Sally Porter and her brother, Bill Navran, had two choices. They could either hire home care aides to live with their 79-year-old mother in her condo in Kansas City, Mo., or put her in an assisted living center. The choice could have been straightforward, but for one thing: Mrs. Porter lived in Tucson and Mr. Navran was in Hawaii.

The two knew nothing about health care services in Missouri and did not know where to start looking. Luckily, their lawyer knew about Kansas City Home Care, a geriatric care management company that assesses a person's condition and puts together services to address the situation. For $170, a geriatric care manager interviewed their mother, Marjorie Siegel-Navran, for two hours and suggested a way for her to remain at home. They set up four aides, who for $18 an hour would help her bathe, dress, eat and travel.

When her Alzheimer's disease was first diagnosed, she told her children she wanted to be taken care of at home. Luckily, Mrs. Siegel-Navran, who had been active in volunteer work and philanthropy, had diligently saved so there was enough to pay for it. 

Four years later, their mother, who is divorced and can no longer take care of herself, is still living in her condo. Every day she goes out, often to the country club or a favorite restaurant, with an assistant. Up until this year, she visited Mrs. Porter with one of her aides.

"I feel very fortunate that she is able to have this," said Mrs. Porter, 55, a flight attendant with US Airways. "There's the comfort of knowing someone is there."

Geriatric care managers, like Kansas City Home Care, are growing increasingly popular as people live longer and want to grow old in their homes. With adult children often living far away from their elderly parents, these specialists make the job of caring for them much easier — and ease the guilt.

"It's hard to come up to speed, especially when you're flying in from out of state," said Linda Aufderhaar, president of the National Association of Professional Geriatric Care Managers in Tucson. "It's like opening up a phone book. Where do you start?"

That is where geriatric care managers, who can be licensed social workers, counselors, nurses, gerontologists or psychologists with an expertise in elder-care issues, come in. They help families navigate insurance policies, act as advocates at hospitals and nursing homes, monitor medications, find lawyers for legal problems, take parents to medical appointments and even travel with them to their vacation homes. Hourly fees generally range from $85 to $200.

"We do all the things that adult children would do," said Cheryl Smith, founder and owner of Kansas City Home Care. "We become their surrogate family."

There are now 2,041 certified geriatric care managers, up from 50 when the Association of Professional Geriatric Care Managers first started in 1986. While most are private practices, there are some larger companies, like LivHOME of Los Angeles and Senior Bridge of New York, that offer similar services. 

Some people have found their way to care managers through an unlikely source: their banks. Eight years ago, Wells Fargo started an elder services program to help clients take better care of themselves and to head off any problems with medications or living conditions before they occur.

"We're bankers," said Sandra Anderson, co-founder and manager of Wells Fargo's elder services in Minneapolis. "We don't know what the best care is. But a care manager can put us miles ahead of a crisis and tips us off if anything is wrong. 

"I've had one sweet old woman tell a case manager that she always takes the pink pills because that's her favorite color. Never mind that it's her dead husband's pills."

The bank, which now offers the services in 22 offices nationwide, will do everything from selecting a geriatric care manager to finding painters and going to the emergency room with a client. The bankers are often on call 24 hours a day. Clients must pay a 2 percent annual fee and have a minimum of $1 million under management at the bank to qualify for the services.

If you do not have deep pockets, paying for a geriatric care manager can be a huge financial burden. While some insurance programs have started reimbursing these services, most do not. Medicare typically does not cover them. But families can start with an initial assessment for $200 to $500. Often, adult children think their parents need 24-hour care, but they just need a little extra help around the home.

Still, families should be careful when hiring a geriatric care manager. The federal government and states do not regulate or oversee the field, and that makes it easier for people with little experience to become a manager. That leaves it up to consumers to make sure that individuals are certified by the National Association of Professional Geriatric Care Managers and have degrees in areas like social work or nursing. They should also have several years of experience in care planning. 

Care managers are often familiar with local assisted-living centers, their problems, staffing levels and how they treat their patients. They can guide consumers to better assisted-living centers and make sure their clients get the proper care. Sometimes, they can persuade recalcitrant insurance providers to pay for some items.

"A lot of the help care managers give is in knowing the system," said Norman Hannay, president and owner of Elder Care Guides in La Jolla, Calif. "A big part of our role is not just providing care, but helping people navigate a confused, fragmented system."

While their expertise in navigating medical bureaucracies can be valuable, some geriatric care clients come to appreciate a less tangible benefit: peace of mind. Indeed, the specialists see a major part of their role as helping alleviate some of the emotional stress families feel when making decisions about elder care. 

"We come in and give you a perspective that you can't have because you're confused or burnt out," Ms. Aufderhaar said.