Wednesday, September 10, 2008

How Not To Hire A Geriatric Care Manager (Part 3)

I knew I had made a serious mistake in hiring this particular Geriatric Care Manager. Suddenly, it seemed as though I was paying an hourly fee for the time she spent having lunches with Mom—plus she expected me to pay the cost of these lunches which were listed as “Related Expenses” on her bills.

She was also billing for chauffer services, and for waiting around in doctors’ offices (which could sometimes be several hours of waiting time times her hourly rate). I thought I had hired a GCM. Instead, I appeared to have “bought” a new best friend for my Mom (who had managed to alienate all of her “free” friends).

What was going on here, I wondered? I had hoped for an objective ally to help me plan for Mom’s needs but, suddenly, (according to the GCM) Mom had "hostile feelings that needed expressing." So I found myself dealing with two adversarial camps: Mom and the GCM versus me.

It was time to evaluate the situation. The GCM concept still made sense to me, but perhaps I had selected the wrong person. She was adding to my stress, rather than relieving it…not at all what I had in mind by hiring her. But was she helping Mom? So I asked Mom how she'd feel if I fired this GCM and, surprise…surprise, she was actually happy to see the lady go.

Shortly thereafter, I found a real geriatric professional, one of the social workers at a local family service, who made it a priority to evaluate Mom’s needs, who conducted herself professionally, and who reported regularly to me. I'll call her Gloria, although that was not her real name.

She was a breath of fresh air—everything I had hoped for in hiring her predecessor (that I didn’t get). She soon discovered that Mom had known all along that the other lady was charging us a fee. So she knew the lady was not a "real" friend, just a hired gun. Rather than confront me with this news, however, my mother deliberately ran up the clock as her way of killing the arrangement. At least, that’s what she told Gloria.

It didn’t take long for Gloria to figure out that Mom had some real emotional and cognitive problems, that she was probably at the beginning stage of some sort of dementia, and that the symptoms were certain to get worse.

She began to prepare me for a day, in the not too distant future, when my mother would need to move again, this time into a more sheltered environment.

But that’s a story for another time.

Bob Tell
Author, "Dementia-Diary, A Caregiver's Journal"


Dementia said...

Gloria does sound wonderful. I hope this relationship keeps flourishing with your mother's needs met. And of course yours, too.

Bob Tell said...

Thank you so much for visiting my blog and for your supportive comments. Mom passed away two years ago, but I still publish these experiences in the hope of providing some relief to current caregivers.

Bob Tell

Amy Abrams said...

I just came across your blog, and am enjoying it very much. The experiences of real-life caregivers are invaluable, and I appreciate that you continue to write on these important topics.

As a professional geriatric care manager, it is disheartening to read about your encounter. Certification as a care manager was recently mandated as a requirement for membership in the National Association of Professional Geriatric Care Managers, and there is a grievance procedure in place for the protection of consumers such as yourself. There are published Standards of Practices and a Pledge of Ethics for members of NAPGCM. As a member of the association, the professional that you hired should have been held accountable to them.

I thank you for writing about your experiences. As with any profession, it's impossible to know in advance with 100% certainty that you are hiring the right person when it comes to care management. It is a complex relationship, and the mysteries of human chemistry play a significant role in terms of determining "fit." But there are guidelines as to what is and what is not professional, ethical behavior, and hope you will have helped others to detect problems early on.

Bob Tell said...

Amy--I don't have an email address for you so I'll answer you here and hope you see it. Let me know. Thanks you so much for your terrific comments on this blog. I know that there are wonderful geriatric care managers out there and, obviously, you are a professional that cares deeply about the integrity of your colleagues. I am also pleased that certification is now required for membership in NAPGCM and hope the criteria for qualifying will be held at a high level.I wish someone like you were available in my area when my mother needed a care manager. I know your own clients are lucky to have your services. Best wishes.