Consumer Reports is a nonprofit organization providing unbiased product ratings and reviews. We put over 5,000 products through rigorous testing each year. Expert Choice Full Version' title='Expert Choice Full Version' />As if the standard Specialized Epic Expert Carbon wasnt already sufficiently purpose built for crosscountry riding and racing, theres. Evidencebased guidelines for the management of patients with Lyme disease were developed by the International Lyme and Associated Diseases Society ILADS. The. Introduction and General Notes Principles The subbase layer is often the main loadbearing layer of a pavement. It is designed to evenly spread the load of the. When Elder Care Problems Escalate, You Can Hire an Expert. Ms. Zabin did a thorough assessment and found that Ms. Gray had low blood pressure, which is why she passed out, as well as poor vision and balance. She determined that it was time for Ms. Gray to have home care. Ms. Zabin also persuaded Ms. Gray to change her sleep habits something her sons had been trying to do for years. Instead of staying up until 2 a. Ms. Gray shifted to a more normal rhythm asleep by 1. My mom doesnt listen to us, but she listens to Audrey, Howie Gray said. That is another great reason to use a care manager they can play the bad cop, persuading the older person to stop driving or insisting that an aide move in, so you dont have to. That person can also be the voice of reason when a family is not seeing eye to eye. Reesa Tansey and her siblings agreed that their mother, Ruth Tansey Goldberg, should age at her home in Los Angeles. But their mothers husband their stepfather did not think that was a good option for him or for her. Mrs. Goldberg, 8. Alzheimers, but her husband, 8. Bunni Dybnis, a care manager based in Los Angeles, helped the children navigate the complicated terrain. At first, Ms. Dybnis arranged for 2. Mrs. Goldberg. When Mr. Goldberg concluded that his wife would be better off living elsewhere with more stimulation, Ms. Dybnis helped the family find a reliable and intimate residential home for Mrs. Goldberg to move to. This wasnt our first choice, Ms. Tansey, who lives in Berkeley, said. But Bunni helped make it all work out. We never felt like we were drowning. A geriatric manager can swoop in, figure out what needs fixing and move on to the next case. Or the manager can provide continuing support for situations that cannot be resolved quickly. Because care managers charge by the hour typically 5. If you want to hire a geriatric care manager, you can start by asking for names from everyone you know with elderly parents. The majority of new clients come from referrals, notes Phyllis Mensh Brostoff, a geriatric care manager and president of the board of the National Association of Professional Geriatric Care Managers. This is a personal business. Its akin to hiring a babysitter. If that does not work, you can go to the associations Web site, www. Find a Care Manager to locate one in your area. Be sure to ask about backgrounds and credentials. If your parent has complicated medical issues, a care manager with a nursing background might be best. If the parent has cognitive problems or is just plain ornery, someone with a masters in social work might be better. Find out whether the person is a member of the national care managers association, which has strict requirements members must have a masters degree in a field related to care management, like nursing or social work, two years of supervised experience and certification by one of three accrediting agencies. Ask for a brochure and a fee schedule. Learn whether the care manager works alone or in a group practice and if they will be available to you 2. Once you have found someone you like and trust, there are three ways you can use their expertise. CONSULTATION If you want straightforward advice like, Is it time to move my mother to a nursing home set up a consultation. This is generally done in person and typically takes one to two hours. The care manager can help you figure out what you need to concentrate on and what solutions may exist, Ms. Mensh Brostoff said. Cost 1. 00 to 2. ASSESSMENT When your parent is living far away or has multiple problems, you can ask for an in depth assessment. The care manager will spend an hour or so with your parent, speak with family members and doctors, and assess the living arrangement in order to paint a complete picture of the clients situation and challenges. The manager will send you a 5 to 1. Cost 5. 00 to 1,2. CONTINUING CARE If the recommendations are extensive, you might want the care manager to carry them out for you like upgrading a home or locating an assisted living facility. Ms. Mensh Brostoff has one client she has been seeing for more than 2. In Brookline, Mr. Gray and his family rely on Ms. Zabin to make sure their mother, now 9. Ms. Zabin checks in with Ms. Gray periodically and makes recommendations. She owns the case, says Mr. Gray. And that is tremendously comforting to all of us. Cost Hourly fee. Finally, when money is tight, consider free options. If your elderly person has Alzheimers, the Alzheimers Association 8. Also, you can try the Eldercare Locator 8. Department of Health and Human Services, which can connect you with local agencies on aging. Sometimes just attending a free seminar can give you enough information to make tough decisions on your own. Continue reading the main story. Latest Topics ZDNet. By registering you become a member of the CBS Interactive family of sites and you have read and agree to the Terms of Use, Privacy Policy and Video Services Policy. 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