P.I.S.S.D. — Personal Injury, Social Security Disability. Dallas Texas Lawyers

This guest article is from the National Care Planning Council:

Living
in a different city or state — miles from aging parents — can be very
difficult. Keeping in touch by telephone and making long trips to help
parents or aging relatives with their needs can be time consuming and
not nearly as effective as being available full time in person.

Mark
Sessions spent two years juggling his restaurant business with multiple
daily phone calls to his elderly parents, checking on their needs and
answering their questions. Family vacations were spent traveling the
500 miles to his parent's home to personally take care of home
maintenance and provide health care visits to their doctor. During his
last visit, Mark noticed his father had difficulty walking and his
mother was confused as to which medications she was to take and at what
time. This alarming change in his parent's condition concerned Mark
that his parents' care needs required more than frequent phone calls
and vacation visits. Running his business and handling his parent's
long distance care was now becoming very challenging.

According
to a report by the Alzheimer's Association of Los Angeles &
Riverside, California, there are approximately 3.3 million long
distance caregivers in this country with an average distance of 480
miles from the people they care for. The report also states that 15
million days are missed from work each year because of long distance
care giving. Seven million Americans provide 80% of the care to ailing
family members and the number of long distance caregivers will DOUBLE
over the next 15 years.
Long
Distance Caregiver Project – Alzheimer's Association LA &
Riverside, Los Angeles, CA (May 15, 2002, National Web Seminar by
Judith Delaney, MFT, Clinical Coordinator)

The long
distance caregiver is a new role that is thrust upon children and
younger family members. Families used to live closer together, with
children residing and working near their parents. But nowadays family
members are more distant from each other. Society, today, is
recognizing this. Some caregiver services have tweaked their programs
to work as liaisons between long distance caregivers, senior loved ones
and local medical professionals.

Professional care
managers — a lso known as Geriatric Care Managers, Elder Care Managers
or Aging Care Managers — represent a growing trend to help full time,
employed family caregivers provide care for loved ones. Care managers
are expert in assisting caregivers, friends or family members find
government-paid and private resources to help with long term care
decisions.

They are professionals — trained to evaluate
and recommend care for the aged. A care manager might be a nurse,
social worker, psychologist, or gerontologist who specializes in
assessing the abilities and needs of the elderly. Care manger
professionals are also becoming extremely popular as the caretaker
liaison between long distant family members and their aging elder loved
ones.

Jacqueline Marcell — author of "Elder Rage, or Take My Father…Please! How to Survive Caring for Aging Parents" (Impressive, 2000) — says,

"The
most important thing to do is to find a geriatric care manager in the
area where your loved one lives. She will have knowledge of all the
services in the area and can be your eyes."

Below is a partial list of what a care manager or Professional Geriatric Care Manager might do:

• Assess the level and type of care needed and develop a care plan.
• Take steps to start the care plan and keep it functioning.
• Make sure care is in a safe and disability friendly environment.
• Resolve family conflicts and other issues with long term care.
• Become an advocate for the care recipient and the caregiver.
• Manage care for a loved one for out-of-town families .
• Conduct ongoing assessments to implement changes in care.
• Oversee and direct care provided at home.
• Coordinate the efforts of key support systems.
• Provide personal counseling.
• Help with Medicaid qualification and application.
• Arrange for services of legal and financial advisors.
• Provide placement in assisted living facilities or nursing homes.
• Monitor the care received in a nursing home or in assisted living.
• Assist with the monitoring of medications.
• Find appropriate solutions to avoid a crisis.
• Coordinate medical appointments and medical information.
• Provide transportation to medical appointments
• Assist families in positive decision making
• Develop care plans for older loved ones not now needing care
  “The 4 Steps of Long Term Care Planning,” National Care Planning Council

Services
offered will depend on the educational and professional background of
the care manager, but most are qualified to cover items in the list
above or can recommend a professional who can. Fees may vary. There is
often an initial consultation fee that is followed by hourly fees for
services. Health insurance does not generally cover these fees but
long-term care insurance might.

In 2002, the AARP published a survey from geriatric care mangers about their fees:

“Respondents
were asked how much they charged for their services, which might
include: an initial consultation; fees on an hourly or per visit basis;
fees for development of a care plan; and fees on a fixed-price contract
basis. Hourly fees averaged $74 an hour. GCMs charged an average $168
to develop a care plan. Initial consultations averaged $175. Seven of
ten current GCMs responded in the affirmative when asked if they had a
statement that listed their fees. ” Written by
Robyn Stone, DrPH, Principal Investigator; Susan Reinhard, RN, PhD,
Co-Principal Investigator; Jean Machemer, MSG, Research Associate; and
Danylle Rudin, MSW, Research Associate of The Institute for the Future
of Aging Services, Washington, D.C.Barbara Coleman, Project Manager,
AARP Public Policy Institute November 2002

When
you take into account the time absent from work and time to find the
right care resources for your loved ones, along with the cost of travel
expenses to monitor their care, you will probably concur that using a
caregiver is money well spent. Add on to this the stress of handling
your own life circumstances combined with being a caregiver and you
will probably wonder how you could have ever done without the care
manager.

A professional or geriatric care manager can be
an important asset to all families in elder care situations. Here is an
example of how a care manager can help.

Mary
is taking care of her aging husband at home. He has diabetes and is
overweight. Because of the diabetes, her husband has severe neuropathy
in his legs and feet and it is difficult for him to walk. He also has
diabetic retinopathy and, therefore, cannot see very well. She has to
be careful that he does not injure his feet, since the last time that
happened he was in the hospital for four weeks with a severe infection.
She is having difficulty helping him out of bed and with dressing and
using the bathroom. She relies heavily on her son, who lives nearby, to
help her manage her husband's care.

On the advice of a
friend, Mary is told about a professional care manager, Sharon Brown.
The cost of an initial assessment and care plan from the care manager
is $175.00. Mary thinks she has the situation under control and $175.00
for someone from the outside to come in and tell her how to deal with
her situation seems ridiculous.

One day Mary is trying
to lift her husband and injures her back severely. She is bedridden and
cannot care for her husband. Her son, who works fulltime, now has two
parents to care for. On the advice of the same friend, he decides to
bring in Sharon Brown and pay her fee himself.

Sharon
does a thorough assessment of the family's needs. She arranges for
Mary's doctor to order Medicare home care during Mary's recovery.
Therapists come in and help Mary with exercises and advice on lifting.
Sharon advertises for and finds a private individual who is willing to
live in the home for a period of time to help Mary with her recovery
and watch over her husband. Sharon makes sure the new caregiver is
reliable and honest and that taxes are paid for the employment. Sharon
enlists the support of the local area agency on aging and makes sure
all services available are provided for the family.

Sharon
also calls a meeting with Mary's family and explains to them the care
needs and how they need to commit to help with those needs. Sharon
makes arrangements to rent or purchase medical equipment for lifting,
moving and easier use of the bathroom facilities. Medicare will pay
much of this cost. Sharon also works closely with an elder law attorney
and a financial planner who specializes in the elderly. The attorney
prepares documents for the family including powers of attorney, a
living will and advice on preserving Mary's remaining assets. The
financial planner recommends a reverse mortgage specialist to help Mary
and her husband tap unused assets in their home's equity. Some reverse
mortgage proceeds are used to pay off debt. The remaining proceeds are
converted into income with a single premium immediate income annuity in
order to provide Mary adequate income when her husband is gone and she
looses one of the Social Security payments.

With the
help of the care manager, Mary's life and future have been
significantly improved. Her husband as well, if he adheres to the care
plan, may end up having a better quality of life for his remaining
years.
“The 4 Steps of Long Term Care Planning,” National Care Planning Council

The National Care Planning Council promotes and supports professional and geriatric care managers on its website www.longtermcarelink.net .