What services do you need and can you afford them?

Care Management for Your Elderly Parent

by Debra Karplus


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Keeping aging parents out of a nursing home is optimal. Care management services for the elderly may be an acceptable alternative to maintaining quality of life as well as their finances while remaining in their homes. How does one sort through the many options and funding to get the best value?

Imagine this scenario. Dad's been living independently, functioning well. Now you suspect he may not be taking his medications; getting to his numerous doctor appointments is challenging. His friends are deceased, his social network's shrunk, and you suspect he's lonely. You're employed, and your siblings live elsewhere.

Home health services and care management services are not the same.

A parent may have fractured a hip and been in rehabilitation for therapy and then sent home, after their Medicare Part A coverage ended. Following discharge, the physician may have ordered rehabilitation services, such as occupational therapy in home. It's a wonderful service, typically covered by Medicare. It allows the elderly to live at home and avoid a nursing home, yet they don't have to go to an outpatient facility for therapy.

Related: Tips for Protecting Elderly Parents

Care management is different. It helps families navigate the elder care system and coordinate services to fit specific needs of the elderly so that they can continue to live at home. Persons operating care management services typically have a background in social work or related professional training. The National Association of Professional Geriatric Care Managers has a website at CareManager.org that has much useful information.

Care managers can help determine the non-medical needs of the patient.

Your parent may have no obvious medical need, yet it seems like their quality of life could be better. This is where the care management process begins. The first step is to ask friends, relatives, or neighbors or look on line for a reputable care management company that services the area where your parents live. Some are national, such as Home Care Assistance or A Place for Mom. Others are local, but the people who work for these agencies work in the area where they live. The cost of national versus local varies, so you want to inquire about both in your area.

In home care can improve the quality of life for elderly people.

As you would with any other "major purchase," it might be prudent to have more than one agency provide their initial free consult. Once you've contacted an agency, they'll schedule a time to come to the home and assess what services might be needed. Possibly a live-in person might be needed, but more often an hourly person comes in on certain days at definite times to perform specific services. The initial evaluation will help determine what services and how often they are needed.

Related: Helping elderly parents organize financial paperwork and information

What are some services in-home care can provide?

Possibly mom or dad requires assistance with daily living skills, referred to as "ADL" (activities of daily living), including eating, bathing, dressing, hygiene and other self-care needs. An in-home worker might be needed daily at certain times to help with these tasks. Or maybe help is needed with pill sorting or taking medication properly and with or without food as directed. Perhaps transportation to and from medical and other appointments might be needed. An in-home worker can help with any or all of these tasks.

Sometimes, companionship might be all that your aging relative might need at home to make life more enjoyable and meaningful. In home services can provide that as well. You simply need to inquire.

How does one pay for in-home care?

An in-home care giver can cost $15 to $25 per hour, depending on the going rate in your area. Compare that to a nursing home at about $200 daily, which adds up quickly.

So who pays? Though many of these agencies are set up to accept Medicare payments, the services required might not be eligible for Medicare coverage. It depends on how the need is documented. Long-term care may cover some services. Expertise in reading and understanding the "fine print" in these contracts is essential, as there are likely out-of-pocket expenses.

Will you leave
thousands of dollars on the table
by taking Social Security
at the wrong time? Find out.

If you don't have insurance that will cover in-home care, what choices exist? People at your church may be knowledgeable. Or contact your local United Way. Search online for "social services for elderly" in your area. Also, the AARP website has a section on care giving that includes a contact number and links to some resources.

Maintaining an acceptable lifestyle during the aging process is essential, and being able to choose to stay in one's own home is often part of that decision. Consult with a nearby care management service to determine if in-home care is appropriate for your loved one.


Debra is an occupational therapist, accountant, teacher and freelance writer. She is a writer for Advance for Occupational Therapy Practitioners. She also writes for Grand Magazine, has some items (fiction and non fiction) selling on Amazon.com (kindle), has written several travel articles for the Champaign-Urbana News-Gazette and several articles for freelancewriting.com. Learn more about her at DebraKarplus.blogspot.com.

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