A geriatric care manager must first evaluate an older person's needs, including physical and mental health, ability to perform both activities of daily living (ADL's) and instrumental activities of daily living (IADL's), family and community support, environmental deficits, nutrition, medication management, legal planning and finances. Following an assessment a plan of care is developed based on a thorough examination of a client's needs as well as information assembled from family, friends and professionals. A client and caregiver's needs are continuously monitored and re-evaluated to make necessary changes to one's care plan and thus allow for continuity of care. Often care managers are brought into a situation by an adult child, spouse or responsible professional because there has been a change in the health status or the time has come to plan for the future. Sometimes an older person is aware that the daily tasks of life have become overwhelming and will initiate the first call. It is the care manager's responsibility to ensure the client has what they need to remain safe and comfortable to promote aging in place. A trusting relationship between the client and their care manager is the foundation of any plan for long-term care.