What To Do When Publicly Funded Eldercare Programs Can't Fill The Need

We receive requests on a daily basis from around the country from visitors to our main web site, www.elderlifeplanning.com. They are typically caregivers who are juggling both employment responsibilities and trying to help their increasingly frail aging parents, in-laws, or other family members needing assistance.
In many cases, the aging family member is living on a fixed income. While most own their own home-often mortgage free-their home is their only significant asset.

In these cases we always send the caregivers information about publicly funded programs that are provided to elders who can't afford to pay for their own care. For example, here in Massachusetts the state has regional service areas served by a publicly funded network of 30 agencies. Services are available in every city and town in Massachusetts.

A Care Advisor, employed by one of these agencies will visit the home of anyone requesting assistance to help elders and family members to evaluate needs first-hand.

The publicly funded agencies here in MA claim that "From this assessment, a customized plan of care is created. The plan mixes and matches services options into the most appropriate and affordable package. Along with specific support recommendations, you'll receive a comprehensive information packet that identifies local service providers, provides useful educational materials, and defines costs or program eligibility." ..."Care Advisors can provide information on individuals and businesses that provide in-home care, help you decide which choice is the best for you, assist with accessing any entitlement benefits, and guide you through the hiring or contracting process."

"If you wish, we can maintain regular contact to monitor the quality and reliability of the services, and periodically review any changing needs."

"Everyone, regardless of income or level of need, is eligible for a free in-home assessment and personalized package of information."

This is an excellent description of the ideal service for family caregivers. Unfortunately, the reality is somewhat different than the hype. While the agencies and the dedicated employees who work for them do their best to acheive this ideal, budget limitations make it very difficult to live up to this promise. The typical caseload of a "Care Advisor" in Massachusetts' publicly funded elder service agencies is 90 or more frail elders at any one time.

While their needs evaluation may determine that a low income elder is eligible for services, the services may not be there due to a lack of funding. The "eligible" elder is often put on a waiting list. In many cases someone who needs supportive services at home several hours per day, may be provided with only a few hours per week. In summary, your aging parent may be eligible for service...but the services available may not be sufficient to meet their needs.

An alternative that is increasingly sought out by family caregivers is the Professional Geriatric Care Manager. (PGCMs)

PGCMs are health and human services specialists in private practice who help families care for older relatives, while encouraging as much independence as possible. The PGCM may be trained in any of a number of fields related to long-term care, including, but not limited to, nursing, gerontology, social work, or psychology, with a specialized focus on issues related to aging and elder care. The PGCM acts as a guide and advocate -- identifying problems and offering solutions.

Many make it a point to be well informed about private financing options to pay for the cost of care such as long-term care insurance, reverse mortgages and life settlements. A PGCM can often build a care plan around the services available from public agencies, to fill in the gaps and help families use financial resources wisely.

You can learn more about Professional Geriatric Care Managers at the web site of their professional association http://www.caremanager.org.

A short and very informative video about PGCM's can be viewed at care manager.org by following this link http://caremanager.org/displaycommon.cfm?an=1&subarticlenbr=118