GERIATRIC CARE DEMAND BOOMS

When older adults reach the point where they're unable to care for themselves, that responsibility usually falls to their family and loved ones. Unfortunately, most seniors struggle with chronic health conditions, require frequent doctor visits, or need assistance at home, and caregivers soon find themselves overwhelmed.

That's where the services of a geriatric care manager can help, says Jennipher Ama, president and aging life care manager at Family First Senior Care in Spokane Valley.

"A care manager acts as a professional advocate, helping to guide people through the decisions that surround senior care," she says. "We have more of an all-inclusive approach than traditional care giving, and our schedules are a bit more flexible."

Ama says geriatric care managers are trained to evaluate an elderly adult's total care needs and create a plan to address them that includes all medical, legal, and financial components needed for the patient's care.

'What I enjoy most about this job is the holistic approach to care," she says. "As a nurse I was only able to help patients with one small piece of the puzzle, but care managers are able to have a positive effect in many different areas to help to ensure their clients can age successfully."

Ama says that although demand for geriatric care managers is higher than it's ever been, it's still quite hard to spread awareness about their services.

"Demand for this profession is explosive, and with 10,000 baby boomers turning 65 each day, it's only going to keep growing," she says. "We know there are people who need our services; the hard part is getting the word out about who we are and how we can help."

Washington State University professor Mel Haberman is the co-founder and current director of the doctorate of nursing program at the WSU College of Nursing.

Haberman says pathways to a career in geriatric care management at the college are woven throughout all levels of nursing education.

'The focus on geriatric care in the WSU College of Nursing is multifaceted," he says. "All junior bachelor of nursing science students start with a 16-week foundation's course in geriatrics."

Haberman says students in the course learn the legal and ethical aspects of geriatric care, as well as core gerontological nursing skills. The course also includes learning about elder abuse, depression and suicide, dementia, falls and immobility, pressure ulcers, and polypharmacy.

"About 200 students take that class every year," he says. "Baccalaureate-prepared nurses are qualified to become geriatric care managers. They learn the leadership and clinical skills not only to provide direct geriatric care, but to supervise other nurses in the care facility, including certified nursing assistants."

Haberman says WSU College of Nursing's master's and doctorate programs also take an all-inclusive approach to educating students on vulnerable and at-risk populations.

Haberman says he estimates that five out of every 30 Master of Nursing graduates each year will enter the workforce as geriatric care managers, and almost all graduates will work in health care settings that provide care to older adults.

"Many more nurses also gravitate to geriatric practice later in their career as they age and want to slow the pace of clinical practice after years of working in acute-care specialties or with chronically ill populations," he says.

Ama is a registered nurse by training, and she founded Family First Senior Care Inc. in 2005. The company has two offices, one at 521 N. Argonne through which it provides geriatric care management services throughout Spokane County and North Idaho, and another office in Kennewick, Wash., that serves the Tri-Cities area.

The company's care management services include evaluating clients' medical, financial, social, and cognitive issues, as well as helping clients choose a retirement facility, sign up for Medicare and Medicaid, secure long-term care insurance, and select in-home care services.

Ama says Family First has 92 employees total, five of whom are care managers, while the remaining employees are administrative staff or caregivers who provide in-home care services to senior clients.

While aging life care managers aren't required to have a specialized degree, Ama says that most usually have a degree in either nursing or social work.

Ama says specialized care management certifications can be earned through the National Academy of Certified Care Managers or the Commission for Case Manager Certification.

Aging life care managers specialize in eight areas of expertise outlined by the Aging Lifecare Association: health and disability, financial, housing, families, local resources, advocacy, legal, and crisis intervention, Ama says.

Ama says that historically, geriatric care hasn't always been a popular career choice for students, but she's hopeful that will change soon.

"I do think that with the knowledge of this growing need, there are more of us now than there have been previously," she says. "Going forward, there will be a shortage, but all we can hope is that as Spokane grows into more of a medical education hub, more students will be attracted to this field."

Despite the level of interest in the care of aging populations, Haberman says that many students who become geriatric care managers have a variety of educational backgrounds, due in part to current nursing shortages.

"Because of the current and future prediction of a nursing shortage, geriatric care managers come from social work, psychology, and hospitality degree programs that focus on senior living care management."

Like Ama, Haberman says the biggest factor leading to increased demand for geriatric care managers is the number of baby boomers nearing retirement age who will require services for the treatment and management of age-related health conditions.

"By 2030, all baby boomers will be older than age 65. This will expand the size of older adults so that one in every five residents will be retirement age," he says.

Haberman says age-related health conditions already strain the health care system's capacity to provide home and residential care to elders who are currently using the majority of health services for chronic and acute health conditions, and, as society continues to age more, such services will be required.

Ama says that the majority of care management clients she sees are family members of seniors, and the second largest group are spouses of seniors.

"I'd say about 80 percent of clients seeking help with care management are family members, who are either facing a care crisis or have started to notice signs of decline in their loved one," she says. "Most hear about us through elder law attorneys, trust officers, healthcare professionals, rehab facilities, nursing homes, and word-of-mouth."

Because geriatric care can be complex, Ama says Family First encourages people to be proactive in seeking care for their loved ones.

'We encourage clients to come to us before our services are needed, because it's a less reactive approach that often results in better care outcomes," she says.

The care management process starts with an evaluation of a client's needs and assessment of how each part of their life fits together into the hest plan of care, she says.

"Evaluating care needs, finding appropriate resources, and educating the whole family on the changes occurring goes a long way toward easing that burden," she says.

In cases of long-distance relatives needing help with care management, Ama says it helps to have network connections through organizations like the Aging Life Care Association, which can connect more easily with resources available in other states.

"For out-of-state clients, we use our networks to help to vet professionals and recommend the best care options in their area," she says.

Becky Tiller is a licensed mental health counselor and owner of another of Spokane's geriatric care management companies, Tiller Care Strategies, based at 140 S. Arthur.

Tiller says she started the business in 2004, but has been working in the aging field for over 30 years.

"A lot of what I do is provide counseling for caregivers as well as people who have been diagnosed with chronic or dementive illnesses," she says.

Like Ama, Tiller says most of her clients are adult children seeking guidance and care recommendations for their aging parents.

"In some cases, we're almost like a surrogate family member," she says. We do some consultations, but most of what we do involves an initial assessment, followed by recommendations based on the level of care we feel is needed."