before you place your parents in a facility…..

September 13, 2018 By Sig Cohen

When my friend Bill’s mother’s primary care physician informed her that she would need round-the-clock support (because of one unexplained blackout), it was a shocker to her and her family.

What to do? Bill and his brother lived far enough away that they couldn’t provide their mom the required level of personal care. And their Mom was determined to remain in her hometown.

So, they checked out a few assisted living residences, and in an all-too-brief period decided on one. It had a good enough reputation and wasn’t far from her apartment. So, she moved in… and was pretty miserable for her remaining years. Given her temperament, she might have been unhappy no matter where she lived. But I can’t help wondering whether the residence where Bill’s mom moved was the main cause of her upset.

Looking back and knowing what I know now, here’s what I’d have suggested to Bill and his brother:

1. Get a second opinion from another doctor. Compare diagnoses and then consider next steps. If the second opinion matches the first, there’s not much they could have done. But had it differed, they’d have more research to do.

2. When a doctor suggests a patient move to an assisted living or skilled nursing residence, family members should consult with an Aging Life Care Professional. Also known as Geriatric Care Managers, they are skilled at assessing physical, mental health and dementia related problems. They know how to interact with the health care system and facilitate communication among doctor, client and family. They help family members determine the kinds of services – including home health care and hospice – that are right for a client. You can learn more at

3. Shop around. Check out residences in your community. Many have marketing staffs that are more than willing to invite you and your parent for a meal and a tour. While that’s helpful, key is to talk with family members of persons already living at the residence. Take time to get their sense of the residence’s cleanliness, response time to calls for assistance, the staff’s professionalism, and the quality of the food.

4. Learn how much they charge for servicing additional ‘activities of daily living’ or ADLs. As a resident ages, more services may be required. Often, these places ramp up charges (on top of their basic monthly fee) as a resident’s need for additional supports increases.

5. Check their Yelp rating. Yes, Yelp rates assisted living and skill nursing residences. Comments on Yelp may provide insights on the residence’s services and standards of care.

6. Talk to the residence’s activities coordinator, if it has one. Take a look at previous months’ program schedules to gauge the frequency and quality of the residence’s offerings.

7. Finally, take time. Bill and his brother rushed through the process and moved his mother within days of her doctor’s diagnosis. Imagine the shock to her system when suddenly she found herself in a new environment, possibly cut off from her neighbors and friends.

Remember, this could be the last move an elderly parent might have, unless it’s to a hospice or their grave.

Author’s note: I prefer the word “residence” to “facility.” “Facility” connotes a factory or warehouse. “Residence” sounds more human and personal.