Hiring a Geriatric Care Manager
The process of working through care options for seniors is often overwhelming for families. It may be difficult to know what the best choices are. It may be especially stressful when older adults have complex needs or live far from caregivers.
Geriatric care management is a client-centered approach that seniors and their families may find useful when arranging senior care. In this guide, you will learn about the role of a geriatric care manager which will help determine whether or not this service might be right for you.
Professional geriatric care managers are usually nurses or licensed social workers who specialize in geriatrics and senior care planning. They assess older people and their needs and recommend the most appropriate long-term care services. They may also continue to monitor an individual after services are put in place to ensure the services meet the needs that were identified. This guide covers geriatric care management services, helpful questions to ask a potential GCM, geriatric care certification, GCM care costs, and more.
Geriatric care management services
Geriatric care managers provide advice, advocacy, and practical help for seniors and their caregivers. GCM services can cover a wide range of individual tasks, from expert advice to practical
Identify housing options
There are many options for senior housing. A geriatric care manager will be able to present possible housing options to an individual and their family and recommend the best options based on the individual’s needs and budget.
For example, sometimes a senior is unable to maintain their home but does not need the level of care provided in an assisted living facility (ALF) or nursing home. In cases like these, an individual may want to consider independent living facilities. A geriatric care manager will be able to find appropriate local housing options that have openings and arrange tours.
Some of the services provided by geriatric care managers are covered by senior move managers, who provide support while seniors make the transition into long-term care facilities.
Arrange for long-term care
A geriatric case manager will be able to assess long-term health care needs and whether an individual is a good candidate for in-home services. They are able to help determine the long-term in-home caregiving needs, particularly whether the client would benefit from non-medical home care or medical home health care. They may also evaluate an individual’s home for safety and help arrange any home modifications that might be needed.
Respite care is short-term care that provides caregivers with a break from caregiving. It may be used for a single afternoon or for several weeks. It may take place in one’s home or involve temporary placement in an ALF or nursing home. This allows caregivers to take care of other needs or simply have a break from caregiving. A geriatric care manager will be able to provide options for respite care and help caregivers determine how to cover the cost.
Skilled nursing facilities are generally meant for short-term and acute stays. A doctor may recommend an SNF stay if an individual has an acute medical need such as a broken bone or an infection. The person may stay in an SNF until certain goals are met.
For example, an individual who has broken a hip bone and had surgery may need to stay in an SNF until they are able to mobilize safely and perform certain self-care tasks. A geriatric care manager may be able to help plan for this stay and assist with payment options.
Hospice services are focused on end-of-life care needs. When an individual is not expected to recover from an injury or illness, hospice services may be recommended by a doctor or requested by family members. A geriatric care manager will be able to explain to an individual and their family how they may benefit from hospice care and arrange for meetings with local hospice providers.
Coordinate medical services
If an individual needs transportation to medical treatments such as dialysis or cardiac rehabilitation, a geriatric care manager may be able to help make these arrangements. They may be able to help schedule these and other treatments in a way that fits into an individual’s schedule and routine.
Act as an advocate
A geriatric care manager may attend doctor's appointments with a client and make visits to an SNF or another type of long-term care facility if an individual lives in one of these communities. Geriatric care managers are also able to act as advocates and facilitate communication between doctors or facility staff and individuals and families. They are able to help ensure a senior’s needs are being met and know what to do if they are not.
In the event of a medical or another emergency, a geriatric care manager will be able to help an individual obtain treatment. They are able to assist with emergency room stays, hospital admissions, and any additional care needs.
Identifying financial and legal resources
Geriatric care managers may be able to help with financial planning including bill payment. They may be able to work with a client’s power of attorney (POA) to ensure bills are paid. They can help identify national or local resources that may be able to assist with paying for care. In addition, they may also be able to make referrals to elder care lawyers as needed.
Facilitate difficult conversations
Discussions about leaving a home that an individual may have lived in for years or needing advanced medical care may be highly emotional. Caregivers may feel uncomfortable having these important conversations with an elderly family member and the individual who needs care may be resistant to these discussions. A geriatric care manager will be able to help with these conversations and may be able to ease tensions by explaining options that everyone is able to agree on.
When to hire a geriatric care manager
When caregivers feel unprepared in elder care and want expert advice, a geriatric care manager (GCM) may be a good option. A GCM helps families find the right resources and providers for elderly individuals. It may be beneficial to consult a geriatric care manager when you need a professional with extensive knowledge who can help navigate complex elder care situations, such as when:
Multiple medical or psychological issues arise
If an individual has multiple health conditions, it may be difficult to prioritize their care needs and know what help the person requires. For example, if an individual has congestive heart failure (CHF), difficulty mobilizing,
Living alone is no longer an option
An individual who has an illness or an injury may no longer able to manage their own care. They may not be able to do daily tasks such as showering, dressing, or toileting. These tasks are referred to as the activities of daily living (ADLs).
They may also feel overwhelmed and no longer able to handle tasks such as money management, cooking, or housekeeping. These tasks are referred to as instrumental activities of daily living (IADLs). When an individual is no longer able to perform ADLs and IADLs, it may be a good idea to consult a geriatric care manager.
Care needs increase or change
When an individual has care providers who are not meeting their needs, they may not know how to advocate for themselves or change the situation. A geriatric care manager will be able to advocate for the individual and assist in making other arrangements for care if required.
Planning long-term care needs
Family members may not be knowledgeable about the medical conditions an individual has and feel unprepared to make a comprehensive care plan. They may feel their lack of knowledge about medical conditions or about different types of care means they will not be able to help make good care decisions. Seniors often prefer in-home care and geriatric care managers will have a better idea whether in-home care is a realistic long-term option. Family members may also live far from an elderly individual or be busy and not have time to assist with decisions about care. In these situations, a geriatric care manager can act as an expert and advocate helping clients maintain health and wellbeing with
Family members disagree about care
Spouses, adult children, or other caregivers may not be able to agree on important decisions about their family. While disagreement isn't unusual, caregiving disagreements can cause significant family issues. One adult child may feel they are doing their best to help an aging parent remain independent while another adult sibling may feel things would best be handled if their aging parent moved in with them.
Families may also disagree about whether or not to sell a home and about whether a senior needs long-term care in a facility or not. A geriatric care manager can help mediate in these situations while providing a more objective and expert opinion.
Preventing or treating caregiver burn-out
When caregivers are providing care while also trying to plan the transition to another type of care or secure resources, it may lead to burnout. Geriatric care management services can help caregivers plan a care transition as well as identify appropriate resources to make this change. Investing in caregiving support can improve family relationships and help caregivers provide better care.
Family caregivers live far away
If an individual does not have family support or caregivers who are able to help with decisions and arrange for care, they may be uncomfortable making decisions on their own. Or if all family members live far away, long-distance caregiving is often better with a local geriatric care manager to assist. Seniors may be unsure of what help they need and where to turn for help. Planning for long-term care can be daunting to take on alone. A geriatric care manager will help clients with few personal supports feel more in control of their care options and more certain they are making the best choices.
Financial or legal advice is needed
The payment options for short or long-term care can be overwhelming. Individuals who need care may not know what Medicare will pay for or know the differences between Medicare and Medicaid. They also may not know how to apply for Medicaid or other long-term coverage options.
An individual also may be unsure how to set up legal healthcare directives such a living will or POA. A geriatric care manager will be able to provide information and education on these topics for seniors and may be able to help with many steps in these legal processes.
Geriatric care manager certification
For geriatric care management, certification is becoming a professional standard. Certification requires having a bachelor’s degree or master’s degree in a field such as nursing, social work, professional counseling, mental health, gerontology, or occupational therapy.
Initial geriatric care management certification also usually requires that the professional work in the geriatric care management field under
The Aging Life Care Association (ALCA) is a national organization for professional geriatric care managers. Members of this organization are known as Aging Life Care Professionals.
ALCA members receive certification from a credentialing board and adhere to a code of ethics and standards of practice. The ALCA was formerly known as the National Association of Private Geriatric Care Managers and has been in existence since 1985. The ALCA has branches throughout the U.S.
Professional certifications recognized by the ALCA to become an Aging Life Care Professional are granted by the following credentialing boards:
- National Academy of Certified Care Managers (NACCM) offers the designation of Care Manager Certified (CMC)
- Commission for Case Manager Certification (CCMC) offers a Certified Case Manager certification
- National Association of Social Workers (NASW) offers a Certified Social Work Case Manager certification and a Certified Advanced Social Work Case Manager certification
These certifying bodies identify an individual as a professional geriatric care manager. Some geriatric care managers are not certified and may not have a master’s degree, bachelor’s degree, or the experience required for certification or professional membership. An individual and their family should inquire about a geriatric care manager certification and experience before hiring.
Selecting a geriatric care manager
Choosing the right geriatric care manager is a decision that can make the other decisions an individual and their family need to make easier. Support groups for various medical conditions may be able to recommend geriatric care managers that have worked with group members in the past.
The U.S. government’s Eldercare Locator service may also be used as a resource to find local geriatric care managers.
An individual and their family may want to speak with a few geriatric care managers before selecting one to assist them. Some questions to ask a geriatric care manager include:
- How long have they been providing services?
- What kind of education and training do they have?
- Are they certified? Licensed?
- What services do they provide?
- What do they charge for GCM services?
- How will they communicate with caregivers?
- What is their availability in case of an emergency?
- Are they associated with any providers (e.g., home care agencies)?
- Are they able to provide references
Working with a geriatric care manager
An elderly individual and their family should do their best to ensure the geriatric care manager they choose is a person they trust and who has their best interests in mind. They should feel comfortable asking questions about why certain recommendations are being made or certain actions are being taken. A geriatric care manager works for the individual who needs care and should recommend the most appropriate solutions for that individual.
When working with a geriatric care manager, it is important to have a written contract outlining what services will be provided and the cost of these services. Even if there is not a written contract, an individual or their family may still be responsible for the cost of services provided. Having a written agreement protects the individual and the geriatric care manager.
Once an agreement has been made, the geriatric care manager will visit the individual in their current residence. The geriatric care manager will ask the individual questions about their current situation and their future goals. They will want to meet with any family members or caregivers. The individual and their family should be prepared to discuss the person’s needs and concerns.
Some examples of needs that should be discussed include:
- Medical needs — The individual’s health and specific medical care needs will help determine what type of care is required
- Mental health needs — Individuals with mental health conditions and concerns sometimes require different facilities or treatment protocols than individuals without mental health needs. Additionally, there may be mental health resources available
- Social needs — For some seniors, isolation can lead to mental health issues and may make self-care more difficult. Geriatric care managers may be able to help individuals meet social needs with providers such as a day programs for seniors or independent living facilities with group activities
- Spiritual needs — If attending weekly church services or being around other individuals who are part of a faith community is important for the individual, this should be discussed with the geriatric care manager. They may be able to find providers to help meet spiritual needs or connect the individual with local church programs
- Safety needs — An individual may have safety needs as well. For example, an individual with dementia may need to live in a secured unit with an alarm or lock to prevent wandering. A geriatric care manager can help identify safety concerns and recommend ways to keep an individual safe
- Financial needs — A geriatric care manager may be able to help identify resources to cover costs of long-term or medical care. They will also be able to help an individual apply for programs such as Medicaid. However, it is important to be clear with the geriatric case manager about what services the individual can afford before they begin their work
Once the individual’s case has been discussed, the geriatric care manager will present some preliminary options and ideas. Some important questions to ask a geriatric care manager during an initial meeting.
How much time and cost will be required?
The geriatric care manager may not have a solution right away, but they should be able to give an estimate of what tasks might be involved, as well as the time frame and costs associated with those tasks.
Are there any alternatives for this situation?
The geriatric care manager should be able to present what they think the best course of action is along with other alternatives that could meet the individual’s need. The geriatric care manager may need time to look into some of these options in more depth, but they should have a general idea based on relationships with local providers and on work with past clients.
What are the advantages?
Asking about the benefits of each option provided will give an individual and their family a better sense of what choice may be best for them.
What are the disadvantages?
Alternatives may have disadvantages as well such as high cost, loss of independence, or distance from family and friends.
Who else will be working with the GCM?
A GCM may have a team of people they will be working with. An individual and their family should know who these people are and if they are able to contact them.
When will services end?
When working with a geriatric care manager, it may be helpful to have a set end point in mind. In some cases, the geriatric care manager will stay on as an emergency contact person for an extended period of time. In other cases, a person and their family may just want to access these services for a few weeks until they have solved a problem.
Costs of geriatric care management
Different professionals handle billing and fees differently. Initial geriatric care consultations cost an average of $175 and the average cost for service after that is $74 per hour. GCM fees aren't usually covered by Medicare or other insurance, although long-term care insurance may be used to cover part of these costs.
Geriatric care managers may bill weekly, monthly, or after the completion of services. An individual and their family should ensure they know when and how much they will be expected to pay before agreeing to services.
Additional fees may also be charged on top of an hourly rate. These may include fees for expenses such as:
- Travel expenses including mileage and gas
- Caregiving supplies
- Long-distance phone calls
- Consultation with other professionals
Having a written contract in place that identifies potential costs in advance helps clients and their families know what to expect when it comes time to pay for services. A geriatric care manager should be able to identify all possible fees before they begin providing any service.
Geriatric care management FAQs
- What are geriatric care managers unable to do?
A geriatric care manager is not a lawyer. They may be able to refer an individual and their family to legal services, however, they are not able to provide legal advice. A geriatric care manager is also not able to provide direct nursing care or take the place of another caregiver. While the geriatric care manager may have a nursing license, their role is not to provide medical or “hands-on” personal care.
- Why would a family pay extra money for things they can do themselves?
Many people are able to handle long-term care planning without additional services. They may already be very involved in caring for the aging individual or already know about local resources. Some seniors research options such as independent living years before they need these services. However, long-term care choices may be difficult and stressful for some people.
Making a choice about long-term care that is not a good fit for an individual may end up costing more money than hiring a geriatric care manager initially when making the decision about long-term care. Moving from one facility to another may have transportation and other costs associated with it. In addition, the wrong long-term care provider may erode
Each person and their family must decide if the cost of a geriatric care manager is worth the benefits they would receive. For some individuals, it may not be worth the cost, but for others, it may be money well spent. Setting up an initial consultation may also help with this decision. While the consultation is not free, it may help an individual and their family determine if they would benefit from this service.
- Does Medicare cover the costs of geriatric care management?
In general, Medicare does not pay long-term care or custodial care. However, Medicare may pay for some of the services of geriatric care management if the services are considered necessary for chronic care management.
Other requirements also need to be met for Medicare to cover geriatric care management. These requirements include that an individual has two or more significant and chronic conditions such as:
These conditions must be expected to last for at least year.
If these requirements are met, Medicare will cover the following services:
- Phone check-ins with a geriatric care manager.
- At least 20 minutes/month of geriatric care management services.
- Care coordination between doctors, hospitals, pharmacies and testing centers.
- Emergency 24-hour access to a healthcare professional.
- Creation of a personalized plan of care based on individual needs and goals.
- Assistance to reach
An individual and their family should ask a geriatric care manager if any portion of their services is eligible for coverage under Medicare.
- What is the difference between a case manager and a geriatric care manager?
The term “case manager” may be used to refer to a number of professionals in different settings. For example, a social worker at an SNF who is assigned to an individual might be referred to as their “case manager”.
In another facility, the term “case manager” may refer to the nurse in charge of an individual’s daily care or to a financial planner helping an individual apply for Medicaid. Some facilities differentiate between roles with titles such as “clinical case manager” or “nurse case manager,” but this is not always the case.
While becoming a geriatric care manager may involve a case management certification or degree, the term “geriatric care manager” refers to a specific professional role and designation.
Although geriatric care managers may have different professional licenses and work experience before they became a geriatric care manager, their role is the same. All geriatric care managers assist elderly individuals and families with
Proximity of care is very important when considering options
Research care options that are nearby when thinking about the next step for your loved ones.
Leona J. Werezak RN, BSN, MN is a registered nurse and adjunct nursing professor. She has 24 years experience working in a variety of healthcare settings including such remote locations as the Arctic Circle. Her research in early stage dementia was published in the Canadian Journal of Nursing Research and re-published in their 40th anniversary issue which showcased exceptional research published since the journal began. Her work in dementia care has also been published in the Journal of Gerontological Nursing. She currently teaches surgical nursing care on a thoracic/vascular unit to baccalaureate nursing students. Her clinical work with nursing students involves extensive work with older adults who have multiple chronic health conditions.