This article reprinted with permission from the National Care Planning Council for
non-commercial use.
Find original article  at this webaddress:
http://www.longtermcarelink.net/article-2009-4-8.htm


“My personal mission is to give back to the community including using my
business knowledge and expertise to help others achieve personal success.”
Janet L Heitzig, CLU, ChFC, CLTC
Principal Financial Group
14755 N Outer 40-Ste 110
Chesterfield, MO  63017
Phone  636-449-0734     Fax  1-866-488-0903
Securities and advisory products offered through Princor Financial
Services Corporation, 800-247-1737 , member SIPC, Des Moines, IA   50392.  
Senior Strategies, L.L.C. is not an affiliate of Princor.  
e-mail
Heitzig.Janet@principal.com
Princor Registered Representative, Financial Advisor, Financial Representative,
Principal Life Insurance Company.

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Janet has studied extensively under Ed Slott,
nationally-known CPA, tax-advisor, and IRA planning expert.
(You may have seen Ed Slott programs on PBS.)

Long Distance Care Givers Receive Help

Living in a different city or state -- miles from aging parents --
be very difficult. Keeping in touch by telephone and making long
trips to help parents or aging relatives with their needs can be time
consuming and not nearly as effective as being available full time in
person.

Mark Sessions spent two years juggling his restaurant business with multiple daily phone
calls to his elderly parents, checking on their needs and answering their questions. Family
vacations were spent traveling the 500 miles to his parent's home to personally take care of
home maintenance and provide health care visits to their doctor. During his last visit, Mark
noticed his father had difficulty walking and his mother was confused as to which
medications she was to take and at what time. This alarming change in his parent's condition
concerned Mark that his parents' care needs required more than frequent phone calls and
vacation visits. Running his business and handling his parent's long distance care was now
becoming very challenging.

According to a report by the Alzheimer's Association of Los Angeles & Riverside, California,
there are approximately 3.3 million long distance caregivers in this country with an average
distance of 480 miles from the people they care for. The report also states that 15 million
days are missed from work each year because of long distance care giving. Seven million
Americans provide 80% of the care to ailing family members and the number of long distance
caregivers will DOUBLE over the next 15 years.
Long Distance Caregiver Project – Alzheimer's Association LA & Riverside, Los Angeles, CA (May 15, 2002, National
Web Seminar by Judith Delaney, MFT, Clinical Coordinator)

The long distance caregiver is a new role that is thrust upon children and younger family
members. Families used to live closer together, with children residing and working near their
parents. But nowadays family members are more distant from each other. Society, today, is
recognizing this. Some caregiver services have tweaked their programs to work as liaisons
between long distance caregivers, senior loved ones and local medical professionals.

Professional care managers -- a lso known as Geriatric Care Managers, Elder Care
Managers or Aging Care Managers -- represent a growing trend to help full time, employed
family caregivers provide care for loved ones. Care managers are expert in assisting
caregivers, friends or family members find government-paid and private resources to help
with long term care decisions.

They are professionals -- trained to evaluate and recommend care for the aged. A care
manager might be a nurse, social worker, psychologist, or gerontologist who specializes in
assessing the abilities and needs of the elderly. Care manger professionals are also
becoming extremely popular as the caretaker liaison between long distant family members
and their aging elder loved ones.

Jacqueline Marcell -- author of "Elder Rage, or Take My Father...Please! How to Survive
Caring for Aging Parents" (Impressive, 2000) -- says,

"The most important thing to do is to find a geriatric care manager in the area where your
loved one lives. She will have knowledge of all the services in the area and can be your
eyes."

Below is a partial list of what a care manager or Professional Geriatric Care Manager might
do:

  • Assess the level and type of care needed and develop a care plan.
  • Take steps to start the care plan and keep it functioning.
  • Make sure care is in a safe and disability friendly environment.
  • Resolve family conflicts and other issues with long term care.
  • Become an advocate for the care recipient and the caregiver.
  • Manage care for a loved one for out-of-town families .
  • Conduct ongoing assessments to implement changes in care.
  • Oversee and direct care provided at home.
  • Coordinate the efforts of key support systems.
  • Provide personal counseling.
  • Help with Medicaid qualification and application.
  • Arrange for services of legal and financial advisors.
  • Provide placement in assisted living facilities or nursing homes.
  • Monitor the care received in a nursing home or in assisted living.
  • Assist with the monitoring of medications.
  • Find appropriate solutions to avoid a crisis.
  • Coordinate medical appointments and medical information.
  • Provide transportation to medical appointments
  • Assist families in positive decision making
  • Develop care plans for older loved ones not now needing care

“The 4 Steps of Long Term Care Planning,” National Care Planning Council
Services offered will depend on the educational and professional background of the care
manager, but most are qualified to cover items in the list above or can recommend a
professional who can. Fees may vary. There is often an initial consultation fee that is
followed by hourly fees for services. Health insurance does not generally cover these fees
but long-term care insurance might.

In 2002, the AARP published a survey from geriatric care mangers about their fees:

“Respondents were asked how much they charged for their services, which might include: an
initial consultation; fees on an hourly or per visit basis; fees for development of a care plan;
and fees on a fixed-price contract basis. Hourly fees averaged $74 an hour. GCMs charged
an average $168 to develop a care plan. Initial consultations averaged $175. Seven of ten
current GCMs responded in the affirmative when asked if they had a statement that listed
their fees. ”
Written by Robyn Stone, DrPH, Principal Investigator; Susan Reinhard, RN, PhD, Co-Principal
Investigator; Jean Machemer, MSG, Research Associate; and Danylle Rudin, MSW, Research Associate of The
Institute for the Future of Aging Services, Washington, D.C.Barbara Coleman, Project Manager,
AARP Public Policy Institute November 2002

When you take into account the time absent from work and time to find the right care
resources for your loved ones, along with the cost of travel expenses to monitor their care,
you will probably concur that using a caregiver is money well spent. Add on to this the stress
of handling your own life circumstances combined with being a caregiver and you will
probably wonder how you could have ever done without the care manager.

A professional or geriatric care manager can be an important
asset to all families in elder care situations. Here is an example
of how a care manager can help.

Mary is taking care of her aging husband at home. He has diabetes and is overweight.
Because of the diabetes, her husband has severe neuropathy in his legs and feet and it is
difficult for him to walk. He also has diabetic retinopathy and, therefore, cannot see very well.
She has to be careful that he does not injure his feet, since the last time that happened he
was in the hospital for four weeks with a severe infection. She is having difficulty helping him
out of bed and with dressing and using the bathroom. She relies heavily on her son, who
lives nearby, to help her manage her husband's care.

On the advice of a friend, Mary is told about a professional care manager, Sharon Brown.
The cost of an initial assessment and care plan from the care manager is $175.00. Mary
thinks she has the situation under control and $175.00 for someone from the outside to come
in and tell her how to deal with her situation seems ridiculous.

One day Mary is trying to lift her husband and injures her back severely. She is bedridden
and cannot care for her husband. Her son, who works fulltime, now has two parents to care
for. On the advice of the same friend, he decides to bring in Sharon Brown and pay her fee
himself.

Sharon does a thorough assessment of the family's needs. She arranges for Mary's doctor to
order Medicare home care during Mary's recovery. Therapists come in and help Mary with
exercises and advice on lifting. Sharon advertises for and finds a private individual who is
willing to live in the home for a period of time to help Mary with her recovery and watch over
her husband. Sharon makes sure the new caregiver is reliable and honest and that taxes are
paid for the employment. Sharon enlists the support of the local area agency on aging and
makes sure all services available are provided for the family.

Sharon also calls a meeting with Mary's family and explains to them the care needs and how
they need to commit to help with those needs. Sharon makes arrangements to rent or
purchase medical equipment for lifting, moving and easier use of the bathroom facilities.
Medicare will pay much of this cost. Sharon also works closely with an elder law attorney and
a financial planner who specializes in the elderly. The attorney prepares documents for the
family including powers of attorney, a living will and advice on preserving Mary's remaining
assets. The financial planner recommends a reverse mortgage specialist to help Mary and
her husband tap unused assets in their home's equity. Some reverse mortgage proceeds are
used to pay off debt. The remaining proceeds are converted into income with a single
premium immediate income annuity in order to provide Mary adequate income when her
husband is gone and she looses one of the Social Security payments.

With the help of the care manager, Mary's life and future have been significantly improved.
Her husband as well, if he adheres to the care plan, may end up having a better quality of life
for his remaining years.
“The 4 Steps of Long Term Care Planning,” National Care Planning Council

The National Care Planning Council promotes and supports professional and geriatric care
managers on its website
www.longtermcarelink.net .

"Planning for Eldercare" April 8, 2009
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