You live 800 miles from your mother. She's been in the hospital twice this year, her neighbor says she's not eating, and you can't tell from phone calls how she's really doing. You need someone local who knows the system, can see her in person, and can tell you honestly what she needs.
That's the role of a geriatric care manager. This guide explains what they do and how to find a good one.
What a geriatric care manager does
The Aging Life Care Association describes Aging Life Care, also known as geriatric care management, as a holistic, client-centered approach to caring for older adults or others facing ongoing health challenges1. Its members have varied educational and professional backgrounds with a specialized focus on aging and disability, and they work through consultation, assessment, care coordination and advocacy1. In practice, that often looks like this:
- A home assessment. Visiting your parent to look at health, memory, safety, daily routine, finances, and support from family and friends.
- A written care plan. Clear recommendations about what help is needed now and what to plan for.
- Arranging services. Finding and checking home care, adult day programs, meal delivery or transportation.
- Helping with moves. Comparing assisted living, memory care or nursing homes, and helping with the transition.
- Going to appointments. Attending doctor visits or care plan meetings, and helping your parent be heard.
- Crisis help. Being the local contact during a hospital stay or after a fall, and helping the family decide what to do next.
- Family support. Running family meetings and helping siblings agree on a plan, then checking that the plan is working.
When to consider hiring one
Families most often call a care manager when one of these is true:
- You live far away. A local professional can be your eyes and ears. See long-distance caregiving.
- Needs are complicated. Several chronic conditions, dementia, or a lot of medications and specialists.
- A hospital discharge is coming. And you're not sure your parent can go home safely. See hospital discharge planning.
- Your parent resists help. A neutral outsider is sometimes easier to hear than a son or daughter. See when a parent refuses help.
- Family members disagree. About what's needed, who should help or how money is spent.
- You're burning out. See caregiver burnout.
Credentials and background
There's no single license for care managers, so background matters. Aging Life Care Association members come from fields like social work, nursing, gerontology and counseling1, and members agree to the association's standards of practice and code of ethics1. Some hold certifications in care management. Ask about:
- Education and licensure. Is the person a licensed social worker or registered nurse in your parent's state?
- Experience. How long have they worked with older adults, and with problems like your parent's, such as dementia or Parkinson's?
- Local knowledge. Do they know the area's home care agencies, communities and hospitals?
- Availability. Who covers nights, weekends and vacations?
What a first assessment looks like
Most care managers start with an in-person assessment, often at your parent's home, that takes a couple of hours. Expect questions about health conditions, recent hospital stays, medications and who prescribes them. The care manager will usually watch how your parent moves around the house, gets up from a chair, and handles stairs, and will look at the bathroom and kitchen for safety risks. They may ask about memory, mood, sleep and appetite, and how your parent spends a typical day. They'll also ask about money in general terms, such as whether bills are being paid, and about legal papers.
Afterward, you should get a written report with specific recommendations: for example, a medication review with the doctor, grab bars and better lighting, a few hours of home care each week, or a list of local programs your parent might enjoy. Good reports separate what's urgent from what can wait, and explain the reasons. Use the report as a planning tool, and share it with siblings so everyone works from the same facts. Our guide to home modifications can help you act on safety recommendations.
Care managers and dementia
Care managers are especially helpful when a parent has dementia, because needs change over time and the right kind of help at one stage may not work at the next. A care manager who knows dementia can help you plan for changes in behavior, safety and supervision, find adult day programs or in-home help trained in memory care, and recognize when it may be time to consider a move. They can also be a calm voice when a parent becomes suspicious or resists care. If your parent is in the early stages, they can help you put plans in place while your parent can still take part. Our guide to dementia stages and care needs explains what to expect.
How care managers are paid
Most private care managers bill by the hour, and many charge a set price for the first assessment. Medicare and most health plans generally don't pay for private care management, though long-term care insurance sometimes does; check the policy. See long-term care insurance. Ask for a written agreement that lists what's included, how time is billed, including travel and phone calls, and how you'll get updates.
Because costs add up, many families use a care manager for a focused job: an assessment and care plan, help choosing a community, or coverage during a crisis. Then they handle the day-to-day themselves.
Free and lower-cost alternatives
Before hiring privately, check these:
- Area Agencies on Aging. Many offer free or low-cost care coordination and can connect you with local services. Find yours through the Eldercare Locator2.
- Family caregiver support programs. Funded by the Older Americans Act, these programs offer information, counseling and respite3.
- Medicaid waiver case managers. If your parent gets home care through a Medicaid waiver, a case manager is usually part of the program.
- Hospital and health plan case managers. Ask during a hospital stay or call your parent's health plan.
- Dementia care programs. Medicare's GUIDE model provides care coordination, a 24/7 support line and caregiver training for eligible people with dementia4. See the GUIDE dementia program.
How to find one
The Aging Life Care Association has a directory of members by location1. You can also ask a hospital social worker, your parent's doctor, an elder law attorney or the Area Agency on Aging for names. Interview at least two. Pay attention to how well they listen and whether they ask about your parent's wishes, not just the family's. A good first conversation should leave you with a clear sense of what they would do, how long it might take, and how they would keep you informed. If a care manager promises quick fixes or pushes one particular agency or community, keep looking. Trust your instincts, too: this person may be in your parent's home and medical appointments, so your parent should feel comfortable with them.
Questions to ask before you hire
- What's your background, and are you licensed in this state?
- How do you bill, and what does a first assessment include?
- How will you communicate with us? Phone, email, a written report after each visit?
- Who is your client? If your parent is competent, the care manager should respect their wishes and privacy.
- Do you have any financial ties to home care agencies or communities you might recommend? You want independent advice.
- Can you share references from families you've worked with?
Getting the most from a care manager
Share everything up front: medical history, medications, the names of doctors, any legal documents like a power of attorney, and what worries you most. Tell the care manager about family dynamics too. If one sibling holds the purse strings and another lives nearby, they need to know who to update and who makes decisions.
Agree on goals. Is the aim to keep your parent safely at home as long as possible, to find the right community, or just to get through a crisis? A clear goal keeps the work focused and the billed hours reasonable. Ask for a short written update after each visit, and keep them in one place so everyone in the family sees the same information.
Introducing a care manager to your parent
Some parents welcome help; others feel threatened by a stranger asking about their bathroom or their bank account. Frame the visit as support for you, not a test of them: "I worry because I'm far away, and I'd feel better if someone local could check in." Ask the care manager to explain their role in plain terms, and let your parent lead parts of the conversation. Over time, many older adults come to see their care manager as an ally who helps them stay independent.
An example
After her father's second fall, Priya hired a care manager near his home in Arizona. The care manager visited, noticed loose rugs, an expired medication list and a refrigerator with little food. She arranged a home safety visit, set up meal delivery and part-time home care, and went with him to his next doctor's appointment to review medications. Priya got a written report after each visit. Six months later, when he needed more help, the care manager helped them compare assisted living options near Priya. This is an illustration.
