Navigating the World of Geriatric Care Management

In this conversation, Janet Engel speaks with geriatric care managers Amy McWilliams and Lauren Magana about the vital role of geriatric care management in supporting seniors and their families. They discuss the unique challenges faced by seniors, the importance of navigating complex healthcare systems, and the various resources available for aging in place. The conversation also touches on family dynamics, crisis management, and the financial aspects of elder care, emphasizing the need for informed decision-making and advocacy. In this conversation, Amy McWilliams and Lauren Magana discuss the importance of long-term care policies, the role of geriatric care managers, and the significance of home modifications for fall prevention. They highlight the benefits of the Aging Life Care Association (ALCA) and the need for more professionals in geriatric care management as the population ages. The discussion emphasizes the complexity of care management and the value of having knowledgeable professionals to assist families in navigating these challenges.

Takeaways

• Geriatric care management is essential for supporting seniors and families.
• Many families seek help only when in crisis, not for planning.
• Understanding healthcare systems is crucial for effective care management.
• Crisis management can help seniors return to independent living.
• Financial resources like long-term care insurance are often underutilized.
• Aging in place means different things to different individuals.
• Family dynamics can complicate care decisions for seniors.
• Geriatric care managers help families navigate emotional challenges.
• Education on healthcare options is vital for families.
• Cost management in elder care requires exploring all available resources. Long-term care policies can help prevent the need for nursing homes.
• Home modifications are essential for maintaining independence.
• Geriatric care managers play a crucial role in elder care.
• The Aging Life Care Association supports care managers with resources.
• Home safety assessments can prevent falls in seniors.
• Understanding the fine print of care policies is vital.
• Collaboration among care managers enhances client support.
• There is a growing need for geriatric care professionals.
• Quality of life is important at every age.
• Building trust with clients is essential in care management.

Sound Bites

• "Geriatric care management is a unique niche."
• "I know enough to be dangerous."
• "We try to vet our resources very well."
• "We’re willing to work within a budget."
• "These policies provide help in the home."
• "You have to read the fine print."
• "Home safety is crucial for fall prevention."
• "ALCA is th

Transcript

Janet Engel (00:01.543)
Hello everyone and thank you for being with me today. My guests are Amy Williams, McWilliams. She is the owner of Not Your Average Joe. She is a licensed social worker and she is also a geriatric care manager. She has been in the senior niche for over 10 years, helping seniors do all kinds of things to maintain a good quality of life.

Joining us as well is her coworker Lauren Magana. She is also a licensed social worker and a geriatric care manager. Amy, thank you for being with us today.

Amy McWilliams (00:47.559)
Yes, thank you for having us.

Janet Engel (00:48.605)
Yes, Amy, tell me a little bit about yourself and your work as a social worker and as a geriatric care manager and what inspired you to get into the senior niche.

Amy McWilliams (01:11.536)
Well, to be honest with you, kind of fell into it initially. I stayed home with my daughters. I have two girls that are now hopefully going to fly the coop soon. But when they were younger, I wanted to work part time and kind of fell into a role in home health. I remember going to the interview and telling the

Janet Engel (01:19.741)
you

Amy McWilliams (01:40.58)
director of the unit we were in that I don't know a whole lot about seniors, but I guarantee you this if there's a resource I can find it. That's what I told her and so I got the job and absolutely fell into working with seniors even to the point where when I met my first one of my first clients he was in the first wave of Normandy.

Janet Engel (01:51.385)
Thank you.

Amy McWilliams (02:05.774)
and I'll never forget him. asked him if he was scared and he said, hell yeah. And I've never met any atheist there either. It was just, I'll never forget that that fell out. And that was just the coolest experience. So yeah, that was the start of it.

Janet Engel (02:19.917)
Okay, great story. Can you explain to us what a geriatric care manager does and how this role supports seniors and their families?

Amy McWilliams (02:34.384)
Sure, yes, geriatric care management is a unique niche that I don't think a lot of people know about. So it's great. And we're just so honored to be on your show to share how important it is. We come alongside families, particularly as care managers, we're hired by the family privately to assess the family member that could potentially use some.

Support and we look at all facets. We look at the financial we look at social We look at behavioral we look at environmental I Feel like I'm missing one No, I think and legal we look at the lease of legal aspects and we come up with what's called a care plan to address the needs of the client and it can vary from client to client vastly and

Because as care managers, we come in at different stages. Some are in crisis. Some are trying to plan for their future, which we love. And so care management was kind of designed, I believe, from nurses many years ago when they saw that families needed advocacy outside of the health care system. They needed someone to be able to come to doctor's appointments with them and help kind of

process what the doctor recommended and make sure that we follow up on those recommendations and things like that. So it's a very unique role that we have that we are designed strictly there for the client, which is really, really one of my favorite parts.

Janet Engel (04:20.601)
Amy, you mentioned something that we run into as occupational therapists and I'm sure many other healthcare professionals do as well. You mentioned that some clients when they come to you, they're in crisis and then others are planning for their future. I'm curious from your perspective, how many

are planning versus how many are coming in crisis.

Amy McWilliams (05:01.422)
wow. Not as many come for planning as we would like. What do you think, Lauren? What percentage come for planning?

Lauren Magana (05:12.046)
I think in planning is so it's kind of like a broad definition. So there, I always give this example, like when I was working in elder care law, it's kind of the same with care management after the holidays or like mother's day, we get a lot of phone calls, because you know, sons and daughters will visit their family and go, Hmm, I don't think my parents are doing as good as I thought they were.

because a lot of people present really well from the outside, but on the inside of the home, they're really struggling with some of their activities of daily living or just keeping up with certain stuff. So I would say 75 % of the ones that I've seen so far, were like, Hey, we're not quite in crisis yet, but I have a feeling something could happen soon. And then the other percentage is they're already in the hospital.

And, you know, they've reached a point where they need to immediately talk to an advocate and they need, you know, us to go visit them in the ICU.

Amy McWilliams (06:08.324)
Mm-hmm.

Amy McWilliams (06:17.774)
Yeah, that's fair.

Janet Engel (06:18.193)
Well, that's unfortunate. Lauren, how do geriatric care managers help families navigate these complex healthcare systems like what you just described?

Lauren Magana (06:34.254)
Mm hmm. So it helps that social workers like Amy and I have worked in hospitals, home health, nursing homes, hospice, elder care a lot. Like we kind of come from like a lot of backgrounds. And I tell families all the time, I know enough to be dangerous. I'm a really good professional botherer of people in order to get the answer that I want. Because a lot of the times these families are really overwhelmed and they don't know

how a hospital works. They don't know how a rehab works. And so having been behind the scenes, I set the expectations first and I say, hey, this is what admission to getting the care that you need to discharge works. This is what the timeline looks like and here's who we need to talk to for every single need. So for example, a nurse might come into a room in the hospital and the family

Amy McWilliams (07:11.886)
Yeah.

Lauren Magana (07:31.66)
wants to latch on to like one person and believe they have all the answers. And the poor nurse is like, my gosh, I'm just here to do the IV. I'm just here to do the medical part. So I get really organized with families. I say, let's go ahead and sign up for the portal for the hospital or for the doctor that we're at. Let's print out all of the things that you need. Let's make sure you have an advanced directive in your hand.

and that we do a lot of education on what those terms even mean. You know, what's an advanced directive? What does a certain medication do? What's the difference between an assisted living and a nursing home? So we provide the education and then we make a professional determination, like a recommendation, say, hey, I think this is where your family member is going to thrive the most or do the best in. And then the tricky part is also

Amy McWilliams (08:04.344)
Thank

Lauren Magana (08:29.582)
talking to the client themselves and aligning the plan as closely as possible with what they want while being realistic.

Janet Engel (08:38.877)
That's a great answer. And how would you say when you do have a client that is in crisis mode, have you ever had an example where you've been able to get them back to a place where the only option was not an assisted living or memory care and getting them back?

to be at home and functional with their ADLs and healthy and safe.

Amy McWilliams (09:19.773)
Sure, think I mean it varies of course depending on the diagnosis and what the Resources are because that's one of the things We're immediately assessing upon meeting the client is what's available to them resource wise We're very big into advocating

If you have a long-term care benefit, meaning long-term care insurance, how to access that. A lot of our families, they say they have a policy, but they don't even know what it means or how to activate it. So that's one of the things that's been actually part of, think, Not Your Evers Joe's mission is to empower families to know what resources are available and don't wait until

you know, the quality of life has gone down so much that you can't return back to some of those, you know, everyday living skills with the proper care. And that's why not your average Joe was started was Joe, the fella I named him after named the business after, was actually he's a prime example. He, you know, he was trending medically in a negative way. And with proper care, he was able to come home.

and lived in his environment with support and was able to be alone at night. So he wasn't 24-hour care, but absolutely. He's a prime example of accessing the right resources and setting the right expectations, which is really huge. Lauren, that was an excellent point. Because a lot of this is a lot of misunderstanding about what these services really do entail.

And what's realistic and what our clients are entitled to is really important.

Janet Engel (11:20.829)
Yeah, I imagine that connection to resources is extremely important. Like you were saying earlier, people don't even know what they've already bought into, for example, with a long term care plan and what it will do for them. I also think that a lot of people aren't

aware of other financial resources that may be available to them. For example, the HECM, which stands for Home Equity Conversion Mortgage, it has replaced what used to be the reverse mortgage before President Reagan changed the terms on it and really gives people an opportunity to use the equity that they have in their home.

to age in place. Is this a resource that geriatric care managers are now educating their clients on?

Amy McWilliams (12:28.836)
You know, that actual resource comes up and one of the things about geriatric care managers, we are all over the US and actually some globally, we periodically get requests for people like in Paris to help out with other care managers to help out with clients or, you know, in other countries. And so the ALCA associates in the Aging Life Care Association,

Janet Engel (12:47.005)
Hmm.

Amy McWilliams (12:56.41)
has a listserv that comes out and we are constantly, it's kind of like our community to kind of problem solve if there's something that's really complicated. And this topic comes up periodically as a resource. I think the biggest important part is, yes, giving the client the right information. We try to vet our resources very well to make sure they're getting wise counsel on their financial decisions.

Janet Engel (13:22.397)
Mm-hmm.

Amy McWilliams (13:26.414)
which is really important because you make a point that sometimes aging in a facility may not be in the best interest of the client depending on the needs of the client. So I can't say that it's come up as often with my clients recently. However, at Home Health, it had come up quite a bit that this was an option. However, our families often

struggle with a certain amount of legacy, leaving a legacy for family, that can become an obstacle in considering options like this is that they have a lot of pride in deleting their assets. But it's absolutely a resource that can, you know, that their financial advisor could explore with them. And we certainly use, we assess that in our assessment. Who are they getting legal, I mean, financial counsel from?

Janet Engel (14:22.889)
Mm-hmm. Yes, and I'm no expert on the Hecum's, but they, that legacy resource can, or that can be preserved with the Hecum.

So it really is a great tool for people to be able to, for example, pay for someone to stay at home with them, pay for a caregiver instead of having to move into a senior living community. And even someone who wants to downsize, they can use that money to purchase another home.

Amy McWilliams (15:00.634)
Sure.

Janet Engel (15:06.491)
I'm an OT, I could only talk about it superficially, but I have learned enough, like you said, Lauren, to be dangerous about financial resources out there. So I also wanted to ask about aging in place.

Amy McWilliams (15:17.946)
Mm-hmm.

Janet Engel (15:28.249)
According to A or P, 75 % of older adults want to age in place. If you look at other sources, it's closer to 90%. What do you ladies come across when you start, when you take on a new client and they're telling you about what their goals are and where they want to live? What are people saying?

Lauren Magana (15:58.862)
I'd say it really depends on the on the person aging in place for some people means different things like I'll give an example of my own family my father-in-law has been diagnosed with early stage Alzheimer's and You know my mother-in-law when she says age in place what she means is Sell this house with the stairs and the small doorways and let's get into

like a cute ranch style and stay there for the rest of our lives. And then I have some clients who are really, really connected with their house or their property. I just saw someone on Friday, I did a consult with who lives on this beautiful property. She's got dogs, she's got goats, but she's, you know, she's been a paraplegic since 16 and she recently just had a bilateral amputation of both lower limbs due

to a septic infection. And so she's got like a different set of needs now. And so we talked about what aging in place means for her and like how realistic is keeping the property and these animals. And, you know, do we want to basically hire, you know, a staff to help you maintain this environment versus do we want to move to a different environment where

where there you will age in place. So it's different things for different people. Some people we find, and that's another thing we do a lot of, is finding a good match in terms of going somewhere. So if we are going to go to an assisted living, if we're going to go to a personal care home, if we're going to stay at home, how can we match you with a caregiver that matches your vibe and your personality? Same thing with a place. How can we find a place that matches your personality and your

your wants and needs. We've got people that love the like resort style assisted living. And then we've got other people that are like, you know, I just want a comfy bed, my baseball games on TV and some snacks available to me whenever I want them. So it's really up to the individual.

Janet Engel (18:14.307)
Yeah, I agree with you. Aging in place isn't necessarily living in the home you're currently in. It's living in your home of choice, being able to control where you live, whether that's a smaller home or an apartment, a rental apartment or

an independent living community, right? As long as you're not forced into a living situation that you don't want, then you're aging in place. Now, what about family dynamics? This was an issue that I ran into a lot working in home healthcare where there were siblings that...

sometimes were not friendly to each other anymore because there had been conflicts for many years about properties, money, about how their parents' healthcare was being managed. How do geriatric care managers deal with these disagreements about care decisions? And what strategies do you recommend for maintaining harmony?

Lauren Magana (19:37.646)
I'm big on informed consent. So, you know, what is the capacity of the client themselves? Because we were hired by the power of attorney or we're hired by the caregiver and we might be paid by those people, but ultimately we are beholden to the client themselves. And so, you know, if they have capacity, then the first thing I ask is I pull them aside and sometimes we'll talk alone where I ask them,

What are your goals? Do you have an advanced directive? It used to be called in Georgia, Medical Power of Attorney. And then I kind of give them the overhead view of, hey, this is what I see. Here's what I think is realistic for you. And what do you want? And it's so interesting to watch people pause. And you can see the wheels turning in terms of them thinking about what others' expectations are of them.

Janet Engel (20:25.213)
Thank

Lauren Magana (20:35.436)
what their daughter might want, what their son might want. But eventually they always arrive there and they're able to tell us, know, this is what I desire for the rest of my life. And I tell people all the time, this is one of the final things that you will like have ultimate control over. So like use the power you have and the power of choice to tell me what you want.

Amy McWilliams (20:35.524)
Mm-hmm.

Lauren Magana (21:00.566)
and then let me negotiate the emotions of like a tense situation as a third party. And then I'll be able to find the solution. Because it can be so hard to confront or disagree with your own family.

Amy McWilliams (21:14.704)
That's very true. it is.

Janet Engel (21:16.285)
Yeah, and I agree with you.

Janet Engel (21:26.663)
Go ahead Amy.

Amy McWilliams (21:27.684)
I just was going to say it. Yeah, I was just going to say she did an excellent job explaining that. I think that it is complicated navigating the emotions. And I think that's one thing as social workers, we're trained really well in trying to be considerate of those around us, but also empower the one that truly has the authority, right? Like the one that

Self-determination is one of our core values and part of our code of ethics.

Janet Engel (22:02.733)
Yes, and I can see how a parent may not want to further inflame a bad relationship between siblings. And it just gets so complicated. So I really do think you guys have a really tough job and...

you do a really good job at going through the process. How do geriatric care managers help families manage costs associated with elder care?

Lauren Magana (22:49.902)
I'll let Amy jump in if you have something to add, but recently we've gotten a few calls where, you know, families, it's so funny. They want to ask so badly first, how much does this cost? And we kind of dance around it until, you know, I get to my spiel. And I've had the pleasure of listening to Amy give her spiel because I'm learning a lot from her too. And one of the things that I've been saying is we're willing to work. The cool thing about being

an hourly contractor is that we're willing to work within a budget and within the capacity of the family. Like some people have asked me, what's your estimated cost for something like care management and long-term care planning? And I say, will you tell me how involved you want me to be? I can formulate a plan and guidance and hand you one, two, three, four steps and you guys can handle it. Or you can tell me, Lauren, I want you to do.

all the things, please take on the administrative burden of making these phone calls to my long-term care insurance company. But we also try to explore things that people are entitled to. So that long-term care insurance, do they have the right healthcare coverage? Are they getting good Medicare coverage, prescription coverage? Do they have some resources that...

Amy McWilliams (24:07.267)
Thank

Lauren Magana (24:15.756)
They need a financial advisor to look at, because a lot of people, especially in this older generation, have tucked away a lot of resources, like Amy said, for that legacy. And now is the time to tap into some of that. I tell people, you can't take it with you, so let's use it when you need it.

Amy McWilliams (24:38.572)
No, that's really fair. Yeah, that's that was great, Lauren. I think the one thing that's so underutilized, like I mentioned, is the long term care insurance. And one of the things that I'm not even sure people are aware of is that in a lot of these policies, they have what's called care coordination services. And that's actually a benefit, particularly in a lot of the older policies that pays for our services. And so I think it's really important to make sure that

Janet Engel (24:38.715)
young.

Amy McWilliams (25:07.952)
someone knows what they're doing when they look at the policies.

Janet Engel (25:12.157)
That's a great answer. And Amy, I want to tell you, I have a long-term care policy that I bought when I was in my late 20s. And it was because as an OT, I worked at an outpatient clinic and the only patients that I had that got to go to the mall and out to lunch were...

people who had a long-term care policy because they had an aid that would drive them, you know, to their appointments, take them to the mall, take them shopping. And so I said, well, I'm going to buy a long-term care policy. So out of all of my friends, I'm the only one I think that has a good long-term care policy because I bought it many years ago and I've been paying for it ever since.

Lauren Magana (25:48.205)
You

Janet Engel (26:05.105)
But tell me what are some of the things that long-term care policies cover? Because I think that there are a lot of people that don't buy one because by the time they start thinking about purchasing one, they're in their late 40s or early 50s, and then it's really expensive.

Amy McWilliams (26:25.412)
Yes, I can speak to that. It covers a variety of things and it really depends on the policy. It certainly can cover in-home care, i.e. for example, someone to come in and help with activities of daily living, Help you get dressed, bathe, fix you meals, light housekeeping, take you to the doctor. So the aid can do a variety of things.

That seems to be the biggest thing that people think it's for, or actually my parents' generation, who they're in their 80s, I think a lot of that generation just thinks it's only there for nursing homes. Okay, when I need a nursing home, I'll activate the policy. But actually, these policies are beautiful because they provide help in the home before the nursing home. And my...

What I think a lot of people don't realize is if you activate it early and utilize it in that way, you likely could prevent a fall and not have to go to a nursing home or need a higher level of care is what we say, because there's all different levels depending on your needs. The policy can also cover something that's a beautiful benefit is home modifications.

For example, my mother and father have a policy and they each have $2,000 per person for modifications. Not a whole lot of money if you're looking at like replacing a whole shop, know, redoing a shower. But hey, every little bit helps when you're looking at, you know, modifying something. But helping with putting grab bars in or I guess it go toward a chairlift if people are looking for that. So that can be a benefit in a policy.

And then there is often the care coordination. There's even like a life alert resource in there. I think my parents actually have that in theirs where they will reimburse for like a life alert button if you were to fall and you needed assistance. That's available to some of these policies. And then of course the daily per diem for an assisted living or

Amy McWilliams (28:48.706)
memory care facility. But like I said, you have to read the fine print to just make sure you know what you're doing when it comes to utilizing because it just really depends on what facility you're looking for and what needs you have. So yeah, the policy can be really helpful in a lot of ways. And it can be really overwhelming to look at, that's for sure, if you don't know what you're looking at.

Janet Engel (29:13.117)
So right there is a good reason to hire a geriatric care manager. From what you've said, I think everyone could use a geriatric care manager for at least six months in their lives.

Lauren Magana (29:17.902)
you

Amy McWilliams (29:25.968)
Sure, absolutely. I have two people reaching out now just to evaluate their policies. I've actually had one client and the client came to my, actually my friend who's a physician's assistant in orthopedics, and he came to her for just a checkup and he said, do you know anybody that can help with a long-term care policy? We've called lawyers and that's not what they do. And my girlfriend who knows what I do, she said, I know just the person.

So yeah, they just hired me to tell them how to activate the policy and to help them make decisions. That's all they needed. So I was grateful to be able to help.

Janet Engel (30:05.415)
Well, that's great. And I wanna go back to asking you guys about home modifications and fall prevention. Amy, you mentioned that earlier, that if someone would use their long-term care policy prior to entering a facility, that they could probably stay in their home longer because they may have prevented a fall.

As geriatric care managers, what is your process to go through a home and help educate people on what barriers are in the home or where you find hazards that could pose potential problems in order for people to make these changes?

Amy McWilliams (30:58.891)
You want to take that one, Lauren?

Lauren Magana (31:00.622)
Sure. What's funny, because I'm actually doing this tomorrow. I have two huge assessments to do tomorrow. And part of what we do when we go into the home, I think, overlaps a lot with that more traditional OT role when in home health, you go in and inspect for safety. And one of the things I was excited about

with what you were talking about at GSPN the other day was having another set of eyes on the helm. Because we know as social workers, the very basics. And I just as a person in very type A and very detail oriented, I'm sure my poor grandparents were like, you're here for Christmas, stop telling us that this rug in the dining room needs to go.

Janet Engel (31:42.365)
Thank

Lauren Magana (31:51.022)
So very similar, know, walk in, how big is this doorway? Can we fit your walkers through the doorway? By the way, do you have a clear path to the kitchen? What's with this box of stuff over here that's, you know, a tripping hazard? It's funny because some people are a little nervous, you know, about you being in their home. And so I'll say, can I please use your restroom? And I'll kind of go in there, do a quick overview, come back out and say, by the way, I noticed that

you don't have X, Y, and Z. And it's funny how little we think about those logistical changes that we can make until it becomes a problem. Until you come home, you have a walker, and then suddenly it's bumping into the corners of your door. So we do a lot of that of just, hey, show me how you walk around your house and how you get things done.

Amy McWilliams (32:46.544)
you

Lauren Magana (32:49.006)
in order to see what the barriers are.

Janet Engel (32:53.301)
Yes, and that is completely necessary. It's I learned as an OT, you cannot take people's word because they will most of the time make themselves sound more independent than they really are or because they're used to doing things a certain way. They don't realize how dangerous their habits are or their process. And they really need education on

You know, I understand that you're used to walking into your home with all the lights off because they have their home memorized, right? But it's all you need is that one day where you feel a little weaker or maybe you're not as sharp. and then you trip over something and there's a fall, right? So, and I'm glad you mentioned that Lauren, because I want you to have a chance to use our

home safety platform. So I'm going to give you a code so that you can use it on one of your clients tomorrow and see what you think of the process.

Lauren Magana (34:01.333)
that'd be great!

Amy McWilliams (34:02.914)
that's wonderful. Yeah.

Janet Engel (34:06.523)
Yeah, I just think that home safety, home modifications, and it's not my opinion. According to the CDC, half to two thirds of all falls in people age 65 and older are due to home hazards. And so the home is the first place where we need to start when it comes to fall prevention.

Amy McWilliams (34:34.692)
Yes.

Janet Engel (34:34.961)
So ladies, tell me about ALCA. Amy, you've mentioned this to me the first time we met. And so I really want to learn more about ALCA and also what type of healthcare professionals become geriatric care managers.

Amy McWilliams (34:56.128)
great question. Yes. So ALCA is the Aging Life Care Association. If you search literally ALCA, you won't get it. So you have to look up aging life care. I noticed that, you know. But I think we just rebranded. We used to be called geriatric care managers, but we rebranded to ALCA or the aging life care manager to really include

which I think is a really great thing that we've done to include potentially younger individuals, not just, you know, we're all aging at some point. However, we wanted to encompass potentially the disabled. We have some care managers in this association that specialize like in special needs. And so we wanted to make sure that we didn't exclude certain demographics or populations with the geriatric name.

And so aging life care is really looking at a variety of different, you know, groups of individuals and planning for, you know, as they age. And it's a great organization because they support us and they also, we are also governed by a code of ethics, which is really important that you have to be certified to be a part of the organization. There's credentials that you have to meet, you know, you.

You have to show a certain number of years of working in this space. And there's certain levels. Like I'm an advanced professional. I believe there's one below it that is still credentialed, but it just depends on the number of years in licensure. You don't have to be a social worker. You can be a nurse. Like I said, I believe this organization was pretty much a

founded and created by nurses probably very early on and when I first started my company, which I launched not your average Joe November of 2020 just coming out of the pandemic or really starting the pandemic really I would meet with individuals just to you know, hear more about the organization and other care managers and

Amy McWilliams (37:14.754)
One of the things they were saying is that they're excited about younger care managers coming because a lot of the nurses that started this field are starting to retire. And so there's another generation coming. And this generation is social workers and actually occupational therapists are coming. There's a few, not as many, there's a couple of nurse practitioners, but generally it's nurses, social workers. And I think I see, like I said, a portion of occupational therapists.

And so we all do collaborate throughout the US. I have a client in North Carolina that I got through community contact and I've been able to support her and kind of collaborate with care manager in North Carolina just to be able to provide quality. But we certainly refer out all the time. I had a client in Florida that was bringing here and I reached out to somebody in Florida that was a care manager to help me.

Like like boots on the as we say boots on the ground in Florida before she came here, which was really helpful so she was able to See my client in person in Florida and give me an assessment so I could you know have more of a formal understanding of what was going on because like you just mentioned It's one thing to hear it from people but it's another thing for you to have lay eyes on the individual yourself

And so yeah, it's a great organization. They provide a lot of continuing ed and they're really advocating for this discipline. It's every time I speak with someone, it seems like I didn't know about care management. So we're really working hard to continue to educate the community about what we do because when people hear it or, you know, and they hire us, they're like, I wish I'd known about you sooner or I wish I knew about you.

when my father-in-law, before my father-in-law passed away. I hear that story quite often. I wish I had had you when I took care of my mother.

Janet Engel (39:18.141)
And how many care managers? Yes, and I think that's the same thing that I hear many professionals say when it comes to home safety is I wish that I had known about the sooner before that fall happened. But I wanted to ask you, Amy, how many care managers are there in the US?

Lauren Magana (39:54.856)
you broke up a little bit. you asking how, how many care managers are kind of out there in the field?

Janet Engel (39:58.685)
How many care managers are there in the US?

Amy McWilliams (40:05.584)
That's a good question. I don't even know. I know that the that was one important part actually. Thank you for bringing this question up. On the website for Aging Life Care Association, there is a way to access per area. But I honestly don't know how many are out there. Now I can tell you there's Aging Life Care. When you go on the website, you're getting a credentialed individual that has been

Lauren Magana (40:07.598)
Ian.

Amy McWilliams (40:33.88)
Associated with the association right there are care managers in this space that may do this but it may not be credentialed or just Partnering with the aging life care association. So yes, there's a body that is connected with Alka the aging life care and then you might run up against somebody who's maybe doing it independently that just doesn't want to connect with Alka, you know But I honestly don't know I don't have any that's a very good question

And I'm sorry, I don't know the answer to that but I can tell you certain areas are more prominent than others and But the website you can search by zip code and find one in your area pretty easily if you're in a somewhat of a Very well populated like if you're in a very rural area, it might be hard like for example Someone was looking for somebody in Savannah and I had a hard time with finding somebody in Savannah at one point for them

Like in person, yeah.

Janet Engel (41:36.133)
that's surprising. So I can't imagine what it's like in more rural areas than because Savannah is not rural.

Amy McWilliams (41:38.767)
Mm-hmm.

Amy McWilliams (41:48.1)
I hear you. Yeah, I was kind of surprised by that as well. But again, maybe they were independent. There might be some independence out there, but I always try to utilize the association because they've been vetted, know, their license, you know, their credentials are, you know, it's a process. You have references, you know, it's something where you're governed by someone who is credentialed and not necessarily hanging a shingle, but, you know, to each his own.

Janet Engel (42:18.491)
Right, and is ALCA the best place to look for a geriatric care manager in your area?

Amy McWilliams (42:27.852)
Absolutely. Yeah, I would recommend aging life care. There are some other resources. You can speak with your elder care attorney if you feel like you have a good attorney they can recommend. That's often we partner very closely with elder care because they're hearing a lot of times the planning that's happening before us. And they're very grateful to have us because you know they only have so much time to get into some of the family dynamics right. Or they can see for example the risk

of, my goodness, this person's declining and there isn't any plan. And they can recommend aging. And actually, I got my very first client through an elder care attorney that actually didn't even know, but he looked me up on ALCA and found me. So was really grateful.

Janet Engel (43:15.805)
Well, that's great. Well, from everything I've learned today, and I've worked with geriatric care managers in the past as an OT working in home health, I think it's such a valuable resource because as both of you said earlier, it's just such a complicated platform where you're talking about home safety, you're talking about legal issues, you're talking about where they're going to live.

You're talking about their activities of daily living and care, just so many things that have to be covered for someone to live with quality of life that it just is overwhelming. I just am so thankful that my mom right now doesn't need help in that area because I'm so busy I wouldn't be able to help her.

your resources, the services you guys offer are invaluable.

Lauren Magana (44:11.512)
Mm-hmm.

Amy McWilliams (44:18.896)
Thank you. Yes. I love what I do. I have to tell you, I look forward to my day. I think what's really fascinating and I'm so grateful for Lauren because I think each case is it's got its own complex complex complexive six is can be very complex. Sorry. Yeah, complexity. There it goes. Which I love because like I think I shared with a client once we learned one thing in a client and then

Janet Engel (44:36.071)
Complexity.

Lauren Magana (44:36.408)
you

Amy McWilliams (44:48.76)
We take that knowledge and it's helpful for the next client, right, at times. So we build our knowledge base and our resources with each client, which is really, really, really cool. And so I look forward to that. And I really look forward to being an advocate. That's one of the biggest things is I know that when you're in crisis or when you're overwhelmed, just having somebody

Lauren Magana (44:57.016)
Okay.

Amy McWilliams (45:17.102)
And I hear this a lot with the clients. I'm just so grateful I have somebody who I can go to for some really hard questions. And it's nice to have that role and people feel comfortable with us advising. So that's really important. And I always tell people I don't ever take it for granted either. They're trusting us. This is a very trusting business.

It's not one of these things you can just put a website up and just expect people to come. It's a very, very trusting business. we don't ever take that lightly when it comes to making decisions and recommendations for our clients.

Janet Engel (46:00.091)
Lauren, is there anything you want to add before we finish our conversation today?

Lauren Magana (46:08.302)
No, I guess just that this is the coolest job ever. That people working, solving problems is really fun. think coming from a space in social work, especially medical social work for so many years, I did that before this, I was getting frustrated with not having the power.

to touch more parts of my clients' lives. I might've worked in a medical space, like just came from the dialysis world, the kidney failure world, and there were so many issues I couldn't solve because I wasn't going to these people's homes. That wasn't part of what we did. And I just felt like there had to be a different role out there in which if I saw a problem, I did have the power to solve it, or at least the power to try.

which is why this is such a neat niche because I think that's what a lot of people are looking for too is, you we want someone to go to who has a little bit of knowledge, a little bit of authority to kind of take some of that, the pressure and the burden off, especially for some of these adult children and caregivers and family members. And that's really just a privilege. Like it's a privilege to work with

people in general and have them literally tell you everything about their entire life. And a lot of the times their life has been really cool. Like it's been, they've lived full and neat lives. And so getting to figure out how to finish it out in the best way is a privilege.

Amy McWilliams (47:42.063)
Mm-hmm.

Janet Engel (47:50.045)
I agree that was one of my favorite parts about working in home health that you really had the opportunity to build a relationship with your client or your patient and you had the opportunity to learn about them and I just met so many great people and I really credit the success of my marriage which we're going to

have our 15th year anniversary next fall to what I learned from older adults, which was that having a lasting marriage doesn't just happen, it's a choice. And you can choose to be a good partner and be a loving partner and someone who's supportive. And then that's

Amy McWilliams (48:28.867)
Hmm.

Amy McWilliams (48:38.884)
Mm-hmm.

Janet Engel (48:47.023)
the result is a long lasting marriage. So just so much we can learn from our elders. It was great. It was great having you guys on the show today. I learned a lot more than I knew about geriatric care managers and

Amy McWilliams (48:54.788)
Mm.

Amy McWilliams (48:59.984)
Absolutely, yes.

Janet Engel (49:13.177)
I still believe like I did prior to this conversation that you guys do so much good and offer so much value to seniors and their families. And I really hope that your profession continues to grow because...

With 10,000 baby boomers turning 65 every day and 20 % of our population being 65 and older by the year 2030, we are desperately going to need more professionals like yourselves.

Amy McWilliams (49:56.02)
I agree. I agree. And I think that quality of life is so important at every age. So yes, thank you for letting us be here and share about the work that we do and continuing to get the word out is just so important. And thank you for what you're putting together with your with dwell safe, because I think it is a way to reinforce kind of what we're saying in a way that's very visual for some people who just need that. So, you know, they need that.

you know, so I'm really grateful for that as well.

Janet Engel (50:29.527)
Yes, and we really are excited about introducing DwellSafe to the geriatric care manager community. We think it's a great tool to help them do their jobs more effectively.

Amy McWilliams (50:47.489)
I can definitely see that, yeah.

Janet Engel (50:49.085)
Well, thank you so much ladies and I look forward to seeing you again.

Lauren Magana (50:56.098)
Thank you.

Amy McWilliams (50:56.218)
Thanks, Janet.

Janet Engel (50:58.641)
Don't hang up yet, because it's uploading.

Lauren Magana (51:01.388)
Okay.