Ana Cottle

Caring for aging parents or grandparents is a difficult and daunting task. It comes with all the regular stress of managing finances and personal needs, but has the added emotional strain of balancing your family member’s wishes with the best care possible.

If figuring out a care plan is going to take a significant amount of time, and you’ll need time off or gain some flexibility in your schedule, talk to your employer about what you can do. You should also be eligible to use at least part of your sick leave to care for and provide assistance to a family member.

There are many options for elder care services. The first and perhaps most crucial step is honestly evaluating your loved one’s condition and needs. If she is still capable of living alone but is having a hard time keeping up with daily tasks like cooking and cleaning or can no longer drive, you might want to look into in-home care options. You could, for instance, hire a caregiver hired privately or through an agency. That way, your loved one will be able to stay in her home and maintain her lifestyle and independence. Similarly, independent living communities are an option for seniors and elderly people who just need a little extra help with tasks involved with daily living. These communities provide meals, options for cleaning services, and social activities.

If a caregiver or independent living housing can’t provide enough support, or there’s a danger in leaving your aging relative alone for periods of time, there are many options for assisted living. Assisted living needs can vary greatly, and it’s important to take note of what kind of services your loved one needs, particularly if she has Alzheimer’s, dementia, or any other health issues for which she needs extra care.

In this case, using a placement service can be helpful; the service will do a lot of the leg work for you and can help assess which residences or facilities have the services you need. One decision to make is whether you prefer smaller residential board-and-care nursing homes or assisted living facilities. A board and care is typically a residential home with several residents and has the benefit of still feeling like a home. Residents can get to know each other, and there are fewer caregivers, so the experience can feel more personal.

For those elderly people who are still relatively active, assisted living facilities may provide more activities and options for staying busy than a board-and-care home can. Additionally, for seniors with Alzheimer’s or dementia, wandering can be an issue. In these cases, residents may need a higher level of personal care may be required, making an assisted living facility a good option.

As you weigh your options, there are many factors you should consider.

1. Cleanliness

How often is the facility cleaned? How often are sheets, towels, and laundry done? As you walk around, keep an eye out and see if the bathrooms, kitchen, and common spaces seem like they’re regularly cleaned. As people age, they become more susceptible to illnesses, so it’s important that the environment be kept to a high standard.

2. Personal care

Ask how the staff handle personal care. Will the staff assist residents with the tasks of daily living, such as brushing their teeth, trimming their nails, and showering? If the resident needs a haircut, is there someone who comes on site, or will they provide transportation?

3. Medical needs

Since health care is an important aspect of elderly care services, make sure the nursing homes have the resources to support your loved one. Ask what their system is to track medications. Check with their health insurance company, and see if they support home visits from doctors or nurses. If not, find out if the facility provides transportation to appointments and if a caregiver will accompany them.

4. Caregivers and staff

Talk to the caregivers. Ask how long they’ve worked there—have they been working in the facility long term?—and ask questions about how they provide elderly care. Make sure the staff seem knowledgeable about each resident and the program. High staff turnover is a huge red flag. Ask about how they handle specific situations to get a sense of their experience with senior care and individual patient needs. Even their tone will be helpful in determining if they seem kind and patient.

5. Additional Services and Costs

Find out what additional services long-term care facilities can provide your loved one should she need them in the future, and if there will be an extra cost associated with it. Also, ask about their discharge policy to determine if the facility makes long-term sense. Although someone may not currently need incontinence care, help showering, or assistance eating, it’s important to know what to expect if these issues become needs down the line.

6. References

Ask to be put in touch with family members of current or past residents who participated in the program long term. These contacts can give you an honest picture of what to expect.

7. Activities

Visit at different times of the day to see if the level of activity is a good fit. Even if someone has a low capacity for different activities, residents should still be engaged throughout the day in a senior care facility. Although some residents may prefer to have some space, take note if it seems like the majority of residents are alone in their rooms large parts of the day, and if staff try to engage them.

8. Meals

Request to see a sample of the menu, and visit during a meal time to see what the food looks like. Find out if they provide additional snacks, or if you’ll be expected to bring extra groceries. Ask how they monitor if everyone is at meals and is eating enough or drinking enough water throughout the day.

9. The physical space

There’s no one-size-fits-all facility, and it’s important to determine what will work best for your loved one. If someone is liable to wander, make sure the facility is set up so they have plenty of room to roam but aren’t able to wander out of the facility. What is the outdoor space like? Are there chairs, and is there shade? Ask to see a bedroom, and find out if they’ll allow you to bring in your own furniture or personal items, if that would be a comfort to your loved one. Find out if rooms are shared or private. While a private room may seem preferable, some facilities recommend shared rooms for dementia patients, since they can ease loneliness and anxiety.

Most importantly, if there’s anything you’re unsure of, ask questions. Ask more questions than you think you need to. Remember that you’re your loved one’s best advocate.

Ana Cottle studied Comparative Literature at UC Berkeley. She has lived and worked in Uruguay and Argentina and speaks both Spanish and Yiddish. She is passionate about issues facing women and has worked for several nonprofits along with writing for books, newspapers, and online journals. Currently, she serves as an editor for Policy Shift. Read more from Ana at