How Best To Decide On Assisted Living Care For Your Loved One

Question: My mother-in-law is living at home alone, but needs help with many things. How do we find & choose a facility?

Answer: As Geriatric Care Managers, we work with many people in a variety of different situations. This type of situation can be especially difficult. As we all age, our abilities change. When we are young and ‘growing up’, we usually gain abilities and skills to handle situations around us. As we begin to get older, we sometimes lose some of those skills. Most individuals have a time in their lives when they need the help of someone else.

Aging tends to bring up issues related to driving, shopping for groceries, cleaning, caring for the home, managing finances, and similar skills. Help in these activities often comes from family or friends. Sometimes it requires hiring someone to help you. All these activities are called or categorized as Instrumental Activities of Daily Living (IADL’s). These items do not require hands on care to the individual, but are important to the success of the home situation.

Aging can sometimes requires hands-on-care for the individual, activities like; bathing, dressing, transferring, ambulating, toileting and eating. This category is called Activities of Daily Living (ADL’s). This can require the help of another person, family, friend, aide, or nurse. These individuals can be doing it without pay (usually family) or with pay (aide or nurse).

There are times when that care is difficult to provide to them in their home. It can be difficult because the bathroom is upstairs, or there is a tub, not a shower. It can be difficult because it is hard to find and keep staff. It can be difficult because the home has 5 steps up from the street and the older person can no longer climb the stairs. These types of situations can require the individual to leave their home and move to a facility.

This type of transition is especially difficult as it involves many different decisions and priorities. As Geriatric Care Managers, we try very hard to be helpful in handling the many different situations involved in aging.

One of the ways that we stay current with topics is through trainings, and attending conferences. We use the training and learning to help our clients with their particular situations.

Another way that we try to stay current is by visiting facilities and service providers in our communities. These visits give us an opportunity to see first-hand how facilities look, where they are located, and the types of services they provide.

There are so many different types of facilities that assist older adults: Apartments, Retirement Communities, Adult Day Programs, Assisted Living Facilities, Assisted Living Programs, Skilled Nursing Facilities, Rehabilitation Centers, and Hospitals. It is hard to know what they do and how suitable they are by just driving by.

We also know that just like people, facilities change. They may remodel, or have new owners, or change what they do completely. I often hear when talking with families, “Oh, I won’t let Mom go there. Her aunt was there years ago and it was terrible!” I understand that statement, but what a facility was 10, 15 or 20 years ago, may not be the same as it is today.

The facility may no longer even be there. If it is still there, it definitely has been remodeled; it definitely has different staffing and most likely provides some different services. The best way to know the types of facilities and their services is to visit them!

During these months where life at Senior Life Matters is a little slower and we are not overly busy with Insurance Open Enrollment Counseling (Insurance Season), we take this opportunity to visit facilities in the region. Erin and I recently spent a day visiting Warren, Pa., facilities. We will be visiting some other Pennsylvania facilities later this summer. We could not fit them all in, in just one day!

It was really interesting touring the places we visited. Some of the locations were under new owners and had some updated services and policies. Some of the locations were completely new to us. We definitely felt like we learned a lot, and made some new ‘business friends’.

As a family, you probably don’t think of doing this until you really have a need for it. A slightly different situation, which you might relate to, is that of going to college. You probably don’t start visiting colleges before you have children, or even when your children are young. You usually start visiting colleges when your children are close to attending college, know where they might like to go, or have a major they are considering.

In thinking of facilities for your father/mother or father/mother-in-law, there are some similarities. You know that time is coming, but we seldom are fully prepared to make any change until we really have to do it. You are thinking it might be time, but not really sure. My recommendation is to first talk to the individual, and see what they think or how they feel. Then take the time to research some alternatives in a location or part of the country that makes the most sense for them to be. Then visit those places personally, if you have time and opportunity. That will give you the best feel for what they can offer, how they look, and to learn the services they provide and at what cost.

In the event you can’t physically do that yourself, you can look to the experiences of professionals. You can also speak with friends and family who may have been in this situation themselves. What did they do, how did they handle it? What lessons did they learn? Keep in mind that their situation is not exactly like yours, so the answer may be very different.

There are a number of ‘services’ that you can use on the internet that promise to help with issues like this. My experience has been that many of these services will only tell you about locations that contract with them, or pay a membership fee to be listed as a potential service provider. I recently reached out to one online service, and acted like a daughter who needed a Nursing Home in Chautauqua County for my mother. The person I spoke with stated there were TWO available in the county. Now, you know we have more than two nursing homes. We have EIGHT (8) Nursing Homes in the county. When I tried to ask about one they didn’t mention, they told me they didn’t know of that one and that I must be mistaken?! I was pretty concerned. I have to wonder who else has called and asked for information about services and was not given all the options.

Of course you can just ‘search’ Nursing Homes, or Assisted Living and you will come up with most of the alternatives. What you won’t get from that search, is what are they like? How much do they cost? How is their staffing? These are items you can find out when you visit, take a tour and see for yourself.

I hope this has provided some useful tips. I always suggest visiting places you are considering, maybe preview them yourself and then take your family back to the ones you liked. If you do that before you are in a crisis, you will have more time to look at and think of options and alternatives.

To contact Janell Sluga, GCMC with insurance questions or concerns, please call 720-9797 or e-mail her at