De-mystifying geriatric care managers.

• Author: Sarenski, Theodore J.

CPAs are trusted advisers. Their technical training makes them experts in navigating the many complexities of taxation and financial planning. However, they are also a witness to private aspects of their clients' lives that few others may see.

Messy and emotional life events like divorce, a terminal diagnosis in the family, or the declining capacity in a loved one share a common thread. They all have financial consequences. The CPA may not always feel well equipped to handle these conversations--and yet clients need help with critical money decisions in the midst of events they had hoped would never happen. That includes situations where a client might be on the verge of burnout, with a marriage falling apart or a job compromised, all because of having to shoulder care for an aging parent with dementia or chronic age-related issues.

A geriatric care manager (GCM) can become a valuable partner to the practitioner and his or her clients. GCMs are experts at navigating the medical system. They can serve as advocates inside and between care facilities. They can also step in to supervise care if adult children live elsewhere. By partnering with a GCM, the practitioner gains an ally in ensuring that care decisions align with financial goals and the family's resources.

Despite the many benefits that a GCM can deliver, the decision to hire one is often difficult. Some clients might feel it is an extravagance only the wealthy can afford. Others have never heard about geriatric care management as a specialty field and do not know where to begin.

This column's purpose is to de-mystify the emerging geriatric care management field and arm CPA financial planners to provide valuable guidance to their client families.

Geriatric care management 101: What services does a GCM provide?

Geriatric care management is a new field, and many families do not even know that this service is available--until they need it. That puts them in the position of having to make quick decisions without sufficient background or the benefit of proper expectations. What does a GCM do, exactly?

Here is a quick overview of services that can be available through a GCM.

Coordinating health care across several agencies: A GCM can help the family choose the right balance of care locations depending on the circumstances, insurance, and financial resources that are available (e.g., in-home care, specialized facility, etc.)

Financial coordination services: Experienced GCMs have a deep knowledge of the medical and care systems. They can help the family plan for future care and estimate what it might cost. They can also recommend appropriate state and local relief programs.

Family assistance: A trained GCM can streamline conversations between care providers to avoid miscommunications. He or she can also help with conflict management and mediating tough conversations.

Advocacy within the health care system: A GCM can serve as the voice for the client and family inside facilities. This is particularly helpful if the patient's family does not live near the facility or has a strained relationship with service providers.

Legal coordination: GCMs are not attorneys, but they can connect client families with lawyers and other specialists if that becomes necessary.

Knowledge of local resources: A GCM can educate the client family about local resources that are available, make recommendations, and begin introductions.

Crisis intervention: GCMs can navigate hospital emergency departments, unexpected hospitalizations, etc. This is especially valuable for family...