Baby Boomers were once called the Me Generation, but now they’re defined less by Me and more by We—the family universe of aging parents, adult children and often grandchildren, nieces and nephews. For most Boomers, the most pressing concerns are usually for older loved ones, whose needs grow more complex with each year.
Add a fall, a major illness or concerns about increasing forgetfulness, and it can be overwhelming.
Making decisions about what to do, how and when, isn’t easy. Lifelong patterns are hard to change; we’re used to our parents making their own decisions, just as we make ours. It’s hard to intervene when you are not sure whether it is really necessary. Family members often disagree about what should be done and by whom. And indecision or procrastination can intensify physical and emotional issues.
How hard can it be to find quality help, to find a good doctor, or to know which rehab is best? If you turn to the internet for help, you’ll find that search engine results can be misleading, confusing, overwhelming or all three. It may come as a big surprise to people who are confident about sourcing information for work, or are skilled at internet research, when they can’t seem to find the right information on their own.
Consider these typical scenarios:
- You visit your mother in the morning and she is standing at the stove cooking a steak, a stack of unpaid bills on the kitchen table and prescription bottles mixed together in a bag along with a few unlabeled bottles containing an assortment of different-colored pills. She assures you that she knows exactly what and when to take them, but it doesn’t seem likely. Putting help into the house for four hours a day of home care should help, but as the parent’s functioning deteriorates, four hours becomes eight, then possibly more. Eventually the family is paying $100,000 a year for non-professional help.
- It seems as if an assisted living is the next step, so you call that number you see advertised on TV and tell the “advisor” about your mom. Your advisor takes your personal information and the next thing you know you are inundated by calls and third-class mail touting senior living.
- After the last fall, your father spent three days in the hospital and you are informed that he wasn’t really admitted, that he was under observation and that if he goes to rehab he will have to pay out of pocket. Didn’t he go to rehab last time he fell?
- Your parents thought their AARP membership card was a Medicare Part D prescription drug plan and you find out there are penalties and higher premiums forever—and, anyway, they can’t sign up for another couple of months and even then the plan doesn’t go into effect until next year. Your parents continued with the same insurance company that provided their health insurance when they were working. How could they know that their doctor wasn’t in the network now that they were on Medicare?
What a care manager can do
Yes, handling these issues is difficult and emotionally charged. What—actually who—can ease the way is a geriatric care manager sometimes called an “aging life care” expert. These are certified professionals, often social workers or nurses, who understand older adults, our health system and the complex web of resources, both public and private, that support health and well-being. Care managers also offer advice and support when it’s time to make important decisions about short- and long-term care, whether at home or in a facility.
Here’s what you need to know:
- When you hire an elder care expert, you want to make sure that they are your advocate and that they have a fiduciary relationship with the older adult. They work independently from hospital, rehab and residential facilities, and do not accept commissions or referral fees. They work on a straight consulting agreement, typically by the hour.
- They know about the gaps and pitfalls you’ll likely encounter, and they know how to navigate continuity of care.
- They are especially helpful when family members don’t live near the patient, when family members don’t agree on a course of action or when there is some sort of transition, either from living independently to living in an assisted living facility; from hospital to rehab to home; from home to hospice; from driving to not driving; from walking with a cane to a wheelchair or even going from no help to some help at home.
- Investing a few dollars upfront can save you thousands of dollars of mistaken choices, misunderstood benefits or lack of awareness of special programs that exist to support older adults aging in place in their own home.
- They are well versed in the intricacies of Medicare and Medicaid, and know what can be outsourced and what only family members can do.
Still on the fence about hiring an elder care expert? Most families hire specialists to help with tax prep, college admissions and career moves. Hiring a professional to help with an aging parent is just as worthwhile.
Malka Young is a licensed independent clinical social worker and certified care manager. Email her at firstname.lastname@example.org.
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