What Care Does Your Elder Really Need?

In the late summer last year, my 87-year-old mother began experiencing such serious anxiety that it dramatically affected her sleep patterns and caused her some associated chronic pain. I no longer live near enough to my mom to run over every time she has a health issue, but I visit frequently and I was shocked when I arrived in September to see how debilitated she had become in a short time.

My mom lives in a senior community that she loves, in her own apartment. In her mind, she was staring down the prospect of moving to the assisted living section, which she dreads because she likes being in control of her life and her schedule. But it was clear that something needed to change, and that she needed more help.

If “long-term care” is a regular part of your lexicon, you know that Long-Term Care insurance covers help for the elderly when they can no longer perform one of six activities of daily living: dressing, bathing, eating, toileting, continence, getting in and out of a bed or chair, and walking. In my mom’s case, however, she was capable of doing all those things. What was causing her great difficulty, on the other hand, was managing her complicated medication schedule, dealing with doctors and medical folks, and getting to and from doctor appointments since she no longer drives.

What she needed was another “me.” When I discussed this with her main physician, the doctor told me about a type of caregiver who does not help with bathing and toileting, but instead provides the type of “executive” management and decision making that was becoming so difficult for my mom. They are called Geriatric Care Managers, or GCMs. Generally, GCMs are trained nurses or gerontologists who visit as needed and are paid on an hourly basis to assist in just the sort of tasks my mom was finding challenging.

Luckily, a GCM company was already operating at my mom’s community, so we were able to plug her in quickly. Her GCM reviews her weekly medications, takes her to some of her doctor appointments, makes sure my mom understands what the doctors say and instruct (which is invaluable since my mom is very hard of hearing), and even helps when my mom has trouble with her email, which is an important lifeline for her. In a few months, her GCM has proven to be an invaluable member of our family team. By the time I arrived for Thanksgiving, Mom’s situation had improved dramatically.

We have also taken a few additional steps. Upon her request, I took over more of her financial responsibilities, and we found some solutions to aid in her sleeping. Happily, Mom’s anxiety has decreased significantly, she regularly sleeps as long as she needs, and her mobility has visibly improved. On the phone recently, she jumped at the chance to go visit relatives in another state during my next visit. This past September, I was pretty sure she would never make that trip again.

GCM’s are not inexpensive, and their fees are generally not covered by Medicare or LTC insurance. We have found, however, that their fees are significantly less than the additional costs if Mom had to move to assisted living. By using a GCM and implementing a few other strategies, it looks like Mom is fine to stay in her own apartment for the foreseeable future. And that is worth a lot.


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