The Weil Perspective
GCMs - The New “Mission Impossible” Force
By James Weil, Managing Director – Successful Aging

Most people have never heard of a Geriatric Care Manager (GCM). Yet GCMs are the professional backbone of our nation's caregiving network. Some would say that these professionals have a tremendously challenging mission—a “mission impossible,” so to speak. And as a first hand observer, I would agree.

In case you're not familiar with what GCMs do, listen in to the “Mission: Impossible” episode that never made it to your television set …

“Good morning, Mr. Phelps. This is Lily, an adult care specialist from LifeCare. We have determined that you are one of the most qualified GCMs who can best assist a client of ours with a complex elder care situation. This particular client is a woman in Chicago whose father in California just had a stroke.

“Here's the situation:

	The woman is a manager in a large corporation. She is entering her busiest period at work, so the news of her father comes at a terrible time. She is expressing all the usual emotions: shock, disbelief, confusion, you know the drill.
	She’s grappling with her own emotions and finding it increasingly difficult to focus on her work. In addition, her mother keeps calling her at the office and crying on the phone. Our client is reluctant to tell her boss, afraid he won’t understand, and concerned because project deadlines are fast approaching.
	Her husband thinks Dad should go directly to a nursing home. Her mother wants him to come home. Her brother simply can’t deal with the situation and he’s constantly on business trips.
	No one seems to know where the checkbook is or how the father manages the bank accounts. The family will clearly need a bookkeeper but they don’t know how to find one or whether they’ll be able to trust him.
	The hospital says he’ll be able to come home but he’ll need home health aides and therapists. How will they find good ones? How will they know if they’re being charged a fair price?
	They neither know what Medicare will cover nor know whether he has insurance from his old company. The family is terrified that they could lose all of their savings taking care of him.
	Our client’s brother will be home in a few days but the two are not close. They’ll likely disagree on just about every decision they’ll have to make.

“Your job, if you accept this assignment, will be to meet with the mother and the father, talk to his physician, speak to the son and daughter, and visit the home to see whether it offers the best possible living arrangement. You’ll need to quickly get to the bottom of his finances, arrange a bookkeeper and, as always, provide aid, comfort and guidance.  The family is falling apart. They need you now.”

Mr. Phelps, the GCM, quickly accepts this “mission impossible” and he and Lily discuss the situation in detail and reach agreement on a plan of action. Lily calls the family and briefs them on the next steps that should be taken to help their father. She then schedules several appointments for Mr. Phelps, the GCM, so that he can personally assess the situation in detail.

As he drives to the hospital, Mr. Phelps knows he is about to hear multiple “truths,” conflicting “facts,” and differing points of view. His interviews will be structured to listen hard, evaluate carefully, and only then make his recommendations. He starts his interviews with the doctor and nurse, working as the family’s liaison and gathering information about their father’s condition and the prognosis for his recovery. Then he meets with the patient’s wife, comforts her, and listens carefully to discern her fears, aspirations, needs, vulnerabilities and capabilities. What can/can’t she do? (Lift him? Turn him? Change his clothes? Bathe him?) How does she feel about his moving into an assisted living environment? What physical, mental, emotional and spiritual support does she have at home?  Does she know their financial condition or where her husband keeps their records? This conversation lasts an hour, and as he’s leaving to visit the daughter, Mr. Phelps knows that the path to his optimum recommendation and a detailed care plan has just begun.

To find out what where Mr. Phelps’ Mission Impossible takes him next, tune in to my next column!

To learn more about Geriatric Care Managers and how they help thousands of families make critical elder care decisions every year, please contact LifeCare at 800-873-4636. We can help you resolve your organization's elder care needs.