When to call a geriatric care manager, and what they actually do

Most families never plan to need help. Then Mom falls, Dad gets a new diagnosis, or the person who was quietly managing everything can't anymore. Suddenly you are juggling doctors, insurance, home care agencies and siblings in three time zones.

That is the moment a geriatric care manager earns their fee. Think of one as a professional guide who knows the local system, has seen your situation many times before, and works for your family rather than for a hospital or an agency.

What does a care manager do?

A good care manager starts with a full assessment. They visit your parent at home, talk with the family and review medications, health history, safety, finances and daily routines. From there they write a care plan with short and long term goals.

After that, the work depends on what your family needs. Common tasks include:

• Finding, screening and overseeing home care aides
• Going to medical appointments and making sure everyone leaves with the same plan
• Advocating with doctors, hospitals and rehab centers
• Helping a family compare assisted living, memory care or nursing homes
• Sorting out paperwork, bills and benefit applications
• Stepping in during a crisis, such as a hospital discharge on a Friday afternoon
• Keeping adult children who live far away up to date
• Helping siblings who disagree reach a plan everyone can live with

Who becomes a care manager?

Most care managers are licensed clinical social workers or registered nurses who have spent years working with older adults. The field's professional group is the Aging Life Care Association, which sets standards and certifies members. Some care managers also hold the C-ASWCM credential, which stands for Certified Advanced Social Work Care Manager.

Credentials matter because this person may be in the room for some of the hardest decisions your family makes. Ask about licensing, certification and how many years they have worked with older adults in your county.

When is it time to call one?

You don't need to wait for an emergency. These are common moments when families reach out:

• A parent was just discharged from the hospital and nobody is sure what happens next
• You live out of state and can't be there for appointments
• Memory problems are starting to affect bills, driving or medications
• Siblings disagree about whether a parent should move
• A home care aide isn't working out and you don't know where to turn
• You suspect someone is taking advantage of a parent financially
• You are the main caregiver and you are running out of steam

What does it cost?

Private care management is usually paid by the hour, and Medicare does not cover it. Many care managers charge separately for the first assessment and then bill for ongoing work as needed. Some long-term care insurance policies reimburse part of the cost, so check the policy before you start.

Ask for fees in writing before the first visit. A clear care manager will tell you what the assessment costs, how they bill for phone calls and travel, and how they will keep you updated.

Questions to ask before you hire

1. Are you licensed, and are you a member of the Aging Life Care Association?
2. How long have you worked with older adults in this area?
3. Who covers for you on nights, weekends and vacations?
4. How do you communicate with family members, and how often?
5. Do you receive referral fees from any agency or facility you recommend? (The answer should be no.)
6. Can you share references from families or local professionals?

A care management practice we know well

Connections Care Management is a care management practice with offices in Montclair, New Jersey and Suffern, New York. It serves Bergen, Essex, Passaic, Union, Hudson, Morris and Middlesex counties in New Jersey, plus Rockland County in New York.

The practice is led by Lisa Kolton, LCSW, C-ASWCM, and Kimberly Hamilton, LCSW, C-ASWCM. Both are licensed clinical social workers with more than 25 years of experience with older adults and their families, and both are certified care managers. Their services include assessments and care plans, going to medical appointments, overseeing home care, help choosing senior housing, benefit applications, crisis help and protection from financial exploitation.

Families can reach Lisa Kolton at 973-747-5571 or Kim Hamilton at 845-480-1561, or learn more at caremanagementconnect.net.

Full disclosure: Lisa Kolton is the mother of this site's publisher. We mention her practice because we know firsthand the care she gives families, and we encourage you to ask any care manager the questions above.

How to find others

The Aging Life Care Association has a search tool that lists certified members by location. Your doctor, a hospital social worker or an elder law attorney can also suggest names. Speak with two or three before choosing, and pick the one who listens best.

Common questions

Does Medicare pay for a geriatric care manager?

No. Private care management is not covered by Medicare. Some long-term care insurance policies reimburse part of the cost, so check your policy.

Is a care manager the same as a home health aide?

No. An aide provides hands-on care such as bathing and meals. A care manager is a licensed professional who assesses, plans and coordinates all of the care, including aides.

Can a care manager help if I live out of state?

Yes. Keeping long-distance family informed is one of the most common reasons people hire one.

Is there a free alternative?

Your county office on aging offers free screening and referrals. Call 1-877-222-3737 to reach yours.

This guide is for general information. Program rules and income limits change, so confirm with the official source before you apply.