In our role as care manager, we walk side-by-side with our clients and families as they make difficult decisions about their living situation. The transitions between home and long-term care setting are emotionally, physically, and financially challenging for all families. In the best of circumstances, the choice is one that is undertaken with plenty of time and preparation, including ample opportunity to explore all the options. More realistically, often clients or families are forced by circumstances such as a health care crisis to make a move that they were not anticipating and find themselves grasping for information, support and, above all, reassurance that the individual or couple who are moving will be safe and well cared for.
Sorting through and weighing the pros and cons of various living options is a priority when a care manager is working with a client, and a situation in which we encourage our clients to seek additional expertise and resources. It is our practice to refer our clients to a senior referral agency to work with a referral agent, and we always strongly recommend they work with an agency that is a member in good standing of OSRAA, the Oregon Senior Referral Agency Association. OSRAA was formed in 2004 with the stated purpose of protecting consumers by establishing a code of ethics and standards. In 2017 they successfully spearheaded legislation requiring all senior referral agents in Oregon to be registered with the Department of Human Services, and meet several requirements including a background check.
Simply put, this is a group of professionals who have been holding themselves to a higher standard than what was required by the state for many years and went out of their way to promote public policy that would hold themselves more accountable and protect their customers. We applaud their work ethic and their dedication and skill in shepherding people through the delicate process of choosing a long-term care option that is the best fit for them. In discussions with OSRAA members, we learned that an unlevel playing field has been contributing to consumers being unwittingly shortchanged, while they are in the middle of a stressful and overwhelming process. Because consumers do not pay out of their pocket for the services of a senior referral agent (a commission is paid by the facility to the agency after placement is complete) online agencies have utilized strategies that in the past enabled them to take an internet referral and capture the commission even in cases where they do no actual face-to-face or personal consultation and service for the potential resident. For example, a person who is just starting to research the idea of potentially moving to assisted living in the future might put their information in on a website and receive a list of area facilities, but with no real regard or insight into location, services or other details. Behind the scenes, the individual’s name is now being sent out to multiple facilities, so if they come in for a tour, the website agency collects a commission. Recent legislation passed in Oregon contributed to fixing some of the imbalance, but concerns remain.
In sharp contrast to this questionable business model, our experience with local senior referral agents is that they pay close attention to all the needs and requirements of the client they are working with, in order to find them a community that will be a good long-term care placement and provide quality care. The process starts with a phone call from the care manager to either a specific agent that we believe is the best match for our client, or to the OSRAA referral line to be directed to an agent who can be available quickly. As care managers who have already done an assessment and have a good background on our client and their needs, we know the information that a senior referral agent will need to start their list of potential communities to assess on behalf of the client. Of course, the referral agent will also want to meet with the client personally and get to know them, discuss budget, goals and preferences.
One of the great advantages of working with a local referral agent is their depth of knowledge of the types of long term care facilities, the culture of different communities, which facilities have high or low turnover or internal issues, and of course, most important – who has the best chef? It gives us great confidence in connecting our clients with an expert that we know will be exploring all the options that could best serve their needs. Referral agents are also a wealth of information when it comes to the many types of long term care settings, such as independent living, assisted living, nursing facilities, and adult care homes. Through conversations with the client and family, they can explain the nuances of each one, and narrow it down to options that provide variety in choice while syncing up with the specific needs and personality of the client. Once the senior referral agent has established a profile of what the client is looking for, he or she will arrange for personal tours of the communities and accompany the client through the tour. One of my most memorable experiences was when I joined a client and a referral agent at a unique facility that actually arranged that afternoon’s social activity around a sports theme to help him feel at home with his potential neighbors.
Families can also rely on senior referral agents to check available public information about complaints, safety issues and compliance with regulation. Local referral agents take their role in helping families through the transition very seriously, and form connections with their clients during the process. I’ve known referral agents who show up on move day to help pack boxes or check in with a client after they move to make sure they are settling in well. We have worked with referral agents who go above and beyond to find an adult care home where the operator speaks the same language as the client, or to find hospice that will also accommodate a beloved pet. At the end of the day, they are doing this job because they genuinely care about the people they work with and want to make sure they are well cared for and happy.
For resources in finding local referral agents outside of Oregon, OSRAA is happy to provide referrals to agencies in other states, or contact a care manager in your area through the Aging Life Care Association.
Written by Bethany Wofford, MSSW