ELDER CARE: Caring for California’s Aging Population : Waging War to Let Elderly Stay at Home : Care managers arrange for non-medical services such as cooking and driving that maintain independence.

Every day when Monika White goes to work, she wages a war to keep people at home.

The alternative for the people she deals with is life in a nursing facility. And White thinks that is unnecessary most of the time.

White runs the Senior Care Network at Huntington Memorial Hospital in Pasadena, where a dozen “care managers” arrange such non-medical services as housekeeping, cooking, driving, bathing and legal advice for elderly people who struggle with such tasks on their own.

The workload at Senior Care Network is tremendous, she says, with about 600 clients to monitor and 300 telephone calls each day from people requesting help for a family member.

The network tries to solve problems over the telephone, calling private and public service groups to arrange doorstep service.

White, who has worked 14 years in the field of aging, said care managers can get overwhelmed by the day-to-day pressures--dealing with emergencies they are unequipped to handle, searching for services in high demand but with low supply, hiring service groups unprepared to deal with elderly customers and wondering who will pay for it all.

“Case managers are asked on a daily basis to respond to the kind of emergencies you’d normally call police or an ambulance to handle,” White said. “We’re always trying to respond to crisis situations, but we don’t have crisis services available and we can’t get things done fast in our network.

“Sometimes we get phone calls we have to refer to 911,” White said. “And sometimes it’s a call saying a family person is going out of town and they need someone to stay with their mother--tonight.

“There’s no way for us respond to those things because it’s very difficult to find the in-home services people need just as people discover they need them.”

The quality and quantity of such services are relatively poor because low wages don’t attract workers who are well-trained and sensitive to elderly people, White said.

“We’re always running up against walls looking for good service agencies,” she said. “One of the major long-term challenges for care management is going to be whether there’s going to be a sufficient quantity workers to provide in-home services.”

White decries what she says is the attitude among many that elderly relatives should be institutionalized prematurely, imposing a heavy financial burden before it is necessary.

“Usually what happens is we get a call saying, ‘Give me the name of a good nursing home. We’ve had it. We’ve got to put her away,’ ” she said.

“Many people who consider nursing home care for someone in the family could have checked into some options first, but most people don’t know there are alternatives.”