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Senior Citizen's Guide to Connecticut

Geriatric Care Managers, Attorneys, Are Partners in Elder

“Taking one day at a time is a great way to relax on vacation,” says Joanne Walsh, MBA, president and CEO of Constellation Health Services (CHS) in Norwalk, “but it’s not a good way to approach the needs that may arise as a person ages.”

And, in the 21st century, more of us will be looking to address those challenges —  medical, social, and legal.  According to U.S. government figures, since 1950, the number of Americans over 65 has nearly tripled, and the probability of surviving past 80 years of age has doubled.

Of course, many elders remain healthy, active, and independent. Still, “retaining independence,” says CHS’s Phyllis Boynton, RN, MPH, CCM, “does not mean that a person doesn’t need help.”   Finding the right kind of help, and coordinating the often complex range of services that elders and their families need, is the job of the geriatric care manager (GCM).

While families and professionals have always attended to the needs of elders, geriatric care management as a profession is a relatively new field, having emerged in the early 1980s.  As the services provided by credentialed GCMs have become more familiar to the general public, so have more family and elder care attorneys come to understand the benefits of partnering with GCMs. As an example, Walsh notes, “We can look at one issue that comes up frequently: housing. A family will need an attorney to help them sell a house. But an attorney will turn to us to help a client figure out whether the time has come to sell, or whether staying in the home safely is a viable option. And if staying is a viable option, the GCM can coordinate the resources necessary to ensure safety and comfort.”

The work of the GCM — who can come from a background in social work, nursing, gerontology or psychology —  begins with a thorough assessment, done wherever the elder is living, usually with family present.  Boynton, Director of Geriatric Care Management at Constellation Private Duty LLC, explains, “I look at the whole picture. What is the person’s medical status? How appropriate is the current living situation? Are there legal or financial issues to attend to?  What services or benefits programs are they eligible for? What support systems are in place? What do they need help with? What are their goals? How are the family dynamics? An important part of this process is that it encourages elders to make their wishes known.”

“Once the initial assessment is completed, the GCM’s work can take many forms. Whatever she does, Walsh says, “the GCM is responsible only to the client — not to any institution.” 

In addition to concerns related to housing, Boynton notes a range of circumstances under which family attorneys or elder care attorneys might seek the services of geriatric care managers. “GCMs are experts in developing comprehensive care plans and securing appropriate services, as well as in seeking payment sources and public benefit programs to help pay for care. We can assist with insurance applications and completing applications for public benefits programs. We help with hospital discharge planning; act as the coordinators when care is being accessed through multiple providers; and the services of a GCM, who has access to all relevant information, are invaluable in emergency situations.”

Boynton cites from her own experience circumstances in which attorneys have sought or recommended the services of a GCM. 

In a situation that has become increasingly common, Boynton recently helped a client with no family nearby to coordinate the myriad details of a move from a nursing home to an assisted living facility under a state Medicare-waiver program. For loved ones at a distance, the GCM is “a particular godsend,” says Boynton, overseeing care, alerting families to problems and, whether family is available or not, being an on-the-scene advocate in times of crisis, such as sudden hospitalization.

“Attorneys and GCMs have complementary skill sets,” says Boynton, “and, increasingly, the two professions are working together for the well-being of clients.” She continues, “Every person is different, every family is different. What works for one may not work for another; what worked today may not work tomorrow. Our mission as GCMs is to offer the information clients need to make their best decisions, and then to do whatever is necessary to help elders live lives that are as healthy, fulfilling and independent as possible.”

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