Caring for elders leads to new profession

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Carol Sorgen
Jacqueline Kreinik turned her nursing experience and interest in gerontology into a career as an elder care manager. She recently established a nonsectarian, elder care management program at Jewish Community Services.
Photo courtesy of Jacqueline Kreinik

When Jacqueline Kreinik became a nurse more than three decades ago, she found that she enjoyed caring for her older patients the most. “I liked hearing the stories they told,” recalled Kreinik, 61, who began her nursing career in New York.

Kreinik’s interest in elder care led her to California to pursue a graduate degree in gerontology — the study of the process of healthy aging. But a 20-some-year detour into running a family business with her husband in Baltimore took her out of the healthcare profession.

About seven years ago, the Kreiniks sold the business — a consumer do-it-yourself-kit manufacturing company — and Kreinik began thinking of following her earlier passion.

Kreinik liked the fact that healthcare is more patient-centered than it was when she left the field. She also thought that with the customer service expertise she had gained as a business owner, it might be a good time to apply those skills in a new (or in her case, previous) direction.

Through contacts she made while working at several healthcare organizations in Baltimore, Kreinik was asked two years ago to set up a new, nonsectarian elder-care management program at Jewish Community Services (JCS).

An elder care manager can cut through red tape, navigate the healthcare system, coordinate medical care, and get results, Kreinik explained.

How care managers help

Called an ECM for short, an elder care manager “advocates for your older relative and collaborates with the family, almost like becoming part of a team. The ECM can gather information and resources, and help you make informed decisions that are right for your family,” Kreinik said.

The field of geriatric care management is relatively new, but growing. According to the U.S. Bureau of Labor Statistics, the occupation is expected to grow by a healthy 19 percent through 2018. The growth is being fueled by the increasing needs of the aging baby boomer population, especially in popular retirement states like Florida, Texas and California.

Elder care managers often work for healthcare consulting companies, social service agencies like JCS, or own their own elder care management practice.

The National Association of Professional Care Managers can help you find an elder care manager in your — or your loved one’s — community; log on to www.caremanager.org. Other helpful websites in locating a care manager
include www.caring.com, www.agingcare.com, www.seniorbridge.com, and www.midatlanticgcm.org.

“Elders and their families need an advocate,” said Kreinik, “…someone who can speak for them and follow up to see that their needs are being met.”

Individual assessments

Along with a team of elder care specialists — including licensed nurses and social workers who specialize in caring for the aging — Kreinik’s first charge when meeting a new client is to assess the elder’s current physical, emotional, mental and cognitive health, as well as safety within their living environment.

In addition to the individualized assessment, the elder care management team can develop a detailed action plan, coordinate ongoing care, and advocate with physicians and other members of a client’s healthcare team.

“Our objective is to determine how well the elder is adapting to the process of aging, and to help him or her have a higher quality of life,” said Kreinik.

Kreinik and the other JCS care managers can meet clients where they live, whether they reside in their own homes, an assisted living facility, or a continuing care retirement community (CCRC). They can also work within a hospital or hospice situation to make sure the elder’s needs and wants are being met.

“That’s paramount,” said Kreinik, adding that care managers can step in when family members become so overwhelmed by the demands of caring for an older loved one that they may not even be aware of the resources available to help them.

“We highlight the main issues and create recommendations and suggestions,” said Kreinik, noting that doctors — however well-intentioned — just don’t have the time to provide this kind of integrative healthcare.

Kreinik added that by taking many responsibilities and dilemmas off the caregiver’s shoulders and by helping them plan for the future, an ECM allows family members to focus on their relationship with each other.

“No matter how good our relationships with our loved ones may be, the responsibilities and stresses of caregiving can feel overwhelming, and they’re intensified when we feel we have to handle things alone,” Kreinik said.

In the two years since the program began, Kreinik has seen more than 100 clients. An initial one-hour consultation, which costs $125, identifies the elder’s current issues. “Sometimes that’s all the family needs and they’ll take things from there,” said Kreinik.

The next step, for those who want additional services, is a two- to four-hour full assessment for $650 where Kreinik can begin to develop a relationship with the client, outline the major issues facing the family, and write a report recommending various options — be it hiring an aide who comes to help with medications, to moving to a more secure environment, to arranging for transportation to doctors, shopping and social activities. Ongoing care coordination costs $125 an hour.

Kreinik has found that many elders are resistant to change, but as she develops a trusting relationship with them, they begin to be more honest in revealing some of their concerns. In working with them and creating a set of recommendations, Kreinik also takes the burden off the adult children — which benefits all concerned.

“Parents don’t want to be told what to do, and grown children don’t want the responsibility of having to make important life decisions if their parents are still able to do so” for themselves, she said.    

For Kreinik the joys of working as an elder care manager include the opportunity to create change, and the one-on-one relationships she develops. “My true satisfaction is having the time to get to know my clients,” she said.

For more information about Jewish Community Services’ Elder Care Management Program, call (410) 466-9200 or log on to www.jcsbaltimore.org. For more information on career opportunities in elder care management, visit the National Association of Professional Geriatric Care Managers at www.caremanager.org.