Elder Care: Providing For Parents

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A handful of states have embraced the Medicaid idea. In New Mexico, for example, 6,238 Medicaid recipients have family members or friends providing basic, nonmedical care for them at a fee of $9 an hour, says Crystal Mata, manager of the program for the state's human-services department. Nearly 60% of those receiving care are 65 or older. Caregivers are required to take 12 hours of training each year, including CPR and first aid. The training is provided by 107 social-service agencies in the state, says Suzette Lindemuth, director of Senior Living Systems, a Los Lunas, N.M., personal-care agency that participates in the program. Agencies like Lindemuth's also arrange for monthly visits to check on the work of caregivers.

"Having this program makes Mom feel better, knowing that my husband and I are getting paid something," says Prescilia Burt, 57, a retired public relations executive in Albuquerque who takes care of her legally blind mother Terezina Valdez, 83. Burt quickly adds that "no family member does this for the money; it just provides a little bit of cushion." Her husband David, 59, a retired management consultant, also helps. They bought Valdez a house next door to them, pay for all her living expenses and spend about 80 to 100 hours a week maintaining her house, managing her medications, cooking her meals and taking her to doctor appointments. Together they are paid for 40 hours of care a week, totaling $360.

For the estimated 8 million Americans who live at least an hour away from older relatives who need attention, remote-control help can be provided by a growing group of professionals known as geriatric-care managers (GCMs). They assess an elderly person's health condition and living situation, arrange and monitor in-home help, aid with placements in nursing homes or assisted-living facilities and serve as a liaison to family members, says Erica Karp, secretary of the 1,600-member National Association of Professional Geriatric Care Managers and owner of an agency in this practice area. GCMs, who typically have backgrounds in social work, gerontology and nursing, charge $50 to $150 an hour.

Jack Mendelsohn, 68, a retired State Department official living in Washington, obtained home care for his mother in Chicago by working with Karp's Evanston, Ill., agency. His mother, who was frail and becoming forgetful, was receiving care she was dissatisfied with. Karp found a more suitable attendant and supervised her with regular home visits. Karp's fee was $90 an hour, and home care cost $125 a day--all paid for by Mendelsohn. His mother died last year, at 91. "You need a professional on-site to supervise this kind of continuous care, check in with the doctors and keep everything going smoothly," Mendelsohn says. "If not, we would have wound up moving my mother near us, and she didn't want to leave her home."