When Roles Reverse

Who to call

The professionals worth knowing — and what each one actually does.

  • Medical

    Primary care physician

    First-line medical evaluation, medication review, referrals to specialists, cognitive screening (MoCA/MMSE), care coordination across providers.

    When to call

    Almost always start here. Any new symptom, behavior change, fall, medication confusion, or before any specialist visit.

    How to find one

    Their existing doctor's office. If no current PCP, your insurance directory or Medicare.gov 'find a provider'.

    Typical cost: Covered by Medicare Part B with copay. $100-300 cash if uninsured.

  • Medical

    Geriatric care manager

    Assesses your parent's whole situation — medical, cognitive, home safety, finances — and writes a care plan. Acts as your project manager when you can't be there.

    When to call

    Long-distance caregiving. Multiple specialists with no coordination. After a fall or hospitalization. When you don't know what you don't know.

    How to find one

    Aging Life Care Association (aginglifecare.org). Many states require licensure.

    Typical cost: $150-250/hour. Initial assessment usually 4-6 hours.

  • Medical

    Geriatric neurologist or memory clinic

    Formal dementia diagnosis, distinguishing types (Alzheimer's vs vascular vs Lewy body vs frontotemporal). Manages medication. Connects to research and trials.

    When to call

    Cognitive screening showed something. Personality change. Memory loss interfering with daily life. Suspected medication-induced confusion.

    How to find one

    Referral from primary care. Major hospital systems usually have a memory clinic.

    Typical cost: Medicare-covered with referral. Initial consult 60-90 minutes.

  • Medical

    Hospice (intake nurse)

    End-of-life care at home or in a facility. Pain management, family support, 24/7 nurse line, chaplaincy, bereavement counseling for survivors.

    When to call

    Doctor mentioned it. Six-month prognosis or less. Patient is choosing comfort over treatment. Don't wait for the last week — hospice is most useful with weeks of runway.

    How to find one

    Ask the discharging hospital, your parent's PCP, or search local non-profit hospice agencies. Free informational visits common.

    Typical cost: Fully covered by Medicare Hospice Benefit. No copay.

  • Practical

    Hospital or community social worker

    Discharge planning, finding skilled-nursing or rehab placement, connecting to benefits, navigating Medicaid, family meeting facilitation.

    When to call

    Hospital discharge. Looking for benefits help. Family conflict over care decisions. Don't know what resources exist.

    How to find one

    Hospital social work department (free during inpatient stay). Aging council in your county.

    Typical cost: Free during hospitalization. Community social workers often free or sliding-scale.

  • Practical

    Area Agency on Aging (AAA)

    County-level navigator. Free benefits screening, meals on wheels, in-home services, caregiver respite grants, ombudsman for facility complaints.

    When to call

    Anytime. The first call you should make and most caregivers don't know exists.

    How to find one

    eldercare.acl.gov or call 1-800-677-1116 (Eldercare Locator).

    Typical cost: Free. Many programs free or income-based.

  • Legal

    Elder law attorney

    Power of attorney (POA), advance directive, healthcare proxy, will updates, revocable and irrevocable trusts, Medicaid planning, guardianship if capacity is in question.

    When to call

    Before any cognitive decline diagnosis. After a diagnosis (window is closing for them to sign anything). Any significant assets at stake. Considering Medicaid for long-term care.

    How to find one

    National Academy of Elder Law Attorneys (naela.org). Local bar association referral. Avoid generalists for this.

    Typical cost: Initial consult often $300-500 or free. Full POA + advance directive package $500-1,500. Trust $2,000-5,000+.

  • Legal

    Estate planning attorney

    Wills, trusts, estate tax planning, probate after death.

    When to call

    Significant assets, blended families, business ownership, real estate in multiple states, charitable goals.

    How to find one

    State bar referral. Ask your CPA or financial advisor.

    Typical cost: Simple will $500-1,500. Trust package $2,500-7,500. Probate fees usually a percentage of estate.

  • Financial

    Fee-only fiduciary financial planner

    Long-term care funding strategy, retirement income, beneficiary checks, insurance audit, tax planning. Fiduciaries are legally required to act in your parent's interest, not sell products.

    When to call

    Approaching long-term care costs. Selling a home. Inheritance arriving. Confusion about Medicare vs Medicaid vs Medigap. Suspected financial exploitation.

    How to find one

    NAPFA (napfa.org) — fee-only fiduciaries. Avoid commission-based 'advisors' for this work.

    Typical cost: $200-400/hour. Or flat $2,500-5,000 for a comprehensive plan.

  • Financial

    Daily money manager

    Pays bills, balances accounts, organizes paperwork, watches for fraud, coordinates with the elder law attorney and financial planner. Bonded and background-checked.

    When to call

    Parent is missing bills. Late fees stacking up. Long-distance caregiving. Mild cognitive impairment. You don't have time to do this on top of everything else.

    How to find one

    American Association of Daily Money Managers (aadmm.com).

    Typical cost: $60-100/hour. Usually 2-8 hours per month is plenty.

  • Support

    Alzheimer's Association Helpline

    24/7 free phone support. Master's-level clinicians. Walks you through any dementia situation, including 3 a.m. crises. Will refer to local resources.

    When to call

    Anytime. You don't need a diagnosis. You don't need to be the legal caregiver. Free.

    How to find one

    1-800-272-3900. Available in 200+ languages.

    Typical cost: Free.

  • Support

    Caregiver support group

    A room of people who get it. In-person, online, or hybrid. Disease-specific groups are usually most useful (dementia, Parkinson's, cancer caregivers).

    When to call

    When you feel alone. When you feel crazy. When the rage scares you. When you can't tell anyone in your real life.

    How to find one

    Ask the relevant disease association (Alzheimer's Association, American Heart, etc.). AARP and local hospitals also run them.

    Typical cost: Free.

  • Practical

    Long-term care ombudsman

    Advocates inside nursing homes and assisted living facilities. Investigates complaints, mediates disputes, knows the regulations cold.

    When to call

    Concerned about quality of care, neglect, billing irregularities, retaliation for complaints, sudden discharge notice.

    How to find one

    Through your state's Long-Term Care Ombudsman office. Eldercare Locator (1-800-677-1116) will route you.

    Typical cost: Free.

  • Practical

    Adult Protective Services (APS)

    Investigates suspected abuse, neglect, exploitation, or self-neglect of vulnerable adults. Can intervene legally if needed.

    When to call

    You suspect abuse — physical, financial, emotional, or neglect — including self-neglect (parent refusing all help while clearly unsafe). Including by family members.

    How to find one

    Eldercare Locator (1-800-677-1116) or your state's APS hotline. Most states have a 24/7 number.

    Typical cost: Free.

Every professional listed is a type of person to find — not a specific endorsement. Vet anyone you hire. Ask for credentials, references, and (for legal/financial) fee structure in writing.

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