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Creating a Geriatric Care Management Elective in Post-Graduate Education

Care Management is a set of activities that improve patient care by reducing the need for medical services, addressing risks, and improving self-management by patients (Berry-Millett & Bodenheimer, 2009; Tomoaia-Cotisel et al., 2018). While care management is an effective strategy to achieve tangible clinical outcomes (such as improved blood glucose management) (Dorr et al., 2005), there is immense variability in the definition and application of care management practice (Donelan et al., 2018, 2019; Tomoaia-Cotisel et al., 2018). This variability is evident at the program level, with differing objectives and payment models, as well as in care management education, which encompasses varying didactic and practical components and exposure (Grinberg et al., 2016). The philosophical foundation of care management, which focuses on reducing utilization and improving care continuity, is particularly suitable for older adults (those aged 65 and above). In the United States, older adults are the highest users of healthcare (Institute of Medicine Committee on the Future Health Care Workforce for Older Americans, 2008; Moroch, 2020), and they consistently report dissatisfaction with uncoordinated care (Meeting the Growing Demand for Age-Friendly Care: Health Care at the Crossroads, 2024). Older adults who are frail and have multiple chronic conditions account for just 4% of Medicare patients but 43.9% of total potentially preventable spending (Figueroa et al., 2017). Reducing preventable medical expenditures improves individual satisfaction and quality of care. It could have a significant economic benefit, as more of the population ages into Medicare eligibility, with a projected growth of 13% between 2020 and 2024 (U.S. Census Bureau, 2025)

The increasing number of older adults has resulted in a rapidly growing need for geriatrics-prepared healthcare professionals who are prepared to identify and address common geriatric syndromes, as well as take a strengths-based, holistic perspective on aging, supporting healthy aging, resource navigation, caregiving, and long-term care. Despite the need, exposure to geriatrics is not routine in health professional education. For example, only 45% of medical schools require rotations in geriatrics (American Medical Association, 2024). In 2022, the Accreditation Council for Graduate Medical Education (Rentsch et al., 2022) reduced the requirements for geriatrics education. Integrating geriatrics education into training programs creates a better-prepared workforce and helps increase the number of students who choose a career in geriatrics. Previous research has demonstrated that exposing older adults to clinical and pre-clinical training has a positive impact on their interest in geriatrics (Meiboom et al., 2015; Nuss et al., 2020).

Care Managers specializing in older adults are frequently referred to as “Geriatric Care Managers” (GCM’s) or “Life Care Managers” (LCM). Like other care managers, GCMs focus on improving healthcare outcomes; however, GCMs supporting older adults and their families have specialty knowledge of the relevant health and social care continuums, such as long-term supports and services, and age-based resources (Cress, 2001; National Institute on Aging, 2023; Wideman, 2012). Care management provided to older adults has shown positive social and medical impact, including reduced depression (Rowe et al., 2019) and sustained independence. Although care management can provide significant benefits to recipients, there is limited literature on geriatric care management education.

According to a 2020 survey of more than 2,800 care managers (also called case managers in the protocol) “on the job” training was the predominant method of education for their practice (Campagna & Treiger, 2022; Pearson et al., 2025; Tahan et al., 2020). Care management is a practical discipline, and protocols and objectives vary across programs; therefore, “on-the-job” training is realistic and necessary. However, there are limitations to competencies and opportunities that can be provided in an “on-the-job” environment. First, it is only accessible to those already in the workforce. Second, the protocols and skills associated with one job site may not be transferable or applicable to another. This creates barriers to growing a discipline or evaluating outcomes because it is difficult to assess the workforce.

Teaching care management as a component of health profession student education addresses the limitations of an “on-the-job” training environment by expanding the number of individuals who have been exposed to key concepts and can create an environment for broader discussion around program learning outcomes and required competencies in care management for accreditation. Aligning care management education and standards to other professional competencies is also beneficial because, while care management is sometimes provided by one person (i.e., a care manager), components of care management duties may be spread out among multiple members of an interprofessional team (AHRQ, 2015).

Academic gerontology programs are well-positioned to support the identification and training of future GCMs, as well as to improve the overall geriatric competency of the workforce by providing students in aligned career tracks with exposure to gerontological concepts during clinical training (Manoogian & Cannon, 2019). In a 2016 study by Costly (Costley, 2016), undergraduate students were exposed to the GCM career and, through learning modules, practiced a mix of GCM skills using didactic training and simulation. These modules increased both interest in GCM as a career and confidence in GCM skills. Physical therapy students who attended a 60-minute lecture on gerontology and ageism reported reduced aging anxiety and greater preparation to work with older adults. (Williams & Gendron, 2025). Offering GCM education to health professional students may increase the number of students interested in focusing on geriatrics after graduation and decrease the anxiety of all students about working with older adults. Offering innovative and flexible opportunities to students are crucial for increasing exposure to geriatrics electives. Previous courses have integrated methods like simulation-based learning or flexible hours (Costley, 2016; Khan et al., 2023; Marsh, 2021; Michel et al., 2023; Solberg et al., 2019; Solomon, 2024) .

Developing an Online Geriatric Care Management Elective

Faculty at an academic gerontology department built a 3-credit, semester-length course titled “Geriatric Care Management” to expand geriatrics exposure for health professions students and to identify and train gerontology students interested in becoming a Certified Geriatric Care Managers™ (CGCM®) a credential offered by the International Commission for Health Care Certification™ (ICHCC®) (Certified Geriatric Care ManagersTM (CGCM®), n.d.). The course was developed using a backwards design approach. Backward Design differs from traditional curriculum design in that it generates activities and topics for student learning based on the intended outcome (see Figure 1) (Where to Start: Backward Design, n.d.; Wiggins & McTighe, 2005). The primary goal of the elective is to expose students to the knowledge requirements of GCM and prepare them for eventual certification. A secondary aim was to expose students outside the gerontology program, or those not interested in GCM as a career, to fundamental concepts of gerontology, geriatrics, and care management. ICHCC® CGCM® Faculty developed the course in partnership with two instructional designers.

In addition to meeting the training requirements of the ICHCC® CGCM®, the course learning objectives and content were aligned with the Academy of Gerontology in Higher Education (AGHE) competencies (Academy for Gerontology in Higher Education, 2020), which are the competencies used by the Accreditation for Gerontology Education Council (AGEC, 2022). Aligning the content with accredited competencies increases the value proposition for students and future employers (Van Dussen et al., 2012). The primary goal of the elective is to expose students to the knowledge requirements of GCM and prepare them for eventual certification (see Table 1).

Table 1.Content Map
AGHE Competencies ICHCC Training Requirement(s) Module Topics and Learning Objectives
Introduction to Care Management
  • Attitudes and Perspectives
  • Well-Being and Mental Health
  • Ethics and Professional Standards
  • Social Health
  • Communication with and on Behalf of Older Persons
  • Ethical, Legal, and Financial Issues in Older Adult Care Management
  • Geriatric Care Management and Case Management Methodology and Concepts.
  • Client/Patient Assessment
 Reflect on how care management standards will apply to future or current practice.
Discuss the difference between strengths and deficit-based approaches to care management
Define moral injury
Demonstrate the ethical considerations that a care manager must undertake in practice
Review best practices
for care management documentation
Distinguish the difference between care management and care coordination
Practice trauma-informed approaches and how to integrate them at the resident and organizational levels.
Practice applying a case-based scenario to real-world practice.
Define elder abuse and identify the risk factors and associated requirements if suspected or confirmed.
Geriatric Assessment
  • Biological Aspects of Aging
  • Psychological Aspects of Aging
  • Well-Being, Health and Mental Health
  • Interdisciplinary and Community Collaboration
  • Policy
  • Functional and Psychological Aspects of Aging
  • Care Planning, Technology, and Ongoing Care Monitoring
  • Working in Different CGM Settings and Private Practice
 Define Functional Assessment and Psychosocial Assessment
Review the 3Ds (Dementia, Delirium, and Depression (AKA the 3Ds)
Review neuroanatomy and the cognitive domains that MoCA assesses
Identify risk factors of delirium
Observe a functional assessment
Practice care planning
List components of a care plan and geriatric assessment
Use case-based learning to make recommendations for information and referral
Identify key factors contributing to food insecurity in older adults and review available resources to address these challenges.
Define the differences between food insecurity and malnutrition.
Dementia Care Management
  • Well-Being Health and Mental Health
  • Communication with and on Behalf of Older Persons
  • Geriatric Care Management and Case Management Methodology and Concepts
  • Functional and Psychological Aspects of Aging
  • Client/Patient Assessment
  • Late Life Relocation, Facility Living, and Placement Issues
 Demonstrate the basics of care ecosystem principles for people living with dementia.
Apply person-centered care navigation recommendations.
Long Term Services and Supports
  • Interdisciplinary and Community Collaboration
  • Well-Being Health and Mental Health
  • Policy
  • Client/Patient Assessment
  • Ethical, Legal, and Financial Issues in Older Adult Care Management
  • Late Life Relocation, Facility Living, and Placement Issues
  • Working in Different CGM Settings and Private Practice
 Review the most common types of long-term services and supports.
Distinguish different types of LTSS from one another.
Assess which type of LTSS may be appropriate for a patient or client.
Legal Documents and Advance Care Plans
  • Ethics and Professional Standards
  • Well-Being, Health and Mental Health
  • Communication with and on Behalf of Older Persons
  • Ethical, Legal, and Financial Issues in Older Adult Care Management
  • Late Life Relocation, Facility Living, and Placement Issues
  • Care Planning, Technology, and Ongoing Care Monitoring
 Define types of Advance Care Documents.
Identify tools to facilitate Advanced Care Planning Conversations.
Distinguish between conservatorships and guardianships.
Identify two guardianship alternatives.
Define trusts, wills, and their place in Geriatric Care Management
Low Income Housing and Family Support
  • Program and Service Development
  • Social Health
  • Policy
  • Ethical, Legal, and Financial Issues in Older Adult Care Management
  • Late Life Relocation, Facility Living, and Placement Issues
 Describe Section 202, Section 811, public housing, Section 8 Housing, Veterans Housing, and Homelessness Assistance.
Explain how to support families as part of the care management plan.

Learning Environment Approach and Assessment

Across healthcare education, a variety of challenges and opportunities have emerged as teaching has evolved from a classroom-based, teacher-centered model into more self-directed and student-centered models (O’Doherty et al., 2018; Regmi & Jones, 2020). One of the most significant opportunities is that it introduces content to a larger potential audience, increasing access. However, engaging in online learning effectively requires digital literacy from the students and often digital and teaching mastery from the educators (O’Doherty et al., 2018).

To achieve the learning objectives (Table 1), faculty and instructional designers collaborated to curate a range of approaches and assessment methods for the course content in Geriatric Care Management, with a focus on applied, competency-based pedagogy. Students who take this course with the intention of becoming GCMs as a career often enroll in it during or immediately before their 600-hour care management practicum. Therefore, a focus on applied, active learning can immediately support them in their work with clients/patients. The course tries to demonstrate a variety of GCM practice environments authentically and has a strong focus on professional preparation. The most frequent teaching approaches were Case-Based Learning and Certifications.

In Case-Based Learning (CBL), students act as the GCM in various situations, typically the formal assessment was demonstrated through a SOAP note. Cases were typically real-world cases from faculty experience and ranged from food insecurity to caregiver role strain. CBL has been shown to increase student engagement as compared to classroom-based learning and supports critical thinking skills. (Case-Based Learning: Applying Knowledge to Real-World Case Studies, n.d.; Mohd et al., 2016; Murphy & Radloff, 2019; Samuelson et al., 2017; Thurman et al., 2009). Certifications were used as an assessment tool to increase the value proposition of the class and to demonstrate understanding of the content. For example, during the Geriatric Assessment module, students become certified to administer the Montreal Cognitive Assessment (MoCA). Over the semester, the students receive certifications in 4 external training certificates.

Future Work

The first semester of the Geriatric Care Management elective was in Fall 2025, with plans for course refinement based on student feedback, emerging best practices, and evolving standards in GCM practice. It is currently co-taught by two ICHCC® CGCM®s. To the author’s knowledge, this is the only geriatric care management course that aligns AGHE competencies with those of the ICHCC®, bridging the academic and practice pathways for students.

Aligning ICHCC® and AGHE addresses a critical gap in the field. The absence of GCM training has led to significant variability in care manager preparation, prompting some states to adopt blanket licensure requirements rather than competency-based credentialing (Van Dussen et al., 2012).

This regulatory response, while ensuring some baseline oversight, may not adequately ensure that practitioners possess the specialized gerontological knowledge and skills required for effective care management with older adults. By integrating accredited academic competencies with professional certification standards, this course model offers a roadmap for how academic gerontology programs can systematically prepare future GCMs while advancing the professionalization and standardization of care management education.

Author Note

I have no known conflicts of interest to disclose.

Correspondence

Correspondence concerning this article should be addressed to Annie Rhodes, Ph.D., Virginia Commonwealth University – College of Health Professions, Department of Gerontology, P.O. Box 980228, 900 E. Leigh Street, 7th Floor, Office 7224, Richmond, VA 23298-0228. Email: rhodesas2@vcu.edu