How a former home-care director turned PGS Care Manager leads with presence, respect, and a social-work model.
As a Care Manager at Public Guardian Services, Patricia Burke takes the responsibility of her role with just as much seriousness as she does heart.
And that doesn’t just apply to the legal responsibilities of guardianship. For Patricia, the work is about holding space for clients’ beliefs, showing up consistently, and making sure every voice — from doctors to nursing staff to the clients themselves — is heard. She describes her role more like a conductor than a soloist: not the end-all service provider, but the one making sure all the moving parts work together to achieve the best outcomes for her clients.
Patricia’s approach to care is grounded in decades of experience. With both a bachelor’s and master’s in social work, she spent more than twenty years at Boston Senior Home Care, where she worked across case management, caregiver programs, and information and referral services before becoming a director. Before joining PGS, much of Patricia’s career focused on providing care management and care coordination of in-home services for clients. The goal was to support clients to live safely and independently at home and hopefully defer nursing home placement.
But her path to social work began much earlier.
In high school, Patricia joined a program called Helping Friends, which paired older students with children who needed companionship. Through that experience, and later in conversations with social workers while she was in college, Patricia saw an open door. She was drawn to people’s stories, their resilience, and the opportunity to support them through difficult moments.
Although she originally imagined working with children, Patricia discovered a passion for elder care. She became interested in family systems and fascinated by the decades of life that the people she was supporting had already lived before she met them.
She remembers one client in her 90s who was largely bedbound and relied heavily on home care services. Although others believed she should move into a nursing facility, the woman was adamant that she wanted to remain in the home where she had lived for most of her life.
“She said she was happy where she was,” Patricia recalls. “And that’s what stays with me, exploring what setting is right for the person and what they want.”
That person-centered philosophy naturally carried into her work at PGS, where Patricia holds space for the extremes of her role. On one hand, she works to understand what her clients truly want. On the other hand, she carries the responsibility of protecting their safety and well-being. It’s important to her that her clients understand that while she may legally be the decision-maker, their thoughts, preferences, and wishes remain central to every decision.
What’s funny, she says, is that she’s often met with two seemingly contradictory responses to this:
“I don’t need a guardian.”
Followed moments later by:
“How can you help me?”
Her secret to managing these opposing forces is to get to know the person first. And at PGS, that mission is central to every relationship between Care Manager and client.
One of Patricia’s clients regularly tells her that he doesn’t want to talk to her before spending the next forty-five minutes doing exactly that. She approaches those conversations with simple reassurances that help him feel seen and heard:
“I’m here solely to visit with you. What do you need? And is there anything I could do, even if I don’t know if I can do it, anything that you think will benefit your life or make you feel better?”
That presence also extends beyond her conversations with clients. Patricia makes it a priority to know the nurses, physicians, and facility staff caring for each person. She wants to know whether they truly know the client, how they’re spending their days, whether they’re being seen regularly, and if there are concerns that need attention.
She remembers another individual she accompanied to a cardiology appointment who became frustrated and started arguing with medical staff.
“I said to him, ‘I understand your frustration,’” Patricia recalls. “‘But if we don’t deal with this now, the alternative is ending up in a hospital bed, or worse.’”
The client paused. He told her he’d never thought about it that way.
Moments like that remind Patricia that consistency and transparency matter. Many of her clients have few visitors, and simply showing up month after month helps build trust so she can be the advocate they need.
She hopes that, over time, her clients come to realize that they have someone looking out for them.
“It’s the reliability,” Patrica says. “It’s knowing that someone is there.”