What Would You Like To Know About Healthcare?

By Nancy L. Johnson, LSW, CMC
President, Affinity Associates, Ltd.

Dodge Park Administrators have invited me to be a resource to the community by providing a Question and Answer forum via their newsletter. I’m a Licensed Social Worker (LSW) and a Care Manager Certified (CMC) with 25+ years of practice in different facets of the Healthcare field. I’ve worked as a Social Worker in a hospital, nursing home and certified home care agency; worked with a team to develop a Psychiatric Rehabilitation Day Program when State Hospitals were transitioning their patients from in-patient facilities to the community based housing. For the past 14 years I’ve owned a Geriatric Care Management company. I’ve been a hospice volunteer, served on the Hearing Committee of the Board of Bar Overseers of the Supreme Judicial Court, served as a Guardian Ad Litem and a Guardian and several advisory boards of non profit agencies. These experiences have given me a broad breadth of education and familiarity with the systems and procedures in our complex health arena.

With that as my background, I’m pleased to share my expertise in helping others act as advocates and knowledgeable consumers in answering questions that enhance the quality of life for their loved ones.
To begin this series, I will do the Q & A on my passion, “Geriatric Care Management”, a young field of 20 years, that does not have “household” notoriety but will in the next decade. I encourage you to send your questions to nancyj@affinitygcm.com. I will respond in the monthly Dodge Park Monthly Publication to the best of my ability and include resources to research additional information.

Q. What is a Geriatric Care Manager?
A. Geriatric Care Managers (GCM) are typically social workers, nurses, therapist and other health and human services professionals that specialize in chronic illness and eldercare issues. They assess the needs associated with medical, psycho-social, legal and financial matters, identify the resources and options to develop a realistic, affordable care plan. They appraise t the medical condition, preferences for care and living situation, family dynamics, finances, spiritual beliefs, etc., then creates a plan that allows the greatest degree of independence, safety and comfort.

Q. What types of services do GCM’s provide?
A. Besides the assessment and care plan mentioned previously, GCM’s services include consultation to client and families, professionals in the community such as guardians, attorneys, trust officers and others that serve disabled or elders. Counseling and educating families and services; crisis intervention; coordinating services, i.e., medical, home care, meals, maintenance services and socialization; monitoring and assessing services for families at a distance, residential and long term placement.

Q. How do I know when to hire a GCM?
A. When your loved one has cognitive, physical or emotional changes, i.e., confusion, forgetfulness, paranoia, isolation, unpaid bills. When you notice housekeeping or hygiene is declining, when there’s an increase in falls, emergency room visits, or loss of energy or appetite. If you notice mood changes, aggression, or sadness and your help is resisted. A major indicator for a double crisis brewing is when the caregiver is exhausted, stressed and overwhelmed. Often times family has limited time, or is facing staunch resistance to getting assistance or family dynamics cause difficulty in coming to a consensus about the next steps or plan.

Q. What questions should I ask a GCM when interviewing and how do I find one?
A. You would ask what their background and experience is, how long have they been a GCM, are they licensed in their State, i.e., social work, nursing; do they belong to the National Association of Professional Geriatric Care Managers (this association has ethics and standards that GCM’s are guided by); how many clients do they have, how much do they charge, will they supply references you can speak with. You can give a quick synopsis of your concern and ask how they can help you.

Any GCM that is a member of the National Association of Professional Geriatric Care Managers (NAPGCM) is listed on their web site by entering the city, state or area code and it will identify all the care managers in that area. That web site is: www.caremanager.org . You can also call Elder Services of Worcester Area (ESWA) 1-800-243-5111 or check their web site at: www.eswa.org as well as Central Massachusetts Agency on Aging (AAA) at 1-800-244-3032, web site: www.SeniorConnection.org.

Q. How long do I have to stay involved with a GCM?
A. Length of involvement is totally up to you. GCM’s can consult with you for an hour to educate on a particular issue and be done. They can do a comprehensive assessment, create a care plan and have the family put the plan into action or, the GCM can coordinate, implement and monitor that plan. The initial assessment and implementation takes the most time and that can stabilize a situation and end the involvement. If monitoring is needed or on-going care is indicated, we can stay involved to coordinate/supervise services, or do bi-monthly visits to prevent crisis and address significant issues – it’s what meets your needs and you determine that.

Q. How much do they cost?
A.
GCM’s charge by the hour and that ranges from $80 to $150 per hour depending on the area you live in. The larger cities in the North East are at the higher end and the rural areas, the lower end. GCM’s do not accept any fees from places they refer to.

Q. What are the benefits?
A. One of the first signs we see when we begin working with clients is peace of mind and relief. It relieves the stressed and overwhelmed feelings because we can assure them we are familiar with the healthcare maze and can design step by step solutions to resolving their immediate dilemma. We save you time, energy, money, emotional exhaustion; we can teach and instruct you on what to expect and how to care for a specific diagnosis, we are your personal social worker/nurse/advocate and supporter. We have contacts with providers in all facets of chronic and eldercare. We can expedite situations and help you to avoid costly mistakes with regard to housing, financial, legal and insurance issues. Most importantly, we can offer expert options and comparative costs of those options so you can make your own informed decisions.
Private Geriatric Care Management is not inexpensive because of the focus needed to insure specialized attention to your needs. We typically work in teams with a social work, nurse and often times, aides that are involved with the family. We have a case load of approximately 10 to 12 clients per professional to assure continuity of communication and quality service.

Elder Services of Worcester Area (ESWA) is a formidable resource that can provide affordable case management services that can help you remain in your home if your income meets their financial guidelines. If you are out of their service area they can advise you with the agency that does cover your area. Again, their number and web site are: 1-800-243-5111 and www.eswa.org.