What Does a Geriatric Care Manager Do? A Guide for Families

When a parent or spouse starts needing more help, families often face many decisions at once: doctors, medications, home care, money, and where to live. A geriatric care manager helps you sort it out and make a plan. This guide explains what they do, when to call one, what it costs, and how to choose one.

What is a geriatric care manager?

A geriatric care manager is a health and human services professional who guides and advocates for older adults and their families. Many have backgrounds in social work, nursing, gerontology, or counseling. The profession also uses the name Aging Life Care Professional, the term used by the Aging Life Care Association, the national professional group.

Think of a care manager as a coach and coordinator. They don't replace doctors or home care workers. They help everyone work together around the older adult's goals.

The Aging Life Care Association describes eight areas of knowledge that care managers bring:

• Health and disability: understanding conditions, treatments, and what they mean for daily life
• Housing: comparing staying at home, assisted living, and nursing homes
• Family: helping relatives communicate and share responsibilities
• Local resources: knowing community services and how to get them
• Financial: understanding costs and benefits such as Medicare, Medi-Cal, and long-term care insurance
• Legal: knowing when to involve an elder law attorney, for example about powers of attorney
• Advocacy: speaking up for the older adult's wishes with providers and programs
• Crisis intervention: helping when something sudden happens, such as a fall or hospital stay

What does a care manager actually do?

• Assessment: a visit to look at health, memory, safety at home, daily activities, and support from family.
• Care plan: a written plan with goals, recommended services, and who does what.
• Coordination: arranging services such as home care, adult day programs, meals, and transportation.
• Medication review: working with doctors and pharmacists to simplify medications and reduce risks.
• Communication: going to appointments, talking with doctors, and keeping family members informed.
• Transitions: helping with hospital discharge or a move to assisted living or a nursing home.
• Monitoring: regular check-ins and updates to the plan as needs change.
• Family support: education, family meetings, and help for caregivers who are stretched thin.

When should you call a care manager?

Families often reach out when:

• A parent is coming home from the hospital or a rehab stay and needs a safe plan
• There is a new diagnosis, such as dementia or Parkinson's disease
• Falls, missed medications, or unpaid bills suggest it's no longer safe to live alone
• You live far away and need someone local you can trust
• Family members disagree about what to do
• You're weighing home care vs. assisted living vs. a nursing home
• You, the caregiver, are exhausted and need a plan you can keep up with

How is this different from other "care managers"?

Several people may use the title "case manager" or "care manager." The difference is who they work for and how long they stay involved.

All of these can help. An independent care manager is the one whose job is to look at everything and work for your family's goals, not one provider's.

How much does a geriatric care manager cost?

Costs vary by location, experience, and how much help you need. Published estimates generally fall in these ranges:

Ask whether travel time, phone calls, and emails are billed, and whether the assessment is a flat fee or hourly.

Does insurance pay?

• Medicare: Original Medicare generally does not pay for a private geriatric care manager. Some Medicare Advantage plans offer care management to members, so check with the plan.
• Long-term care insurance: some policies include a care coordination benefit. Look for it in the policy or ask the insurer.
• Medi-Cal: Medi-Cal doesn't pay for a private care manager, but it offers its own care management programs (below).

Free and low-cost options in Los Angeles County

If paying privately isn't possible, these programs may help. Each has its own rules, so ask whether you qualify.

• Enhanced Care Management (ECM): a Medi-Cal benefit for members of a Medi-Cal health plan with complex needs, including older adults at risk of needing a nursing home. Ask your Medi-Cal health plan for a referral. See ECM.
• Multipurpose Senior Services Program (MSSP): care management and in-home help for older adults on Medi-Cal who would otherwise qualify for nursing home care. In the San Gabriel and Pomona Valleys, Huntington Health runs an MSSP site.
• LA County Linkages program: care management for older adults and adults with disabilities who are at risk of moving to a nursing home and aren't getting other case management.
• LA County Information & Assistance line: call (800) 510-2020 to find these and other services for older adults. You can also call or text 211.

How to choose a care manager: questions to ask

1. What are your credentials? Are you licensed or certified (for example as a social worker or nurse)?
2. Are you certified in care management? (Look for CMC, CCM, C-ASWCM, or C-SWCM.)
3. How long have you worked with older adults, and with situations like ours?
4. What services do you offer, and who will actually do the work?
5. How do you communicate with family members, especially those who live far away?
6. Who can we reach after hours or in an emergency?
7. How are fees calculated? Are travel time and phone calls billed?
8. Do you receive referral fees from any facility or agency you might recommend?
9. Can you give us references?
10. Will you put our agreement in writing?

What to expect when you get started

1. 1

   Step 1: First call: you describe what's going on, and the care manager explains how they can help and what it costs.

2. 2

   Step 2: Assessment: a visit, usually at home, to understand health, safety, daily needs, and goals.

3. 3

   Step 3: Care plan: a written plan with recommendations, shared with the older adult and the family.

4. 4

   Step 4: Putting the plan in place: arranging services and talking with doctors and providers.

5. 5

   Step 5: Ongoing check-ins: regular updates, and changes to the plan as needs change.

Before the first visit, gather a list of medications, doctors' names, insurance cards, and any legal documents such as a power of attorney or advance directive.

How Quality of Life Group can help

Quality of Life Group is a nonprofit that has worked with older adults and families since 2009. Our Geriatric Case Management service includes health and daily-living assessments, a personalized care plan, medication review with your providers, communication with doctors and specialists, support for family caregivers, and regular check-ins as needs change.