Ask Karen

Senior Living Guide
Fall 2002
What's New In Long-Term Care?

As our population achieves a longer lifespan, many families are faced with the devastating problem of how to best care for an aging family member who can no longer live alone and needs constant care. Facilities have been built throughout the country to house and care for these very needs. The quality of these facilities varies tremendously, however, and it is often extremely difficult for the family to recognize which setting and which features are most essential for their situation. Determining quality care and the setting that will offer the best possible quality of life for their loved one is fast becoming a major stressor to the American family. This is especially true for families faced with care needs and quality of life for Alzheimer's or related dementia.

GERONTOLOGY
Gerontologists are specifically trained to work with the geriatric population. Through their study on human aging, they have gained a multi-disciplinary focus and skills enabling them to make evaluations on quality care settings and programs offered. Similarly, with their study of individuals and family structures, gerontologists are able to advise families on the factors involved in quality of life which enable even the most frail elderly person to continue to get satisfaction from life.

Gerontology is an interdisciplinary study of changes from middle age through later life with an integrated focus on health and diseases in later life; healthcare systems; the changes in society resulting from an aging population, and the application of this knowledge to polices and programs. Neurogerontology's focus is the aging nervous system. Here, non-normal aging like dementia of the Alzheimer's type and related issues are studied.

CONTINUUM OF CARE SERVICES
The 1990's found care settings rapidly responding to the need for more special care units for cognitively impaired persons. Initially, there were dedicated areas developed in nursing homes, then the trend moved into assisted living. Today, some facilities are totally dedicated to providing dementia care and programming.

Such advances have challenged the continuum of care which today is often highly fragmented. When combining the complexities of diagnosis, prognosis and care management, families can be overwhelmed. As a result, there has been an increase in private geriatric care management services which offer clarity and advice to families faced with care decisions and who are feeling considerable confusion over options and quality.

CARE MANAGEMENT SERVICES
AARP defines care managers as family advocates and states that their services vary widely. Some include: empowering the consumer and increasing the consumer's ability to: find and receive long-term care services, learn the qualifications for publicly funded services, complete the paperwork for publicly funded services, coordinate long-term care services of different agencies, and evaluate service effectiveness. Care management costs vary too. Prices range from free, sliding scale or a range of $50 to $175 an hour for a care manager in private practice. AARP emphasizes that consumers must assume the responsibility of acting on their own behalf in using care management. Of particular importance is to understand the specific services each offers and to weigh the services with the manager's qualifications and expertise. Training in gerontology is critical to the equation.

Currently, many families are confused over the words "assisted living" (A.L.). The fact that so many A.L. facilities are being built every year triggers curiosity. What A.L. means varies from one setting to the next as do the services themselves. The A.L. options and which options families should closely examine can become overwhelming.

Care management services certainly can help. When considering care management services for assisted living, families should find out if the manager has gerontology training plus determine his/her knowledge and experience with assisted living contracts, levels of care and programming, and state and federal regulations. How these differ from nursing home settings is equally important. For specialized needs like Alzheimer's, a care manager should also offer families expertise on how dementia care differs from normal aging and how care settings differ in meeting these needs to ensure security, quality, and peace of mind.

Author Karen Rice is a gerontologist, mediator and licensed nursing home administrator in private practice in dementia care services alzheimerfamilycaremanagement.com.