A physical and occupational therapist can assist with mobility or activities of daily living but often they find their clients need assistance with life care planning and the “big picture” of their lives. It’s not uncommon for therapist (by default) to take on the role of geriatric care manager. This can become uncomfortable when you’re acting outside the scope of physical or occupational therapy. A referral to a geriatric care manager and ongoing collaboration can take the stress and worry out of therapy sessions and put the focus back on the clinical experience.
Collaboration between physical therapists, occupational therapists and geriatric care managers can be critical when an elderly client is struggling to reach their goals and maintain their independence: depression, anxiety, poor family support, unmet critical needs, long-distance families, poor problem solving skills are just a few indicators that a referral to a geriatric care manager may be in order. As a therapist this conversation can be uncomfortable so therefore the referral doesn’t get made and everyone continues to struggle.
Overcoming Barriers to the Referral
While the therapist sees the value in working with a geriatric care manger (no doubt it makes their life a little easier) but how do you get the aging client and family to take a leap of faith and say yes to the referral?
Without a doubt the number one barrier for physical and occupational therapist in referring to a geriatric care manager is the perception that it is “too expensive”. Since a fee for service geriatric care manager is not paid for by insurance or Medicare the perception for a lot of people is that they can’t afford the service and expertise of a geriatric care manager.
I contend that the average person can’t afford not to hire a geriatric care manager. With the average cost of a consult being under $200 and a clarity session being as little as $65, the benefits gained such as improved communication and quality of life far outweigh the money you stand to lose because of poor planning, miscommunication and lack of knowledge about available resources.
Ways a Geriatric Care Manager Can Help a Therapist Help Their Client Reach Their Goals
Service Coordination - often times physical and occupational therapist are able to identify unmet needs but are unable to assist in locating and coordinating the appropriate services. A geriatric care manager is able to collaborate with the therapy team by providing service coordination and reporting back any additional concerns and updates.
Transitions – a physical or occupational therapist may be the professional that indicates a need for additional care or a move to assisted living. The geriatric care manager can provide the client with resources and education to assure that the best individual solution is identified. They can also assist with the actual move and transition to a new home.
Additional Screens – while physical and occupational therapist focus on the physical it’s not uncommon for the emotional to get in the way of reaching therapy goals. A geriatric care manager is able to provide additional mental health screens such as a geriatric depression screen or quality of life assessment and additional mental health screens such as a geriatric depression screen or quality of life assessment and report the results to the physician and the rest of the clinical team.
Medical Management – facilitate communication between doctor, client, family and other health care providers to assure that everyone is on the same page and working towards compatible goals. A GCM can also monitor adherence to medical orders and instruction: strategize interventions if necessary and recommend appropriate resources.
Family Meetings – let’s face it, it’s becoming more and more common for family dynamics and friction to interfere with the goals of therapies. A family that is not engaged with the process can easily side track your client and create challenges in reaching goals. A family meeting with a geriatric care manager can clarify the issues and create consensus in moving forward.
Ongoing Monitoring – physical and occupational therapist have insurance and Medicare guidelines they must meet in order to receive reimbursement. For therapist, this means they sometimes have to discharge a person from their case load even though they have concerns about their care and well-being. A fee-for-service geriatric care manager can be that safety net that provides ongoing monitoring and the ability to refer back to the therapist as needed.
When the therapist and geriatric care manager work together for their clients, they offer a holistic and comprehensive approach that is unique in the world of health care. A comprehensive approach ensures that the goal of maximizing an older adult’s independence and quality of life are met and clients are satisfied with the care they are receiving and the life they are leading. The leadership and client focus that the GCM brings can empower the entire team, including the client, to work towards care plan goals and maximizing potential.
If you are a physical or occupational therapist exploring ways to refer your clients to a geriatric care manager or integrate geriatric care management into your therapy company, I’d love to hear from you.
LuAnn Smith, email: firstname.lastname@example.org or phone: (970) 223-5656
Your feedback is always appreciated!