Tag Archives: geriatric

Counseling and Geriatric Care Management; What’s the Difference?


I’m often asked about the difference between counseling and geriatric care management. In a nut shell, counseling looks at a person’s past and very specifically their emotional state of mind.  A geriatric care manager looks at assessing and coordinating geriatric or elder care services. Some geriatric care managers are clinical social workers and, while capable and trained to provide the counseling piece, it’s best for the two disciplines to remain separate.  If your counselor is a Medicare provider, they can bill Medicare B for your sessions but you will need to obtain a doctor’s order. Fee-for-service geriatric care managers are paid for out-of-pocket: no need for a doctor’s order. A counselor’s role is very specific; a geriatric care manager’s role is broad in nature.

A geriatric or aging counselor may be a psychiatrist, psychologist, clinical social worker, marriage and family counselor or an addictions counselor with specific training in the areas of aging. A geriatric care manager is educated and experienced in any number of fields related to geriatrics; nursing, social worker, gerontology, human development and human services.

Collaborative Referrals

Geriatric care managers and counselors often refer to one another. If issues related to the specifics of elder care come up in counseling sessions, a counselor may recommend a geriatric care manager to assist with assessing and obtaining appropriate services. As a geriatric care manager, I will refer to a counselor when a client scores high on a geriatric depression screen, appears to be struggling emotionally with a transition or if mental health issues are interfering with our ability to obtain appropriate services. The geriatric care manager and counselor can then work in tandem to create strategies to provide our client with the best quality of life in the least restrictive environment possible for them.

Nursing Homes: Make the Best of it!

Admitting your aging parent in to a nursing home is a very difficult thing to do even it it’s just temporary. I’ll never forget the look on my dad’s face when he was wheeled out of an ambulance in to a nursing home for rehabilitation. I’ll most definitely not forget that horrible feeling in the pit of my stomach. Lucky for us, I knew how to make the best of it and I want you to be able to do the same for you and your aging parent…

Education + Positive Attitude = Better Experience

Ombudsman: Every nursing home in America has an ombudsman assigned to them. There is variation from state to state in terms of qualifications and scope of practice but they should all be able to field complaints, provide information, and advocate for your aging parent. It’s important to always work with the facility first on any issue you have but know that your ombudsman is there for you and can help you facilitate any concerns you may have. To find your local ombudsman Google: ombudsman, your county name and the name of your long term care facility.

Care Conference: Just as every nursing home has an ombudsman assigned to them every  nursing home in required to hold a series of care conferences that include you, your aging parent and an interdisciplinary team that should include a  nurse, social worker, activities director, dietician and a member of the therapy team, if appropriate. You and your parent should receive an invitation to this conference. If this is not happening, ask to be invited and attend. This gives you an opportunity to have an entire team of professionals in front of you at one time and you can get some very valuable input.

Connect: Find the person in the nursing home that can help you. For us, it was the evening shift nurse. She seemed to know what she was doing was willing to share information and always followed through. Plus she did a heck of a job with my dad’s catheter care. There’s no guarantees but your social work would be your best bet in terms of finding your advocate and the person willing to help you the most. On the other hand, a nursing assistant may be the person to provide you with the most insight in to how your aging parent is getting along. Regardless of their title, I want you to find that person you feel you can trust and connect with.

Attitude: Don’t go in to this with a chip on your shoulder. It’s very common and oh so easy to project your fears and anxieties on to the nursing home staff. The saying “you can catch more bees with honey versus vinegar” could not be more true when it comes to working with the nursing home staff. In general, nursing home employees care a great deal for the residents they care for and you’re going to get a lot more help and understanding if you treat them well. This is not to say that you overlook poor care or live in fear of retribution but be respectful. They work hard and your attitude towards them can make make all the difference in the world. It’s human nature to gravitate towards those who appreciate us so try to keep a positive attitude!

Pick Your Battles: There will be plenty of things you can complain about in the nursing home so I advise you pick your battles wisely. What are your “line in the sand” issues? What are problems that you can live with? What are the deal breakers? For us, I wasn’t real thrilled about the overall environment and communication in our nursing home but the nursing staff did an amazing job at providing intermittent Foley catheter care without introducing infection. The lack of communication drove me nuts but at the end of the day the catheter care was far more important and I relied on the evening nurse to get the information I needed so I didn’t complain. Pick your battle wisely!

I don’t think anything can really prepare you for that moment when you have to admit your aging parent in to a  nursing home but knowledge and a positive attitude can help ease the anxiety and make for a better nursing home experience. I know a lot of you have had this experience so please feel free to share any ideas or tips you may have that could help someone else make the best if it!

Aging Parents: Navigating Acute Care Hospitals!

For many, the first realization that mom or dad needs help is admission to the acute care hospital. It can be a stressful and disheartening experience for many aging families. Acute hospital settings are not designed to help you and your aging parent find long term solutions to life’s challenges. The role of the acute care setting or hospital is to stabilize your parent’s medical condition and discharge them.  It’s not uncommon for families to be ignored and left out of conversations.  Discharge happens with little or no notice and you have to make quick decisions about issues you know little or nothing about. It’s not that hospitals don’t care or do a good job but as you know there is more to your mom or dad’s life than what  the hospital staff sees in the hospital bed. There’s no way we are going to change the system today but there are some things you can do that will help you navigate the insanity of the hospital stay…

Connect: Refer to staff by their name, whether it’s the doctor or the nurse. Immediately connecting with staff by calling them by their name will go a long way in establishing an immediate relationship. Along with this, say please and thank you!

Take notes: Information is going to be coming at you really quick and there is no way on God’s green earth you will remember it all. Purchase a little note book  at the hospital gift shop so you can document who said what and when.  Write down questions as they pop in to your head.   When you see your physician (if you are lucky enough) his or her time will be limited so don’t waste it.

Lower your expectations: It pains me to say this but don’t expect too much in terms of hand holding or education. It’s probably not going to happen in the acute setting.  Look for support elsewhere!

Paperwork: If you have power of attorney for your mom or dad get copies in the chart immediately! Same with advance directives or living wills. Don’t assume that these documents will be read so be sure to advocate and assert yourself as the decision maker, if indeed, you have the legal authority to do so.

Long Distance: If you travel to care for your parents, chances are you’ll need to take time off from work. Keep in mind you may qualify for unpaid leave via the Federal Family Leave Act so check with your human resource director at work if you are worried about the time off.

If you’ve experienced the traumatic experience of helping your parents navigate the acute hospital setting, you may have some tips that can help others. If so, leave a comment with your tip!