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.
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.
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.
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.
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.
Standards of Practice Table of Contents
Regarding the Client Relationship:
Identifying the Client
Promoting Self-Determination
Client Confidentiality
Communication Technology and Practice
Use of Social Media
Recognition of the Aging Life Care Professional’s Personal Values and Beliefs
Maintaining Professional Boundaries
Continuity of Service
Termination of Service
Regarding the Professionalism of the Practice:
Explanation of Role
Plan of Care
Client Records
Educating Clients Regarding Engaging Caregiving Services
Undertaking Decision-Making Authority
Working with Clients under Court Jurisdiction
Continuing Education
Consultation
Certification
Regarding Business Policies:
Fees for Service
Advertising and Marketing
Disclosure of Relationships with Service Providers
Emergency Preparedness for the Aging Life Care Practice
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Standard 1 – Identifying the Client
Standard
The Aging Life Care Professional should identify who is the client and who are the members of the client system.
Rationale
Clients are part of complex systems and their needs must be considered in the context of their relationships.
Guidelines
The client is the person whose care needs have initiated the referral and should remain the focus of services.
The client may not necessarily be the person who makes the initial contact or the person responsible for payment for services.
All others affected by or who impact, the client’s care needs should be considered part of the “client system” and may include:
family members within and outside of the client’s household,
formal and informal caregivers,
friends, neighbors, faith communities, and local agencies,
third parties with fiduciary responsibilities, for example guardians, conservators, trustees, powers of attorney, and health care surrogates,
other professionals, such as health care providers, attorneys, and,
Aging Life Care Professionals
In the event of conflicting or multiple needs within the client system (for example, two clients), it may not be possible for the Aging Life Care Professional to serve each client. The ALCP may consider consulting with or bringing in a second ALCP.
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Standard 2 – Promoting Self-Determination
Standard
Aging Life Care Professionals should promote client self-determination as appropriate within the context of their situation.
Rationale
The Aging Life Care Professional has a responsibility to identify and articulate client wishes, values and preferences so that these can be incorporated into the plan of care.
Guidelines
To the greatest extent possible, the Aging Life Care Professional should involve the client in decisions that impact their life.
The Aging Life Care Professional encourages the client to express their wishes, verbally or non-verbally.
The client’s decisional capacity should be evaluated if it is in question.
If the client cannot make an informed decision, the Aging Life Care Professional should see that decisions are made by the person(s) with the legal authority to do so.
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Standard 3 – Client Confidentiality
Standard
The Aging Life Care Professional should maintain client confidentiality.
Rationale
The Aging Life Care Professional frequently needs to share information with others. 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 confidentiality of this information.
Guidelines
The Aging Life Care Professional should consider all information in client records confidential. This pertains to active and inactive clients as well as closed cases.
The Aging Life Care Professional should maintain a valid and current authorization to exchange information.
The Aging Life Care Professional should use discretion when sharing client information with others.
The Aging Life Care Professional should not disclose identifying information when discussing clients for teaching, training or consultation purposes.
The Aging Life Care Professional should explain to the client or designated decision maker that confidentiality may be waived if the Aging Life Care Professional believes it is necessary to protect the client from harming self or others.
The Aging Life Care Professional has a responsibility to be familiar with, and abide by, all applicable state and federal laws and regulations regarding confidentiality and the client’s right to privacy.
The Aging Life Care Professional has a responsibility to abide by laws and regulations regarding the reporting of abuse, neglect and/or exploitation of vulnerable persons.
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Standard 4 – Communication Technology and Practice
Standard:
The Aging Life Care Professional should take precautions to mitigate the inherent risk of using electronic communications.
Rationale
Technology has enhanced the ability of the Aging Life Care Professional to communicate with clients and client systems. The use of communication technologies presents challenges for the client and the Aging Life Care Professional.
Guidelines
The Aging Life Care Professional needs to be sensitive to privacy concerns when interacting with clients/client systems on electronic and digital communication platforms.
The Aging Life Care Professional should take steps to maintain privacy by being mindful of the environment in which the communication takes place.
The Aging Life Care Professional and client/client system should discuss the pros and cons of various communication options in order to determine the preferred method for their particular situation.
The Aging Life Care Professional should exercise caution when sending electronic information (e.g., having the correct e-mail address) and recognize the possibility of information inadvertently being misdirected.
The Aging Life Care Professional should practice in a manner consistent with state regulations and agency policies regarding electronic communications.
Standard 5 – Use of Social Media
Standard
The Aging Life Care Professional should understand the benefits and risks of participating on social media platforms.
Rationale
Social media offers opportunities for professional networking, profile enhancement, and sharing expertise. However, the use of social media carries the risks of conflict of interest, inappropriate self-disclosure, and the violation of privacy, confidentiality, and professional boundaries.
Guidelines
The Aging Life Care Professional should differentiate between one’s personal and professional presence on social media.
The Aging Life Care Professional should be mindful of how one’s online presence reflects on one’s professional image.
The Aging Life Care Professional should bear in mind that any exchange of information may extend beyond the intended circle of contacts.
The Aging Life Care Professional should be aware of state laws and regulations regarding social media.
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Standard 6 – Recognition of the Aging Life Care Professional’s Personal Values and Beliefs
Standard
The Aging Life Care Professional should have a conscious awareness of personal values and beliefs and how these impact their practice.
Rationale
Personal awareness is necessary to provide objective professional services.
Guidelines
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.
If the client’s wishes and preferences conflict with the professional judgment and values of the Aging Life Care Professional, this should be acknowledged, and a solution sought.
The Aging Life Care Professional may decline to accept a new case or continue in a case if they believe the situation requires compromising their values or beliefs. The Aging Life Care Professional can end the professional relationship consistent with the Standard on Termination of Service.
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Standard 7 – Maintaining Professional Boundaries
Standard
The Aging Life Care Professional should maintain appropriate boundaries in relationships with clients and/or members of client systems.
Rationale
The Aging Life Care Professional should be aware of the power of the relationship when working with vulnerable populations who are at risk of exploitation.
Guidelines
The Aging Life Care Professional should:
Avoid actions that take or appear to take advantage of clients/client systems for personal and/or financial gain.
Consider the risks of entering into a dual relationship in which the Aging Life Care Professional’s effectiveness or objectivity might be compromised. A dual relationship exists when providers establish multiple roles with clients or client systems, whether professional, personal, or business.
Be mindful of how the giving or receiving of gifts may affect the professional relationship and be sensitive to cultural dynamics related to gifting.
Never engage in sexual behaviors with the client and/or members of the client system.
Consider seeking consultation or supervision when needed.
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Standard 8 – Continuity of Service
Standard
The Aging Life Care Professional should prepare for practice coverage in the event of an absence which may be temporary or permanent.
Rationale
Clients and families rely on the availability of the Aging Life Care Professional.
Guidelines
Plans should be in place to address circumstances that may interrupt the delivery of ALCP services such as:
Anticipated absences including vacation, scheduled leave, or change in employment status.
Unanticipated absences including personal medical situations, family emergencies, disability, or death.
In the event of any interruption, the Aging Life Care Professional or a designated personshould communicate the plan for continuity of services to the client/client system.
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Standard 9 -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
When there is a termination for any reason, the needs of the client are central to the process.The Aging Life Care Professional should be sensitive to the impact of the termination and take reasonable steps to facilitate client access to needed support and services
The client should be notified in writing of alternative services when an Aging Life Care Professional
Closes or sells their practice.
Retires or changes jobs.
Moves out of the area.
Recognizes the client requires different expertise.
Termination ideally should occur with the agreement of the client or decision maker. There are circumstances, however, when service may ethically be terminated without that agreement. Examples may include, but are not limited to:
The Aging Life Care Professional becomes ill or incapacitated.
The client violates a contractual agreement.
The client files a lawsuit and/or an official complaint against the Aging Life Care Professional or the Aging Life Care practice.
The Aging Life Care Professional has a reasonable concern their safety may be at risk.
The client and/or client system is verbally abusive or making unreasonable demands.
In complex situations, the Aging Life Care Professional is encouraged to seek appropriate consultation and guidance regarding legal and/or clinical issues.
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Standard 10 – Explanation of Role
Standard
The Aging Life Care Professional should provide a clear, comprehensive explanation of their role, responsibilities, and scope of practice to clients and the client system.
Rationale
The client and client system should have realistic expectations of the services being provided in order to establish a productive working relationship.
Guidelines
The Aging Life Care Professional Should:
Offer only services for which one has the skills, knowledge and training.
Determine the scope of service that will be provided.
Provide clear ongoing communication about the roles, responsibilities, and scope of practice with the client and client system.
Carefully consider requests for services to be provided to the client that are outside of the customary scope of practice, e.g social outings, meal preparation, etc. The Aging Life Care Professional should be able to document how these requests are part of the care plan and benefit the client.
Refer clients to other professionals as needed.
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Standard 11 – Plan of Care
Standard
The Aging Life Care Professional strives 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 actions and defines the role of the Aging Life Care Professional.
Guidelines
The care plan should:
be a result of collaboration between the Aging Life Care Professional and the client and/or client system.
be based on an individualized assessment conducted by the Aging Life Care Professional.
address the needs, values, and preferences of the client and/or the client system.
be consistent with the client’s circumstances.
be responsive to changing needs and circumstances and revised when indicated.
address the client’s potential needs during natural disasters and/or other emergencies.
be reviewed with the client and/or responsible party and documented in the client record.
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Standard 12 – Client Records
Standard
The Aging Life Care Professional should maintain client records.
Rationale
The purpose of the client record is to document services provided to the client and/or client system and to facilitate the ongoing delivery of such services.
Guidelines
The Aging Life Care Professional should accurately document interactions and interventions on behalf of the client.
Client records should be stored responsibly, with consideration to security, data back up, and disaster recovery.
Following the termination of services, the Aging Life Care Professional should retain records to allow for future access. Record retention periods may be dictated by statutes and/or licensing requirements. Where there is no specific statute, common practice is to retain records for at least seven years post termination.
The Aging Life Care Professional may consider consulting with legal counsel if they have questions regarding the release of records. .
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Standard 13 – Educating Clients Regarding Engaging Caregiving Services
Standard
The Aging Life Care Professional should assist clients to make informed decisions about paid caregiver services.
Rationale
The Aging Life Care Professional serve clients by informing them of the range of available caregiver services and the implications of each option.
Guidelines
The Aging Life Care Professional should be aware of various paid caregiver options within the client’s community.
The Aging Life Care Professional should be aware that there are laws regarding employment practices.
When the Aging Life Care Professional is aware that the client has or is considering hiring an independent caregiver, the Aging Life Care Professional should encourage the client and/or client system to consult with a qualified professional (e.g. an attorney, accountant, and/or insurance agent specializing in employment matters).
The Aging Life Care Professional should understand their roles and responsibilities with respect to the relationship with paid caregivers (including agency-based and independent providers) and communicate the same to clients and client systems.
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Standard 14 – Undertaking Decision-Making Authority
Standard
The Aging Life Care Professional should exercise extreme caution when accepting decision-making authority on behalf of a client. Decision-making authority may include, but is not limited to, healthcare decisions and financial management.
Rationale
When the Aging Life Care Professional becomes a legally appointed decision-maker, their role changes from one of an advisor to that of a responsible party. Continuing in both roles represents an inherent conflict of interest.
Guidelines
An Aging Life Care Professional who is the decision-maker should clearly differentiate between the decision-making role and the care management role.
The Aging Life Care Professional should establish safeguards to manage the conflict of interest in this dual relationship (see Standard “Maintaining Professional Boundaries”).
The Aging Life Care Professional should have written documentation of the legal authority granted.
The Aging Life Care Professional who becomes a decision-maker should review the National Guardianship Association Standards of Practice (see www.guardianship.org/documents/Standards_of_Practice.pdf)
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 (see Standard “Promoting Self Determination”).
The Aging Life Care Professional should avoid, where possible, self-payment. If there is no alternative other than to assist the client to pay for services services provided by the Aging Life Care Professional and/or their company, it is recommended that a third party provide oversight for these transactions.
Examples of authority include but are not limited to:
Guardianship / Conservatorship
Health Care Surrogacy / Health Care Proxy / Health Care Power of Attorney
Financial Power of Attorney
Representative Payee, and
Other similar authority
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Standard 15 – Working with Clients under Court Jurisdiction
Standard
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
The client is the person whom the court has determined to be in need of protection.
The client system may include but is not limited to:
Judge and/or Court Representative,
Guardians or Conservators,
Attorneys and/or guardians ad litem,
Family or informal support system,
Healthcare Providers,
Adult Protective Services
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 the Aging Life Care Association’s Standards of Practice and Code of Ethics.
The Aging Life Care Professional should communicate frequently and clearly with the legal decision maker(s) and strive to advocate for the vulnerable person.
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:
Complex or conflictual dynamics in the client system
Availability, access and/or control of financial resources
Ongoing legal disputes
Lack of appropriate and available care options
In consultation with the legal decision maker(s), the Aging Life Care Professional should reach out to families if/when appropriate.
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 16 – 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
Continuing education is a self-directed process, which requires Aging Life Care Professionals to assume responsibility for their own professional development.
Continuing education can include:
Attendance at conferences, workshops, and seminars;
Participation in webinars and self-study programs; and
Reading of professional literature.
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Standard 17 – Consultation
Standard
The Aging Life Care Professional should utilize consultation on an ongoing basis.
Rationale
Consultation enhances professional practice.
Guidelines
Consultation benefits the Aging Life Care Professional by providing guidance and support in dealing with challenges such as:
working with complex situations;
managing client/client system crises;
identifying and resolving ethical dilemmas;
developing cultural competence.
Consultation may be provided by ALCA colleagues or other professionals.
Consultation can take a variety of forms including:
In person meetings;
Telephonic and/or video conferencing;
Peer Case Review/Peer Case Conferences.
Listserv discussion does not constitute consultation.
Consultation is not supervision. Formal supervision may be needed for licensure or certification.
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Standard 18 – 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
The Aging Life Care Professional should be certified according to those certifications endorsed by ALCA.
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Standard 19 – 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
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.
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:
Fee structure and rates
E.g., hourly, monthly package, etc.
Out of pocket expenses and purchases made on behalf of clients
Charges for written and verbal communication
Travel time and/or mileage expenses
Fees for consultations, assessments and/or follow-up services
Payment terms
Retainers/Deposits
Frequency of invoicing
Late fee policy
Invoices should be sent in a timely manner consistent with the terms of the service agreement and should be clearly itemized.
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.
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.
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 20 – 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
Advertising and marketing is any printed, verbal, or electronic communication to the public.
Statements in advertising and marketing material regarding the Aging Life Care Professional’s qualifications, expertise, or agency business practices should be truthful and not misleading.
Any representation of backgrounds, affiliations, or credentials made by the Aging Life Care Professional should be accurate and current.
Only the individual who is the member of ALCA may advertise that membership.
Use of the ALCA logo shall be in accordance with current policy.
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Standard 21 – 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 objectivity when making any recommendations for services in order to avoid an actual, or perceived conflict of interest.
Guidelines
Referrals made by an Aging Life Care Professional must be based solely on the best interests of the client. This includes both referrals made to outside providers and those made internally within an Aging Life Care practice.
When the Aging Life Care Professional has a relationship with a recommended entity, they should provide the client with specific information regarding the nature of the relationship and offer alternative choices. Relationships to be disclosed might include, but are not limited to:
Business involvement such as owner, investor, or Board Member,
Personal relationships such as a relative or friend,
Professional colleague or employee,
Any business or financial relationship with a recommended resource.
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Standard 22 – Emergency Preparedness for the Aging Life Care Practice
Standard
Each Aging Life Care practice, no matter the size, should have a plan in place to address potential business disruptions.
Rationale
Circumstances beyond the control of the ALCP may arise which impact the functioning of the business.
Guidelines
Aging Life Care Professionals should plan for business interruptions due to a variety of reasons including, but not limited, to:
technology failure,
power outages,
natural disasters,
specific threats unique to location.
In developing the plan Aging Life Care Professionals should consider:
backup of data,
access to key client and business information,
multiple communication modalities to notify clients and client systems of business status such as email, texting, social media, websites, and local media outlets,
maintaining current contact information for all staff.
The ALCP should have knowledge of local emergency management resources.
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