“Life is multi-faceted for older adults, and long-term care choice and dignity have financial and legal components.”
-Patricia Hanson, IKOR Owner and Directing Manager
When Mom lives far away, when Dad needs help managing his finances, when there is no one to make medical decisions for an incapacitated older adult, advocacy firms can provide a surprisingly wide range of services.
Life care management services offer support for older adults that encompasses almost everything except physical caregiving, such as the care that home aides provide. Take the following case, for example:
“Susan” is a diabetic older adult with no family members living nearby. She can no longer drive, and her eyesight is failing. Fortunately, she found a firm that specializes in life care for seniors. This firm provides a financial expert, social worker, nurses, and a mental health expert on staff. The company, IKOR of Western Pennsylvania, not only manages her finances, but also accompanies her to the grocery store for wise food choices, schedules and accompanies her to doctor appointments, and follows up on needed services. In effect, they do everything a son or daughter might do if Susan had a child who lived close by and had the time, energy, and knowledge to manage her affairs.
Life care management services can be tailored to fit the specific needs of an individual client, whether it is an older adult or someone with special needs. They encompass everything from helping make major decisions, such as deciding whether the client should move into a senior living facility or age in place with extra care, to the little details. Would the client benefit from a home delivery service for meals? Does she need transportation to the senior center or a religious institution? Would he like a daily phone call to check in?
It is important to note that life care management services do not include direct assistance with activities of daily living (ADLs). Whereas a firm may hire such help for a client, they do not provide it. Rather, they concentrate on instrumental daily living (IDL) assistance to sustain and enhance the life of their clients. This can include going shopping with clients, accompanying them to a movie, or any activities that establish a social bond.
Many individuals offer their services in one specialty, such as help with errands and appointments. That may be all an older adult needs at the start. However, it is common for more services to be added as time goes on. Make sure that the professional or professionals whom you work with are connected with other companies that provide complete services for when they are needed.
“Life is multi-faceted for older adults, and long-term care choices and dignity have financial and legal components,” says Patricia Hanson, owner and managing director at IKOR. “Most aging life-care professionals don’t address the financial areas of their client’s life.”
Firms like IKOR offer comprehensive services including medical, psychosocial, environmental, and routine financial services like bill payment and daily money management. They can even step in to serve as medical or financial power of attorney, or in the role of guardian, executor, or trustee. The firm partners with outside financial and wealth management professionals, as well as elder law and estate planning attorneys, to fill in the gaps.
“In my experience, working as a team to understand how medical, care, financial and legal aspects of life can intersect usually creates the best outcomes,” says Hanson.
An older adult who experiences a health crisis may need management professionals to step in on a temporary or permanent basis. This person can attend doctor visits and keep track of what was said, then coordinate with therapists and pharmacists regarding treatment. A health management professional can also coordinate care from hospitals to rehabilitation facilities or homes while advocating for the patient. He or she can make visits in a variety of settings to ensure continuity of care.
Someone who specializes in daily money management can do everything from paying bills, making deposits, reconciling bank statements, and sorting the mail. This service may include budgeting, filing tax returns, or creating income and expense reports. If necessary, a money manager can even monitor medical bills and insurance claims, find missing accounts and documents, and assist with the sale of real estate and personal property. Finally, this professional can help protect an older adult from financial fraud and abuse by overseeing the big picture of investments, including trusts and beneficiaries.
Many life care management firms provide concierge services such as making and scheduling reminders for non-medical appointments, making travel arrangements, taking care of automobile service, and running errands. They can also help out at the grocery store by making healthy food selections on the client’s behalf.
Concierge assistants can oversee home services such as lawn care, routine maintenance, and repairs. They may keep track of birthdays, wrap gifts, and decorate for the holidays. They can also manage pet care, including walking Fido or taking her to the veterinarian and groomer.
These versatile professionals may also help with home organization, including waiting for deliveries or maintenance people. They can stand in line for tickets and even attend the event with a client who may not have many social contacts or may just prefer a companion who can assist with transportation, locating seats, and so on.
Services Continue in Senior Living Facilities
Life care management services continue when older adults move to senior living. Even with certified nursing assistants, onsite dining, and round-the-clock care, many gaps still exist. Money management is one of these, including navigating a long-term care policy that includes requesting benefits, tracking benefits for tax purposes, submitting monthly requests for payment, and keeping an eye on retirement funds. Additionally, doctor, dental, hearing, and vision appointments must be scheduled and attended. A fall can trigger a chain of health needs, leaving an older adult in a compromised state; who will decide which rehab facility to take them to or how to get there, and keep track of follow-up care and payments?
On a smaller scale, but just as important to the client, management service personnel may order briefs and wipes, buy towels and clothing, or evaluate the need for a voice assistant as an older adult’s hearing diminishes.
Some clients will develop varying degrees of dementia. A health advocate can help decide when a client needs to move from independent living to assisted living or memory care. When the time comes, he or she can also assist with the decision to call in hospice services.
Evaluating Service Providers
“All aging life care professionals are not created equal,” says Hanson. “Most aging life care professionals are self-employed individuals working from their homes. So, making sure that the aging life care professional you are working with has established a business entity and carries liability insurance is essential.”
Hanson emphasizes the importance of insurance when the service provider works in a legal or financial capacity. IKOR provides comprehensive services; the firm carries fiduciary insurance, liability insurance, and an umbrella liability policy. Furthermore, IKOR can be bonded if the limit of their insurance policies is not enough.
Today’s families often live hundreds, or even thousands, of miles apart from one another. Sometimes an older adult only has children and children-in-law who must work full time. In many cases, there are either no children, or none available, to help older adults navigate their later years. In these instances, life care management services can act in the best interests of the senior. The client and family members both benefit from transferring responsibilities to a reliable third party.
How to Choose Management Service Providers
Pick these services providers just like you would any other professional.
- Seek out recommendations.
- Make sure they are fiduciaries, who act only in their clients’ best interest.
- Ask if they accept referral fees. A fiduciary will not.
- Check professional certifications. Those with higher qualifications will charge more but should be better able to assist with more complicated financial or health matters.
- Ask if they operate as a recognized business entity.
- Ask if they work with other professionals to provide comprehensive care.
How to Find Management Services
If you type “senior advocacy services” into a search bar hoping to find a management firm, you’ll be disappointed. You need special language to modify your search to be more selective, whether you want the complete spectrum of available services or just a particular slice. For better results, try the following terms instead:
- Elder Advocate
- Mental Health Advocate
- Financial Advocate
- Daily Money Management
- Life Care Management Services
- Life Enhancement
- Lifecare for Seniors
- Geriatric Case Management
What will it cost?
Payment is often based on a billable hour rate structure. The cost varies by service and complexity, but roughly falls into the $90 to $200 per hour range. In areas with higher living costs like New York City and Los Angeles, the hourly rate can be over $250 per hour. Although insurance will not cover these services, some long-term care policies will pay for an initial consultation.