At Support For Home Health Care, we provide a variety of services to our clients and patients – and their families – but none of those services are any more critical, when needed, than Geriatric Care Management. However, the first thing I would point out is that it is a poorly understood function, and therefore poorly executed by many folks who call themselves by that title.
Frankly, the title is misleading. Geriatrics, by definition, relates to the medical needs and treatment of elderly people. It is an absolutely critical branch of medicine and is practiced by (i.e., understood by) far too few physicians. I have talked about that problem a number of times in prior postings.
Geriatric Care Management, on the other hand, is much broader and more comprehensive in scope. Wikipedia actually has a pretty good view of the scope, including services such as:
- Conducting care-planning assessments to identify needs, problems and eligibility for assistance;
- Screening, arranging, and monitoring in-home help and other services;
- Reviewing financial, legal, or medical issues;
- Offering referrals to specialists to avoid future problems and to conserve assets;
- Providing crisis intervention;
- Acting as a liaison to families at a distance;
- Making sure things are going well and alerting families of problems;
- Assisting with moving their clients to or from a retirement complex, assisted living facility, rehabilitation facility or nursing home;
- Providing client and family education and advocacy;
- Offering counseling and support.
These services can be absolutely critical to the well-being of the client / patient involved and to the family and loved ones affected. A very brief case study might be useful.
One of our two Geriatric Care Managers (GCMs) is an RN, with years of experience in skilled nursing facilities, home health and hospice. The other is a Gerontologist by academic training. This gives them a very good balance of clinical and non-clinical perspectives on the issues of aging. That is very important in looking for a GCM to help your family or loved one. The GCM has to think very broadly and have a diverse array of resources to which she / he can turn.
Those resources, by the way, need to be absolutely free from any kickback or commission arrangements. For example, if the family needs a trust / elder lawy attorney, the GCM needs to know who the good ones are and not receive any payment from the attorneys for referrals. Since Medicare, at this time, does not cover GCM services, any charges for the GCM’s services need to be billed to the client or family (or to Long-Term Care Insurance, in some cases).
The GCM also needs to look into every nook and cranny of need – literally. We recently began providing GCM services to a client, for example, for whom we determined the need for (among other services):
- a doctor’s visit to the home – done, thanks to a great home care physician named Dr. Shirley
- a referral to a great home health agency – in this case, Sutter Care at Home here in the greater Sacramento, CA region
- Bathing services, four times per week
- Deep cleaning of the home
- Pest control services
The last two services are examples of the breadth of vision a good GCM must have. Lining up all the other aspects of care would produce less than adequate results unless the living environment was addressed.
So, GCM services can be absolutely critical to maintaining – or improving – the life of the client and family, but make sure the GCM (1) adheres to the ethics of no kickbacks or commissions for arranging services, and (2) has the breadth of vision to look beyond the obvious medical needs.
Best wishes. Bert