Private Care Management
A new group of health care professionals who provide private care management has recently
emerged to help older people and their family members focus on and resolve these exact
questions and issues. They are independent practitioner-specialists with advanced
degrees in social work fields such as, nursing, psychology, gerontology, and
rehabilitation. Because they work in the community where the older person resides,
they are familiar with the full array of available medical, home health, residential,
social, legal, and financial services required by older people.
A private care manager can be your eyes, ears, and legs, helping you and your elderly
family members make the best possible decisions. While private care managers offer a
wide range of services, the degree to which you utilize those services will depend on your
individual circumstances. You may have the ability, willingness, and time to do many
of these things on your own. Because private care managers charge for their
services, you may need to be selective about the extent of their involvement.
Services provided by private care managers include the following:
ASSESSMENT
One of the first priorities of the private care manager is to conduct a comprehensive
assessment of your relative's physical health, activities of daily living (ADL) skills,
social supports, physical environment, emotional status, intellectual functioning,
resources, strengths, needs, wishes, and desires. Information is gathered during a
face-to-face interview, and significant others are contacted for additional pertinent
information. The private care manager can speak with you on the telephone or prepare
a written report which summarizes the findings, lists the alternatives available to meet
the needs, and recommends a ccurse of action.
PLANNING
Once the assessment is complete, an action plan is developed that specifies the resources,
programs, services, and supports required to meet the needs identified. The plan
usually specifies immediate actions necessary as well as procedures to follow in the event
of an emergency. The private care manager can help you determine how to use your
time and energy effectively, and can help implement those parts of the plan that you
or other people in your relative's support network are unable or unavailable to implement.
COORDINATION
Securing services and resources to meet your relative's needs can be an overwhelming task,
even for caregivers living in the same location as their loved one. Private care
managers are able to coordinate your relative's health care and social service needs by
arranging for both privately and publicly funded services and programs.
Because care managers are fellow professionals, doctors, hospital personnel, and other
service providers usually respond promptly to inquiries. Publicly funded programs
and services frequently have changing eligibility requirements and long waiting lists, and
it sometimes takes an expert, with contacts in the field, to negotiate the bureaucracy and
cut red tape. A private care manager can work with your relative's friends and
neighbors in an effort to secure assistance and support. If you are spending
significant time and money calling service providers in another state, it may be more
cost-effective to use a private care manager.
Many long-distance caregivers spend vast amounts on air travel only to be frustrated by
accomplishing so little during their stay. A private care manager can apply for
services, accompany or arrange for your relative to be accompanied to scheduled
doctors appointments, and attend planning meetings concerning your loved one.
Regular telephone contact and periodic professional visits with your relative can also be
scheduled, and you will be advised of newly identified needs as they occur.
MONITORING
Your relative's well-being, and the programs and services received, need to be monitored
to ensure that they are appropriate and successful. While it is true that many
people receive less than they require, some receive (and pay for) more than they need.
Because no amount of money paid for a service can guarantee that service's
quality or appropriateness, it can be very helpful to have the oversight of a skilled and
independent professional.
If your relative receiving home health services, you will want to know how reliable the
people providing that service are. If your relative is in a nursing home or adult
congregate living facility, you will want to know that his or her needs aren't being
neglected and that they are free from abuse. By scheduling periodic visits with your
relative, the private care manager can evaluate the quality and effectiveness of services
provided, and take immediate action to correct any deficiencies.
ADVOCACY
Many people are unaware of their rights and entitlements. Others, who may be well
aware, are unable to advocate for themselves. In some cases, it requires not only
knowledge of the health care and social service system, but also well-refined
communication skills to ensure quality treatment, benefits, and services. A private
care manager can also advocate on behalf of your relative to preserve his or her well
being and dignity.
Locating a Private Care Manager
Currently, there is no state or professional licensure available for geriatric care
managers, however, credentialing efforts are well underway through several
professional care management organizations. Until such credentialing is complete,
you should be prepared to ask the following questions to determine whether the
professionals you screen will be able to meet your family's needs:
· Is the person certified by a national professional organization (i.e., a state board of
nursing or social work)? Private care managers should be willing to show you copies
of current certifications.
· What are the person's qualifications? How many years has he or she been providing
care management services?
· Does the person carry professional liability insurance that covers care
management services?
· Does the person provide care management on a full or part-time basis?
· Will the person be available in an emergency situation (i.e., after 5 p.m. and on
weekends)?
· Does the person provide alternative coverage during times when he or she is not
available?
· Is written information available that describes the full range of care management
services that can be provided?
· Is a clearly written fee schedule available which specifies all charges?
· Is a letter of agreement or contract used which specifies the services to be provided?
· How knowledgeable is the person in the areas of publicly and privately funded services?
· Does the person provide other direct services (i.e., home health services,
transportation services, financial, and management services)? If so, what kind of
procedure exist to monitor any potential conflict of interest?
· Can the person provide references?
Private care management generally is not covered by private insurance. Rates range from
$6O to $120 per hour. In most cases, time spent on phone calls, professional visits,
attendance at meetings, preparation of written reports, correspondence, and travel time
are logged and billed.
The National Association of Professional Geriatric Care Managers (NAPGCM) provides a list
of professionals across the country who may be able to assist you. The organization
is located at 655 Alvernon Way, Suite 108, Tucson, AZ, 85711, telephone (602) 881-8008.