By Jeni Miller
While inflation continues to be a part of the economic landscape of 2024, aging healthcare consumers and their families are considering their options for managing care. With that, private care management, paid for by the consumer, is becoming more popular.
“The healthcare system is becoming more fragmented, benefits are becoming harder to access and navigate, and there is a rapidly rising aging demographic, many of whom do not have advocates or support networks in place,” says Anne Sansevero, RN, MA, GNP, CCM, board president and fellow of the Aging Life Care Association (ALCA) and owner of HealthSense LLC.
These private care management professionals work with clients and their families to design a care plan to carry them through the various stages of aging. These tailored plans are for people living independently as well as in assisted living capacities.
“Aging Life Care professionals perform comprehensive and holistic assessments that identify critical problems that need to be addressed to get a client or family out of crisis, but they also provide a roadmap with key areas to focus on to optimize their clients’ aging journey going forward,” Sansevero explains. “They are expert problem-solvers and can rapidly mobilize local resources when providing solutions.”
ALCA members are thoroughly vetted concerning education and experience in the aging field, and the organization “also encourages its members to take a geriatric care management certification exam once they are eligible, and only those certified can apply for the higher levels of membership,” Sansevero says. “ALCA also has a code of values, ethics, and standards that their members subscribe to, [which] helps ensure that ALCA members adhere to the highest professional standards in the aging life care field.”
Hospital case managers who collaborate with aging life care professionals have the benefit of expanding their offerings to aging patients who need continuity of care. For many, this means a lower readmission rate, a simpler discharge process, and improved outcomes.
“ALCA care managers share many of the same goals as hospital case managers,” said Sansevero. “They both care deeply about continuity and quality of care. ALCA care managers have expertise in community problem-solving, marshaling local resources, and following through with a client, especially during the first few weeks after a transition from the hospital to home or other senior living environment. When hospital case managers have a complex discharge challenge for their patients, they should consider partnering with a local aging life care professional to decrease the likelihood of a rebound admission.”
Transitioning seamlessly from the hospital to care under the guidance of an aging life care professional starts with getting to know the local professionals and developing a referral plan. Sansevero encourages hospital case managers to “consider inviting a local care manager to provide an educational meeting at their hospital to get to know how they can best refer to optimize more complex discharge planning issues.”
These care managers, Sansevero adds, often can implement medication management systems to enhance compliance, oversee environmental modifications to enhance home safety, and help families vet and hire the right care team that is best matched to their needs.
“They may also be helpful in benefit advocacy, assisting families with long-term care insurance or Medicaid applications, and referrals to trusted elder care legal resources,” Sansevero explains. “Many care managers are also knowledgeable on local senior living housing resources and can guide families on the best matches for care needs.”
Hospital case managers should be attentive and alert to identifying patients who might be a good fit for the guidance of an aging life care professional. Some patients that may benefit from this type of referral include:
- Patients who are rebound admissions and likely cannot independently adhere to a discharge plan effectively;
- Solo agers (seniors living alone with poor support systems);
- Patients with complex chronic medical conditions who require more support with ongoing care monitoring and care coordination needs;
- Clients who need medication management support and oversight;
- Clients with cognitive decline or dementia with limited family or community supports;
- Clients with complex family dynamics where an objective, knowledgeable, and qualified mediator can provide support;
- Clients who need support with transitions of care or senior living options.
Care managers like those with the ALCA serve as independent consulting professionals under their private business entities. As fee-for-service professionals, they typically bill hourly for their time, and rates vary based on experience and geographic location. According to Sansevero, clients can expect to spend an average of $150 to $250 per hour, but some care managers will charge a flat fee for a care management assessment that includes a visit and written summary and plan with recommended resources. In some circumstances, a care manager might offer sliding scale fee rates based on need.
“To use a care manager most effectively, be strategic on how you want to use their time,” Sansevero recommends. “You can also provide some monthly budgetary guidelines if appropriate. Some long-term care insurance policies and catastrophic care plans will reimburse a client for care management services. Many families find that the solutions and insights a care manager brings to a complex problem saves them significant time and money in the long term and brings effective solutions and much-needed peace of mind.”
ALCA care managers and hospital case managers working collaboratively can be highly effective advocates for their clients, especially those with complex care needs. More information on aging life professionals is available at: www.aginglifecareassociation.org.
While inflation continues to be a part of the economic landscape of 2024, aging healthcare consumers and their families are considering their options for managing care. With that, private care management, paid for by the consumer, is becoming more popular. These private care management professionals work with clients and their families to design a care plan to carry them through the various stages of aging.
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