By Mary Lynn Pannen 

A Professional Geriatric Care Managers (PGCM) is a health and human services specialist who helps families who are caring for older relatives. The PGCM is trained and experienced in any of several fields related to long-term care, including but not limited to nursing, gerontology, social work, or psychology, with a specialized focus on issues related to aging and elder care.

The PGCM assists older adults and persons with disabilities in attaining their maximum functional potential. In addition, the PGCM is an experienced guide and resource for families of older adults and others with chronic needs.

Geriatric care managers who are members of the National Association of Professional Geriatric Care Managers (NAPGCM) are committed to adhering to NAPGCM standards of practice and it's Pledge of Ethics.

Looking for a Professional Geriatric Care Manager

Making that First Phone Call

Ask lots of questions before choosing your PGCM. Start with the initial phone call. Is the call professionally answered? If you leave a message, is it returned promptly? This is your first indication of the kind of professional relationship you might expect. You should also ask:

• What are the primary services provided by your agency/business?
• What other service does your agency/business provide?
• How many PGCMs are in this agency/business?
• Is there a fee for the initial consultation and if so, how much is it?

The answers to your questions will assist you in determining whether that particular PGCM and agency/business has the qualifications important to you for a successful relationship. If you have a specific issue that requires immediate attention, be sure to inform the PGCM of this during the initial telephone conversation.

Questions To Ask When Looking For a Professional Geriatric Care Manager

Professional geriatric care managers have diverse experience, education, and backgrounds. Many are licensed in their state in specific fields (such as nursing or social work).

PGCMs do not specialize in all areas. When a PGCM says s/he practices "care management," find out her/his areas of expertise. You will want to hire someone who regularly handles clients with similar needs.

PGCMs who primarily work with older adults bring more to their practice than an expertise in geriatrics. They bring knowledge of aging issues that allow them and their staff to overcome the myths relating to aging and to focus on the problems at hand. At the same time, they will bring an experience of working with resources in your community. They are more aware of real life problems, health and otherwise, that emerge as persons age and the tools that are available to address those issues. They are also connected with a community of social workers, nurses, psychologists, elder law attorneys, advocates, and other elder care professionals who may be of assistance to you.

It is important for the wise consumer to ask questions. Some of these include:

1. What are your professional credentials?
2. Are you licensed in your profession?
3. Are you a member of the National Association of Professional Geriatric Care Managers?
4. How long have you been providing care management services?
5. Are you available for emergencies?
6. Does your company also provide home care services?
7. How do you communicate information to me?
8. What are your fees? (These should be provided to the consumer/responsible party in writing prior to services starting.)
9. Can you provide me with references?

Once You Have Found a PGCM

After you find the PGCM who is right for you, s/he will most likely visit you for an "on-site assessment". During the assessment, you will be asked to give the PGCM the reasons you are seeking help, and s/he will want to meet all the parties involved. It is especially helpful that you are prepared with all relevant information for the care of your family member or friend.

After you have discussed your situation, ask:

1. What resources will it take to handle this situation?
2. Are there any alternative courses of action?
3. What are the advantages and disadvantages of each alternative?
4. Who will be working with you?
5. How many professionals may be involved? What about off-hours and backup?
6. How are fees computed?
7. How are travel time and mileage handled?
8. How are services terminated?

Discussing Fees

There are many different ways of charging fees and each PGCM works differently. You will need to know how often s/he bills. Some PGCMs bill weekly, some bill monthly, some bill upon completion of work. Ask about these matters at the initial conference and ask for them in writing, so there will be no surprises. If you don't understand, ask again. If you need clarification, say so. It is very important that you feel comfortable regarding your financial obligations.

In addition to fees, most PGCMs will charge for out-of-pocket expenses, which may include charges for mileage, care giving supplies, long-distance telephone calls, etc. Find out if there will be any other incidental costs.

Note: There may also be additional fees if outside professionals are called into the case. It is imperative that the PGCM receives approval to bring others in before the situation arises, if at all possible.

Be sure to discuss and make sure you have all questions answered before proceeding with an agreement for services. You should expect a written agreement including fees before the commencement of services.

Get It in Writing

Once you decide to hire a PGCM, ask that your engagement be put in writing. The writing can be a letter or a formal contract. It should spell out what services the PGCM will perform for you and what the fee and expense arrangements will be. Remember: even if your agreement remains oral and is not put into writing, you have made a contract and are responsible for all charges for work done by the PGCM and her/his staff.

Make It a Good Experience

A positive and open relationship between a PGCM and a client is important to successful outcomes. The key to getting there is communication. The communication starts with asking the kinds of questions discussed here. Use the answers to the questions as a guide not only to the PGCM's qualifications, but also as a way of determining whether you can comfortably work with this person.

If your concerns are not responded to professionally and personally, if you don't like the answers to your questions, if you don't like the PGCM's reaction to being asked all your questions, or if you simply do not feel relaxed with this particular person, DO NOT HIRE THAT PERSON. Only if you are satisfied with the PGCM you have hired from the very start will you trust him or her to do the best job for you. Only if you have established a relationship of open communication will you be able to resolve any difficulties that may arise between the two of you.

If you take the time to make sure you are happy and compatible right at the beginning, you can make this a productive experience, giving you peace of mind and your family member the highest quality of life possible. You will thank yourself, and your PGCM will thank you.

Do I Really Need a Professional Geriatric Care Manager?

When considering engaging the services of a PGCM, you should evaluate whether you have the time, inclination, or skills to manage the challenges of geriatric care. If you are not sure, ask a trusted advisor to help you decide if an elder care expert may be helpful. Enlisting the support of other family members to consult a professional is a good way to build a consensus on the solutions. Questions that you may wish to consider:

• Are the problems that you or your loved ones are facing becoming larger and more complex than you can comfortably manage?
• Are other demands and responsibilities now so great that you are not able to provide the desired level of supervision and attention to your loved one's problems?

What Can a PGCM Do for Me?

• Conduct care-planning assessments to identify problems and to provide solutions.
• Screen, arrange, and monitor in-home help or other services.
• Provide short- or long-term assistance for caregivers living near or far away.
• Review financial, legal, or medical issues and offer referrals to geriatric specialists.
• Provide crisis intervention.
• Act as a liaison to families at a distance, overseeing care, and quickly alerting families to problems.
• Assist with moving an older person to or from a retirement complex, assisted care home, or nursing home.
• Provide consumer education and advocacy.
• Offer counseling and support.

Some PGCMs also provide family or individual therapy, finance management, conservatorship or guardianship assistance, and/or care giving services.

What are the Benefits of Using a PGCM?

Professional Geriatric Care Management services are offered in a variety of settings. Professional Geriatric Care Managers (PGCMs) can serve the needs of their clients with the following services:

• Personalized and compassionate service -- focusing on the individual's wants and needs.
• Accessibility -- care is typically available 24 hours a day, 7 days a week.
• Continuity of care management – communications are coordinated between family members, doctors and other professionals, and service providers.
• Cost containment -- inappropriate placements, duplication of services, and unnecessary hospitalizations are avoided.