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By Gregory Solometo

In the February issue of WestView, I discussed elders’ need for a comprehensive network of expert service providers across varying disciplines, in addition to trustworthy and reliable hourly shift workers supporting the Activities of Daily Living (ADL) (e.g., bathing, toileting, food preparation, etc.) Elder care requires a proverbial village, or symphony, of experts whose collective participation is more than the sum of its parts.

Based on our experience within the last 10 years, I have highlighted some of the key players in our band:

Geriatric Care Managers (GCMs): GCMs are also known as Aging Life Care Professionals. These are often social workers or Registered Nurses who help to navigate the entire landscape of home care. They are the first people on the scene and conduct the initial assessment. These professionals draft a comprehensive summary of the complete picture (e.g., elder care needs, medication, home safety, family dynamics, financial summary, etc.) and suggest plans of action and referrals. All of our clients are supplied with a dedicated GCM to help them and their families develop a roadmap and find the appropriate living conditions. Sometimes, home is not the right environment and is counterproductive to our business model, but we are guided by the Grandma Rule® to find the right solution.

“…the secret of the care of the patient is in caring for the patient.”

—Francis W. Peabody

October 21, 1925

Elder Care Attorney: All elders in this stage of life need working and updated legal documents that an elder care attorney provides, as well as advice on Medicaid, estate planning, and intelligent ways to manage the financial aspects of long-term care planning for the adult children. Often, it’s too late for the clients themselves to make meaningful changes to these documents, but the adult children can certainly learn from those mistakes.

Physical/Occupational/Speech Therapy: Elders living at home and wishing to remain there often need a physical therapist to retain or build up their physical stature. Based on the diagnosis, occupational therapy and speech therapy are commonly engaged as well. Medicare covers much of what is needed in these cases.

Nutrition and Food Program: Food and hydration is commonly overlooked in elders. They should be evaluated initially, and then periodically, by a Registered Dietitian or nutritionist to assess their food and hydration regime. Recently, we developed a best practice of combining nutritionist guidance with the hands-on expertise of an organic chef who educates the team on sourcing and preparing healthy meals consistently.

Financial Organizer: The healthy home care environment often includes an organizer of elders’ financial affairs such that petty cash is available, bills and vendors are paid on time, and the home runs smoothly.

Home Visiting Physicians: Often in our home care programs, visiting physicians and specialists are brought in to manage different medical conditions. Psychologists manage depression, podiatrists address footing stability, and general practitioners assess lungs and respiration ahead of, or during, a cold or flu episode. Even dentists can visit the home for almost all preventative and basic care needs. We have recently learned of a new Medicare program that supports Chronic Care Management (CCM). Essentially, a physician visits the home and provides monthly remote video check-ins on a wifi-enabled tablet to support the general practitioner’s care in the home. This is available to our clients and for anyone with Medicare.

Recreation Specialist: Based on a person’s hobbies, interests, career, and usage of spare time prior to home care, recreation can mean many things. Having someone engaged in their activities and hobbies, whether that be visiting the Met, obtaining music therapy, attending art gallery openings and poetry readings, receiving pet therapy, reading the Sunday Times, executing water color painting, or playing Mahjong, elders should be supported thoroughly to continue living a full life at home or in the community.

Spa and Lifestyle Services: If someone regularly received massages, did yoga or liked regular manicure/pedicure sessions, these services should be incorporated at home.

How is this ecosystem financed? The simple truth is that it’s mostly private and out of pocket. In our next segment, we will discuss more about the financial options and landscape.


Gregory Solometo started Alliance Homecare after caring for his ailing grandmother for five years. He created The Grandma Rule® hiring philosophy to provide all clients with an elite and highly qualified team of healthcare professionals. Prior to Alliance Homecare, Gregory worked primarily in the financial services industry. He graduated from Emory University in 1995.

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