What is Certified Geriatric Care Management?
🆘 Knowing about this profession can help -we spoke with Kathy Kemp, a certified geriatric care manager.
This story is about three things: an occupation, a woman who chose that occupation and a family that understood they needed help.
Let’s review some trends that affect the modern caregiver before we begin. I see three trends - but hey - comment if you have others…..
First, the physical distance of the caregiver from those (family) who traditionally assume care. Generally, nothing is better than in-person representation. Second, the time crunch. In the standard 12 hour day, how can anyone thoughtfully manage care? Third, the increasing complexity of the healthcare ecosystem🧑⚕️. Then the elephant in the room - COVID 19. Add to physical distance, time crunches, and growing healthcare complexity - a pandemic – and many are turning to others to assist in care management.
Kathy Kemp is a Certified Geriatric Care Manager who agreed to speak and share her path to founding her business, “Sage Advice Geriatric Care Management”. I spoke with her in early October of 2021. She runs her practice out of Massachusetts, and this has been a busy year.
Kathy and I met years before, in the fall of 2019. Kathy meets many families when they are in a tough spot, and I was no exception. I was at my wit’s end. My mother, living over 3,000 miles away, had a serious fall and had broken her right upper arm in 14 places. Understandably, she was distraught. I was in a new job, and it was a critical time in that new job. I dealt with everything but broke out in shingles. On painkillers for the shingles outbreak and working insane hours to manage it all…..I arrived at one truth. I needed help. 🆘 There had to be a better way.
In the process of interviewing, I decided that I wanted someone who had a form of certification. Certifications help create a standard and hold members to an ethical and educational standard. In the U.S., certification designations can appear as initials after one’s name. Here are Kathy’s:
- OTR/L – Licensed occupational therapist
- LSW – Licensed Social Worker
- CMC – Certified Care Manager
I would note the use of the word Certified here, anyone can say they are a care manager.
Problems Kathy is trained to handle include:
- Occupational therapy issues like walking safely
- Mental health issues faced by younger and older adults
- Working with the ecosystem that surrounds the person needing care
What’s in an ecosystem for a Certified Care Manager? For fidelity, I have clipped the client system definition directly from their website. The NACCM calls it the “client system”. When my Mom had her accident, I was managing everything listed 🔽* Seeing it all listed out does give one pause. *I’m summarizing the NACCM site.
All others affected by or who impact the client’s care needs should be considered part of the “client system” and may include:
1. family members within and outside of the client’s household,
2. formal and informal caregivers,
3. friends, neighbors, faith communities, local agencies, and service providers,
4. third parties with fiduciary responsibilities, for example guardians, conservators, trustees, powers of attorney, and health care surrogates,
5. other professionals, such as health care providers, attorneys, and
6. care managers
In the event of conflicting or multiple needs within the client system (for example, two clients), it may not be possible for the CMC to serve each client. The care manager may consider consulting with or bringing in a second care manager.
When I was speaking to Kathy about her path to becoming a geriatric care manager, a thought that repeatedly ran through my head was, “Hang on, isn’t that a nurse’s job?” OR “Hang on, my doctor used to do that – they don’t anymore?” Here was my “AHA” moment.
As I sat on the phone grappling with my (outdated) concepts of “how things are done” Kathy gave me a great example:
She began…..“Let’s take case managers – they work in hospitals and rehab centers. They handle, discharge, and help plan aftercare for the patient.”
I interrupted, “But they work for the hospital – right?”
Kathy gave me an affirmative yes – and then pointed out that sometimes case managers are under pressure to discharge patients quickly. Most facilities will need a bed for the next patient.
When Kathy began working as a certified care manager, she grew an entire program of care managers very rapidly before moving on to start her own business. Care managers can sometimes be seen as an annoyance to case managers attempting to get a person discharged. What Kathy learned was to create a strong alliance between the case manager ( discharging a person) and the care manager – so that the person requiring care benefited.
Let me pause here for a minute. Some of her clients have been with her for a long period of time, meaning – care managers – when they do their job well, can support a better quality of life and perhaps even extend that life through proper care management.
For example: You’ll notice one of her logos on the website is the National Multiple Sclerosis(MS) Society. Many patients with MS will retain a certified care manager to help coordinate care.
Certainly, there is no perfect solution, but coordination of care is a strong step in the right direction. Healthcare and ecosystems are changing. Caregivers need to consistently understand the pressures placed on doctors and hospitals so they can take care of the ecosystem.
It is the job of a certified care manager to confirm and evaluate this ecosystem health. For better or worse, the complexity society has introduced into caregiving has created the need for a specialized guide. One pressure point I know is worse is the ratio of nurses to patients in this post COVID world. But hospitals aren’t advertising their insufficient ratios of care, and most laypeople don’t know what a good ratio of care to caregiver is in a hospital or rehab. I sure don’t.
As a certified care manager, it’s Kathy’s job to know these things.
A certified care manager can navigate the system, using what they have learned about where to push. They have learned which hospitals are under what pressure – and this type of knowledge becomes invaluable when someone you love needs help.
I’m closing with a summary of the mission of a certified care manager, called, “The Code”.
It’s a high-level overview of the ethical principles and standards of practice that supports the principles held by The National Association of Certified Care Managers(NACCM)
It moved me. And it moved my mother because after I read this code to her she asked about hiring her own certified care manager in Arizona. Her first attempt did not meet her standards, but she is continuing to look.
THE CODE: ETHICAL PRINCIPLES AND STANDARDS OF PRACTICE SUPPORTING THESE PRINCIPLES
Integrity
Loyalty and ResponsibilityPromoting Benefit and Avoiding HarmRespect for Clients’ Rights and Dignity
Justice
Source: https://www.naccm.net/about/code-of-ethics/
Abbreviations used in this article
OTR/L
OTR/L is the standard occupational therapy credential and signifies that the professional is…
an “OT”( Occupational Therapist) who is
“R,” registered by the national OT credentialing board, and
“L,” licensed by your particular state.[1]
LSW
The Licensed Social Worker (LSW) is a specially trained Social Worker who has met requirements for licensure in order to help clients with mental health issues.
The Licensed Social Worker brings a special “Social Work” frame to the realm of mental health healing. [2]
CMC
Certified Care Manager: This designation is granted by the National Academy of Certified Care Managers. You can see the Code of Ethics below[3]
[1] https://www.verywellhealth.com/occupational-therapy-degrees-and-training-2509970
[2] https://www.humanservicesedu.org/lsw/
[3] https://www.naccm.net/careers/benefits-of-hiring-a-cmc/
Thanks for an informative & interesting essay. Health care service by a licensed / certified care manager is obviously vital. An area challenging to a patient, senior or otherwise, and family - if not in a hospital or nursing home or hospice - is the financial requirements incumbent on one utilizing a care manager, i.e. my understanding there are limits (or non-coverage) by MediCAID, MediCARE and private insurance - unless already covered by a pre-contracted home health or nurse home coverage. Thanks again. Be well. Rich & Anne