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Building Client Confidence
Geriatric Care Managers usually meet prospective clients
during or shortly following a health crisis. It is difficult to evaluate how all family
members will, under normal circumstances relate to each other., when this is the
introduction you receive. However, many times the crisis brings all people involved to
some stark realizations related to mortality and prognosis at relatively the same time
within the family.
This reality check, devastating as it may be, usually sets the stage for some frank
discussion related to health care needs, living arrangements, division of labor between
siblings, and most controversially, financial matters.
Almost always, the family unit has already appointed a leader or someone has assumed, due
to close proximity, control of finances and health care decisions are usually made by one
person. Some families have discussed the issues prior to the crisis and are well aware of
what the wishes of the older adult may be. Most have not. The Geriatric Care Manager is
most helpful if they approach their first intervention as though everyone may be their
client within the family. Addressing the needs of all family members present may best
serve the client. Being certain if there are questions related to the distribution of
finances needed for care, and obtaining answers for everyone can save misperceptions
later.
For example, one family member may express sadness related to their parent not being able
to remain in their own home. When you provide the concerned family member an empathetic
ear, you are able to assess the level of understanding regarding cost and choices
available to the older adult. Most people do not have a grasp of Medicaid benefits and do
not understand eligibility and estate recovery guidelines.
Siblings may blame each other when the parent dies and they expect to receive a portion of
monies generated from the sale of the family home. However, nursing facility cost are more
than $3,500 per month in most cases , and if the parent survives longer than one year the
house will become a vulnerable asset under new Medicaid guidelines. After several years in
the nursing facility the home will no longer be considered to be available to the
"heirs". It will instead be part of the repayment of the long term care costs.
One can only imagine that even though this news is frightening to many middle class
people, making certain that siblings not involved in handling the funds be aware of the
restrictions placed on the sibling asked to assume the care management duties.
Public Education is suggested, through public forums, from financial planners, trust
officers, attorneys, social workers, and senior center workers. Many hospitals have
developed Senior groups that enjoy presentations on medical topics and social events.
Strongly encourage these and like groups to champion this endeavor.
The generation that is considered the "old old" have lived through the
depression and world war, it seems unfair to traumatize them in times of crisis with
information that is new and disturbing. Rather, allow families to meet, discuss and plan
for the future together.
Information Provided by : Julie Coyle M., Ed., LSW
Acknowledgement to ElderCare Advocates for their
kind permission to reproduce this article.
If you have any question/ concerns or need assistance contact your local Geriatric Care
Manager: Sheri D. Fanning, RN,CMC at 269-5888 or e-mail to sheri@caremate.com
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