If all this seems overwhelming, there is another option: geriatric-care management. Like a wedding planner, a care manager will orchestrate the entire process of finding and organizing care for an elder (they can do anything from providing an hour of advice or interviewing prospective aides to accompanying a senior on doctor’s appointments and making sure insurance forms are filled out properly). It’s expensive, about $150 an hour, but might be worth it. It’s mostly a word-of-mouth business, but there is a national professional organization, and its Website (caremanager.org) is a good place to start if you don’t have a referral. All of the managers on the index have either a degree in nursing, psychology, or social work or at least three years’ experience in gerontology-related services. Choose someone close to where you or your loved one lives and ask about their caseload—fifteen to twenty clients is about all one manager can reasonably handle. Finally, look for someone who never turns off their cell phone. “I sleep with mine,” says Irene Zelterman, a Brooklyn-based geriatric-care manager.
“I am half-deaf and my children hired an aide who comes five days a week. I hate it. She eats half a big box of cereal and talks on the phone all day to her boyfriend. Our temperaments are opposite. When we go out walking she holds me at all times, which I hate, of course. We argue over idiotic things.”
Margo Bachman, 93, at home, Upper East Side
Whether you hire a full-service care manager or find every last attendant, aide, and nurse yourself, it’s critical to foster a healthy relationship between caregiver and client. If you’re hiring someone for a parent, try to be around in the first few weeks that the attendant is in the home to help facilitate the bond, and establish a relationship with the aide yourself by calling regularly and asking for updates or by dropping in occasionally. Avoid potential problems before they begin by removing any valuables from the house; dementia and forgetfulness on the part of a senior often lead to suspicion. (If you believe a caregiver is stealing or, worse, abusing or neglecting your parent, contact the Department for the Aging’s elder-abuse program at 212-442-3103.) Whether you or a parent is receiving care, keep the house stocked with food, perhaps some of the aide’s favorites. Feeding an aide isn’t required, but eating meals together can forge bonds. If the aide is live-in, ensure she has a private room or at least some personal space. Work a regular paid vacation into her schedule. (Visiting Nurse Service has a “respite service,” short-term replacement caregivers for just this kind of thing.) Don’t ask an aide to do laundry or housework that’s not related to the senior whom she is hired to care for, and consider using a cleaning service, if necessary, to keep the house tidy. And, as with everyone, a little basic respect goes a long way. “They’re health-care professionals, not your servants or slaves,” says Joe Campanella of the Home Care Council of New York City. “You want to treat them like human beings.”