Tough Decisions: Providing Care for Aging Parents and Relatives

Weighing in-home care against assisted living communities.

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The Boomeraterâ„¢ Report, our weekly collaboration with Boomerater, deals this week with some tough decisions that family members confront in taking care of aging parents and relatives.

Q. I am trying to decide between a retirement/assisted living facility for my mother or hiring in-home care for her. Anyone have advice? Also, what's best way to find a quality assisted living community?

A. There are a lot of factors to consider, including: Is your mother willing to move or does she want to stay in her home? Do you have access to quality in-home care? Is there a good assisted-living community near her or you? What is the financial situation? How is her health and do you anticipate she may need more care as time goes on? If you decide on assisted living, I encourage you to look at a Continuing Care Retirement Community (CCRC). She can move from independent to assisted living, and if necessary, to a full nursing home without leaving the community or the friends she will meet there. Moving once is hard enough, but having to move again for health reasons is very hard for many people. Also, CCRCs tend to have a whole range of activities and outings for your mom to chose from to get her involved in her new community.

[See How to Set Up a Caregiving Agreement.]

I had to make the same decision for my mom. A Place for Mom was a great help. You can fill out an assessment form to determine the level of care she needs. Also they have free advisers you can speak to about facilities in your area. Eldercare is also a good resource.

A. Definitely check Medicare. This site has added a 5-star quality rating for facilities of all levels of care. They rate by overall, health inspections, staffing and quality measures. Just go to the bottom of the home page and click on "Compare Nursing Homes in Your Area." You can search by name, zip code, etc.

[Check out U.S. News's recently launched America's Best Nursing Homes.]

A. My mother had open heart surgery and was in the early stages of Alzheimer's Disease. My sister and I thought it best for her to remain in her own home in Florida (we live in New Jersey) so we hired home health care workers. Some were from an agency and some worked independently. However, I recommend using an agency because they have many caregivers available on short notice.

[See 15 Things You Can Do to Keep Mom and Dad at Home.]

Our situation worked out well for a while, but then we had to deal with many stressful issues. My mother and the daytime caregiver would get on each other's nerves after being together so much. Sometimes a caregiver couldn't work her scheduled shift and we had to quickly find a substitute. Sometimes it was difficult for my mother to deal with the different personalities of the caregivers.

We eventually moved my mother to New Jersey to a wonderful facility that takes care of all her needs, helps her maintain her sense of self, and provides activities that are both fun and stimulating, thereby providing peace of mind for me and my sister. However, a good facility is costly and this must be taken into consideration as well.

[Also see The Recession Hits Retirement Communities.]

Boomerater is an online resource for baby boomers covering everything from great gift ideas to interesting vacation and getaway trips. The site also contains forums where boomers can post questions and swap first-hand experiences. If there are questions on your mind that you would like answered by other people who have faced similar situations, or you have advice of your own to share, go to and participate in the forums. Say that The Best Life sent you.