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When Elder Care Becomes Difficult, You Can Hire An Expert

CARING for an elderly parent is emotionally and mentally draining. There are diagnoses to decipher, housing issues to consider, health aides to vet and a raft of legal documents to complete. It can seem overwhelming, even when families are in complete agreement on how to care for an elderly relative. And often they are not.

A geriatric manager can swoop in, figure out what needs fixing and move on to the next case. Or the manager can provide continuing support for situations that cannot be resolved quickly. Because care managers charge by the hour — typically $50 to $200 — what you or your insurance will pay will be based on how long you choose to keep them on the case.

If you want to hire a geriatric care manager, you can start by asking for names from everyone you know with elderly parents.

“The majority of new clients come from referrals,” notes Phyllis Mensh Brostoff, a geriatric care manager and president of the board of the National Association of Professional Geriatric Care Managers. “This is a personal business.”

If that does not work, you can go to the association’s Web site, www.caremanager.org, and click on Find a Care Manager to locate one in your area.

Be sure to ask about backgrounds and credentials. If your parent has complicated medical issues, a care manager with a nursing background might be best. If the parent has cognitive problems or is just plain ornery, someone with a master’s in social work might be better.

Find out whether the person is a member of the national care managers’ association, which has strict requirements: members must have a master’s degree in a field related to care management, like nursing or social work, two years of supervised experience and certification by one of three accrediting agencies. Ask for a brochure and a fee schedule. Learn whether the care manager works alone or in a group practice and if they will be available to you 24 hours a day or just on weekdays.

Once you have found someone you like and trust, there are three ways you can use their expertise.

CONSULTATION: If you want straightforward advice — like, “Is it time to move my mother to a nursing home?” — set up a consultation. This is generally done in person and typically takes one to two hours. “The care manager can help you figure out what you need to concentrate on and what solutions may exist, ” Ms. Mensh Brostoff said.

ASSESSMENT: When your parent is living far away or has multiple problems, you can ask for an in-depth assessment. The care manager will spend an hour or so with your parent, speak with family members and doctors, and assess the living arrangement in order to paint a complete picture of the client’s situation and challenges. The manager will send you a 5- to 10-page written report with specific recommendations.

Finally, when money is tight, consider free options. If your elderly person has Alzheimer’s, the Alzheimer’s Association (800-272-3900; www.alz.org) can set up a free care consultation with a social worker, who can provide advice and connect you with useful services in the community.

Also, you can try the Eldercare Locator (800-677-1116; www.eldercare.gov), a service of the Department of Health and Human Services, which can connect you with local agencies on aging. Sometimes just attending a free seminar can give you enough information to make tough decisions on your own.