Geriatric Care Managers: When Do You Need One?

Geriatric Care Managers are certified professionals who understand how to navigate senior care and interact with a senior in order to understand their preferences and needs when it comes to senior care.  They are trained to understand all the care options and costs in a local area and know how to create a professional care plan.  Geriatric Care Managers charge an hourly fee, similar to the way an attorney might bill a client.  There is usually an initial consultation and the hourly fee can be between $60 and $150 per hour.  Geriatric Care Managers are called "GCM's" within the senior care industry.

When can a senior benefit from hiring a professional Geriatric Care Manager?

  • Adult children do not live nearby
  • No living heirs
  • Multiple medical conditions requiring monitoring and coordination of care
  • Financial fraud by family member or loved one requires third-party management of care needs
  • Unsure about senior care options and preferences
  • Long-term care planning for spouses
  • Memory loss requires third-party to make sure all senior care services are coordinated effectively
  • Full-time care needs require management by someone other than senior
  • Prefers professional to manage senior care
  • Unique medical conditions require traveling to a specialist

Geriatric care managers can find the best care services to meet the preferences of a senior and explain the costs of care and coordinate all of the care providers along with making sure all the possible Medicare or Medicaid benefits are in place.  As Medicare does not pay for long-term senior care, it may be necessary to allocate financial resources to allow for a senior or their spouse to "spend-down" their assets to qualify for Medicaid benefits.  Medicaid, for low-income seniors, does pay for nursing home care ongoing and a healthy spouse may keep the home and some assets.  This is just one example of how planning for senior care can be a bit complicated and a professional geriatric care manager can be very valuable.

Caregiverlist's guest columnist, Charlotte Bishop, has provided geriatric care management services for more than 20 years and shares her experiences about the benefits of hiring a geriatric care manager.

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Illinois Revokes Nursing Home's License

A Chicago Tribune investigative report has been succesful in exposing a lack of compliance to Illinois laws for admitting and caring for nursing home residents.  Criminal background checks and risk assessments were not being conducted on new residents, allowing for mentally ill patients and convicted felons to become rent-free residents of Medicaid nursing homes and placing senior residents at risk.

Seniors who do not have personal assets and a monthly income to pay for nursing home costs can qualify for ongoing care in a nursing home paid for by Medicaid, a state and federally funded program.  Owning a Medicaid nursing home can be compared to owning an apartment complex which is always rented - as long as you can admit qualifying patients, the government will pay the rent each month. 

One nursing home housed 18 felons and drew attention after 17 assualts and 2 incidents of sexual violence were reported.

If a nursing home is housing a large percentage of mentally ill patients, additional staff are needed, along with around-the-clock supervision to protect seniors who may have memory loss and not be aware of how to interact with someone who is mentally ill and could cause them harm.  One of the easiest ways to find out if a nursing home houses a large percent of mentally ill patients is to check the average age of residents - - if there are lots of residents who are not seniors then this is a red flag that the qualifying residents are there for mental illness.  It follows that necessary precautions should be in place to prevent the assaults and sexual abuse that happened at the Chicago nursing homes.

Somerset Place in Chicago housed more than 300 residents and the federal government has pulled the plug on their Medicaid payments.  However, it took good reporting to make this happen - another indicator that the state nursing home inspection reports do not provide all the answers for maintaining quality nursing homes.  Felons belong in prisons, not nursing homes.

 

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Caregiver Employment

As the population ages, the U.S. Bureau of Labor Statistics projects the personal and home care aide job category will more than double in the next ten years.  If you are looking for job stability, becoming a senior caregiver could be the career for you.

While advances in medicine are enabling seniors to live longer, additional care services are often required.  For instance, the risk of developing Alzheimer's disease increases dramatically for those over age 65.

According to the UCLA Neuropsychiatric Institute, about 40% of people aged 65 or older have age associated memory impairment (about 16 million people in the U.S.A.). Only about 1% of them will progress to dementia each year.  Although patients with mild cognitive impairment are able to continue to live independently, they show objective memory  impairments similar to those seen in people with very mild Alzheimer's disease. And about 10% of people aged 65 years or older have mild cognitive impairment, and nearly 15% of them develop Alzheimer's disease each year.

These are just the statistics for Alzheimer's disease care needs.  The likelihood for heart disease, stroke, cancer and Parkinson's disease also increase as we age.  Another interesting statistic:  the number one risk for women to develop breast cancer is living a longer life - the older we are, the greater the risk. 

The caregiver category is identified as professionals who help the elderly, disabled, ill and mentally disabled live in their own homes or in residential care facilities instead of in health facilities.

What type of jobs are available for senior caregivers? Nursing homes, assisted living communities, hospitals and senior home care agencies all hire certified nursing aides.  Usually certification can be obtained within two months and sometimes scholarships or grants are available from community programs. 

Caregiverlist's Senior News reports nursing homes will continue to need Certified Nursing Aides and provides information about the nursing aide programs in California and Illinois.

Have you worked as a nursing aide in a nursing home, hospital or for a senior home care agency?  We invite you to share with our site visitors which type of position you preferred.

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Nursing Home Shootings

Yesterday, a Certified Nursing Aide's estranged husband entered a nursing home in Carthage, North Carolina, where she was employed, and killed 7 residents and a nurse during his shooting rampage. 

Usually the nursing home deaths which make the news are related to mistreatment of residents or improper care procedures which lead to death.  This is one of the reasons more people are opting for care in the home, instead of a nursing home, especially for short-term care needs, as a one-on-one caregiver can often deliver better care.

Nursing home incidents which result in inferior care are usually connected to staffing issues.  Sometimes nursing homes staff only 1 nursing aide to as many as 15 residents.  This is why many times experienced Certified Nursing Aides will move into home care positions where they know they can provide quality care to just one client,.

Earlier this year, an Itasca, Illinois nursing home employee watched television for more than an hour and ignored the alarm that indicated a woman with Alzheimer's disease was wandering.  The elderly resident went outside in freezing temperatures and her frozen body was later found in the facility's courtyard.

The employee was charged with criminal neglect.

Senior Home Care Agencies provide professionally managed caregivers for seniors and these caregivers are usually highly qualified and experienced.  Home care agencies perform background checks on all caregivers and also train and actively manage the caregivers for each assignment.

You can learn about the background check laws in each state on Caregiverlist's "by state" information section (because as in the situation above, it is also important that companies do not hire someone who has demonstrated poor judgement in the past.  Most career caregivers want to receive high recommendations from their managers as they know they will need to be reassigned after a current client's condition improves or after the senior passes. And, as they have invested in training to become a professional caregiver, they want to continue to be employed).
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Nursing Home Inspections and Nursing Home Violations

The government has been advertising the Medicare.gov website to let seniors know the nursing home inspection reports are available online (they also allow other websites to download this information and Caregiverlist also provides it).  I have been hearing the ads on NPR and elsewhere.

The nursing home inspection reports are a nice starting point  for seniors and their family members when evaluating a nursing facility for a short or long-term nursing stay.  But it is important to realize that these nursing home inspections are only performed once every 15 months.  Ask any Certified Nursing Aide who has worked at a nursing home (working at a hospital or nursing home is required as part of their certification training) and they will tell you that most nursing homes have an alert "code" that goes out when the nursing home inspectors walk in the door - - - it could be just announcing on the P.A. that "Minerva is on line 1".  This means everyone is on their best behavior.  It reminds me of elementary school when parents sat in on the classroom - even the bullies were nice to everyone on those days, including the teacher.

In addition to the inspections only being made every 15 months,  the nursing home violations are not included in the inspection report, and, actually, this is the information you really need to know when evaluating a nursing facility. 

If you really want to make sure you are going to be moving a senior into a quality nursing home, the best way to find out the quality of the care is to find out the number of nursing aides on staff per number of beds and to talk to the staff.  In addition, find out the monthly nursing home violation report in your state.  As you'll see from the June, 2008, violations in Illinois, many of the violations most likely happen because there just aren't enough caregivers to manage problem residents and to assist with bed sore management.

This is why more seniors are opting for care in the home by a one-on-one caregiver.  Senior Home Care Agencies provide in-home care for a cost of between $16 - $28 per hour, depending on what part of the country you live in, and this fee provides for all the payroll taxes, insurance protection and active management of the caregiver.

Nursing Home Violations For The Month Of June 2008

SPRINGFIELD, Ill – The Illinois Department of Public Health today announced the following type “A” violations of the Nursing Home Care Act were cited during the month of June. An “A” violation, which is the most serious licensure violation imposed by the state, pertains to a condition in which there is a substantial probability that death or serious mental or physical harm will result.

The statement of violation for each facility can be obtained by clicking on the facility's name.

Alden Alma Nelson Manor, a 268-bed skilled facility located at 550 S. Mulford Avenue, Rockford, has been fined $32,500 and notified of license revocation for failure to prevent and protect residents from abuse. Three residents were physically attacked by another resident. The facility has requested a hearing on the Department’s action. A status was held February 26 and settlement negotiations are underway.

All American Nursing Home, a 144-bed skilled and intermediate care facility located at 5448 N. Broadway Street, Chicago, has been fined for failure to maintain a sanitary kitchen and ensure proper food handling to prevent hazardous food borne illnesses. Kitchen staff was observed preparing food without washing hands or using gloves. The facility requested a hearing on the Department’s action. A hearing was held and the facility paid $1,200.

Allen Court, a 16-bed intermediate care facility for the developmentally disabled located 1650 E. Main Street, Clinton, has been fined $20,000 for failure to implement its own policies to prevent neglect of a resident. Staff failed to provide a thorough assessment of the resident’s symptoms and did not provide immediate medical attention after a fall. The facility has requested a hearing on the Department’s action. A status in the case was held February 25.

Belhaven Nursing & Rehab Center, a 221-bed skilled care facility located at 11401 S. Oakley Avenue, Chicago, has been fined $30,000 for failure to provide necessary care and services to residents to prevent pressure sores and treat new sores. The facility has requested a hearing on the Department’s action. A status in the case is April 16.

Blue Island Nursing Home, a 30-bed intermediate care facilities located at 2427 West 127th Street, Blue Island, has been fined $15,000 for failure to adequately supervise residents and monitor a resident’s consumption of alcohol and prevent the resident from physically abusing two other residents and a staff member. The facility requested a hearing on the Department’s action. A status in the case was held February 26 and settlement negotiations are underway.

Brother James Court, a 99-bed intermediate care facility for the developmentally disabled located at 52508 St. James Road, Springfield, has been fined $10,000 for failure to implement facility policy and procedure on Abuse and Neglect. The facility also failed to recognize the need for additional supervision of a resident after a sexual incident between two residents. The facility has requested a hearing on the Department’s action. A status in the case is March 31.

Cardinal Hill Healthcare, 90-bed skilled care facility located at 400 E. Hillview Avenue, Greenville, has been fined $55,000 for failure to provide adequate supervision to prevent a resident from choking which resulted in death. A resident took another resident’s sandwich without staff knowledge; was later found without vital signs and pronounced dead. The facility has requested a hearing on the Department’s action. A status in the case is March 31.

East Peoria Gardens Healthcare Center, a 103-bed skilled and intermediate care facility located at 1920 Springfield Road, East Peoria, has been fined for failure to provide necessary care and services to maintain health. In the case of 4 residents, the facility did not (1) perform cardio pulmonary resuscitation (CPR), (2) provide adequate supervision, and (3) monitor worsening medical condition. As a result, 3 residents died and a fourth suffered gangrene to a toe. The facility requested a hearing on the Department’s action. A hearing was held and the facility paid $32,500.

Mosaic Living Center, a 150-bed long term care facility for residents under the age of 22 located at 7464 N. Sheridan Road., Chicago, has been fined $10,000 failure to provide nursing care in accordance with a residents needs. Due to the facility’s failure to properly monitor a resident with a history of removing a feeding tube, the resident lost almost 30 pounds. The facility has requested a hearing on the Department’s action. A status conference was held February 8 and settlement negotiations are underway.

Moweaqua Nursing & Retirement Center, a 70-bed skilled care facility located at Maple and Macon Streets, Moweaqua, has been fined $50,000 for failure to supervise a resident at high risk for falls. The facility did not assess nor make changes to the plan of care for the resident, after repeated falls. As a result, the resident fell and died after suffering facial fractures and head injuries. The facility has requested a hearing on the Department’s action. A status in the case was held February 25.

Parents and Friends of the Specialized Living Center, a 100-bed intermediate care facility for the developmentally disabled located at 1450 Caseyville Avenue, Swansea, has been fined $20,000 for failure to implement a diet order for a resident at risk for choking. The facility did not monitor the resident who had received the wrong texture and consistency of food. The resident was hospitalized after choking. The facility has requested a hearing on the Department’s action. A status in the case was held February 25.

Regal Health & Rehab Center, a 143-bed skilled and intermediate care facility located at 9525 S. Mayfield, Oak Lawn, has been fined $25,000 for failure to adequately supervise four residents identified as unsafe smokers. Three of the four residents require continuous oxygen therapy. The lack of supervision resulted in one resident suffering burns to his face. The facility has requested a hearing on the Department’s action. A status in the case is March 5.

St. Anthony’s Nursing & Rehab Center, a 120-bed skilled and intermediate care facility located at 767 30th Street, Rock Island, has been fined for failure to develop and implement a plan to address a resident’s sexual behavior toward other residents. The facility also failed to implement effective interventions to monitor the resident responsible for sexually abusing two other residents. The facility requested a hearing on the Department’s action. A hearing was held and the facility paid $12,000.

Timbercreek Rehab & Health Care Center, a 202-bed skilled care facility located at 2220 State Street, Pekin, has been fined $20,000 for allowing two Certified Nursing Assistants with findings of abuse on the Health Care Worker Registry to work at the facility. The facility also failed to protect residents from abuse by one of the CNAs, who was later found to have broken the wrist of a resident. Both were terminated. The facility has requested a hearing on the Department’s action. A status in the case is March 3.

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Evaluating Nursing Homes

Medicare and Medicaid certified nursing homes are required to complete government inspections at least once every 15 months.  The government provides information on the results of these inspections on Medicare.gov.

The nursing home inspection information provides a nice starting point for evaluating a nursing home but they do not include information on many violations and incidents of abuse which may be reported.  You must visit a nursing home and question staff and family members of other residents to find out more information.

This week, the news media reported a group of teens working at a nursing home in Minnesota sexually abused and humiliated elderly residents with dementia.  This information will not be found on Medicare's website of inspection results for this nursing home, for example, yet it is valuable information to know if you are considering placement at this nursing facility.  Many caregivers who work for Senior Home Care Agencies have worked in nursing homes at some point in their career.  If you know a professional caregiver, ask them about the nursing homes in your area.  Caregivers also know other caregivers, expecially if they completed a nursing aide certificate, and can be a valuable resource for letting you know the inside scoop on the care at local nursing homes.

You may search the recent nursing home inspection reports on Caregiverlist's Nursing Home List.

 

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