Kristin Martinelli began her workday at 7:30 a.m. on a recent Monday, completing an online Medicaid recertification form for a client in a nursing home in Austin, Texas.<\/p>\n
Next, she drove to meet an 85-year-old and her daughter, who had come in from out of town. The older woman had \u201cpretty advanced dementia\u201d and was scheduled to move into the secure memory care unit of a senior living facility that day, said Martinelli, who works as an aging life care manager with Mir Care Consultants in Central Texas. The three of them had a 9 a.m. meeting with the primary care doctor who would complete the paperwork for the move.<\/p>\n
At the meeting, Martinelli explained the situation, and the doctor said he\u2019d fill in the patient\u2019s forms that afternoon. But later in the day, she got a call from a colleague saying that the doctor wouldn\u2019t be able to complete the forms that day after all. That created a scramble because the woman wasn\u2019t safe alone in her house. Martinelli ended up calling a home care agency she trusted. \u201cI begged them to provide me with a caregiver in the next four hours,\u201d she said.<\/p>\n
If a combination of appointments, bureaucracy, vigilance, and worry about a vulnerable older person \u2014 often interspersed with medical emergencies \u2014 sounds familiar, it might help to know about a service its providers ruefully call the best-kept secret in eldercare.<\/p>\n
Independent certified professionals like Martinelli used to be known as geriatric care managers. That\u2019s what I called the people who helped my 88-year-old father<\/a> make the 125-mile move from his apartment to a continuing care community near me, and later helped my disabled sister transition from her home to an assisted living facility.<\/p>\n I also used words like \u201cgodsend\u201d and \u201cindispensable.\u201d After the moves, the care managers kept tabs on both my father and sister monthly and eased my fears that something urgent might strike the moment I left on a vacation or a work trip.<\/p>\n About a decade ago, these experts rebranded themselves as aging life care managers. It usually takes a couple of years to become one. Most enter the profession as nurses or social workers; some are physical or occupational therapists or gerontologists. They must attain a required combination of advanced education and supervised experience<\/a> before they can take the certification exam.<\/p>\n The Aging Life Care Association, the nonprofit that represents these professionals, was founded in the 1980s and has grown to more than 2,000 members, but care managers still have a persistent public awareness problem.<\/p>\n \u201cWhen we talk to someone, they say, \u2018I wish I could have called you six months ago, but I didn\u2019t know you existed,\u2019\u201d said Susy Elder Murphy, who owns Aging Well Eldercare, a large practice serving Washington, D.C., and its Maryland suburbs.<\/p>\n The caller is typically an adult child, the Aging Life Care Association has reported. Martinelli described a common scenario: \u201cMom is in the hospital, or the children went to visit and hadn\u2019t realized she was so sick. They\u2019re in a crisis.\u201d<\/p>\n Enter the aging life care manager. What distinguishes her (it is usually a woman) from people with confusingly similar names \u2014 senior care advisers, patient advocates, care navigators \u2014 is her independence.<\/p>\n Aging life care managers work for the client and the family paying them, not for hospitals or insurance companies. Moreover, the association\u2019s extensive code of ethics<\/a> specifically prohibits \u201caccepting or giving referral fees, fee splitting, kickbacks or other similar arrangements in exchange for client referrals.\u201d<\/p>\n Contrast that with companies that promise free advice on senior living, like A Place for Mom. Care facilities pay A Place for Mom fees for steering new residents their way, as the organization discloses on its website<\/a>. Advisers for companies that receive fees may be unlikely to recommend places that don\u2019t pay, or to recommend home care, unless the company also contracts with local agencies.<\/p>\n \u201cThey\u2019re really marketers, salespeople,\u201d Julie Wagner, chief executive of the Aging Life Care Association, said about the referral companies. Some companies are more transparent than others<\/a> about these financial incentives.<\/p>\n \u201cIf you want to buy a car and you go to the Ford dealer, they will not say, \u2018I really see you in a Subaru,\u2019\u201d Murphy said. \u201cYou should be talking to someone who\u2019s objective, neutral, and experienced.\u201d<\/p>\n Care managers don\u2019t come cheap. Wagner said association members\u2019 hourly rates range from $150 to $350, with big geographic variations. In Texas, Mir\u2019s standard rate is $185 an hour, billed in 15-minute increments. In Washington, Murphy\u2019s practice charges $210 an hour. Sometimes families share the cost, as my sister and I did. And in some cities, social service agencies provide these specialists on a sliding scale.<\/p>\n Aging life care managers serve as coordinators, not hands-on caregivers, and the range of services they provide is quite broad.<\/p>\n They can, for example: Arrange and oversee a move to or within a senior living facility. Deal with insurers, including Medicare and Medicaid. Drive a client to the dentist. Recommend not only local residential communities and home care agencies but elder law lawyers, medical specialists, therapists, senior move managers<\/a>, and hospice organizations. Visit weekly or monthly to see that everything is going smoothly. Alert family members if it isn\u2019t.<\/p>\n \u201cA part of our job is mediating between family members, acting as a sounding board,\u201d Martinelli said.<\/p>\n In fact, care managers like Murphy find their clients often seem more willing to listen to them than to their adult children \u2014 even if the advice is the same. \u201cYour mom didn\u2019t change our diapers or teach us to talk,\u201d she said. \u201cIt\u2019s a different relationship.\u201d<\/p>\n In a 2025 survey<\/a> of clients and families commissioned by the Aging Life Care Association, \u201cthe responses were overwhelmingly positive,\u201d said Jullie Gray, a co-author of the study who teaches at the University of Washington School of Social Work.<\/p>\n The nearly 200 respondents did not constitute a representative national sample, Gray said. But 93% said the benefits of hiring an aging life care manager outweighed the costs, and 99% said they would recommend such a manager to someone else. The survey\u2019s findings were presented at the 2025 meeting of the Gerontological Society of America.<\/p>\n Jeffrey Bernstein, an engineer in Middleton, Massachusetts, has for years relied on Aging Well Eldercare for help with his parents, two older siblings, and an aunt, all in Maryland. Like many people who eventually learn about care managers, \u201cI had no idea such a person existed,\u201d he said, until his wife read about them in a magazine.<\/p>\n Bernstein, 65, was unable to relocate to care for his family directly. But with care managers, \u201cwhen something came up, they were there, they stepped up,\u201d he said. \u201cMore importantly, they knew what to do when I wouldn\u2019t have. It was tremendously helpful for my peace of mind.\u201d<\/p>\n The same was true with Martinelli\u2019s 85-year-old client in Austin. She spent the night with temporary caregivers and moved into her new home in the memory care unit that Tuesday, after her doctor finally produced the necessary documentation. \u201cShe went in just before noon,\u201d Martinelli reported. \u201cShe had lunch.\u201d<\/p>\n How was the new resident adjusting? \u201cIt\u2019s been OK,\u201d Martinelli said, sounding relieved. \u201cSo far, so good.\u201d<\/p>\n The New Old Age is produced through a partnership with <\/em>The New York Times<\/em><\/a>.<\/em><\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/em><\/p>\n This article<\/a> first appeared on KFF Health News<\/a> and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License<\/a>.<\/p>","protected":false},"excerpt":{"rendered":" Kristin Martinelli began her workday at 7:30 a.m. on a recent Monday, completing an online Medicaid recertification form for a client in a nursing home in Austin, Texas. Next, she drove to meet an 85-year-old and her daughter, who had come in from out of town. The older woman had \u201cpretty advanced dementia\u201d and was…<\/p>\n","protected":false},"author":0,"featured_media":16103,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-16102","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/16102"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=16102"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/16102\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/16103"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=16102"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=16102"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=16102"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}