are even adversarial to the seniors they are paid to support. My mom is functional but old, so I can see that maybe she isn't able to deal with certain levels of complexity that she's presented with, and also not able to "quarterback" whatever service providers may be at her disposal, if only she knew how to engage their services. I give my mom extra money sometimes, but lately she has asked for more, and I'm wondering if that money is making up for assistance that she'd be entitled to (like Medicaid, or certain low-income housing benefits, etc.) if only she were able to contend with the massive bureaucracy involved in actually getting those benefits delivered. From my mom's story, it sounds like the government creates massive complex bureaucracy and stonewalling in order to make it harder for seniors to get benefits. As for me, I have no understanding of the complex web of senior programs and how to get them to deliver the benefits that they, in theory, are there to deliver. My mom says the local "area agency on aging" is of no help, and when I tried to call them myself 10 years ago (regarding my father), they said they can't talk to me because I'm not an elderly person calling on my own behalf. Has anyone ever seen or heard of a "personal senior-services bureaucracy-busting agent"? It seems to be something that does not exist, and without that, we are stuck.

Guestshopadmin Aug 2016
Yes, working to get people into programs is difficult and time consuming. It is set up so that you have to "prove you are eligible" for programs. And sometimes folks slip through the cracks. You might actually start with talking with your mother's doctor to see if there is a diagnosis that you are unaware of that is adding to confusion or medication. You sound really upset that it is not easy to navigate the system from many states away. And I think you may be assuming that your parent is more capable than she really is - the labyrinth of programs and difficulty is why so many experts can charge $300/hr. Because the amount of time, energy, and money spent to become an expert is not something that everybody can do. I hope that you are able to find help through the non-profit. Barring that, if your mother gives you a power of attorney and her last Medicaid application, you could see about getting her application restarted. Don't be surprised if she has trouble locating it.

Guestshopadmin Aug 2016
Han Solo - how much do you think you should pay someone to do the tasks you want? The range for Geriatric Care Manager salaries is $30,000-$100,000 per year. This is truly a case where you will either have to move your mother closer to you where you can provide more direct help, find a non-profit, or pay for someone to do these tasks. My thought is that hiring a $10 per hour person isn't in your mother's best interest.
Job Description for Geriatric Care Manager
A geriatric care manager works with older patients to devise a plan of care. They must have extensive knowledge of available resources, associations, and health care establishments to help create plans that fit the needs and budget of the patients. In addition to helping locate resources, the geriatric care manager might also have to make appointments and arrangements for transportation. The plan needs to include how included goals are to be achieved.

The geriatric care manager works with the patient, the patient’s family, or a combination of both. When families are separated from the patient, the geriatric care manager might act as a sort of representative for the patient. This manager needs to constantly evaluate plans to make sure that they are working, and if not, work with the patient to make necessary changes.

Geriatric care manager positions usually require status as a registered nurse or licensed social worker. Previous experience as a geriatric manager might also be necessary. These professionals generally must be able to pass a criminal background check as well. This position may require visiting patients in their homes, visiting places that provide resources, and escorting patients to appointments. Therefore a valid driver’s license is essential.
Geriatric Care Manager Tasks

Keep records and prepare reports for owner or management concerning visits with clients.
Provide information and refer individuals to public or private agencies or community services for assistance with elderly patient care.
Plan and direct the hospice program.
Visit individuals in homes or attend group meetings to provide information on agency services or options to care for elderly persons.

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BarbBrooklyn Aug 2016
Two more thoughts: You might want to look up mom's local Area Agency on Aging ( which MAY be a local non profit org, it is in my area) and ask for a " needs assessment " for your mom. You can get one from a geriatric care manager as well, but that is going to cost money.

You want a needs assessment because you need a professional assessment of your mother's needs for housing, care, and support. Your mom may be completely competent, or she could be starting to slip in ways that aren't always obvious to family members.

BarbBrooklyn Aug 2016
If you hit the "find care" bar on this site and the scroll to "elder services", one of the options is Geriatric Care Managers. I have no idea what they cost, but I know that my Midwestern cousins were able to find one in Florida who helped tremendously with their parents.

BarbBrooklyn Aug 2016
You can hire a geriatric care manager to handle these tasks.

jeannegibbs Aug 2016
Yes, you do need to qualify for Medicaid each year. The application for renewal is much, much easier than the original one. But if you miss the deadline for the renewal application then you need to fill out the original application again. If you've saved a copy then it isn't so grueling to do, with just updating the items that have changed. So the very first thing to do here is to get your mother back on Medicaid.

Medicaid does not require that you live in subsidized housing. Many applicants do, but many others own a home, which they can keep and still be on Medicaid. And others simply rent a house or apartment. Whether your mother's apartment is subsidized or not has nothing to do with whether she was on Medicaid.

I don't know how it is where your mother lives, but in my state Medicaid recipients have two case workers; one is for finances, and the other is for personal services. The services case worker visits at least every 6 months and does a needs assessment -- is the person still in need of all the services she is getting? Are there other things that should be added? And a budget is set for the next 6 months. This person is also a very helpful contact when there are questions.

In my experience, though, someone has to be alert enough to make those phone calls. If someone calls and says "Mom didn't send her renewal app in on time, now what do we do?" they can provide very complete directions. But someone has to call. Better yet, someone should have called and asked "Why did I get this application form? I'm on Medicaid already!" Is someone calls and says "we got a notice that Mom's rent is going up because the building is no longer subsidized. What does this mean and what can we do?" the answer will be straight-forward and easy to understand. BUT someone has to be clear-headed enough to know to make those calls.

Not everyone on Medicaid is confused and muddled. But when they are that may be a sign that they can no longer handle their own affairs. If they have a spouse or a child or a cousin, etc., who can do it for them, they are very lucky! If they have no one, then it may be time to consider a supervised living arrangement.

Some people move closer to an adult child who could stop in a couple times a week and go over all the mail. Some people move to Assisted Living.

Some people hire a geriatric care manager.

HanSolo Aug 2016
Thanks for the responses thus far. To respond:

("Can you go over to your mom's place and call the local Area Agency on Agency together?") No. I live in a different state. Because of this and the other reasons I cited, it seems that the Area Agency is a dead end.

("I always tell our residents to go through senior services") OK, I went to google and typed "senior services" and the city name. Turns out there's some kind of non-profit organization I never heard of before (not the Area Agency I mentioned). I will call them in the daytime to see if they can help at all.

("sit down with Mom and your computer and apply for Ohio Medicaid online") As I don't live in the same state, I can't fly there every month or whenever she runs into an administrative hassle. That's why I want to hire someone (also because I'm not well-informed enough to know how to navigate a dizzying array of programs in the first place, some of which aren't even publicized).

("If she is privately paying for Independent Living") Not sure what you mean by that. She lives in a so-called senior apartment building that used to be eligible for some kind of subsidy program (not Section 8 but something else, according to my mom), but for some unknown reason, that building's eligibility came to an end. This is another reason why she is having financial issues.

("I have a feeling she never was on Medicaid, she is just confused about it") I agree that my mom is confused about what her options are, and about how to confront massive bureaucracy and incompetence on the part of the government. Aside from that, I'm fairly certain she's mentally competent enough to know what programs she was on, so I'll give her the benefit of the doubt on that until there's evidence to the contrary (in other words, all indications are that she's about as competent as I am!). I don't see any reason why she couldn't have been on Medicaid. If she wouldn't qualify, then probably nobody would.

I'll pursue the lead mentioned above. But based on the responses I've seen thus far, it appears that the answer to the specific question I asked is "no" (or at least no one here has ever hired such a person or knows of any existing).

pamstegma Aug 2016
HanSolo, sit down with Mom and your computer and apply for Ohio Medicaid online if she is low income with few resources. If she is privately paying for Independent Living, I have a feeling she never was on Medicaid, she is just confused about it.

wvavet Aug 2016
I see this a lot at work in a low income senior at building. I get so frustrated at the people who are overwhelmed at the paperwork to get the help they deserve and/or are entitled to! Most of the programs (medicaid, food stamps, waiver of medicare pmt, LEAP) fall under DHHR but the people there seem useless. I always tell our residents to go through senior services, they are great advocates and help them thru the "system".

BarbBrooklyn Aug 2016
Han, how about this. Can you go over to your mom's place and call the local Area Agency on Agency together? Or perhaps make an appointment to go inand see them with your mom.?

Make a list beforehnd of what your questions are. You might want to ask, at the outset, for a "needs assessment", where they wil come up with a checklist of what you mom's current needs are.
Then they can point you to next steps.

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