How Can Long-Term Care Patient Navigators Support Family Caregivers?

Joshua Iversen

Providing long-term care can be a challenging task. Besides the complexity of determining how to best care for a loved one, it can also be difficult to handle the financial issues involved in arranging supportive care. 

For many caregivers, providing care prevents them from working a full-time job, or even working another job at all, in some cases. As a result, for many patients, accessing funds or looking for available caregiving services can be crucial to receiving an adequate level of care. 

To help guide patients in finding the best and most affordable care, patient navigation has become increasingly popular. Whether helping arrange a cancer screening at a cancer center or discussing treatment options, navigators can offer essential assistance in finding the best care options available.

What Is A Care Navigator?

A care navigator is a healthcare staff member who works closely with patients and the patient’s caregiver to overcome any medical or care-related roadblocks.

Care navigation
generally involves a one-on-one consultation between a healthcare professional such as a nurse navigator and the patient or patient’s caregiver to help them identify ways to avoid barriers, whether financial or procedural, that can make it difficult for a patient to receive the care they need from the health care system. Through these partnerships, care navigators can provide the emotional support that comes from knowing your loved one has someone helping them find the best treatment options.

Care navigation can be pursued on its own or in conjunction with care coordination.

Care navigators who specialize in long-term care issues can help caregivers and care recipients find a care path that works within their financial and personal circumstances for as long as possible rather than for a short increment of time. They may also be able to provide advice about how to handle doctor’s visits or coordinate care with a patient’s care team, act as a patient advocate, and offer follow-up consultations to make sure a patient’s care continuum is maintained at an acceptable quality.

4 Cost-Saving Benefits For Caregivers Working With A Long-Term Care Navigator 

Working closely with a long-term care navigator can provide numerous benefits for caregivers and care recipients alike, including the peace of mind of knowing all options for care are being investigated.

Let’s review four cost-saving benefits that can result from engaging with a long-term care navigator:

1. Understanding Medicare & Medicaid Long-Term Care Policies

Many people who require caregiving are over the age of 65 and thus eligible for Medicare. 

While Medicare does not pay for long-term care, it is important for caregivers to understand the benefits Medicare does offer in case those under their care require hospitalization or long-term rehabilitation services, which are covered, for a certain amount of time, by Medicare.

In addition to helping caregivers understand the ins and outs of the Medicare program, a long-term patient navigator can explain how patients may be able to benefit from Medicaid’s provisions for caregiving if they qualify for the program.

Unlike Medicare, qualifying for Medicaid is typically based on a person’s income and assets, with those making under a certain amount qualifying in most states. 

For those who do qualify for Medicaid, the program offers a waiver (Medicaid waiver self-directed long-term services and supports (LTSS) programs) that in some cases allows payment for at-home caregiving services to help meet a patient’s healthcare needs.

A navigator can provide information about this and other aspects of Medicaid that may benefit patients needing long-term care.

2. Identifying State & Local Options For Caregiving Support

Another area where long-term patient care management services can be helpful is in identifying state and local programs that offer financial or other assistance for caregiving services and help with outreach if needed.

In addition, to the various state health departments, in each state, local organizations which are linked to the Administration on Aging (AAA) may offer services to assist caregivers

You can use a navigator can help you search to find resources in your area that provide information and assistance for older adults and caregivers.


3. Learning About Alternate Long-Term Care Support Options For Caregivers 

Another area where a long-term care navigator can help save money is by directing people to other public health programs that can offer assistance to those requiring caregiving services. These services can be directed at general health care assistance or specialized services such as cancer care for oncology patients.

Here are a few options to consider:

  • Centers for Medicare & Medicaid Services (CMS)
    The CMS offers several programs to eligible individuals, with different features from state to state. The CMS facilitates accessible and affordable options for care with Medicaid, Medicare and Health Insurance Exchanges.

    • The Program of All-inclusive Care for the Elderly (PACE)

      PACE is another program that a navigator may suggest looking into. PACE is sponsored by Medicare and covers some of the medical and social service expenses paid by adults who need nursing home care level at home.

      The program’s goal is to enable adults to stay in their homes while receiving care instead of moving to a long-term care facility. This program is not available in every state.

    • Veterans Care Programs

      A navigator who specializes in long-term care solutions can also direct veterans who need caregiving to the services offered by the VA. Military veterans may qualify for the Veteran Directed Care Program, which provides funds for veterans to pay family caregivers.

      Another program, Aid & Attendance, may also provide funds for caregiver services.


4. Consider Other Financial Options

Besides government-sponsored programs, a patient navigator may also be able to offer expertise with regard to private insurance and other financial approaches to paying for long-term care, including:

  • Long-term care insurance
    Understanding how long-term care insurance works is important to maximizing the benefits a patient can derive from it. A navigator can explain how these policies function.

    • Reverse mortgage
      Patients requiring long-term care who own their homes may want to ask a navigator about taking out a reverse mortgage if there are no other options available to pay for their care.

      These mortgages typically allow the homeowner to stay in their house for as long as they live, with an option to buy out the reverse mortgage if they decide at a later date they want to retain the house.


Where To Find A Long-Term Care Navigator

To assess if you need a long-term care patient navigator, consider whether you have the knowledge and expertise to determine how best to seek financial and other aid for the services you are providing to help improve the patient’s quality of life. If you don’t have the know-how, seeking out a long-term care navigator or patient navigation program can be a valuable way to improve the quality of the caregiving support you provide. 

When searching for a patient navigator to help draw up a care plan for your loved one as part of a healthcare team, a first step is to check with the agency or organization offering support to the person receiving caregiving services to see if they offer care management assistance. You can also check with your local Area Agency on Aging, Aging and Disability Resource Center, your state’s department of health or human services or department of aging, or a social service agency.

Some lawyers specializing in family law or eldercare law will either offer navigation services themselves or be able to provide you with referrals to community health workers or social workers specializing in such services.

In addition, you can also find patient navigators through an online search or by checking with health care providers and facilities that offer long-term care services such as hospitals and nursing homes. These organizations may have formed partnerships with patient navigators as part of a patient management program.