Guardian Angels

  • When Fannie Smith, 82, was found to have lung cancer two years ago, her son Ray had nightmarish visions of commuting weekly between his home in Denver and his mother's place in Linden, N.J. "Mom wasn't going to move, and she didn't want to go to a nursing home," the 59-year-old financial adviser recalls. But all kinds of problems, from fixing the hot-water heater to lining up 24-hour health care for her, suddenly became his responsibility. "How do you handle all that from 1,800 miles away?" he wondered. "You just can't do it by yourself."

    Fortunately, Ray found Connie Rosenberg, whose official job title is "geriatric-care manager" but who is more simply described by her clients as a godsend. Over the next several months, Connie was in fact the next best thing to a guardian angel for the Smiths. She put Ray in touch with a reputable home-health-care agency. When his mother became too weak to climb the steps in her home, she got a stair chair installed. "I still had to make a lot of decisions," Ray recalls. "But Connie was my resource on the ground."

    For years, ailing elderly parents have been cared for by adult children, often their daughters or daughters-in-law. But as families spread across state lines, and more and more women work outside the home, the need for geriatric-care managers has increased dramatically. And their services are being more widely sought. Now here's the catch: unless you have a long-term health insurance policy, you will probably have to pay out of pocket for such services. Costs range from $75 to $125 an hour, and even a simple assessment can run a few hundred dollars. Still, you may discover that they are worth it--especially if they can direct you to hard-to-find health-care services or act as an objective outsider during difficult, emotion-fraught decision making.

    Currently, there are no licensing requirements for geriatric-care managers, although there is a voluntary certification process. Besides word-of-mouth recommendations, you can contact the National Association of Professional Geriatric Care Managers in Tucson, Ariz., by phone (520-881-8008) or on the Web at www.caremanager.org .

    Because the specialty is relatively new, most geriatric-care managers started out as registered nurses or social workers. (Rosenberg is an R.N.) Make sure these professional credentials are up to date. Find out what services a manager provides and whether they include coordination of care for such ailments as diabetes or Alzheimer's disease. Ask who fills in when the manager is on vacation.

    Be straightforward about your expectations and what you can afford to pay. You may want to think twice about hiring anyone who gets a commission from other health-care agencies or has a stake in them.

    In any case, keep your bags packed. As it was, either Ray Smith or his brother found himself flying to New Jersey at least once a month during the mother's final illness. "The logistics of keeping a gravely ill parent in her own house are just overwhelming," Ray says. But with Connie's help, Ray and his brother were able to honor their mother's wishes. On Sept. 13, Fannie Smith died peacefully at home.

    For more information you can visit:
    The AARP Research Page
    Medicares's Nursing Alternatives

    You can send e-mail for Christine to gorman@time.com