Can you “rent a relative” from an agency if you have none?

I just looked up geriatric care managers and found they charge $220 and hour!

KathleenQ: Your 84 year old neighbor should be in contact with her town's COA (Council on Aging). This local organization will have on staff a dedicated elder care worker in addition to a social worker as well as help for balancing checkbooks and more. My legally blind late mother lived alone many states away from me and received assistance from the COA until it became quite apparent that I had to move in with her as her blood pressure plummeted.

She should start to streamline her bill paying and such to make those matters easier to manage, She can talk to the local authorities about having a guardian ad litem appointed to her.

You have to find a trustworthy person as people have noted. Even relatives are not necessarily trustworthy. There are many out there; but you have to look. Good luck.

dear OP,
:)

you have 2 options:
-hire a "professional"
-hire a friend

either option, they can be thieves. anyone who "supervises finances", might take advantage in subtle ways, so as to get away with it.

indeed, relatives can also take advantage, or be careless.

in the end, you need lots of luck to find someone trustworthy. trust your gut. if the person seems dishonest, uncaring...if you see something worrisome, they'll probably do more and more bad things in the future.

fire them. find a new person.

it's not easy. i personally, prefer the "friend" option.

Have her contact an Elder Law Attorney and ask for a Guardian Service referral. We set it up so that our attorney would supervise the Guardian and hold him/her accountable.


The people who visit nursing homes are called, "Ombudsmen."

It all comes down to how much your neighbor has saved up for these years. Although a certified geriatric care manager is a good option, they can be expensive. In my area, the going rate is about $140-180/hour - which includes travel times and wait times. These rates can add up . I did utilize the services of a very competent geriatric care manger for my mother - someone who could be there for her when I couldn't and it got expensive very quickly.

The at-home companion/care services are another option but once again, given the staffing shortages, many agencies around here require a 3-4 hour commitment at least 2-3X week. And the problem comes that they are not able to always send the same person for the visits - this frustrated my mother because it would be like started from scratch every time. Also, many of the care providers doing this work because they can't or don't want to get a job elsewhere - meaning, yes, they will 'be' there, but different individuals provide different levels of engagement. My neighbor actually had one who would show up, sit in the chair for 4 hours reading magazines...didn't offer to help, engage, talk or anything. Also, some are scoping things out for future unethical or illegal activities - meaning, they get the job, check out various clients to see what they have/don't have, quit the job and then return at a later time to either steal or form a "friendship" that then can be taken advantage of.

Elder care lawyers are an option but with the going rate of $400-600/hour around here - definitively out of the question.

Continuing care facilities are an alternative, but once again, all depends on how much your neighbor has saved up and has in assets. In my area, these facilities have buy-ins ranging from $350,000 - $1.2 million, and then add on the monthly costs that are about $6,000-12,000. Limit funds don't go very far for sure.

About the only thing left for someone like your neighbor (whose situation will be mind in the not too far future) is to establish a solid and trustworthy friendship with someone - preferably younger - who would be willing to take on such a huge responsibility. For me, I have 2 such individuals who I have known several decades, who have agreed to step in when and if needed - and of course, I will provide monetary compensation for their efforts and involvement.

It is a frightening situation to be looking at and to be in, especially when one has no family or willing family.

Hi KathleenQ, so glad you asked this question. I live in Florida & am a board-certified geriatric care manager. I call myself your “Professional family”. I manage everything a senior could need (including veteran’s benefits), so, not knowing where you live, you can def have someone that does this in your area for your neighbor. If you call your local Area Agency on Aging or Council on Aging, they can refer you to someone known in your area. And, thank you for caring enough for your neighbor to reach out and ask on their behalf!

We had a neighbor years ago that had no relatives and she took on the task of caring for her and her sister. She was appointed POA and then made sure that she had a caregiver, when the caring got to the point that they (both sisters) needed a nursing home she had them in one close by. She would then visit the sisters at the nursing home at different times of the day at least three days a week and made sure that they were taken care of. Once she found that the clothes she purchased were not on them so she tagged them with huge labels on the front. OH the nursing home was not happy about that because, they told her, that it made the nursing home look like an institution. Her answer was, when the clothing I purchase doesn't get lost then I will not put a label on it but for now I will. She continued to do this until the sisters died and when they did the nursing home returned the clothing to her. The point is... anyone can be appointed POA and the POA can make care giving decisions. Just prayerfully that person does not take advantage of the person. My neighbor... the best trustworthy person ever! I would trust her with my life thats for sure!

You certainly can't rent a "relative" and in fact relatives often don't make the best Fiduciaries to manage all that. You CAN however, hire a Fiduciary. Be certain this is a Certified and Licensed Fiduciary whose practice is managing all of the above, not a "Financial Money Manager" whose practice depends on not being paid hourly, but on investing your money for a 1-4% management fee into vehicles he makes the most money off of. In California, my own state, the certified Fiduciaries are known to elder law attorneys and Trust and Estate Attorneys because they are appointed by the courts when there is no family and a person has management by guardianship of the state. they belong to an organization PFAC, Professional Fiduciary Assn of California and can be contacted at PFAC-pro.org. They may guide you to some in your own state. There are also bill managers, contact secure.aadmm.com/find-a-dmm (certified daily money manager.
I hope there are others who have suggestions for you; Igloo who posts here often is in these know on these type things.

There is such a thing as friendship volunteers for elders aging in place. Mercy Care for the Adirondacks in upstate New York matches elderly people aging at home with trained volunteers who can help them manage. There are limits to what a volunteer can or should do, but they can help relieve loneliness and isolation and give rides to appointments, help with shopping, etc. Pretty much what a caring neighbor might do. Surely there are other such models across the country.

Many times wishing to "age in place" is driven by a bad experience or memory of nursing homes, or a fear of change. I think it would important to take her to visit a new, modern-day senior community that starts with IL and has AL, MC, LTC and hospice. Loneliness is crushing, especially in old age. She needs to see that there are some very wonderful places out there with lots of people like her, activities and events.

Also, does she assume that she'll never become sick or have a profound health incident, like a stroke? What does she think will happen then? Her "relative" will need to move her to where she gets the best care for a price she can afford, so unless she is extremely wealthy, this means a facility. Without someone having an eye on her daily, no one will know that memory loss or dementia is creeping in, and she's not remembering to eat, or she her dementia makes her decide to wander out of the house in the middle of the night, or give all her money to a scammer.

Your neighbor is romanticizing age-related decline. Right now there is an extreme labor shortage in the US. The fact is that Geriatric Care Management is a newer profession and there's not nearly enough of them in relation to the number of aging Baby Boomers. There's a shortage of doctors and for-hire caregivers.

How long does your neighbor want to stay in her home? Does she live in a 1-level home already? Can she get to her car or out her front door and to the driveway without there being any stairs or steps? Does she have the money to modify her house so that she can safely maneuver in the bathroom with a walker, into a zero-clearance shower? Does she have the money to pay for house upkeep and weekly yard maintenance? Who is going to run errands, buy groceries and cook for her when she eventually can't or isn't safe to do this herself? Is she tech-savvy and uses a computer or mobile phone?

I have 2 Aunts who live several states away from me, ages 100 and 103. The younger has mod/adv dementia and the elder has all her mind but a pretty frail body. I manage most (but not all) their finances and decisions, and my other 2 cousins manage their daily care and it is full-time. This arrangement only works because the one cousin refuses to be paid for it and the other only wants a minimum amount of money. Full-time, around the clock in-home care (especially if there are medical needs) can easily be more expensive than a care facility and requires a lot of people management. So, your neighbor would not only be paying for the round-the-clock aids but also all the hours a GCM puts into managing it. And then there's the Fiduciary to be paid as well. And good help and resources often are dependent upon one living in a county that has them. If my Aunts would have bought a house 1 mile north, they'd be in a very rich county with lots to offer. But they don't and it sucks. Example: there's no senior bus service.

Your neighbor needs to make a plan that is based in reality. She has no idea how expensive care is and she needs to know. Maybe she should see a financial planner to know if any of this is even feasible with whatever assets she has.

There are Geriatric Care Managers that do a lot of what you are looking for.
Many facilities that have Continuing Care, meaning they go from Independent Living, Assisted Living, Memory Care and Skilled Nursing.
A caregiver or I should use the phrase "Companion" from an agency might work. They do not do as much as a "caregiver" would need to do if the person does not need direct care.
If a caregiver agency is not what your neighbor would want then there are places like "Care.com" where you can hire a companion, sitter whatever you would want to call them for the hours you would want. Often getting a small number of hours from an agency is difficult.
As far as allowing someone like that to supervise finances I do not think it is a good idea. you would want someone that is licensed.
This is something that she really should talk to an Elder Care Attorney about. There are a lot of legalities that she should be concerned with. (who would be made POA for finances, health, would she need a trust of some sort?...lots of questions)

There are care plans called “continuing care at home”. CCAH. Basically, there is an entry fee based on age and level of coverage and a monthly fee going forward. It includes a care manager as well as future placement in skilled nursing. In Pennsylvania: Pathstones by Phoebe, Smartlife by Willow Valley Retirement community.

A geriatric care manager can help in cases like these. We had one speak to our support group and it was enlightening. They are great at understanding and protecting the rights of the elderly. They can be the “relative” to advise and advocate for a patient with no one to help, offer support for family caregivers, or be the “go-between local contact” when the family is caring from a distance. We had a one-time consultation for my husband and myself when we began considering our long term plans. Of course the more involved they are the more costly. The neighbor might want to have just a consultation for now and the care manager can step up their involvement as her needs progress. They can make recommendations to quality attorneys, financial providers etc. that are better suited for an elder or look over the shoulder of the ones already in place to hold them accountable and prevent scams. They can even be named as executor to handle her affairs after she dies.

check out..

https://www.agingcare.com/local/debra-kelly-lmsw-chapin-geriatric-care-managers-sc

https://www.nia.nih.gov/health/what-geriatric-care-manager

https://www.aarp.org/caregiving/basics/info-2020/geriatric-care-manager.html

https://www.aginglifecare.org/ALCAWEB/What_is_Aging_Life_Care/Find_an_Aging_Life_Care_Expert/ALCAWEB/What_is_Aging_Life_Care/Search/Find_an_Expert.aspx?hkey=6c3ced7c-b5f0-4d27-9d30-37734ab6cf49

https://health.usnews.com/best-assisted-living/articles/when-to-hire-a-geriatric-care-manager

https://www.nia.nih.gov/health/what-geriatric-care-manager

Google certified geriatric care manager to find more info or to locate one in your area. Look for a “Certified” geriatric care manager. We referred a friend to one when he was hospitalized due to lack of proper care and no one stepping up to advocate for him. He had Parkinson’s, was divorced and his children and ex-wife seemed to be financially draining him without always looking out for his best interest physically. We did not want to try and help and get in the middle of a dysfunctional family.

There are licensed financial fiduciaries. Any court is aware of them and any elder law attorney as this is exactly what happens when an elder is incompetent, but without relatives. There are also bill managers, or Certified daily money managers (CDMM). They are certified by the American Assn of Daily Money managers and require 1,500 hours of training. The AARP site online has much information. I am familiar with the Professional Fiduciary Assn of California, but not of other state. The california one may be able to guide you: contact is www.pfac.pro.org or 866 886 7322. You want to be sure you aren't mixing them and what they do up with Professional Money Managers who invest and take 1-4% of your earnings, guiding you into financial vehicles that earn them most. You want someone who will handle everything from placement to bills and daily life needs. I wish you luck in beginning your research. The reason Elder Law Attorney's often have Fiduciary knowledge for their area is that courts work with them in these cases.
I have served as POA and Trustee of Trust for my brother. A huge job. Don't entrust this to friends and acquaintances; it requires meticulous record keeping and a host of other problem. Best to pay to have it done correctly.
Do speak also with any Trust and Estate Attorney who is helping you do wills and paperwork. That person may also be a guide for information.

Got this from the National Institute on Aging website when I did a search for geriatric care manager: "A geriatric care manager, usually a licensed nurse or social worker who specializes in geriatrics, is a sort of "professional relative" who can help you and your family to identify needs and find ways to meet your needs."

If she's competent enough to manage her own affairs, then she's competent enough to consult with an attorney who specializes in elder laws.