Is hiring a geriatric care manager for parents really worth it?


I am thinking of looking for a geriatric care manager. I've read they can be helpful in assessing situations and providing insight for elder care decisions and objective conversations with family members. I currently moved home to help my parents with my mother's health issues and vascular dementia. My father is her primary care but forgetful and not always on top of things like her meds and whether or not she ate lunch. They are in their 80s. I work full time, have just about 12 hour days with a long commute, and have reached a burn out often just trying to keep their house clean and yard in shape although my dad pays a guy to cut the grass. I understand they are elderly, but they basically sit around all day and watch TV. My dad does grocery shopping and my mother still does laundry if he asks her to. She is at the point where she won't shower, etc. I've tried to talk to my dad about this and he says he doesn't want to upset her. He doesn't want to put my mother in a home, and I don't either especially at this point, but I've hit bottom a few times and have told him that that's where she is headed if he doesn't realize it.

My mother has also always been stubborn and has gotten really grumpy, almost nasty in the last month. She's also recently gone on an anti-seizure med and I'm not sure if that's contributing to it. Sadly her "normal" personality is very sweet and caring. She can sometimes still be that way but mostly complains now and I can't always be ok with it. I try not to take it personally but after working all day and sitting in 1 1/2 or rush hour traffic b/c I need to be out where they live, I have no patience. I keep telling myself it could be worse and it will but I need some help so thought about a geriatric care manager to get started. Are they really worth it?



I tried to hire a geriatric care manager for my parents before they became more frail & debilitated. At the time, they were living 7 hours away from me & I thought it would help me with their needs. I know these folks were competant, but my parents just did not get the concept, i.e. " Why do they need to know about my church involvement?" Tried to explain, but they just didn't get it. They charge by the hour, so you need to consider that. Also you might inquire if the care manager is a member of Aging Life Care Association. This association promotes & reinforces professional standards for those in the profession. All members are required to adhere to a strict code of ethics & standards of practice. The website can help find geriatric case managers in your area.
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Reply to nature73

Check to see if their town has a social worker on staff as well as an elder case worker.
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Reply to Llamalover47
drooney Sep 28, 2018
There must be a local agency on aging. They can send a caseworker to assess needs. It is possible to get services for a person over 60 years old via your state homecare if needs assessed as critical. (Bathing, meal prep, medication assist etc). Cost is on a sliding scale depending on elder's income.
I am considering one myself to address the growing list of needs and my increasing burnout. After nine years, I can tell you that it gets harder, not easier over time, and you need to have a plan other than doubling-down on your own efforts.

With regard to your mother's irritability, it may be a side effect of her medication or the inconsistent amount in her system. My father was placed on anti-seizure medication and developed a volatile temper. He was switched to a different medication that he tolerated better. There are about 10 different ones to choose from, they all might cause one side effect or another, they are usually meant to be taken at exact intervals to maintain a therapeutic level in the body (12 hours apart in my dad's case), and it takes some trial and error to adjust the dosage to prevent the seizures but minimize the side effects like sleepiness, dizziness, etc. This should be brought to her doctor's attention asap.

With regard to placement, I actually think it's inevitable, but we all struggle with the idea of it. To give you the other perspective, my upbeat aunt said of her new facility that she finally felt safe because there was always someone available to help her. She also noted that the friendships may be short, but at least there are friends. When I placed my dad, who had only me for company, he suddenly had other people, including residents and their family members, to engage with, as well as more activities and interests to pursue. I put him in a board and care with 5 other people in a residential home. Sometimes couples reside there together. There are different housing options for seniors and different price points to consider. Best to you.
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Reply to Portmarly

Gosh, are you my twin?  If  you have the funds (or they do) and they will accept this person, then I would say you answered your own question.  Think of them as being like an elder care concierge, someone who is immersed in the field and knows the best resources and who will probably support you and be your own source of info as you go forward.  If your parents are like mine, at least my father thinks the cleaning etc is women's work, and there is an expectation without realization of the time, energy not only for the task at hand, but everything else like managing our own lives and needs.  I find what is going on at home increasing distracting from my work efforts, but I need my job.  It gets to be too much.  I feel like I have no days off.  My little one, while canine, is not getting the attention or exercise we both need.  IF you decide to go ahead, remember that you are in control, and can fire as well as hire.  Do your homework, and if you find someone doesn't live up to your expectations, move on.  We got the very best elder law attorney out there who turned out to be an impatient witch who failed miserably in explaining and educating.  It was an expensive mistake but I am so glad we moved on.  Good luck with it all, and don't forget your local Alzheimer's Assn may be a good resource for starters.
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Reply to robinr

Yes, worth it is an understatement!
Also I have found through experience that care managers should not work for the same care agency that is providing care for someone. It is a conflict of interest. As a home care nurse and care manager myself I have been put in this position and what happens is it removes a lot of the power a care manager has because first they are an employee. I'll give you an example. I had a man who needed 24 hour care and a wife with early stages of dementia. They had three daughters involved but all out of state so I was handling everything. We had an aide on that was available overnight and the office was thrilled to have the case well staffed, or so they thought. Truth I came to find out was he had another job all day, came to that house at night, showered and went to sleep!!! The wife reported this to me and I reported as well and was waiting on a replacement that never came. They blew off the wife's complaints saying she has dementia despite my support and continued to send this most disrepectful man who called himself a caregiver to this vulnerable home and my hands were completely tied. If I was on that case privately I would have fired that agency in a hot minute and had another one in there. It made me sick, and I now I have my own company so I will never be in that position again. Nursing is a constant battle between advocating for our patients and being a good employee. They do not go hand in hand, ever. I highly recommend hiring a private care manager.
Believe me these agencies know this too, and are happy to provide a "free" care manager. BEWARE.
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Reply to KellyOrtega
Marcia7321 Sep 25, 2018
I agree with this! We interviewed three. One of them was partially compensated by the people whose services she recommended. Her hourly rate was less expensive. The specialist we ended up hiring often recommended services that were free. ( ie. local volunteer transportation groups and Meals on Wheels) . The one that was compensated by the services really would not have been able to do that.

It's also important to get a good personality fit. Interview at least three.
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We hired an Aging Care Specialist. We have found her to be very helpful. We are trying to help a person and her caregiver and we live six hours away. The Aging Care specialist goes to doctor appointments with them, contacts insurance companies and makes sure that they have help available to them and has helped arrange a way to pay for the help. The only thing she hasn't been able to help us with is getting the caregiver to accept help.

The person providing care in our situation wants only family to help him. I don't think that's a reasonable expectation. You need to set limits on your help. Do what you can and don't be coerced into doing more than you can.

I hope when you say you moved 'back home' you meant to the town your parents live and not into their home. If you moved into their home, I'd speak with a counselor of some sort (or an Aging Care Specialist ) to discuss if that is the best move for you.
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Reply to Marcia7321

I hired one to help navigate very difficult circumstances when my husband was being kicked out of nursing homes for bad behavior. He told me he could help prevent that by working with them and holding them accountable, as a neutral party. In our case, it was a waste of money. I am a nurse and still young (in my 50s) so I knew more than he did. I also think he was not skilled for the treacherous issues we had, and honestly didn’t want to work that hard. I still think it could be a good thing for someone who is unfamiliar with navigating healthcare systems, or can’t be present to oversee things, but my advice would be to get references from other clients.
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Reply to Tboosrn

I hired a GCM to help me assess choices and explain the red tape of care facilities and moving my mother. It turned out to be a wonderful decision, not only for the good, sound information and advice she provided, but she had gone through similar situations with her own mother. She was also like a counselor. It's like anyone you hire to help -- you have to find the right personality. But I think a GCM can be a helpful addition to you world.
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Reply to ArtMom58

Yes they certainly can be but it would most likely lead to them getting assistance in their home at least to start. We hired one years ago for my MIL. Your schedule is far too complicated to continue to contribute although it is admirable. If you could meet with one on a weekend or take a personal day that would be best. They can be immensely helpful in a variety of areas where help is needed. Hopefully your parents will be open to this but first I think it would be best to be advised on how to conduct the initial approach. You should be provided with how to start the process for the help they need and from whom. I hope you can do this as soon as possible as your situation sounds very taxing. Best wishes for you with this.
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Reply to Riverdale

We have a care manager for my dad.  It is another set of eyes on him by someone who is trained in the field.  She works for the same company as our care people and helps with their coordination along with getting dad to appointments, works with the geriatric psyciatrist and the other outside services that are coming in.  It's been a huge help to me.
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Reply to Babs75