Conversation with Maria Miskovic, Care Choice Care Management - Kirkwood Lifestyle Magazine January 2026

I sat down with my friend Maria Miskovic, founder of Care Choice Care Management, to discuss how our partnership over the law 12-years has helped families navigate one of life's most challenging transitions, from self care to care supported by professionals.

“In 2013, I started receiving referrals of clients who had been with another attorney for 20 or 30 years. These were older clients facing issues I'd never encountered before.  Although I was able to assist these families with their legal and financial challenges through changes in their Estate Plans and implementing new Medicaid and Veterans planning—I didn’t have resources to address the non-legal issues associated with aging such as how to help my clients deal with day-to-day care, management of their health care, or finding an independent or assisted living community. I spent more than a year focused on finding those resources, one the first was my friend Maria Miskovic with Care Choice Care Management.” - Shawn Estep.

Maria, explain what care management actually is. Many people haven't heard of it.

We're a team of highly trained professionals who have each spent over 20 years in healthcare. We help people navigate the healthcare system, whether they're dealing with aging issues, disabilities, or mental health challenges. We work with anyone 16 and up. Think of us as healthcare advocates and translators—we help families understand what doctors are really saying, ensure care plans actually reflect what the patient wants, and make sure people are in the right level of care.

Can you give an example of when someone might need a care manager?

Shawn, you actually called us when your mother was in the hospital. The medical team wanted to discharge her to hospice, but they hadn't consulted with her about what she wanted. We helped facilitate that conversation. It turned out hospice wasn't the right choice for her. This happens constantly—patients are often the last people asked about their own care plan.

That's startling. Why does that happen?

In hospitals and even rehabilitation facilities, the focus is on medical protocols rather than individual goals. Staff don't have time to ask, "What does quality of life mean to you?" or "What are you working toward?" When we get involved, we engage the patient in setting their own goals, which makes their recovery more successful and helps everyone understand who that person really is.

From a legal perspective, appointing a healthcare decision-maker for my older clients is a significant issue as they may have lost those people they would otherwise count on to act as decision-maker. I can create a powerful Estate Plan for managing someone's money, and I can create powers of attorney that provide instruictions and powers for making health care decisions, I can structure special needs trusts for disabled adult children. However, during our converations, many clients tell me that they don't have anyone they can trust to make health care decisions for them. That's where having a professional guardian or care manager becomes essential.

Maria, your company also provides guardianship services. How is that different from care management?

Guardianship is court-appointed and kicks in when someone isn't safe to make their own decisions—maybe due to dementia, stroke, or other cognitive issues. Often, there's no family member who can step up, or the family is burned out. We offer an alternative to public administrators, who are good people but overwhelmed with cases. We can personalize care because we have the time and the support of the care management team.

What surprised you about Missouri's approach to guardianship?

Missouri gives protectees—that's what we call the people under guardianship—more autonomy than many other states. We have an ethical obligation to involve clients in their care decisions to the greatest extent possible. It's about finding that line: Where can they participate in their care plan, and where do we need to step in because they might endanger themselves or others?

That must be a difficult balance.

It is. Most guardians don't even attempt to build rapport with their clients, but if someone can trust me a little, they're more empowered to make good decisions and be a functioning part of society. That's always the goal—the least restrictive environment with maximum independence.

We're seeing more aging parents who are caring for an adult child with special needs. They come in terrified: "Who's going to take care of my child when I'm gone?" We can handle all the financial planning—trusts, cash flow management, and retirement assets. But we can't make healthcare decisions. Having someone like Maria and her team means parents can pass on that care and oversight with confidence.

Maria, you also operate a counseling agency that provides psychological testing. How does that fit in?

We conduct psychometric testing to identify issues with decision-making capacity. Maybe someone has early dementia, or they've had a stroke that affected their judgment. We can pinpoint where the cognitive damage exists and where their strengths are. This helps determine what kind of job might suit someone with learning disabilities, or what aspects of life someone will need oversight for.

Have you worked with employment programs?

We work with physicians, school systems, and organizations like the Brain Injury Foundation that do job placement for people with head injuries. But we haven't connected with the Department of Labor directly yet—that's an excellent idea for helping people find work that fits their abilities.

After 12 years of working together, I would say that estate planning isn't just about what happens to your money when you pass away. It's also about who will make healthcare decisions for you if you can't. It's about ensuring your care reflects your values. And if you're caring for someone with special needs, it's about creating a support system that outlasts you.

Maria: I'd add that customer service and personalization matter in healthcare just as much as in any other field. You deserve a care team that knows you, advocates for you, and involves you in decisions about your own life.

Contact Information:

Care Choice Care Management 636-288-1764, ext. 1 www.carechoicestl.com