ARTICLES

• PROFESSIONAL GERIATRIC CARE MANAGEMENT
• Eldercare...Our Needs, Our Choices
• Geriatric Care Management
• What Should I Do

Eldercare ... Our Needs, Our Choices

By Shirley Jennett

Shirley Jennett, RN, is the founder and president of Home Care Resources/Care Management & Resources, Inc. Since 1996, the company has provided high-quality care management for adults living in the metropolitan Denver, Colorado area. Its reliable and effective nurses, companions, personal care and household services assistants all are screened, bonded, insured and trained. Shirley served as president of the Board of Directors of the Colorado Hospice Organization and as a representative to the Rocky Mountain Region on the National Hospice Board of Directors. For many years she has been involved with health planning on local, state, and national levels, focusing on quality care provision. Shirley is on the Board of Directors of the Colorado chapter of the National Private Duty Association, and is a member of the National Association of Professional Geriatric Care Managers.

Statistics compiled by the U.S. Department of Health and Human Services Administration on Aging suggest that the United States may be on the brink of a longevity revolution. In the year 1900 life expectancy at birth was 46 years for males and 48 years for females, but by 2004 life expectancy at birth was 76 years for males and 81 years for females. The Federal Interagency Forum on Aging-Related Statistics indicates that in 2006, people 65 and over accounted for more than 12 percent of the total population. Because Baby Boomers will begin turning 65 in the year 2011, it is projected that by the year 2030 the aged will comprise closer to 20 percent, or one in every five Americans. Today, the population of the “oldest-old” (those who are over 85 years) numbers more than 5.3 million. Increased longevity among older Americans has resulted from advances in medicine, improved access to health care and insurance, better general health before reaching age 65, and an emphasis on healthier aging lifestyles.

These statistics on the growing number of elderly citizens are significant. They mean that increasing numbers of us are being faced with issues regarding the declining abilities of ourselves or our loved ones to manage daily living activities, make decisions, or handle financial affairs. At times the need for assistance may be sudden and unexpected, as when an injury, illness or surgical procedure triggers the necessity for immediate and perhaps on-going personal care. At other times there may be gradually-increasing signs of the loss of ability to maintain independent livelihood. Occurrences such as forgetting to pay bills, keep appointments, take necessary medication, and turn off water faucets or the stove may happen more often. There may be frequent accidents and/or evidence of poor hygiene and nutrition. The person may become a victim of door-to-door, telephone or mail solicitations. Examples of factors that may contribute to lessened abilities may be failing eyesight, hearing, memory, physical agility, nutritional status and/or any one or more disease processes. Other factors may include loneliness, depression, dementia, and impaired thinking and reasoning.

Many times we are caught unprepared for this eventuality and are less than fully informed about the choices and resources available to us. We are unprepared for the considerable time, energy and financial costs of caregiving. Some may be in the "sandwich generation" as well – that is, still caring for children and at the same time becoming increasingly responsible for the care of aging parents. For any one of many reasons, it may not be possible, feasible or desirable that the older adult live with (and/or that all their care needs be provided by) adult children or other relatives.
What resources, then, are available to us? Most of us are familiar with nursing homes. Some of us are familiar with assisted living facilities, and perhaps we’ve heard something about personal care boarding homes. But what if we, or our loved ones requiring assistance, choose to remain in the familiar surroundings of our own homes and neighborhoods? Fewer of us may know about the available choice of supervised, in-home personal care and household services through professional care management.

Professional care managers are committed to assisting adults to continue living in their own homes and communities as independently and as safely as possible. These care managers help to conserve the time, energy and financial resources of families. Statistics from the MetLifeMarket Survey of Nursing Home & Assisted Living Costs indicate that the average cost of one nursing home resident is $69,715 per year, and the average annual cost of one assisted living facility resident is $36,372. In contrast, seniors who want to remain in their homes often can do so more effectively. For example, 20 hours of companionship home care a week costs an average of $18,000 for the entire year. Thus private duty home care can be a very affordable option for many seniors when compared to the costs associated with living away from home. To be sure, a survey conducted by AARP found that the overwhelming majority of seniors – 89 percent of them – prefer to age in their own homes as long as possible.

Through the expertise of the professional care manager, needs are assessed, problems are identified, and appropriate services are screened, arranged and monitored for effectiveness as needs change. The care manager acts as a liaison to family members both locally and long distance, alerting them to any problems that may arise. Help is also provided with arrangements for medical or other assistance and with alternative living situations, as necessary. Care managers also provide advocacy, crisis intervention, consumer education, counseling and support for the older adult, the family members, and other loved ones.

Additional information on the role of care manager can be obtained by contacting the National Association of Professional Geriatric Care Managers, 1604 North Country Club Road, Tucson, AZ 85716, (520) 881-8008.

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Shirley Jennett, RN, a member of the National Association of Professional Geriatric Care Managers, is president of Care Management & Resources, Inc., (303) 639-5455, a company providing high-quality care management and screened, reliable and effective companions, personal care assistants and household services for adults living in the Denver, Colorado, area.