•  Geriatric Care Management and Geriatric Care Managers:
    Frequently Asked Questions (FAQs)

Bobbi is a master's educated Registered Nurse certified in case management. For the past twenty-five years she has been practicing case management in a variety of organizations, including a University Hospital, several health insurance carriers, pharmaceutical companies, and is an adjunct faculty member at local Universities where she teaches undergraduate classes on managed care. She is a Certified Case Manager (CCM) by the Commission for Care Manager Certification and a member of the National Association of Geriatric Care Managers.

Below are some answers to questions that we are frequently asked about Geriatric Care Management that will help you to know if the services of a Geriatric Care Manager would be of benefit to you or a loved one.

Answers to Frequently Asked Questions:

Why might I need a Geriatric Care Manager?

  Sometimes called case managers, elder care managers, service coordinators or care coordinators, Geriatric Care Managers are specialists in assisting older people and their families to plan for and implement ways to allow for the greatest degree of independence, safety and comfort and quality of life. They meet with families, assess the client's needs, and develop a comprehensive care plan with input from caregivers, professionals, and others. They then assist with any appointments, interviews, and other paperwork necessary to implement the care plan and make all preparations for any needed in-home care or arrangements for a transition to a facility. They review all care options clearly and discuss them with the family.

Geriatric Care Managers can be especially helpful to those who are new to elder care or uncomfortable with elder care decision-making; are having difficulty with any aspect of elder care; are faced with a sudden decision or major change, such as a health crisis or a change of residence and those who are dealing with a complex situation such as a psychiatric, cognitive, health, legal, or social issue. Geriatric Care Managers can then also effectively follow up, review and assess the care being given and report to family members to make sure that the their loved ones are getting the highest quality of care.

How can a Geriatric Care Manager help an elder person get all the services they need and benefits to which they are entitled?

  The health care and related services available in the Pittsburgh area can offer more than any other in the city in the USA, if you know how to make them work for you. Unfortunately, most people are unaware of what benefits they should be receiving, or how to interact with the system to obtain the best services for their situation. Bobbi Kolonay, owner of Options For Elder Care, knows this system inside and out and can advocate for you or your loved ones to receive the highest and most compassionate levels of care obtainable and all coverages that your health insurance promises. Bobbi can work with "case managers" from insurance companies, discharge planners in hospitals and rehabilitation facilities, administrators of nursing homes or retirement communities and with home care agencies to ensure that you receive the care you need and deserve. Geriatric Care Managers ensure that the needs of the client are foremost, rather than the needs of a facility or provider.

Aren't these services available for free through government agencies?

  Social Service agencies such as services provided by the Allegheny County "Area Agency On Aging" offer limited services to indigent individuals who otherwise may receive no services at all. The very wealthy often have no trouble obtaining the care they need because they are used to asking for it and can afford to pay quite a bit for it. If you are neither indigent nor extremely wealthy, often times your needs fall through the cracks. There are fewer follow-ups, very little outreach, and no service which is as comprehensive as what private geriatric care management can provide.

How does one begin?

  After an initial telephone consultation - offered free of charge - an assessment is typically necessary for care managers to understand the environment that the older adult is living in, their level of functioning and their current support network. The assessment involves interviewing the older adult and family members, gathering relevant medical records, developing an individualized action plan and discussing the options with the older adult and caregivers.

Is the scope of this assessment limited?

  No. Bobbi Kolonay of Options For Elder Care is trained to evaluate all aspects of an older person's life, including legal, financial, home safety, nutritional, medical, and housing issues. An in-depth assessment would include the client's physical, emotional, mental, social, spiritual, and environmental strengths, weaknesses and concerns. The goal of the assessment is to provide a comprehensive understanding of the support required to assist older adults in functioning as independently - and with the highest quality of life - as possible.

How would Options for Elder Care work with my parents' doctors and other professionals?

  With over twenty-five years of nursing experience, Bobbi Kolonay is extremely comfortable and competent to work closely with every professional and para-professional involved with your relatives health care and well-being. Options For Elder Care can arrange and attend doctor's appointments to ensure that the doctor is getting the full picture and that the elder is able to understand the doctor's instructions. We interface with the home health or hospice nurses and aides who are involved, making sure that the plan of care is followed, and that detailed personal care is always properly performed. We also work closely with attorneys, financial planners, and clergy, to see that all of a person's needs are being met, and not just in one area of life. We will talk to these individuals personally and get their input and medical and professional recommendations regarding the overall care needs and plan.

How do I know if I can afford private geriatric care management services?

  Many people believe they cannot afford private geriatric care management when they really can. Our initial free telephone consultation uncovers many of these misconceptions and will give you an idea of the cost and options involved. Options For Elder Care has helped clients save thousands of dollars by recouping insurance monies, applying for assistance programs, recommending better health insurance plans, and using other cost-effective measures while still providing the highest quality care. Investing in your elder's care through geriatric care management services is often the best thing you could do for them, and for you. Not only will you save money in the long run, you will save valuable and precious time and worry that can exhaust your non-financial resources or interfere with your job or occupation.

I'm worried that my parent can no longer live alone safely. What can I do?

  You should share your concerns with your parent and remain open to considering many possible solutions to this problem, including at-home solutions. Perhaps some help in the house, meal delivery services or an emergency response system could enhance your parent's ability to continue living at home. If our parent is feeing unsafe, s/he may be open to considering a new living arrangement. Unless your parent is in immediate danger, the process of selecting a new home should be a careful process. Please also see the recommendations in Bobbi Kolonay's article, "How Can I Help My Aging Parent Live Independently?".

I have been caring for my 90-year old mother for the past 2 years while running my own home and managing a highly stressful job. I am frequently overwhelmed. I also need help making arrangements for my parents when I am away. I would also like to talk to someone about making long-term plans for my parents. Who should I call?

  It would be best to start by setting up a meeting with Options For Elder Care. A Geriatric Care Manager would be able to help with both short-term care options for while you are on vacation as well as help you with long-term planning for your parents. Options For Elder Care offers a free initial phone consultation and will answer any questions you might have.

I want to know that my mother is doing well at home alone. But, I live too far away to visit often or help her with daily chores. How can I ensure she is doing well?

  Options For Elder Care can act as an advocate and liaison for your mother. We will provide you with written or verbal updates of your mothers well being. As your Geriatric Care Manager, Bobbi Kolonay will keep you informed of unexpected events or emergencies and involve family members in any decision-making. We can also arrange for in-home services to help your mother with specific chores.

I am looking to place my father in an assisted living or nursing home near my home. How do I know what he needs and what to look for when seeking out a facility?

  Options For Elder Care is knowledgeable about local facilities in and around the Pittsburgh area for senior care, can assist you with a medical assessment if necessary and will work with you to look at all your options and assist in making the best recommendations for your father. If needed, a Geriatric Care Manager may also be able to streamline the transition into or out of a senior community, for both the elderly resident, family members and staff.

Family disputes and eldercare - My brothers and sisters and I disagree over how to care for my mother. How do we proceed?

  A Geriatric Care Manager who is experienced in caring for the elderly can be of great help in this situation. Oftentimes, these problems arise because siblings see their parent's needs differently. A Geriatric Care Manager with Options For Elder Care can assess your parent objectively and provide valuable information about what kind of care is best and most realistic under the circumstances.

What is long-term-care insurance? Do I need it?

  Long-term care services are defined as those that help people with chronic conditions maintain their level of functioning. Medicare does not cover these services. Long-term care services include nursing homes, assisted living facilities, adult day care and homemaker/chore services. Long-term-care insurance can be purchased to provide coverage for these services. Some policies also cover care management, caregiver training and respite care to relieve a caregiver temporarily from the daily responsibilities of caregiving. A person's individual financial situation and age will help us to determine whether long-term-care insurance is appropriate.

Eldercare and Medicare - Will Medicare pay for my elder's in-home services?

  Medicare pays for very limited home healthcare services: primarily skilled care like nursing services or physical, occupational or speech therapy. It is a requirement that such care help the patient recover function following an illness or hospitalization and only is continued as long as the patient makes progress and is substantially house-bound. Medicare will pay for a small amount of help with activities of daily living (such as bathing and eating) for a limited time if the patient also is receiving skilled care. Options For Elder Care will advise and assist you regarding government and private insurance coverages and options.

My spouse has been diagnosed with Alzheimer's disease. Is it possible to care for him/her at home?

  Yes, most people with Alzheimer's disease can be cared for at home. It is essential for you to consider that your loved one may have Alzheimer's for many years and the disease will gradually worsen. Caring for a person with Alzheimer's is a marathon, not a sprint. Find enough help so that you can pace yourself for the long term. Caregivers who are unable to do this burn out or develop their own health problems. Options For Elder Care can help you explore the resources in the Pittsburgh area, such as caregiver support groups, adult day health programs, home healthcare, hospice care and respite services. The Alzheimer's Association offers support and information through its local chapters, and your local Area Agency on Aging can offer referrals for other support services.

What if my parent is terminally ill but does not want to die in a hospital or nursing home? Can Hospice Care help?

  According to a Harris Survey on End-of-Life Care conducted in 2002, the vast majority of Americans (86%) believe that people with terminal illness would most like to receive end-of-life care at home. Yet nearly 70% of deaths in America today occur in facilities, primarily in hospitals and long-term care facilities.

Caring for a seriously ill loved one at home can be intimidating and overwhelming. Most of us have no experience or training in caring for an ill person at home. Adding to our sense of overwhelming responsibility is the rapid advance of technology, which has made the array of home-based medical interventions bewildering.

There is little doubt that, when families commit to caring for a seriously ill loved one at home, they face many challenges. These families also benefit from additional support, especially the comprehensive, holistic support offered by hospice. Hospice care is care that addresses the needs (physical, spiritual, emotional, psychological, social, financial, and legal) of a dying person and his or her family. Under certain circumstances, Medicare will pay for hospice care in the home. Options For Elder Care works closely with with Family Hospice and Palliative Care, located in Pittsburgh, PA (and serving the following counties in Western Pennsylvania and the Southeastern part of the state of Ohio).

Healthcare documents - What do I need?

  Everyone should have a basic will, a durable power of attorney, a living will or advance directive and a healthcare proxy statement. Options For Elder Care can assist you with these obtaining these necessary documents and provide recommendations for elder law attorneys if needed.

My parents need help, but won't accept it. How can you help?

  It's common for an older person to initially resist outside help. Professional Geriatric Care Managers have the skills needed to develop rapport even with difficult clients. Options For Elder Care will be able to suggest several different approaches to overcoming a parent's objections.

Who else uses a Geriatric Care Manager?

  Families who live at a distance rely on Geriatric Care Managers to provide a trusted link to their elder parents. Attorneys may use the services of a Geriatric Care Manager for a professional assessment of complex clinical situation in a home care facility or in the community. Trust officers find that a Geriatric Care Manager plays a key part in a professional assessment to assure the provision of well-targeted, cost-effective care for the elder. Physicians, and other health care professionals welcome the specialized individual services that a Geriatric Care Manager can offer to the elder and families a means to prevent clinical crises and avoid unnecessary hospitalization.

How else can professional geriatric care management save me money?

  Geriatric Care Managers can help you save money in several ways. First, they can help to plan effectively for the future, and assist in avoiding a crisis. Second, care managers can often arrange for services to be delivered in an older adult's home rather than requiring a costly move to a retirement or nursing facility. Third, because care managers are aware of both the needs of older adults and the available resources, they can be efficient in matching service needs with appropriate agencies. Also, you can hire a care manager for a single, specific task, such as helping you find a daily caregiver, or to oversee the entire caregiving process.

If you need assistance with caring for an elderly loved one, are new to elder care or uncomfortable with elder care decision-making, are faced with having to make a sudden decision or major change such as a health crisis or change of residence, or simply want some advice about any aspect of elder care, please don't hesitate to contact us at any time.

Barbara Kolonay, RN, BSN, MHRM, CCM
Options For Elder Care
Gibsonia, Pennsylvania
412-443-1365

    •   About the National Association of Professional Geriatric Care Managers (GCM)

GCM was formed in 1984 to advance dignified care for seniors and their families in the United States. The association currently boasts a membership of 1,900 care managers. Geriatric care managers are professionals who have extensive training and experience working with older people and families who need assistance with care giving issues. GCMs help families cope with the growing challenges of aging, and assist families in the search for a suitable nursing home placement or extended care if the need occurs. The practice of geriatric care management and the role of care providers have captured a national spotlight, as generations of Baby Boomers age in the United States and abroad. For more information please visit www.caremanager.org or call 520-881-8008.

    •   Family Hospice and Palliative Care

As one of the Hospice services that Options for Elder Care recommends, Family Hospice and Palliative Care exists to enhance the quality of life for terminally ill patients, their families, and caregivers by providing quality palliative and supportive care, primarily in the home. Their service area includes Allegheny County, Beaver County, Butler County, Crawford County, Fayette County, Greene County, Lawrence County, Mercer County, Venango County, Washington County, and Westmoreland County in Pennsylvania and Columbiana County, Mahoning County, and Trumbull County in Ohio.