Experience with using geriatric care manager/case manager with difficult parents?

Thanks for the answers. As far as general county and medically affiliated social workers, I didnt get very far in getting someone to pay attention and set up a meeting with my dad. It did not seem to hit their radar of attention, which makes sense as he is now in an AL and doing ok from that point of view.

So I'm back to thinking about Geriatric Care Manager. I spoke with one or two options. While it would be good to have backup when I'm out of town and if a medical emergency comes up, and someone else who can drive to a medical appointment and still update me and other doctors on what was said, but yet, 'm still not sure if it will work with a difficult and stubborn parent such as my dad. I'm not sure if he will even accept a GCM in their role, and allow them to participate as they intend.
Any further thoughts in this scenario?
on the one hand, I could try it out, spend some money and see how it goes, at risk of it being a waste.......

Log onto the website below and see if you can find some GCMs in your area to interview so you can ask them your questions especially about non-cooperative patients.

https://www.aginglifecare.org/ALCAWEB/ALCAWEB/Default.aspx

I partnered with a Geriatric Care Manager for my mother, who, at the start of this, was 92yo and living in her own condo still. I am an only child and only family, so all of the responsibility was on me. When you work, or even want to go on a vacation, it can be concerning when your parent is left on their own. The Geriatric Care Manager was GREAT! He had been in the business for over 20 years, was a retired RN, so, he not only went to medical appts with her (after she signed off on the consent form) and relayed all the appt info to me; he was on call 24/7 if we were out of town and would handle any and all crisis and problems. It was SUCH a relief and help. BUT, and here is the BUT, he was expensive - even back in 2018, the hourly charge was $175/hr, and travel time and waiting time for appts, etc, were all charged hourly. So, if mother had a dr. appt, he would pick her up (charged by the hour from whereever he may have been coming from), bring her to the doc, wait with her for the appt, and then go into the appt with her, then bring her back home. This could add up quickly to over $700 for one 'visit' . Then covid happened and I had to terminate the relationship because I just couldn't afford it any more. BUT, if I had won the lottery or had unlimited wealth, this would have been the way to go.

strugglinson: Contact a social worker.

My sense is that you need to interview/contact medical social workers to see who is a good fit for your needs.
Some are state/county employees perhaps.
Some are independent/work privately.
Do find out how / if they are certified or have a license to practice.

Alternatively, you could consider hiring a person (like me) who is an independent and is not a social worker. It depends on your needs.
Always ask for references whoever you consider hiring.

Gena / Touch Matters

I live on the opposite coast from my brother, which I know is unusual. I am his fiduciary, DPOA, Trustee, you name it (he is unmarried, no kids). My brother is bed-bound and has dementia, but sounds "normal" until you realize what he's saying makes no sense. He lives in a RCFE and his caregivers have done a great job in keeping him clean and managing his meds, but they can't do everything. I hired a GCM 2 years ago, and she has been invaluable in visiting him, helping me set up an Alexa device for drop-in video visits (since he lost the ability to use his phone or iPad for Facetime), finding people to do haircut and manicure care for him (the caregivers don't do those things), and being there with him for video or in-person doctor visits. She is able to fill in the health details he avoids talking about (either forgets about or is unaware of) with the doctor. She will also go through his mail with him, (then forwards it to me) has helped with many tedious details. I couldn't manage without her help. She charges $155/hour which typically amounts to $1000-2000/mo depending on how many doctor visits etc.

I have worked with a geriatric care manager for the last three years. First with my sister who has early stage dementia, and now with my husband who has middle to late stage dementia. She charges $125/hour, and the average cost is about $600/month, and it's worth it; she is very helpful.

My husband's family hired one when MILs finances were getting low and they wanted to get her in a ood Medicaid facility before applying.

A neighbor used one to help her sister find a facility that could accept her with morbid obesity with a hoyer lift that could support her weight. Her sister was an hour away with no place to accept her in a desired location. It turned out that moving sis across the the border in another state yet much closer to home had more choices.

You say your parents are already in AL. That's a plus because 'difficult' and 'stubborn' are a lot harder to deal with at home.

I did homecare for a long time. Some of my cases where I was private-duty it was also part of my job to manage doctor's appointments, get the other aides paid, and pretty much everything else along with their care needs and meds.
Of course I charged a fortune for all of this but it was far less than what it would have cost to hire individual people for separately for care, management, etc...

Why not hire a private-duty aide? Look on a caregiver website and hire someone a certain number of hours a week. An 'aide' doesn't always have to mean just personal care and companionship. It can mean management too. Pay high and you'll get someone who will manage what your parents need. It will still cost less than a geriatric care manager. Unless of course they can get that from the state. My private clients or their POA's signed paperwork with their doctor's offices so they could talk to me because I was the one there and it made sense.

If you hire one person working for you, the appointments get scheduled during their work hours. The errands and anything else do too.
A geriatric care manager is not going to work exclusively for you. They are going to assign the tasks to their people who are hired to work for them.

If I were you, I'd hire a private person and eliminate paying a middle man.

I hired a GCM six months ago to support me and my 88-yr-old dad through/following another hospitalization. I have a job that requires me to be physically present in person or via video, so needed to be sure I'd have someone who could advocate for him and be with him at appointments if I ever couldn't be (I'm single, no kids, and I'm an only kid). The GCM has also been a helping sounding board for me, especially when additional hospitalizations have come and decisions about rehab stays, etc. have needed to be made. She and her agency have relationships with care providers across our area and have seen a lot of different situations, so I value their perspective.

I'm now in the same spot you're asking about so don't have direct experience with that yet. After months (actually, 15 years, since my mom died), I have been the buffer, especially when Dad's in a healthcare setting. I've done it mainly for the reasons you've listed - Dad can be quite difficult, non-compliant and argumentative at times. To be fair, he also doesn't hear well and his processing capabilities have changed. I've been worried that asking the GCM to take on more, and be that buffer, would just end up making it more difficult and time-consuming for me. That said, she is coming to visit us today, and I committed to my support group last night that I will ask her to step in more. We have in-home caregivers coming for Dad and I'm over managing that scheduling merry-go-round plus Dad's "feedback" about whoever is here. We are also likely nearing the end of Dad's life based on his non-eating and his chronic conditions; we have a hospice referral request into his PCP. If not now, when?! I don't want our remaining time to be fraught with unnecessary tension every other day. I'm also beyond sure that I have done my share and then some. I really don't need to "protect" others from his difficult behaviors anymore. He's still competent and he can take responsibility for himself in that regard (or not).

Looking forward to what you decide, and to what others have to share from their experience.