Finding Community Resources from a Distance
Locate the documents you collected when you visited your parents. This collection should include business cards, newspapers, and a phone book. These will be important components of your community resources list and research sources. Keep them in an easy-to-access area, but protect them — you may need them frequently.
In fact, in order to keep yourself efficient and organized in the care of your parents, you will need to keep the most frequently used numbers in your Rolodex at work and in personal organizers such as Day Timers, cell phones, or PDAs. This is true whether your parents live far away or in your own home.
One of the best ways to determine the needs and appropriate community resources for your parents is to arrange for a home-health care evaluation. If neither of your parents has a known need for a nurse, one or the other should be able to qualify for a physical therapy home-safety evaluation. Ask the physician to request a medical social-work visit for assistance with community resources as well.
If your parents don't need or qualify for any home-health nursing or therapy evaluations, you can request and pay for a medical social-work visit from a home-health agency to evaluate for community resources and assist with short-term and long-range planning for your parents. The physician will still need to call in an order for this, but it won't be reimbursable by Medicare. The cost should be in the range of $100–$150. Ask the social worker to contact you after he has made the evaluation.
Other Sources of Information
The newspapers and phone book you collected on your visit to your parents' home can come in handy to locate such sources as private caregivers; house cleaning, gardening and other household services; transportation services; government offices; assisted-living facilities; and nursing homes. The sources you can find in these publications can also help you locate other services and assistance you may need. Search through the list of business cards you collected from your tour of your parents' community and you may find a wealth of other services as well.
On the Internet, you can perform a search for the community and then access yellow and white page-type listings, as well as listings for general business headings, health care, shopping, and food services.
Community resources themselves are usually great sources of information for other community resources, so don't forget to ask one source what it may know or recommend for another resource. See Chapter 19 for more information about community resources.
The Geriatric Case Manager
A geriatric case manager can be your best friend, whether your parents live with you, a few miles away, or across the country. These are professionals, usually registered nurses or medical social workers, trained in geriatrics and managing the care of the elderly.
They make periodic visits as needed to assess the home situation and arrange for or recommend resources to meet the current needs of your parents. They coordinate with the PCP and family members to supervise and evaluate the effectiveness of these resources.
Health insurance and Medicare do not usually reimburse this service. The cost of an evaluation is usually about $200–$350 and ongoing costs range from about $200–$1,000 per month, depending upon the needs.
The National Association of Professional Geriatric Care Managers can provide referrals from their member list. They can be reached at 602-881-8008. Their website is
The Discharge Planner
If your parent is hospitalized, the case manager or discharge planner can and should become your best friend. This person's primary job is to get your parent discharged either back home or to an appropriate level of care with the equipment and assistance needed to keep your parent safe and help him recover quickly. They can help arrange for home-health care, provide you with other resources, and advocate for your parent to receive appropriate care while still in the hospital.
If you have issues or concerns while your parent is hospitalized, speak to the physician first. Usually, she can help get issues resolved. If not, there are other patient advocates as well. You can speak to the nurse manger on the floor if you are concerned about the level or quality of care. Above the nurse manager is the director of nursing for the facility.
If you don't receive any satisfaction, find out if the hospital is accredited. Most likely this will be through JCAHO, the Joint Commission on Accreditation of Healthcare Organizations. JCAHO will take your complaint seriously and investigate the situation. This may not happen while your parent is still in the hospital, but they can advise you on what other steps to take at the time. Sometimes just mentioning to the hospital staff or directors that you plan to call JCAHO can help get a response and action. (JCAHO's web-site is
