As your Geriatric Care Manager, a member of our team would begin by coming to your home and completing a bio-psychosocial and spiritual assessment. Most of the information can be gathered through conversation. This usually takes about an hour and fifteen minutes. During this time, we will discuss all of the challenges the client and their current care team are facing. It is often most beneficial if the client and a family member — or reliable source of information — can be present for a portion of the visit.

Next, a Care Plan is completed with solutions to all of the identified challenges.

Your Geriatric Care Manager then reviews the Care Plan with the client, their family and support systems.

We concentrate on identifying and creatively implementing activities that provide a client with a sense of purpose and meaning, while supporting them through a medical crisis, catastrophic diagnosis or a significant deterioration of function. Your comprehensive Care Plan will include everything we discussed and which resources are necessary to create a safer, more comfortable lifestyle with the opportunity for the highest quality of life.

We develop and build a system for the client and home so your loved one can age in place, for as long as possible.

Topics that may be included in the Care Plan are:

• Long-Distance Care: Coordinating the care of a loved one for families that live at a distance; including crisis management. This could include but is not limited to weekly home visits.
• Safety and Security: Monitoring the client at home; recommending technologies to add to security or safety; observing changes and potential risks of exploitation or abuse and anticipating a crisis.
• Medical Management: Attending medical appointments, facilitating communication between client, medical professionals and family, and if appropriate, monitoring client's adherence to medical orders and instructions.
• Liaison: Keeping family members and professionals informed as to the well-being and changing needs of the client.
• Housing Issues: How to make your home safer and/or helping families evaluate alternative residential options.
• Food Shopping and Supplies: Working alongside home care workers and the client to have all food and supplies sent to the home.
• Entitlements: Providing information on Federal and state entitlements; connecting families to local programs, accessing benefits.
• Home Care Services: Discussing options that are right for a client as well as assisting the family with engaging and monitoring those services (Medicaid or private-pay).
• Support: Provide emotional support, concrete tools and strategies to family and home care workers in order to better manage the stress and challenges that arise daily.
• Socialization: Cultivating opportunities, both free and private-pay for client to engage in social, recreational, or cultural activities that enrich their quality of life.
• Legal: Referring and consulting with an elder care law attorney; providing expert opinion for courts in determining level of care and preparing for Medicaid eligibility.
• Financial: May include reviewing or overseeing bill paying, mail sorting or consulting with accountant or client's Power of Attorney. We may also discuss ways to conserve resources.
• Quality Control: Our care management services follow the National Association of Professional Geriatric Care Managers' (NAPGCM) Standards of Practice and Code of Ethics.