May 8, 2000 -- When Sharon Miles' elderly mother grew frail a dozen years
ago in Albuquerque, mother and daughter had a problem. "I was taking care
of her with no support system here in town," says Sharon Miles. "It was
overwhelming. She needed help bathing, eating, getting around. Finally, I had
to place her in a nursing home even though neither of us wanted that." It
was one of the toughest decisions Miles had ever made.
"Now, by contrast, people don't have to do that until it's really
necessary," she says. Staying at home, or "aging in place," as it
has become known, while not necessarily inexpensive, is becoming increasingly
feasible for many older people. And Miles herself has become part of the
Brenda Della Casa had been seeing her primary care physician for two years
and had brushed off her concerns about getting rushed care - until she had a
health scare she couldn’t ignore. She told her doctor she was experiencing
terrible back pain and stomachaches. Her doctor checked her, said she was fine,
and sent her on her way.
Five days later, Della Casa, an author and dating coach in Chicago, was
traveling and had pains so severe she could barely move. When she received a
After the experience with her mother, Miles returned to school for a degree
in social work, with course work in gerontology, and gained experience
arranging care for seniors at an HMO. Then, as a member of the relatively new
profession of geriatric care managers, she formed her own company. Her current
clients, most of them in their mid-80s, all live at home with outside help --
coordinated by Miles.
Putting Together a Plan
As a member of the National Association of Professional Geriatric Care
Managers, Miles specializes in helping seniors live independently for as long
as possible in their own homes -- which, according to the American Association
of Retired Persons (AARP), is what 85% of them want to do. Care managers can
assess what's needed, arrange for services, help with legal, financial, and
insurance issues, coordinate various government, private, and community
services, offer counseling, and act as a liaison for distant families.
A typical new client call comes from a son or daughter, Miles says.
"Last year a daughter in Michigan found me through the national
association's web site and called
about her mother living alone in the Albuquerque home where she'd been for 45
years. The children had noticed that their mother was forgetful and not keeping
up with the bills. They worried that she wasn't taking her medications. She had
a little dog for company and didn't want to move out of her home.
"The children flew in, and we all met at the mother's home. She'd lost
weight, was sloppily dressed, when she'd always been so neat; and the bathtubs
were dusty." With the family, Miles developed a care plan. The mother now
wears a beeper that she can use to call a neighbor if she falls. She receives
hot lunches from the community's Meals on Wheels service. A homemaker/caregiver
comes in every morning for about four hours to help her dress, make sure she
has breakfast, and take her to doctor's appointments. A shower chair, handheld
shower head, and grab bars were installed in the bathroom, with assistance
provided by a city program. Miles removed slippery throw rugs and replaced them
with rubber-backed ones. She continues to monitor the plan, keep in touch with
the children in Michigan, and is ready to respond to any changes in the woman's