Geriatric Care Management Resources

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Here are some resources to help you manage the challenges of geriatric care


Aging Life Care Association (www.caremanager.org). To find a geriatric care manager, go to the website, and click on Find an Aging Life Care Expert to locate professionals in the New York area. Members include more than 2,000 social workers, nurses, gerontologists, and other related professionals. The website also provides links for consumers, with advice about how to work with a care manager.


Nassau County Office for the Aging

www.nassaucountyny.gov/aging

516-227-8900

The aging office offers case management services to assist frail elderly who want to remain in their own homes. Through the Expanded In-Home Services for the Elderly Program (EISEP), people 60 years of age and over who are above Medicaid eligibility may receive non-medical in-home services (homemaker/personal care, or housekeeper/chores).

Case managers provide the following services:

  • Make home visits to evaluate the situation and assess needs, including durable medical equipment.
  • Develop a written care plan identifying services needed, providers, and how and when services will be delivered.
  • Coordinate supportive services and obtain benefits to which the older person may be entitled.
  • Monitor service delivery to be sure it is meeting identified needs and reassess the situation periodically and modify the care plan if necessary.

Eligibility for these services is determined by case managers funded by the Office for the Aging. An assessment process includes a financial assessment to determine the senior’s possible share of the cost of services.

For more information about assessments, including a list of Nassau County facilities that offer comprehensive assessments, click the link, Medical, Nursing, Home Care & Long term care, then What is an Assessment?


Suffolk County Office for the Aging

www.suffolkcountyny.gov/aging

631-853-8200

Provided under the Expanded In-Home Services for the Elderly Program (EISEP), case management consists of five components:

  • Intake and screening
  • Assessment and reassessment
  • Comprehensive services planning
  • Services acquisition
  • Monitoring and follow-up

Service plans are developed with seniors and their support systems to achieve defined goals.


Northwell Health—Circle of Care Program

www.northwell.edu (Search for Circle of Care)

The Circle of Care program offers geriatric care managers who conduct comprehensive evaluations and create plans to meet the specific needs of seniors or their loved ones, including in-home services as well as a variety of community resources. Payment is not covered by most insurance plans, but the program offers affordable self-payment rates.

Care managers can perform a variety of tasks, such as:

  • Setting up companions or home health aides
  • Setting up doctors who make house calls, nursing and therapy services
  • Helping with bill-paying
  • Accompanying clients to doctor appointments
  • Maintaining contact with out-of-town family members
  • Recommending adult day care programs
  • Help clients choose service providers and entitlements related to long term planning

U. S. Department of Veterans Affairs

www.caregiver.va.gov

Toll-free 1-855-260-3274

Through the Caregiver Support Program, local Caregiver Support Coordinators can match families with programs and services for caregivers, including:

Adult Day Health Care—A safe and active environment with constant supervision designed for veterans to get out of the home and participate in activities while caregivers get some time for themselves.

Home-Based Primary Care—Delivery of routine health care in the home when medical issues make it challenging for a veteran to travel. This service can also include physical rehabilitation, mental health care, social work and referrals to community services.

Skilled home care— Similar to Home-Based Primary Care, but involves the VA purchasing care for a veteran from a licensed non-VA medical professional.

Homemaker and home health aide program—Provides in-home care to veterans with personal care needs on a routine schedule. Care is arranged by the Northport VA Medical Center.

Home Telehealth—Connects veterans who live at a distance from VA medical services with a care coordinator through technology (e.g., telephone, computers). These services may also include education and training or online and telephone-based support groups.

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