As the eldercare crisis escalates, families seek help from these coaches and consultants

MW As the eldercare crisis escalates, families seek help from these coaches and consultants

By Jessica Hall

'I can walk into crazy situations and create calm and create a plan'

Bethany Joseph, an elder-care consultant in New Jersey, knows that her phone will ring more often during the holidays when adult children see their parents and realize they've aged and their care is not running smoothly.

"Most of my clients are crisis calls - dealing with a new diagnosis of dementia or dealing with a fall," Joseph said. "I can help with all the details and all the lingo. It's you're trying to navigate a loved one's care and you don't speak hospital and you don't speak insurance, you're up a creek."

Joseph has dealt with the gamut of cases, from helping people live more safely in their homes and navigating Medicaid, to coordinating hospice services and dealing with final death wishes, to referring people to elder-law attorneys.

"We can't prevent the falls 100% but we can help it from being so traumatic," Joseph said. "It's about quality of life and having an advocate who can help you navigate this incredibly hard lift."

Joseph said a lot of her job is coaching people on simplifying their lives and focusing on safety and looking at the next steps for them.

"Safety and independence, if it's done right, can be intertwined," Joseph said. "It brings a lot of joy - helping people through the hardest times of their lives. We need to take care of the most vulnerable."

Joseph is one of an estimated 50,000 professionals nationally who go by various titles such as aging-life care professionals, elder-care consultants and geriatric care managers, according to the Aging Life Care Association.

These private-pay experts help assess the care situation for older adults, create care plans, coordinate caregivers and refer out to necessary experts while liaising with family members.

The majority of clients come to care managers through concerned family members.

Elder-care consultants can help find additional resources for family members who are providing care, as well, to help prevent burnout, financial stress and professional strain as they juggle caregiving with work. One in four four American adults is currently a family caregiver, according to a recent study from AARP and the National Alliance for Caregiving $(NAC)$.

Read: America's 63 million family caregivers are mostly unpaid, stressed and begging for help

Chris, who declined to give her last name, hired a local elder-care consultant in California for an older relative when she was unable to coordinate care from the East Coast. The relative suffered two serious falls, and Chris needed help coordinating the shift from care at the hospital and then the rehabilitation center to home healthcare services.

"I was a healthcare lobbyist in my career and knew a lot of how the industry works and it was still extremely complicated," Chris said in an interview with MarketWatch. "The case manager was so open and caring and it was immediately obvious he had the connections and knowledge to make sure we were getting the best care possible."

The case managers help manage the family's stress and concern, while coordinating care for the older adult, with dignity, said Steven Barlam, president of the Aging Life Care Association and chief executive of JFS Care in Los Angeles.

"Nobody wants to feel less than able or less than capable. We can help reduce risk and enhance quality of life," Barlam said.

As many as 77% of adults 50 and older want to age in place in their homes, according to AARP. Yet 70% of older adults will need some support to age in the home of their choice, according to Harvard University's Joint Center for Housing Studies.

Support could range from assistance with activities of daily living, like dressing and bathing, to more advanced care for someone with dementia or Alzheimer's disease. Aging-life care consultants can help coordinate that care and make it less traumatizing for the older adult and their family.

"Often what people want and what they need aren't the same thing," Barlam said. "We can help with understanding what gets in the way, understanding ways they can hear the information and understanding ways to provide the help and safety."

"The majority of clients don't like to think about how bad it might get. The majority wait and wait until it's an unbearable crisis," Barlam said. He estimated that 15% of his clients call to make forward-looking plans for future care needs, while 85% call during a crisis situation.

Despite the aging population boom, Barlam said there aren't enough doctors, care providers or attorneys who specialize in geriatrics to provide help.

Read: Elder care is overtaking childcare. Governments and employers need to step up.

"Working with older adults isn't sexy," Barlam said. "When we look at medicine and law, they aren't paid as much for geriatric specialties as other specialties. It's often not seen as an attractive profession," Barlam said.

Half of Barlam's practice consists of short-term clients who need only initial assessments and plans for care. The other half requires ongoing care management for multiple years.

Costs for elder-care consultants vary by region and are not covered by Medicare or private insurance. Rates can be in the range of $200 to $300 an hour in the New York metropolitan area, to $150 to $250 an hour around Los Angeles, and lower in more rural areas, Barlam said.

"We stay within our lanes and refer appropriately. We are not skilled nursing care. We're don't provide legal advice and we don't provide psychotherapy, but we can coordinate all those service for clients," Barlam said.

"Many people don't know we exist," Barlam said. "I can walk into crazy situations and create calm and create a plan. We hate when people try to don the cape and be Superman to do it all. It's very hard to do it all yourself. Having an objective pair of eyes on the situation can make all the difference."

Even with his own family, Barlam, who has been an aging-life care professional for 40 years, hired other care managers to help.

"When it came to my own family, I was not making great decisions even though I had all the knowledge to do so. I needed that objectivity of a third party to come and help," Barlam said.

Wendy Sabin, who has been an aging-life care professional in New Jersey for more than 12 years, also hired aging-life care professionals for two older family members to gain an objective set of eyes on their care situation.

"It takes the edge off the children. Coordinating all the doctors, the aides, the drivers, the appointments. It's a lot. Having help allows you to be the daughter again rather than the stressed-out, burned-out caregiver. It's very disruptive. Having help allows you to have your relationship again," Sabin said.

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As the eldercare crisis escalates, families seek help from these coaches and consultants

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