Our older clients come to rely on us more and more for issues that affect both their financial and personal lives. As financial planners, we need to be equipped to answer their questions and help their family find the right resources when a loved one needs more care than the clients are able to provide.
When an older parent or loved one needs more care, it is typically a spouse, family member or close friend that needs to step in and help manage the revolving door of medical professionals and their bills. But not everyone is equipped to do this -- and some may feel overwhelmed by the myriad of medical and financial decisions they may be required to make.
In this situation, our firm recommends that a client work with a geriatric care manager or care coordinator to help ease the burden.
Both geriatric care managers and care coordinators perform similar functions: They adhere to a specific process to help the patient reach their maximum level of functioning comfort.
These professionals assess the situation, whether at home or in a facility, and then create a plan of care to include the necessary support team of doctors, nurses and home health aides. They monitor the progress of the patient while managing the team of professionals to ensure the patient is on track -- and if not, make recommendations to adjust the plan accordingly.
They will also advocate for the patient and facilitate communication between the patient, their medical team, and their loved ones. If a caregiver, such as a spouse or loved one, needs guidance on how to care for the patient, they also provide education and support. These services can be invaluable in the time of need.
It can be difficult to grasp the difference between these two professionals, especially since the titles seem to be used interchangeably. Indeed, anyone can use the term geriatric care manager or geriatric care coordinator/specialist, so it pays to do your homework.
However, there are a few key factors that differentiate the two.
- A care coordinator is usually appointed by the insurance company at no extra cost as part of the benefits package with a long-term care insurance policy. When long-term care services become necessary, the insurer brings in a care coordinator at the beginning to assess and manage the patients care, and help facilitate the claims process.
- Geriatric care managers usually act independently -- while they may be able to help with insurance issues, there could be limitations to their knowledge regarding benefits and claims, and the long-term care policy may not cover their fee.
Care coordinators must be licensed medical professionals -- usually nurses -- because they will make clinical decisions on behalf of the client. Geriatric care managers do not need to be licensed and will only make medical decisions if they have the expertise and authorization to do so.
Many geriatric care managers, however, have gone through a certification process. The basis for certification is often a degree in a field related to care management such as nursing, counseling or social work, plus experience -- but you should ask about an individuals qualifications.
Many geriatric care managers will also provide more hands-on care. They may attend doctors appointments, schedule social events for the patient, provide information on entitlement programs, and act as a coach or counselor to the patient and family as they learn to cope, and thrive.
WHAT TO TELL CLIENTS
As soon as a client calls to tell me that their loved one needs care, I let them know that help is out there. If they have a long-term care policy, I suggest they call the insurance claims department to get the process started and meet with the care coordinator.
If they dont have a policy, or if they want additional assistance, then I suggest they contact a geriatric care manager. The National Association of Geriatric Care Managers has a comprehensive list online; our firm also maintains a list of recommended professionals in our area. Clients have also found help by seeking recommendations from friends, neighbors, or their religious community.
Pricing models vary but services are commonly billed on an hourly basis, based on the needs of the patient and family. In the Washington, D.C., area, where we are based, the average rate is about $130 per hour; by contrast, hourly rates in California can top $250.
Most commonly, clients cover the cost with long-term care policies, because geriatric care managers can qualify as private care help. If the bill needs to be paid out-of-pocket, however, our recommendation for doing so depends on the financial resources and status of the patient. Patients who have the financial means should pay the bill and perhaps look to reduce the burden by writing off the medical expense. If the patient is getting financial help from a relative or other loved one, that person could pay the provider directly to avoid making a gift. And if the patient is considered a dependent, the custodian could use their pre-tax HSA dollars.
If you dont have a tax specialist in house, be sure to have your client check with their tax advisor before deciding on a payment strategy.
Taking care of an aging parent or loved one can be an exhausting act of love. The peace of mind in knowing that a qualified caregiver is available to help manage and coordinate the care of their loved one could mean the world to your clients.
Jessica Ness, CFP, is a client advisor and the director of financial planning at Glassman Wealth Services, a wealth management firm in McLean, Va.