Helping Older People Stay at Home

WebMD Feature

May 8, 2000 -- Geriatric care managers, members of a relatively new specialty, coordinate services that can help older people stay in their homes for as long as possible. For families considering such help, though, finding the right help and weighing the options can be daunting. Here are some tips:

Finding Help

• Members of the National Association of Professional Geriatric Care Managers are equipped to assess the needs of the elderly; to arrange for services, review legal, financial, and medical issues to avoid problems and unnecessary expenses; to coordinate the various government, private, and community services available; to offer counseling; and to act as liaison for distant families.
• Members must have a certain amount of training and experience, but certification is voluntary; most GCMs have state licenses as social workers, registered nurses, or psychologists. Their services are used by seniors who move into eldercare housing as well as those who wish to live independently in their own homes. The national organization is reachable at www.caremanager.org. The site lists members of the Association of Professional Geriatric Care Managers by state or zip code.

If you are about to hire a geriatric care manager, the National Association of Professional Geriatric Care Managers suggests you ask a prospective caregiver these questions:

1. What are your professional credentials?
2. Do you have a state license in your profession?
3. How long have you been providing care management services?
4. Are you available for emergencies?
5. Does your company provide home care services?
6. How will you communicate with family members?
7. What are your fees? (Be sure to get a written agreement before contracting for services.)
8. Can you provide me with references?

Paying the Bill

The job of coordinating services can be done by a family member or friend, but it requires researching what is available, then overseeing the care -- no small task, particularly if done long-distance. A GCM who evaluates what is needed, puts it in place, and keeps it running at a price the family can afford may be well worth the fee, which can be $180 or more for an evaluation visit, then about $60 an hour for follow-up, monitoring, and communicating with the family.

Hired homemakers/caregivers, transportation services, house modifications, and other services add to the bill. The total monthly cost of "aging in place" varies. An elderly woman who needs only light housekeeping or companionship for three hours twice a week might spend around $240 a month, much less than someone who needs help 24 hours a day. That can run $5,000 or more -- much more if a health aide is needed.

There is some financial aid for senior citizens who meet the Medicare or Medicaid qualifications. Less expensive home health care is also available through some state and city social service agencies as well as through the Red Cross, Visiting Nurses Association, and other concerned groups. State agencies on aging, hospital discharge offices, and Medicare offices may also have information about services offered by various private home care agencies.

Where to Go for Help:

www.aarp.org
Provides information about living at home, modifying a home, home improvement contractors, staying socially connected, transportation, and help with home care.

www.elderweb.com
Has extensive links to other sites related to aging in place and independent living.

www.homemods.org
Information on modifying homes for the elderly.

Jeanie Puleston Fleming has written for The New York Times and other publications. She is based in Santa Fe, N.M.

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