We all need someone to lean on at times, and your senior clients are no different. In fact, this need only intensifies as we age. To help your elderly clients, you may may want to introduce them to private care managers.

These are people with expertise in navigating our increasingly complex health-care and social systems. They ensure that the elderly person gets the highest quality of health care and has access to all available social services. They pull together resources and put seniors in touch with professionals in a variety of areas. In the absence of family, the
private care manager is the one to whom seniors can turn.

“I’ve seen seniors at the hospital, not only in pain and traumatized by the belief that hospitals are places where people go to die but also bewildered by what’s going on — and overwhelmed by it all,” says John Crawford, a gerontologist and vice president of education of the Canadian Academy of Senior Advisors in Vancouver. “Having a person you trust to help you make sense of things can be a godsend.”

In today’s society, there is often no one to speak for an ailing or feeble senior. Families are often dispersed across the country or around the world. Or family members have neither the knowledge nor the inclination to help out. At what can be a difficult time, they are mustering their own emotional resources and don’t have the fortitude to take on an advocacy role. And some seniors have no families at all.

In such circumstances, a geriatric care or case manager can be hired. “Care managers are usually former social workers, therapists or nurses who have gone out on their own,” Crawford says. “It’s a profession that’s well-developed in the U.S. but is fairly new in Canada.”

Care managers will do an in-depth needs assessment and set up care arrangements. They can do immediate crisis resolution, such as determining whether a senior is living in unsafe conditions and finding new housing. They can also arrange home safety
checks, hospital and nursing-home visits, and counselling for spouses and families.

They usually charge an hourly rate, which varies across the country. It can be as high as $100 an hour, says Donna Ritch, president of Whitby, Ont.-based Change of Season, a consultancy for people and companies working with the elderly. Ritch is also a faculty member of the Canadian Institute for Elder Planning.

“But once you have a system set up,” Crawford notes, “the manager just needs to review it every six months or so. Some have assistants who can be hired to look after the details such as seeing that medications are in order, supervising home [health-care] aides — down to seeing that someone walks the dog. And they can coach adult children to take on the advocate’s role.”

How do you find a private care manager? Some insurance companies and other companies have staff trained in care management. The University of Manitoba in Winnipeg offers a certificate in care management, and program administrator April Dunn says more companies will be providing geriatric care management as part of their client services as the population ages.

Ritch suggests first contacting the provincial access-to-care system or regional health authority to see what free services are available. A registered nurse will visit the senior and do an assessment based on the safety of the home, physical needs and the support system, such as caring neighbours. Based on this information, the senior will probably be able to access certain publicly funded services.

“But the system is inadequate, and what the senior will get will be pretty minimal,” says Ritch, a former Victorian Order of Nurses nurse. “He or she will be much better off if there is money to pay for services outside the public system.

“You can also check with the local seniors’ centre, the local hospital, the senior’s doctor and pharmacist, or look in the Yellow Pages and on the Internet under ‘home care’,” she adds.

Ritch lists some questions that families should ask when shopping for a private care manager:

> What is the person’s background and experience as a care manager?

> “Is he or she a nurse? This may be important if there are medical issues to deal with,” Ritch says. “Or a social work background may be important.

@page_break@> “Also, how long has he or she worked as a care manager? Get references and talk to the manager’s clients,” she says.

> What are the family’s responsibilities? “Will the case manager manage everything — or are you expected to do certain things?” asks Ritch.

> Make sure the individual is results-oriented. “Talk about what needs to be done, when, where and who needs to be contacted,” she adds.

> For managers in one-person practices, what backup is available in the event of illness and vacation?

Personal rapport is also very important when it comes to private care. And families should make sure they understand what the manager’s fees will be. IE