Standards of Practice and Code of Ethics

Introduction

Aging Life Care Professionals™ (also known as geriatric care managers) have varied educational and professional backgrounds with a specialized focus on issues associated with aging and disabilities. Through consultation, assessment, care coordination and advocacy, an Aging Life Care Professional works with clients and families to address these challenges.

The Code of Ethics and Standards of Practice were developed to guide the Aging Life Care Professional in his or her daily professional and business practices. The ethical principles at the core of the Code of Ethics are the foundation for the Standards of Practice.

The Code of Ethics provides

Accountability to our Clients

ALCA members recognize diversity in our society and embrace a multi-cultural approach to support the worth, dignity, potential and uniqueness of each client. The Code of Ethics acknowledges the vulnerable population we serve and makes explicit the highest standards of practice.

Accountability to the Public

The Code of Ethics sets a national standard for the professional practice of Aging Life Care™. It defines for the public the ethical responsibilities expected of ALCA’s members and the organization’s role in maintaining the highest standards of practice and promotion of ethical behavior.

Education of Aging Life Care Professionals

ALCA recognizes the diversity of the experience and education of its members and the needs of members for guidance in both their professional and business roles, and thus the Code of Ethics was developed to guide members in each of these roles. It states the core values and principles to current and future members, to the public, and to allied professionals. All members of ALCA are expected to understand and behave in a manner that is consistent with the provisions of the Code of Ethics.

A Framework for Analyzing & Resolving Ethical Dilemmas

The Code of Ethics offers a framework for ethical decision-making when conflicts arise in either the practice or the business of Aging Life Care. It assists  Aging Life Care Professionals in examining the ethical issues present in all aspects of their work by identifying what principles need to be considered and how to prioritize them when it is necessary to make a choice.  It asks Aging Life Care Professionals to be aware of their own biases as they seek to resolve ethical dilemmas.

Assistance in Reviewing Complaints

In ALCA’s Peer Review Process the Code of Ethics and Standards of Practice serve as the basis for assessing and resolving ethical or business practice complaints against members in their practice of Aging Life Care.

The Code: Ethical Principles and Standards of Practice Supporting These Principles

Integrity

An Aging Life Care Professional is honest, diligent, and accountable in the provision of service. An Aging Life Care Professional always acts in a manner that is consistent with the professional values stated in this Code. See Standards 4, 7, 8, 11, 12, 13, 14, 15, 16, 17.

Loyalty and Responsibility

An Aging Life Care Professional is trustworthy and dependable in all aspects of both professional and business relationships. An Aging Life Care Professional maintains confidentiality, avoids conflicts of interest, and always pursues the best interest of clients. See Standards 2, 3, 4, 5, 6, 7, 11, 12, 14, 15, 16.

Promoting Benefit and Avoiding Harm

An Aging Life Care Professional promotes clients’ interests, values, and welfare in order to maximize benefits and avoid harm. An Aging Life Care Professional is aware of potential conflicts that may arise when balancing the benefits and risks of interventions being considered. An Aging Life Care Professional strives to assure that vulnerable clients’ individual choices are maximized to the greatest extent possible. See Standards 2, 4, 5, 9, 11, 12.

Respect for Clients’ Rights and Dignity

An Aging Life Care Professional treats clients with respect, as complete individuals with their own history, narrative, and unique cultural identity. An Aging Life Care Professional respects the rights of each client, including the right to privacy, and, for the vulnerable client, strives to balance client autonomy with the need for protection and safety. See Standards 1, 2, 3, 4.

Justice

An Aging Life Care Professional behaves in a just and fair way in all professional and business relationships. An Aging Life Care Professional does not promote or sanction any form of discrimination such as discrimination based on race, ethnicity, gender, religion, sexual orientation, national origin, disability, or socioeconomic status. See Standards 4, 5, 8, 10, 15, 16, 17.

Standards of Practice Table of Contents

Regarding the Client Relationship:

  1. Identifying the Client
  2. Promoting Self-Determination
  3. Right to Privacy
  4. Recognition of the Aging Life Care Professional’s Personal Values and Beliefs
  5. Professionalism of the Relationship
  6. Continuity of Service
  7. Termination of Service

Regarding the Professionalism of the Practice:

  1. Definition of Role
  2. Plan of Care
  3. Knowledge of Employment Laws
  4. Undertaking Decision-Making Authority
  5. Working with Clients under Court Jurisdiction
  6. Continuing Education
  7. Certification

Regarding Business Policies:

  1. Fees for Service
  2. Advertising and Marketing
  3. Disclosure of Relationships with Service Providers
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Standard 1 – Identifying the Client

Standard

The primary client is the person whose care needs have initiated the referral to an Aging Life Care Professional.

Rationale

The primary client’s care needs take place within the context of their family system and physical and social environments.

Guidelines

  1. The primary client may not necessarily be the person who makes the initial contact or the person responsible for payment for services rendered.
  2. All others affected by or have an impact on the client’s care needs should be considered part of the “client system” and may include:
    1. the primary client
    2. a family member within or outside of the primary client‘s household
    3. a paid caregiver
    4. friends, neighbors or community agencies
    5. a third party with fiduciary responsibilities
    6. other professionals, such as a physician, a nurse from a home health care agency, an attorney, etc.
    7. the Aging Life Care Professional (See Standard 4)
  3. In the event of conflicting needs within the client system, the goal of professional intervention should be to strive for resolution through a process of review and discussion among the parties, facilitated by the Aging Life Care Professional.

The Aging Life Care Professional should request assistance of peers, as needed, to help the client system find an acceptable solution when conflicts occur.

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Standard 2 - Promoting Self-Determination

Standard

Aging Life Care Professionals should promote self-determination of the primary client as appropriate within the context of their situation.

Rationale

The Aging Life Care Professional has a responsibility to identify and articulate the client’s wishes, values and preferences so that these can be incorporated into the plan of care to the greatest extent possible.

Guidelines

  1. The Aging Life Care Professional should involve the primary client and/or designated decision maker, to the greatest extent possible, in decisions that impact his/her life regardless of the client’s decisional capacity.
  2. As the primary client and/or the designated decision maker is given the opportunity to make decisions, the Aging Life Care Professional should strive to achieve the following conditions:
    1. The specific information needed to make decisions is discussed and understood.
    2. The risks and benefits of all options are presented and understood.
    3. The Aging Life Care Professional encourages the client and/or decision maker to communicate, verbally or non-verbally, his/her wishes
    4. The client and/or designee consents to services, and the Aging Life Care Professional respects the client’s right to discontinue services at any time.
    5. The client’s decisional capacity should be evaluated if there are questions regarding his/her capacity
  3. If the primary client does not comprehend the factors involved in the decision-making process and, therefore, cannot make an informed decision, then the Aging Life Care Professional should see that all decisions concerning the primary client are made by the person(s) with the legal authority to do so.

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Standard 3 - Right to Privacy

Standard

The Aging Life Care Professional should respect the client’s right to privacy and, when applicable, that of the client system. The limits of confidentiality should be clearly explained to the client or designated decision-maker.

Rationale

The Aging Life Care Professional frequently needs to share information with others in order to fulfill his/her responsibilities. The Aging Life Care Professional utilizes knowledge of the client’s physical and mental status, financial and legal affairs, and family and community supports to achieve maximum well-being for the client. Due diligence must be exercised at all times to protect the privacy of this information.

Guidelines

  1. The Aging Life Care Professional should consider all information in the client's records confidential. This pertains to active and inactive clients as well as closed cases.
  2. The Aging Life Care Professional has a responsibility to be knowledgeable of, and abide by, all applicable state and federal laws and regulations regarding confidentiality and the client’s right to privacy.
  3. The Aging Life Care Professional should take precautions to maintain the confidentiality of information transmitted to other parties through the use of computers, electronic mail, facsimile machines, telephones and telephone answering machines, and other electronic or computer technology. Disclosure of identifying information should be avoided whenever possible.
  4. The Aging Life Care Professional should maintain a valid authorization to release information.
  5. The Aging Life Care Professional should act judiciously when sharing client information with others.
  6. The Aging Life Care Professional should not disclose identifying information when discussing clients for teaching or training or consultation purposes unless the client has consented to disclosure of confidential information.
  7. The Aging Life Care Professional should strive to conduct all communications in a manner that allows for the maximum amount of privacy.
  8. The obligation of confidentiality may be waived in circumstances when the Aging Life Care Professional believes it is necessary to protect the client from harming him/herself or others.
  9. The Aging Life Care Professional has a responsibility to abide by the laws of their state relating to vulnerable adults including the reporting of abuse, neglect and exploitation as required in that state.
  10. The Aging Life Care Professional should take reasonable precautions to protect client confidentiality in the event of the Aging Life Care Professional’s termination of practice, incapacity, or death.
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Standard 4 – Recognition of the Aging Life Care Professional’s Personal Values and Beliefs

Standard:

The Aging Life Care Professional should have a conscious awareness of their personal values and beliefs and the impact of these on their practice with clients.

Rationale

Personal awareness is necessary to provide objective professional services.

Guidelines

  1. The Aging Life Care Professional should be cognizant of their personal and professional value system and beliefs through a continuous process of self-reflection and/or case consultation.
  2. If there is a circumstance in which the client’s wishes and preferences are in conflict with the professional judgment and values of the Aging Life Care Professional, there is an obligation to identify and address the disparity. The Aging Life Care Professional should make every effort to arrive at a mutually acceptable solution. If those disparities cannot be reconciled, the Aging Life Care Professional has an obligation to offer alternative services to the client.
  3. The Aging Life Care Professional may refuse to accept a new case or continue in a case if the Aging Life Care Professional believes that remaining in the situation would require compromising his/her own values or beliefs. The Aging Life Care Professional can terminate his/her involvement consistent with Standard 7.
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Standard 5 - Professionalism of the Relationship

Standard

The Aging Life Care Professional should not exploit professional relationships with the client and/or members of the client system and should maintain appropriate boundaries.

Rationale

The Aging Life Care Professional should be aware of and resist those influences and pressures that may interfere with the exercise of professional discretion and impartial judgment.

Guidelines

Aging Life Care Professionals:

  1. are sensitive to the power of the professional relationship.
  2. should refrain from entering into a dual relationship if the relationship could reasonably be expected to impair the Aging Life Care Professional’s competence or effectiveness or may put the client at risk of exploitation or harm.
  3. should avoid the giving or receiving of any gifts that may impair their impartial judgement or might lead to exploitation.
  4. should never engage in sexual contact with the client and/or members of the client system.
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Standard 6 -Continuity of Service

Standard

The Aging Life Care Professional should develop plans to provide for continuity in the event of an interruption of services.

Rationale

Clients and families rely on the availability of the Aging Life Care Professional and his/her services. Contingency plans should be in place to address circumstances that may arise which interrupt the delivery of these services.

Guidelines

  1. The Aging Life Care Professional should reasonably prepare for practice coverage in the event of an absence which may be temporary or permanent.
    1. Temporary absences may include vacation, personal medical situations, or family emergencies
    2. Permanent absences may include a change in employment status, disability, or death
  2. Each practice, no matter the size, should have a plan to address potential service disruptions (such as technology failure, power outages, and natural disasters).
  3. Aging Life Care Professionals who anticipate the interruption of services should notify clients promptly and make arrangements for continuation of services in consultation with the client and client system.
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Standard 7 -Termination of Service

Standard

Termination of the Aging Life Care relationship should be handled in a professional and ethical manner with consideration given to the unique circumstances and situation of the client/client system.

Rationale

Relationships between the Aging Life Care Professional and clients are terminated for a variety of reasons. The termination process may pose emotional or practical challenges for the client, the client system, and/or the Aging Life Care Professional.

Guidelines

  1. When there is a termination for any reason, the needs of the client are central to the process.
  2. Aging Life Care Professionals should be sensitive to the impact of the termination and take reasonable steps to facilitate client access to needed support and services.
  3. Termination ideally should occur with the agreement of the client or decision maker. There are circumstances, however, when service may ethically be terminated without the agreement of the client or decision maker. Examples may include, but are not limited to:
    1. The client requires expertise different from that of the Aging Life Care Professional.
    2. The Aging Life Care Professional becomes ill or incapacitated, retires, or changes jobs.
    3. The client violates a contractual agreement.
    4. The client files a lawsuit and/or an official complaint against the Aging Life Care Professional or the Aging Life Care practice.
  4. When an Aging Life Care Professional closes, sells his/her practice, or moves out of the area, the client should be notified in writing of available Aging Life Care services.
  5. In complex situations, Aging Life Care Professional are encouraged to seek appropriate consultation and guidance regarding legal and/or clinical issues.
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Standard 8 - Definition of Role

Standard

The Aging Life Care Professional should clearly define his/her role and scope of practice to clients and others involved with the client system.

Rationale

Aging Life Care Professionals are professionals with diverse educational backgrounds and skill sets. Therefore each Aging Life Care Professional should define his/her scope of practice and the particular roles s/he will accept in assisting clients and those involved in the client’s care.

Guidelines
  1. The Aging Life Care Professional should provide a clear, comprehensive explanation of his/her role and responsibilities to clients and the client system.
  2. The Aging Life Care Professional should accept only those roles and responsibilities for which s/he has the skills, knowledge and training. S/he should recommend consultations with other experts as needed.
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Standard 9 - Plan of Care

Standard

The Aging Life Care Professional should strive to provide quality care using a personalized care plan developed in consultation with the client and/or client system.

Rationale

The care plan guides the work of the Aging Life Care Professional by addressing the immediate and long-term needs, wishes and preferences of the client and the client system, and clarifies the expectations of the Aging Life Care Professional role.

Guidelines

The care plan should:

  1. be a result of collaboration between the Aging Life Care Professional, the client, and the client system.
  2. be based on an assessment.
  3. be flexible in order to address the client’s changing status.
  4. address the need for the development of a contingency plan for circumstances such as
    1. Natural Disasters
    2. Illness or change in condition of client
    3. Change in client support system
  5. be reviewed by the client and/or responsible party and included in the client file.
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Standard 10 - Knowledge of Employment Laws

Standard

The Aging Life Care Professional should be familiar with laws relating to employment practices and should not knowingly participate in practices that are inconsistent with these laws.

Rationale

As Aging Life Care Professionals, we should strive to prevent abuse of clients who may be vulnerable to exploitation.

Guidelines

  1. The Aging Life Care Professional should be familiar with the State and Federal agencies that regulate employment practices.
  2. The Aging Life Care Professional should recommend or employ only persons who are legally permitted to work.
  3. The Aging Life Care Professional should encourage payment of payroll taxes, or wages that meet minimum wage requirements.
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Standard 11 - Undertaking Decision-Making Authority

Standard

The Aging Life Care Professional who accepts decision-making authority with respect to healthcare decisions and/or financial management on behalf of a client should act only within his/her knowledge and capabilities and avoid any activities that might suggest a conflict of interest.

Rationale

In accepting the role of decision maker for the client, the Aging Life Care Professional has the responsibility to represent the client’s wishes to the greatest extent possible and guard against making decisions based on his/her own values (see Standard 2).

Guidelines

  1. The Aging Life Care Professional should know and comply with relevant State and Federal laws and statutes.
  2. Prior to accepting the role of proxy or surrogate, the Aging Life Care Professional should ascertain and document the client’s wishes and values.
  3. The Aging Life Care Professional should have legal documentation of the authority granted.
  4. The Aging Life Care Professional should establish safeguards to avoid impropriety or any possible appearance thereof.
  5. The Aging Life Care Professional should avoid, where possible, self-payment. If the Aging Life Care Professional has no alternative than to assist the client to pay for Aging Life Care services, it is recommended that a third party provide oversight for these transactions.
  6. Documentation of all actions should be maintained and made available to authorized parties.
  7. Examples of authority include but are not limited to:
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Standard 12 – Working with Clients under Court Jurisdiction

StandardStandard 12 – Working with Clients under Court Jurisdiction

When working with Guardians, Conservators and/or in a court appointed capacity, the Aging Life Care Professional is obligated to operate within the court system while adhering to ALCA’s Standards and Ethics.

Rationale

Providing services to clients under court jurisdiction adds a layer of complexity since each of the stakeholders have their own professional or personal perspectives. The client and/or family may also feel a loss of control as the court is the final decision-making authority.

Guidelines

  1. The client is the person whom the court has determined to be in need of protection.
  2. The client system may include but is not limited to:
    1. Judge and/or Court Representative,
    2. Guardians or Conservators,
    3. Attorneys and/or guardian ad litem,
    4. Family or informal support system,
    5. Healthcare Providers,
    6. Adult Protective Services
  3. The Aging Life Care Professional should strive to understand and articulate his/her roles and responsibilities, and clarify expectations within the context of the legal and client systems while continuing to follow our Standards of Practice and Code of Ethics.
  4. The Aging Life Care Professional should communicate frequently and clearly with the legal decision maker(s) and strive to advocate for the vulnerable person.
  5. The Aging Life Care Professional should collaborate with the legal decision maker(s) to identify and address potential challenges to service which may include but are not limited to:
    1. Complex or conflictual dynamics in the client system
    2. Availability, access and/or control of financial resources
    3. Ongoing legal disputes
    4. Lack of appropriate and available care options
  6. In consultation with the legal decision maker(s), the Aging Life Care Professional should reach out to families if/when appropriate.
  7. When the Aging Life Care Professional is the guardian, s/he should clearly differentiate between the guardian role and the Aging Life Care role. It is important to avoid even the appearance of conflict of interest or a dual relationship (see Standard 5).
  8. If the situation becomes untenable the Aging Life Care Professional should notify the legal decision maker of intent to terminate.
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Standard 13 - Continuing Education

Standard

The Aging Life Care Professional should participate in continuing education programs.

Rationale

Participation in relevant continuing education programs will enable Aging Life Care Professionals to remain current in best practices and maintain a base of professional knowledge and skills in order to practice in a proficient and ethical manner.

Guidelines

  1. Continuing education is a self-directed process, which requires Aging Life Care Professionals to assume responsibility for their own professional development.
  2. Continuing education can include:
    1. Attendance at conferences, workshops, and seminars;
    2. Participation in webinars and self-study programs; and
    3. Reading of professional literature.
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Standard 14 - Certification

Standard

Members in the Advanced category are required to meet the membership criteria and to hold one of the ALCA-approved certifications.

Rationale

Due to the varied backgrounds of members, certification is an independent method of verifying a basic level of professional practice. Certification provides the public with an objective criterion to evaluate Aging Life Care Professionals before they engage their services.

Guidelines

  1. The Aging Life Care Professional should be certified according to those certifications endorsed by ALCA.
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Standard 15 - Fees for Service

Standard

All fees for Aging Life Care services are to be stated in written form and discussed with the person accepting responsibility for payment.

Rationale

Billing is an integral part of the professional practice of Aging Life Care. When billing issues arise, they may be an expression of the client’s feeling that expectations were not met. To help manage expectations and prevent any misunderstandings regarding fees and services, billing practices should be provided and agreed to in writing.

Guidelines

  1. Prior to the initial meeting, the Aging Life Care Professional should clearly explain, verbally and in writing, the terms and conditions of Aging Life Care services to the responsible party. This should include the cost of services and billing practices. If time does not allow for this, then all information should be verbally presented and followed up in writing.
  2. The Aging Life Care Professional should have a signed agreement for all services, even if it is for consultation only. The signed agreement should specify the scope of services to be provided. The signed agreement also should address and clearly communicate terms with respect to:
    1. Fee structure and rates
      1. E.g., hourly, monthly package, etc.
      2. Out of pocket expenses and purchases made on behalf of clients
      3. Charges for written and verbal communication
      4. Travel time and/or mileage expenses
      5. Fees for consultations, assessments and/or follow-up services
  3. Payment terms
    1. Retainers/Deposits
    2. Frequency of invoicing
    3. Late fee policy
  4. Invoices should be sent in a timely manner consistent with the terms of the service agreement and should be clearly itemized.
  5. Service agreements should be reviewed and updated periodically or as client circumstances change. These may include changes in fees/rates; responsible parties; or capacity of the payer or responsible party.
  6. A client with an established relationship with an Aging Life Care Professional, but who can no longer pay for services, should not be abandoned. If it appears that Aging Life Care services are not affordable, the Aging Life Care Professional should offer referrals to resources consistent with the client situation so that the client's needs continue to be met.
  7. The Aging Life Care Professional should not participate in practices of fee splitting, accepting or giving referral fees or other similar arrangements with any other party providing services to the client. These practices may compromise the objectivity of the Aging Life Care Professional and/or create the appearance of impropriety.
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Standard 16 - Advertising and Marketing

Standard

Advertising and marketing of services should be conducted with honesty, accuracy, and integrity.

Rationale

The Aging Life Care Professional has a responsibility to clearly communicate the nature of Aging Life Care and his or her areas of expertise in order to establish realistic expectations.

Guidelines

  1. Advertising and marketing is any printed, verbal, or electronic communication to the public.
  2. Statements in advertising and marketing material regarding Aging Life Care Professional’s qualifications, expertise, or agency business practices should be truthful and not misleading.
  3. Any representation of backgrounds, affiliations, or credentials made by the Aging Life Care Professional should be accurate and current.
  4. Only the individual who is the member of ALCA may advertise that membership.
  5. Use of the ALCA logo shall be in accordance with current policy.
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Standard 17 - Disclosure of Relationships with Service Providers

Standard

The Aging Life Care Professional should provide full disclosure regarding business, professional or personal relationships when making referrals or recommendations.

Rationale

Clients rely on Aging Life Care Professionals to provide them with reliable and objective information about resources. The Aging Life Care Professional should act with transparency and maintain a position of objectivity when making any recommendations for services to avoid the possibility of a conflict of interest.

Guidelines

  1. Referrals made by an Aging Life Care Professional, whether to outside providers or internally within an Aging Life Care practice, must be based only on the best interests of the client.
  2. When the Aging Life Care Professional has a relationship with a recommended entity, s/he should provide the client with specific information regarding the nature of the relationship and offer alternative choices.
  3. Relationships to be disclosed might include but are not limited to:
    1. Business involvement as owner, investor, or Board Member,
    2. Personal relationships such as a relative or friend,
    3. Professional colleague or employee,
    4. Any business or financial relationship with a recommended resource.
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