(MONEY Magazine) – Psychiatric social worker Phyllis Sharlin, 45, of Potomac, Md. helps people solve personal problems for a living. But she was at a loss for a solution when her own arthritic 79-year-old mother Bertha Kronheimer, who lives alone 1,100 miles away in Hallandale, Fla., hired and fired 10 or so live-in companions within two years. Her mother insisted that they were all incompatible or undependable. Finally, Sharlin and her sister, who lives near her, turned to Aging Network Services in Bethesda, Md., a private agency with ties to 250 private-practice geriatric social workers across the country who locate suitable paraprofessionals for the elderly. Within a week, a Miami social worker had found an amicable, reliable companion for Sharlin's mother. Cost of the service: a flat $325. Best of all, the social worker is available for consultations -- at $55 an hour -- in case some new crisis erupts. Says Sharlin: ''I can't pretend that it's the same as having my sister and me live near our mother, but it relieves a lot of our anxieties.'' Aging Network Services is one of about 600 for-profit case-management agencies for the elderly that have cropped up during the past decade. The social workers, nurses, psychologists and gerontologists who call themselves ( case managers determine what kinds of health and social services elderly clients require and refer them to affordable providers such as home health- care agencies and adult day-care centers. In many instances, case managers continuously monitor clients' needs and respond to emergencies. For example, physical or emotional crises such as a fall in the bathroom, negative reaction to food or drugs, short-notice release from a hospital and the onset of symptoms related to Alzheimer's disease can signal the need for a long-term companion. Such private case management can be costly and is not usually covered by Medicare or other insurance. An initial assessment that includes a visit to the elderly client's home and meetings with his or her physician and relatives, plus a written care plan, costs about $150 to $350. Hourly fees for continuing case management range from $13 to $100, with most firms charging around $50. Nonprofit organizations such as religious charities and hospitals also offer case-management services, generally at much lower fees, but their staffers tend to shoulder far heavier caseloads. For example, Smile Independent Living Services, launched in Albany, N.Y. last March by Catholic Charities and Mercy Care's St. Peter's Hospital, charges $60 for an assessment and $15 a week for continuing case management. Executive director Thomas Yandeau estimates that each staff case manager will eventually handle 40 to 50 cases a month. Private, for-profit case managers, on the other hand, typically oversee 20 or fewer cases monthly. Such lighter loads permit more attention. For example, Sarah Cohen, a trained social worker and private case manager in New York City, is calling home health-care agencies to try to find a companion with a fine arts background to watch over a cultured elderly man suffering from senile dementia and take him to museums. Her fee: $80 an hour. Hiring a case manager who can adequately fill the role of a surrogate family member obviously requires care. Here's what to do: -- Call the state office on aging or a local senior center to find a case- management service in or near your relative's hometown. You can also check two directories: The Care Guide, published by the National Association of Private Geriatric Care Managers, or a booklet published by Children of Aging Parents. (See the box on page 200 for more on these and other resources.) -- Check credentials and references carefully, because case management is generally unregulated. Look for case managers with at least a master's degree in social work or some other human-services profession as well as experience in geriatrics. A member of the National Association of Private Geriatric Care Managers, for example, is state licensed or certified, holds a master's or higher degree and has at least two years of supervised postgraduate experience in a geriatric institution. -- Be wary of case-management agencies that supply home health care and other services directly or recommend only one provider. Though such agencies offer the advantage of one-stop shopping, conflicts of interest may arise. Says Marcie Parker, a senior research associate at the InterStudy Center for Aging and Long-Term Care, a public-policy research organization: ''A company that provides direct services could promote them over more cost-effective public programs.'' -- Make sure that services and fees are spelled out, preferably in writing. Ask if there are extra charges for long-distance phone calls or travel time by case managers to and from clients' homes. Also find out if someone is available around the clock to handle emergencies. Finally, though your opinions may be heartfelt and well intentioned, don't try to impose them on an elderly parent or other relative without first consulting with the professional case manager. Also bear in mind that it may take weeks for your relative, perhaps resentful of an outsider's intrusion, to warm up to a case manager. Assuming the relative is mentally competent, you can smooth the way by talking up the idea of a case manager before you hire one. Says Sarah Cohen: ''Elderly clients who are not significantly mentally impaired have a right to resent us if they haven't been consulted.''

BOX: Help

Here are sources of care-giving assistance for elderly people: -- The Care Guide lists 200 members of the National Association of Private Geriatric Care Managers (Box 6920, Yorkville Station, New York, N.Y. 10128; $17.50). -- A booklet published by Children of Aging Parents lists some 200 case managers and care givers' support groups (2761 Trenton Rd., Levittown, Pa. 19056; $10). Send a self-addressed, stamped envelope to receive free information. -- Aging Network Services (4400 East West Hwy., Suite 907, Bethesda, Md. 20814; 301-986-1608) is among the country's leading care-management referral services. -- Support Services for Elders (1453 Mission St., San Francisco, Calif. 94103; 415-552-6776) offers daily money management from paying bills to income tax and entitlements.