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What to Do When a Senior’s Care is Too Much for the Family

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Families who are dealing with a senior loved one’s chronic care needs are constantly tested in their resolve. It takes a special person to continuously provide care and find resources for support while also managing their own responsibilities. Often it is an adult child who is charged with this task and often that adult child has a family and job of their own to contend with as well.

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Additionally, emotions can run high for the senior and the family members involved in the decision-making. Determining the best course of action can be challenging in this situation. Researching and locating appropriate care options, and then agreeing on which route to take, can create a lot of tension between family members. The decisions that need to be made are usually tough. It can be difficult for an adult child to be in the position to parent a parent and make decisions in their best interest. To counter that, senior parents may not like that their children are telling them what they need to do. If cognitive impairment is involved, the discussions go down a very complicated avenue to solidify the appropriate care and find agreeable solutions for all parties.

A solution that can ease the stress for the whole family is enlisting the guidance of a professional who is trained and perhaps even certified to work with seniors and their families in a health and human services role. Families are busy and can often overlook or misunderstand the extent of the available resources that can combine to provide a solid plan for care and support. A professional can help a family make sense of these available resources. This third party presents a professional view of the situation and frequently helps diffuse the high emotions and stay on track for finding a solution.

These professionals are focused on helping seniors and their families access resources and care. The need for these senior care professionals has paralleled the explosion in the senior population and will continue to grow in the coming decades as Baby Boomers age into senior status at the rate of 10,000 per day. They have different titles and vary in their level of training and certification. While many titles exist for this type of professional, two common professionals who practice these types of service are:

Geriatric Care Manager (GCM) – The GCM is trained and carries a specific certification. Work experience of the GCM will include any of several fields related to care management, including, but not limited to nursing, gerontology, social work, or psychology, with a specialized focus on issues related to aging and elder care. They assist older adults and persons with disabilities in attaining their maximum functional potential. In addition, the GCM is an experienced guide and resource for families of older adults and others with chronic needs, including helping those suffering from Alzheimer’s Disease or Parkinson’s or exhibiting symptoms of dementia.

Patient Navigator (PN) – The role was originally created to assist the poor, uninsured, and those with low literacy levels, but has developed to now include helping patients who find the healthcare system confusing or who are dealing with complex health issues such as diabetes or cancer. The responsibilities may involve coordinating doctors’ visits, maintaining telephone contact between patients and physicians, arranging rides to and from the hospital, helping with insurance forms, and even suggesting what to ask at your next appointment. PNs can be former nurses, social workers, or community health workers. There is no formal training or certification for this category of care assistant. Generally a PN has work experience in a related field such as social work or healthcare administration.

Services that Senior Care Professionals provide include:

  • Conduct care-planning, in-person assessments to identify problems and to provide solutions.
  • Make a care plan.
  • Screen, arrange, and monitor in-home help or other services, including assistance in hiring a qualified caregiver for home care.
  • Provide short- or long-term eldercare assistance for those engaged in local or long distance caregiving.
  • Review financial, legal, or medical issues and offer referrals to geriatric specialists.
  • Provide crisis intervention.
  • Act as a liaison to families at a distance, overseeing care, and quickly alerting families to problems – especially important when families are engaged in long distance caregiving for a loved one.
  • Assist with moving an older person to or from a retirement complex, assisted care home, or nursing home.
  • Provide consumer education and advocacy.
  • Offer eldercare counseling and support.
  • Arrange services for crisis intervention; educate consumers on options for senior housing, power of attorney, and guardianship money management; and provide referrals for family or individual therapy and/or caregiving support services.
  • Monitor the services and arrangements that have been made and conduct periodic re-evaluations to see if any adjustments are needed.

Sources: National Association of Professional Geriatric Care Managers, 2011, and Alzheimer’s Association, 2011,

The Tipping Point

Guidance by a GCM or PN can make all the difference during very challenging health issues and transitions for the senior and the family. The point at which a person realizes he needs help managing and providing the care for a loved one is often not the same point at which that person actually begins working with a senior care manager. Most often, families realize their need for this type of professional help far after they have reached their own limits. Families who are out of state will pursue professional assistance sooner than families who are in the same community as their senior loved one because they are not there to provide any of the care themselves. Families often bring senior care professionals into the picture out of necessity, and sometimes exhaustion.

A couple of considerations help to quantify that tipping point for your family:

  1. Are the problems and care needs of your senior loved one becoming larger and more complex than you and/or your family can manage?
  2. Do you have the time, inclination, or skills to effectively manage the challenges of the necessary geriatric care?

If you are not sure, you can always ask for a consultation first before fully enlisting the services of a GCM or PN. Evaluation services are also part of this professional’s offering. He or she can come into the senior’s home, observe, and assess the needs and available support for that person. Getting an evaluation and a complete report with recommendations for appropriate care moving forward may be all that a family needs to regain control and embark on a more directed path for helping the senior and the family.

Researching a Senior Care Professional

Of course, before working with a professional in this field, you’ll want to get to know that person by asking good questions from the start. It is a good idea to ask for references and follow up by talking to those references. Start with this list of questions:

  • What are your professional credentials?
  • Are you licensed in your profession?
  • Do you have special training in aging, geriatrics, or related senior areas?
  • How long have you been providing care management services?
  • Are you available for emergencies?
  • Does your company also provide home care services?
  • How do you communicate information to me?
  • What are your fees? (Provided in writing before services begin.)
  • How do you bill – monthly, weekly?
  • How often do you re-evaluate the situation?
  • Can you provide me with references?

The cost of these professional services varies by offering and by geographic area. Depending on the size of the job, some will provide an hourly rate while others my offer a contract rate. While some public agencies and hospitals may provide the assistance of a care manger, Medicare, Medicaid and health insurance policies do not cover the fees associated with this kind of assistance. Any fees related to working with a professional with this training fall under the private pay option. Families are typically responsible for all costs. The specialist you decide to work with can help outline the cost related to the services provided and help figure out the best way to provide affordable services for your specific situation.

These senior care specialists pave the way for seniors and their families to positively manage chronic care issues and provide comfort in knowing that their senior loved one is receiving the best possible and most comprehensive care available. Families receive benefit in the form of compassionate and personalized service that focuses on the individual’s situation, care that is accessible 24 hours a day, and continuity in care management by an expert. Ultimately, families are relieved of the burden and daily stresses of providing care.

More About Care Management Professionals

Geriatric Care Managers (GCM)– They are certified through various programs. Universities and other organizations offer senior care focused education that can supplement a career in those areas or stand on its own as a specialized career. The GCM certification may include but is not limited to these certifications:

Certified Geriatric Care Manager (CGCM)

The National Association of Professional Geriatric Care Managers

Care Manager Certified – CMC

National Academy of Certified Care Managers (NACCM)

(800) 962-2260

Certified Case Manager – CCM

Commission for Case Manager Certification (CCMC)

(651) 789-3744

Certified Advanced Social Worker in Case Management (C-ASWCM)

Certified Social Work Case Manager (C-SWCM)*

National Association of Social Workers (NASW)

(800) 638-8799 ext. 409

Patient Navigators (PN)– They are employed by hospitals and public agencies and other organizations like cancer centers. Many hospitals in the U.S. and Canada employ navigators to help patients manage their hospital stays. The National Institutes of Health is funding several Patient Navigator pilot projects across the U.S. in underserved and minority areas.

The National Association of Healthcare Advocacy Consultants( is another organization that is interested in promoting the wellbeing of the public through healthcare advocacy. Its members represent many fields of experience and training, but all have the goal of ensuring consumer protection through development of professional standards and best practices.

Reprinted by Always Best Care Senior Services with permission from Senior Spirit, the newsletter of the Society of Certified Senior AdvisorsThe Certified Senior Advisor (CSA) program provides the advanced knowledge and practical tools to serve seniors at the highest level possible while providing recipients a powerful credential that increases their competitive advantage over other professionals. The CSA works closely with Always Best Care Senior Services to help ABC business owners understand how to build effective relationships with seniors based on a broad-based knowledge of the health, social and financial issues that are important to seniors, and the dynamics of how these factors work together in seniors’ lives. To be a Certified Senior Advisor (CSA) means one willingly accepts and vigilantly upholds the standards in the CSA Code of Professional Responsibility. These standards define the behavior that we owe to seniors, to ourselves, and to our fellow CSAs. The reputation built over the years by the hard work and high standards of CSAs flows to everyone who adds the designation to their name. For more information, visit

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