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How to get good care for your aging parent

Geriatric care manager

Geriatric care managers, or GCMs, usually provide a full range of services, such as finding suitable living arrangements, counseling and financial services. GCMs may also conduct background checks on prospective caregivers, check licensing of facilities and pay personal visits to clients to discuss caregiver issues or options.

They typically come from a variety of fields and backgrounds. They're a good one-stop shopping option for clients who want comprehensive elder care management services.

GCMs, however, can be costly, and Medicare and Medicaid generally do not pay for their services. But some long-term care insurance policies may cover geriatric management fees, which can range from $50 to $200 per hour depending on where you live and the services provided.

GCMs may also charge a fee for an initial visit, during which they can make an in-depth assessment of your parent's care needs. Get all GCM fees in writing in advance so you understand how billing is calculated.

Part-time caretaker

If your parent is relatively independent and doesn't need special medical care, perhaps an informal caretaker can help out. It could be a friend, member of your house of worship or a college student.

These individuals can take your parent grocery shopping or on other errands, or simply offer companionship for an hour or two at your parent's home.

Some caregivers may choose to volunteer their time and not charge anything. But if they do, you can generally negotiate an hourly rate without entering into a special contract.

This solution is typically best for independent parents who do not require medical or other special care. You need to handle screening and beware of scammers. That goes for anyone you hire. Also, part-time caretakers usually do not have any specialized training should a medical emergency pop up.

Home health aide

When your parent is disabled but requires more personal care than family or friends can provide, a home health aide, or HHA, may be the way to go.

They typically provide routine housekeeping and personal care services such as cooking and bathing. They can accompany clients on doctor visits and errands, and in some cases, provide basic psychological support.

Home health aide schedules can be flexible, based on your parent's needs, and they're often available nights and weekends.

They typically receive general training on how to handle emergencies and how to cook for clients on special diets.

Many are professionally certified and affordable. The average home health aide rate in 2008 ranged from $12 per hour in Louisiana to $37 in Mississippi, according to Prudential Insurance. A survey from MetLife put the national average at $20 per hour last year.

The downside is many health aides do not have advanced emergency medical skills, and training requirements vary by state.

Look for HHAs who are certified by the National Association for Home Care and Hospice. They are required to complete a 75-hour course, demonstrate 17 skills for competency and pass a written exam.

Adult day care

An adult day care facility is an option for a physically or mentally disabled parent.

These facilities offer structured programs that may include arts and crafts, entertainment, mental stimulation games and mild exercise.

Meals and snacks are provided and they are usually staffed by a medical professional such as a registered nurse. They are a solution for parents who are somewhat mobile, not too cognitively challenged and sociable.

But they should not be confused with a senior center.

"A senior center is for people of sound mind who are physically well. They just like to mingle with people in their age group," says Hall, who is a director of a long-term care planning program for seniors at the Financial Consulate.

"An adult day care center is specifically for someone who is physically or mentally handicapped."

Costs range from $25 to $70 or more per day. It all depends on where you live and the services provided. The national average was $59 in 2008, according to a 2008 survey by Genworth Financial.

Medicare generally does not cover adult day care costs, but Medicaid may pay for it in certain states if the participant qualifies.

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