As a Massachusetts estate planning attorney, I am well versed in the laws and procedures governing wills, trusts, taxes, and probate. But with elderly clients, their legal issues often overlap with their medical issues. While discussing estate planning with a client, I’m often asked whether an elder can remain in their home, or whether an elder can move in with a child instead of a nursing home. It is with great humility that I answer: “I don’t know.”
Although I am qualified to advise on how to protect assets from the costs of nursing home care, or how to nominate a child to make medical decisions, I am not a doctor, or a nurse, or a clinical social worker. I simply couldn’t know what they know, and still have room in my brain to know what I know. Neither could most lawyers.
So when faced with these questions, and admitting my lack of knowledge, how do I help my clients? Often times I refer them to a Geriatric Care Manager. Geriatric care managers are private consultants that help the elderly and disabled to achieve the highest level of care that they need, in the best possible way.
The scope of the GCM’s duties are set by the client, or the client’s family, and may evolve over time. A geriatric care manager typically begins by doing an assessment of the elder, and writing a report about their medical condition, social condition, support network, and necessary level of care. If the elder is able to live at home, then the care manager can advise the family as to any modifications needed to make the home accessible, or equipment needed to care for the elder at home. If the elder is not able to live at home, then the GCM can help the family locate the optimal assisted living or nursing home facility.
Not only can geriatric care managers locate a great long-term care facility, but they know how to get your relative a bed there.
Nursing home residents invariably end up on Medicaid (MassHealth), and Medicaid reimburses the nursing home at a much lower rate than private-paying residents. Therefore, the best nursing homes tend to avoid Medicaid patients in favor of private paying patients. But there are unwritten rules of thumb at work here, and geriatric care managers know them. For example, if a resident can afford to privately pay for six months,then a GCM may be able to leverage that ability in order to obtain a bed that would otherwise be unavailable. They also know which facilities are poor in quality, and which are high. They can recommend the best facility for an individual’s circumstances, and find a way to get them in there.
Geriatric care managers often have long careers in the nursing home industry, so they know all of the rules and tricks.
And that is why geriatric care managers are a great resource for estate planning attorneys.