"When we're hired, we go in and count the pills, check the food in the refrigerator, we talk to the doctors," she said. "We get a complete picture and we write up a report in lay language. The family knows what we'll do and what it will cost right up front."
The services can get very specific.
"We had one lady who wanted to play bingo and we said, 'No problem, we can get you to bingo.' But she was a German lady and she wanted to play bingo in German," Rappaport said. "We found a place."
Jullie Gray, incoming president of the National Association of Geriatric Care Managers, said membership is now near 2,000, up from fewer than 1,600 a decade ago.
Rappaport said the average fee for her clients is between $1,500 and $2,500 a month, not including the in-home caretakers' pay.
David Cutner, an elder law attorney in Manhattan, said he worries about elderly people exhausting their assets, but added, "People who have a substantial net worth and are not thinking about government benefit programs might well want to hire this type of service."
A much less comprehensive and less costly alternative is offered by CareFamily, which prescreens in-home caregivers and matches them to customers over the Internet. On Monday, the company announced a variety of online tools through which a family can remotely monitor a caregiver's attendance, provide reminders about medications and appointments and exchange care plans and notes via email, texting or phone.
The service would be included in the average $15 an hour fee paid for the caregiver, said CareFamily CEO Tom Knox. He said it can "cut costs while ensuring that the elderly can be well taken care of — without the need to uproot seniors and disrupt families."
Yale Hauptman, an elder law attorney in Livingston, N.J., said many different services are available. His office is often called in by advocates who discover that an elderly person needs a will or power of attorney or a trust.
"We work with people who just do health insurance, cut through red tape, deal with Medicaid," he said.
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