By Lina Supnet-Zapata, MBA, CMC, TxCG
Aging Life Care Manager® and 2026 President-Elect, Aging Life Care Association®

You’ve noticed things that concern you.

The unopened mail stacking up on the kitchen counter. Forgotten conversations. Missed medications. A refrigerator filled with expired food. Maybe your parent seems more withdrawn than usual, or perhaps you are noticing changes during visits that weren’t there six months ago.

You gently bring it up.

“I’m worried about you.”

And the response comes quickly:

“I’m fine. I don’t need help.”

If this sounds familiar, you are not alone.

For many adult children, starting conversations about aging, care, and future planning can feel uncomfortable, emotional, and sometimes impossible. Yet these conversations are some of the most important ones families can have, especially before a health crisis forces urgent decisions.

The good news? This does not have to be one difficult conversation. It can be the beginning of an ongoing dialogue.

Why Families Delay the Conversation

One of the biggest misconceptions adult children have is believing there will be a “right time” to talk.

Often, parents avoid these conversations because they feel independent and capable. Some do not want their adult children involved in personal health or financial matters. Others simply struggle with what aging represents: change, vulnerability, and the reality of mortality.

Many families tell themselves:

• “Nothing major has happened yet.”
• “Dad still seems okay.”
• “Mom would tell me if something was wrong.”

But waiting until a crisis happens can create emotional strain, financial stress, and difficult family dynamics.

When there is no plan, families often find themselves making rushed decisions in emergency rooms, navigating confusion about legal authority, or scrambling to figure out finances and care options.

Planning ahead creates clarity and peace of mind.

The 40/70 Rule: Why Earlier Conversations Matter

I often encourage families to think about what I call the 40/70 Rule.

If the adult child is in their 40s and their parent is in their 70s, it is time to begin the conversation.

Not because something is wrong.

Because planning works best before something happens.

This stage of life provides an opportunity to begin talking informally about wishes, preferences, and future care. The goal is not to take control away from your parent. The goal is to understand how they want to age and how they would want support if circumstances changed.

Signs It May Be Time to Start the Conversation

You do not need to wait for a major medical event.

In fact, some of the most important warning signs appear quietly in everyday life.

Adult children often notice changes during holiday visits, vacations, or trips back home.

Common signs include:

Memory and Cognition

• Forgetting conversations that happened recently
• Missing appointments
• Increased confusion or forgetfulness
• Repeating stories multiple times

Financial Changes

• Unopened mail piling up
• Missed bills or late payments
• Unusual spending habits
• Increased anxiety or paranoia around finances

Physical and Personal Care

• Declining hygiene or refusal to bathe
• Noticeable weight loss
• Poor nutrition or relying on sweets instead of balanced meals
• Mobility changes or increased falls

Home and Social Changes

• Difficulty maintaining the home
• Increased isolation or withdrawal
• Reduced participation in activities they once enjoyed
• Safety concerns around driving

Sometimes these changes happen gradually, making them easy to dismiss. But taken together, they can indicate it is time to begin a conversation.

What a Good Early Conversation Should Cover

The best conversations are not formal interrogations.

They are conversational.

Instead of sitting down for one heavy, emotionally loaded discussion, try smaller conversations over time.

You might ask:

• “If there was an emergency, how would you want me to help?”
• “Have you thought about what you would want if staying at home became difficult?”
• “Who should the doctor call if something happens?”
• “Where do you keep important paperwork?”

Some of the most important topics families should understand early include:

Legal and Healthcare Planning

Families should know:

• Who is named as the medical power of attorney
• Who is named as the financial power of attorney
• Whether advance directives are completed
• Where important documents are stored
• Whether appointed agents have copies

During emergencies, many families discover too late that siblings don’t know who has decision-making authority or where documents were located. That confusion can create avoidable family conflict during already stressful times.

Medical Information

Adult children should understand:

• Healthcare providers involved in care
• Current medications
• Existing medical conditions
• Emergency contacts and preferred hospitals

Financial Logistics

It is also important to discuss practical questions:

If care is ever needed, how would your parent want finances handled?

Would someone need temporary access to funds to help pay for medications, caregiving, equipment, or healthcare expenses?

These conversations may feel uncomfortable at first, but discussing preferences ahead of time preserves dignity and reduces confusion later.

What to Do When Your Parent Says, “I’m Fine”

When a parent resists help, pushing harder usually backfires.

Resistance often comes from fear, loss of independence, or concern about losing control.

Instead of arguing, focus on staying connected.

Try these approaches:

Keep the Conversation Gentle

Avoid statements that feel critical.

Instead of:

“You can’t manage on your own anymore.”

Try:

“I want to make sure I understand what matters most to you.”

Curiosity is often more effective than correction.

Start Small

You do not have to solve everything immediately.

A conversation about emergency contacts today may eventually lead to discussions about healthcare wishes, finances, or caregiving support.

Think of this as an ongoing dialogue, not a one-time event.

Observe and Prepare

Even if your parent refuses help, preparation still matters.

If support is declined, adult children can still gather information, research resources, and begin building a plan.

Because eventually, a medical event, hospitalization, or urgent need often does happen.

Planning from a place of calm is always better than reacting in crisis mode.

When to Bring in an Aging Life Care Professional®

Sometimes families need a neutral third party.

This is especially true when:

• Family dynamics are complicated
• Adult children live far away
• A parent resists advice from family
• is not pleased with current care providers and requires advocacy
• is confused about their own financial and/or legal situation
• Care needs feel overwhelming
• Siblings disagree on next steps

An Aging Life Care Professional® can help families create what I often call a road map for care.

We help identify potential challenges before they become a crisis, coordinate moving parts, advocate for older adults, and guide families through difficult decisions.

You can think of an Aging Life Care Professional as the “air traffic control” for aging care, helping families navigate healthcare, housing, resources, safety concerns, and long-term planning.

For long-distance caregivers, this support can be especially valuable. Knowing someone local is helping oversee care and advocate for your parent can bring tremendous peace of mind.

How to Introduce the Idea Without Triggering Resistance

Parents may resist the idea of “help.”

So avoid framing it that way.

Instead, try:

“This isn’t about taking over. I just want us to have a plan in case something unexpected happens.”

Or:

“Let’s talk to someone who understands aging and planning, just so we know what options exist.”

Many Aging Life Care practices offer introductory consultations, allowing families to ask questions without pressure or commitment.

Sometimes simply hearing options from a trusted professional can make the conversation feel less intimidating.

Start Before You Need To

If there is one message I hope families take away, it is this:

Do not wait for a crisis.

Care conversations are not about giving up independence. They are about preserving choice.

The earlier families begin talking, the more opportunity parents have to express what matters to them and how they want to age.

Start small.

Stay curious.

Keep the conversation going.

Because the best care plans begin long before they are needed.

About the Author

Lina Supnet-Zapata, MBA, CMC, TxCG, is CEO of Mir Senior Care Management, Inc. & Care Consultants in Austin, Texas. An Advanced Professional member of the Aging Life Care Association® (ALCA) since 2016, Lina is a Care Manager Certified (CMC) professional through NACCM and a Certified Texas Private Professional Guardian. She currently serves on the ALCA Board of Directors and the Board of Directors for AGE of Central Texas. In 2022, she received the Joyce Lauck Legacy Award for her dedication to improving the lives of older adults and family caregivers.

Does your aging parent need help?

As an Aging Life Care™ advisor, I know how fiercely older adults want to maintain their independence. Many feel that their adult children don’t understand them or are making something out of nothing — a fall, a burnt pot, a call from the police station. They make promises to ask for help shopping, assure a son they will only drive on familiar streets, and promise to hang up when an unsolicited call for money comes in. The need to be safe and the rejection of that safety in the name of independence and dignity is a real struggle.  So how do you know when safety should outweigh the desire to appear and remain independent?

Here are seven signs that your aging parent may need help:

1. You come for a visit, open the refrigerator to get a glass of juice and the expiration date was three months ago. The refrigerator may have a strong odor, and the kitchen may be full of rotten food.

2. Mail is piling up. Bills may be going unpaid, and utilities at risk of being shut off.

3. You’re not sure that medications are being taken correctly, due to changes in your parent’s vision, dexterity, or memory. Pills are still in their bottles, or medication boxes seem untouched between visits. You may find medications dropped or spilled on the floor.

4. You’re concerned about personal hygiene. You parent may be wearing soiled clothing, bathing infrequently, and not attending to personal care tasks such as oral hygiene.

5. “Mother is absolutely fine,” you hear your father say. And mother automatically agrees. After fifty plus years of marriage, they have learned how to compensate for one another, and they’re arm in arm on the road to trouble.

6. You’re receiving concerned phone calls or emails from friends or neighbors, who may be stepping in to provide help when they can, but are frustrated.

7. The car has noticeable new scratches and dents, maintenance is being ignored, and you’re concerned about your parent’s ability to drive safely.

If you notice just one of these happening with your parent, it is time to have a conversation. If you need help starting that conversation or implementing a plan of care, consider working with an Aging Life Care Professional. Aging Life Care Professionals™ understand the frustration felt by adult children and the desperation felt by older adults who want to hold on to their independence. With an objective perspective on the situation, we can help facilitate difficult family discussions and decision-making to address these and other concerns.

To locate an Aging Life Care Expert near you, search this directory of experts by zip code.

About the author: Miriam Zucker, LMSW, C-ASWCM is an Aging Life Care™ Specialist. She is founder of Directions in Aging, based in Westchester County, New York.

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Caring for an older adult with cognitive difficulties, such as dementia or Alzheimer’s disease, requires patience, empathy, and a thoughtful approach to daily activities. As our loved ones with dementia might have communication challenges, we become more attuned to observing body language and facial expressions. The right activities can provide a sense of purpose, stimulate memory, and improve overall well-being. However, choosing the wrong activities can lead to frustration or confusion. This guide offers practical advice on the dos and don’ts of engaging loved ones with cognitive decline.

Do:        Simplify tasks and break them down into smaller steps.

• For example, if your loved one enjoyed cooking, involve them in simple tasks like stirring ingredients or setting the table. This allows them to participate without feeling overwhelmed by the complexity of the activity.
• Familiar rote tasks can provide a sense of purpose and success i.e.: folding towels or setting the table.

Don’t:        Set up for failure

• Avoid setting high expectations for perfection or completion of tasks. The goal is engagement, not mastery. If your loved one loses interest or struggles with a task, it’s okay to move on to something else without pressure. Try active listening techniques.

Do:        Promote social interaction

• Engage in activities that foster social interaction, like looking through old photo albums, reminiscing about the past, or participating in small group activities. Social engagement is crucial for older adults as it helps combat feelings of isolation and keeps their minds active. Offer prompting open-ended questions to encourage engagement. Consider looking for a local Adult Day Center near you that might offer activities and social interaction.

Don’t:        Overwhelm with large gatherings

• Avoid large social gatherings or unfamiliar environments that could cause sensory overload or anxiety. Instead, keep interactions small and personal, with familiar faces and settings to provide a sense of security and comfort.

Do:        Watch television: many of us utilize television for entertainment but it can often become the primary source of structure and activity for the day.

• Watching cooking shows can be good if you are looking to improve appetite but can also cause overeating.
• Watching nature programs with positive content is engaging, however cycle-of-life or aggressive programming (like natural disasters) can produce anxiety. Baby animal shows can be a particular favorite as there is no plot to follow.
• Watching beloved shows can be nostalgic and comforting, and comedy skit shows also have no plot to follow.
• Consider what types of programs are watched at different times of day – something with no speaking and just photography is good for resting, and sports might spark a desire for more activity.

Don’t:        Allow TV to cause anxiety or be a substitute for activity or personal interaction

• Watching the news can be distressing for some and cause anxiety
• Confrontational talk show formats can be confusing and angry participants may display unwanted behaviors.
• Sitting in front of the TV all day isn’t good for anyone, and this is not engaging in socialization or cognitive stimulation.

Do:        Incorporate music and art

• Use music and art as therapeutic tools. Older adults with cognitive difficulties often respond well to music from their youth or simple art activities like coloring or painting. These activities can stimulate the senses and provide a creative outlet, even for those with advanced cognitive impairment.

Don’t:        Use Activities that require complex decision-making

• Avoid activities that require complex decision-making or too many choices. This can be overwhelming and may lead to frustration. Instead, offer simple, clear options that allow for easy participation. Offer a choice between two things such as menu items or daily clothing choices.

Do:        Accept help when caregiving becomes overwhelming.

• Consider hiring an Aging Life Care Manager.  An Aging Life Care Manager can provide expert guidance, help coordinate care, and offer support in making decisions for your loved one.  You can find one in your local area here www.aginglifecare.org

Don’t:        Set your expectations too high or schedule too full.

• Try to go with the flow and understand things might not go exactly as planned and that’s okay. Schedule in extra time for activities or to get to appointments. If you feel frustrated, step away, regain composure (your loved one if not being difficult on purpose) and try again with a new energy. Read tips on how to deal with caregiver stress.

As you consider what activity choices to offer your loved one, consider variety and time of day. Include exercise and socialization, as well as hygiene and rest. Modify, modify, modify. If they seem overwhelmed with an activity, try simplifying to a point they can successfully engage. For example: a puzzle with fewer and larger pieces, simple matching games, and activities to stimulate fine motor skills.

Remember not to infantilize your loved one, but rather adjust to their needs. Be mindful of your loved ones’ response to an activity and be flexible with both them and yourself.

About the Author: Lisa Kaufman, MS, CMC, CTRS, C-EOLD is a certified care manager, an Aging Life Care Professional, and a certified End of Life Doula. She has owned and operated SeniorCare Options since 2001, and she is a Therapeutic Recreation Specialist.

By Dr. Jennifer Gazda, LCSW, NCG, CMC, CDP

When Siblings Clash Over a Parent’s Care

In a perfect world, families would all agree and get along with each other during stressful situations or times of transition. Unfortunately, this is not often the case and not that uncommon. Families are in a constant state of change as there are transitions as we age and experience different stages of life. When an aging parent needs assistance, it is typically the children of the parent(s) who work together to make decisions.

What happens when the adult children disagree and cannot come up with a plan to support their loved one?

How can an Aging Life Care Professional assist in navigating the decision-making process and move towards a positive outcome?

From personal experience, I find that adult children, sibilings, and extended family often make decisions for their parents instead of including them in the discussion. It is not meant to be with ill intention, but we are quick to try to find solutions to problems and move on. For example, let’s consider Joe* who is starting to show signs of cognitive decline. One child may want to move Joe to an assisted living facility and another child wants him to move into their house, but Joe has said for years he does not want to live anywhere else. Who gets to make this decision? Even if it’s unanimous among the family to move Joe, how are you going to physically have him leave his home when he is adamant to not leave? These types of decisions impact families in many ways and can cause family tension, which only further exacerbates the problem.

When navigating difficult conversations with adult children, especially around aging parents or care decisions, thoughtful communication and mediation can make all the difference. Whether you’re a professional, a designated decision-maker, or a family member trying to help, here are key principles to guide productive and respectful discussions.
 

Make Space for Every Voice

Adult children often bring different perspectives shaped by their subjective experiences and emotions. Allowing time for each person to share their thoughts, without interruption, builds trust and reduces defensiveness. Even when disagreements arise, being heard can lower tension and move the conversation forward.
 

Consider the Challenges of the Power of Attorney (POA)

When a Power of Attorney (POA) has been appointed, their role can be both essential and challenging. They may face criticism or frustration from siblings who feel left out or disagree with decisions. Supporting the POA sometimes means helping absorb complaints, reinforcing that decisions are being made in good faith, and reminding everyone of the legal and ethical responsibilities involved. An Aging Life Care Professional can support the POA through these challenging situations with an aim to prevent burnout and preserve family relationships.
 

Education About Aging and Disease

Misunderstandings about the aging process or specific medical conditions can fuel conflict. Providing clear, accessible education about what is normal aging versus disease-related change helps set realistic expectations. When families understand cognitive decline, mobility limitations, or chronic illness progression, they’re often better equipped to respond with empathy rather than resistance.

Center the Conversation on the Older Adult

In emotionally charged discussions, it’s easy for family dynamics to overshadow the person at the heart of the matter. Always return to the most important question: What does the individual want? Their preferences, values, and quality of life goals should guide every decision whenever possible to allow for dignity and autonomy of the person.

As an Aging Life Care Professional, I have had the opportunity to work with many families over the years. Even the closest of siblings experience struggles and challenges at times, and it is one of the best parts of my work to help support families through these discussions. It can be especially difficult and frustrating for adult children when they live a long distance away from their aging parents. Emotions run strong when you cannot take a quick drive to go check in or when there is a crisis and you are not receiving updates as quickly as you would like. It also may feel like you are excluded from being involved in decisions because you are not physically present with your parents. In the work I have been able to do with families that are not local, I have been able to not only advocate and support the older adult client, but also provide real time updates to the long distance child and give reassurance.

If you are experiencing difficulty with communicating with your siblings or other relatives about someone’s care, I encourage you to reach out to an Aging Life Care Manager. We are able to provide objectivity and sound guidance as you navigate through any challenging situation.

To find an Aging Life Care Manager near you and get the support your family needs, visit the Aging Life Care Association’s “Find an Expert” directory.
 
About the Author
Jennifer Gazda, DSW, LCSW, NCG, CMC, CDP, is the Director of Integrated Care Management and Home Care at Arosa. With more than 20 years of experience, she specializes in Aging Life Care management, clinical supervision, and supporting older adults and individuals with complex needs. Dr. Gazda is also an Adjunct Professor at Aurora University and an active leader in several professional organizations. She is an Advanced Professional member of the Aging Life Care Association and serves on the Board of Directors for the Midwest Chapter.

When many people hear the term Aging Life Care management, they instinctively picture older adults, often someone with multiple medical conditions, declining mobility or cognition, or the need for long-term support.

While older adults absolutely benefit from Aging Life Care management services, this narrow definition misses the bigger truth: At its core, Aging Life Care management isn’t about age, it’s about navigating complexity with expertise, advocacy, and compassion.

In reality, many Aging Life Care Managers work with individuals who are younger, sometimes much younger, navigating medical, psychiatric, developmental, or life-altering challenges that require coordination, advocacy, and sustained support.

At its core, Aging Life Care management is a skill set. And that skill set applies across the lifespan.

The Common Thread: Complexity, Transitions, and Vulnerability

Aging Life Care management exists to support people when systems become overwhelming. This can happen at 25 just as easily as at 85.

Younger adults often face:

• Fragmented medical and mental health systems
• Insurance and benefits confusion
• Poor communication between providers
• Life disruptions that affect work, family, housing, and finances
• A lack of advocates during moments when they are least able to self-advocate

Whether someone is recovering from a traumatic injury, managing a serious psychiatric diagnosis, or living with an intellectual or developmental disability, the need is the same: someone who understands the system and can how to navigate it effectively.

Psychiatric Diagnoses Don’t Exist in a Vacuum

Mental health conditions, such as bipolar disorder, major depression, schizophrenia, or severe anxiety, often impact far more than mood or behavior. They affect medication management, employment stability, housing security, family dynamics, and physical health.

For younger adults with psychiatric diagnoses, Aging Life Care management can provide:

• Coordination between psychiatry, primary care, therapy, and social services
• Support during hospitalizations or transitions between levels of care
• Medication oversight and advocacy regarding side effects or adherence challenges
• Advocacy during moments when symptoms make communication difficult
• Family education and support to reduce burnout and crisis cycles

Without coordinated support, people often fall through the cracks, cycling through emergency care rather than receiving proactive, stabilizing help.

An Aging Life Care Manager can step in to change that trajectory.

Supporting Adults with IDD: Beyond the Pediatric Cliff

Adults with intellectual and developmental disabilities (IDD) frequently experience a sharp drop-off in support after childhood services end. Families are suddenly expected to navigate adult healthcare, benefits, housing options, and community resources with far less guidance.

Aging Life Care management for adults with IDD may include:

• Navigating Medicaid waivers and eligibility
• Coordinating medical, behavioral, and specialty care
• Supporting independent or supported living arrangements
• Advocating for appropriate accommodations and services
• Helping families plan for long-term stability and transitions

This work is not about aging, it’s about ensuring dignity, continuity, and quality of life across adulthood.

Care Navigation During Injury or Illness

A sudden injury or serious illness can turn a young adult’s life upside down overnight. Hospitalizations, surgeries, rehab, insurance appeals, and return-to-work planning can quickly become overwhelming, especially when someone is trying to heal.

Aging Life Care management during these moments can involve:

• Coordinating care across hospitals, specialists, and rehab providers
• Clarifying treatment plans and next steps
• Managing insurance approvals and documentation
• Supporting recovery at home and preventing setbacks
• Helping individuals and families regain a sense of control

These are transitional moments where expertise used in care becomes just as critical for younger individuals.

The Skill Set Is the Same, The Context Is Different

What makes Aging Life Care management effective isn’t the age of the client, it’s the ability to:

• See the whole person, not just the diagnosis
• Anticipate gaps in care before they become crises
• Translate complex systems into clear, actionable plans
• Advocate calmly and persistently across institutions
• Build trust with clients and families during vulnerable moments

Those skills don’t expire at a certain birthday.

Rethinking Who Aging Life Care Is For

When Aging Life Care management is framed only as a service for older adults, younger people who could benefit often don’t realize support is available, or assume they should be able to handle things on their own.

Needing help is not a failure. It’s a recognition that modern healthcare and social systems are complicated, and that no one should have to navigate them alone.

Aging Life Care management is for people:

• Experiencing complexity
• Facing transitions
• Managing chronic or life-altering conditions
• Supporting loved ones while balancing their own lives

That includes older adults and it includes many people who are not.

Expanding the Conversation

When we expand our understanding, we expand access, and ultimately, outcomes.

Aging Life Care management isn’t about how old someone is. It’s about meeting people where they are, with the right expertise, at the moment they need it most.

Finding the right support doesn’t have to feel overwhelming. An Aging Life Care Manager can help you make sense of complex situations, coordinate care, and advocate for the best possible outcomes, no matter your age or diagnosis.

If you or a loved one could benefit from expert guidance, use the Aging Life Care Association’s Find an Expert tool to connect with a qualified professional in your area and take the first step toward clarity and peace of mind.

About the Author:

Catherine Vergara, RN, BSN, TxCG, CCM is an Advanced Professional Member of the Aging Life Care Association® and is the CEO of CareFor. With a strong clinical background and expertise in care management, guardianship and nursing, Catherine is known for developing tailored care strategies, fostering strong client relationships, and guiding individuals and families through complex healthcare decisions with clarity and compassion.

Aging Life Care Professionals™ on Finding the How

By taking a holistic, client-centered approach, Aging Life Care Professionals have the distinct advantage of finding solutions for aging adults that ensure both quality of care and optimal life for their clients.

Here, Aging Life Care Association™ member Kate Granigan, MSW, LICSW, CASWCM shares that not saying “no” to clients, but saying “how,” is what she loves about her job. “It’s what we get to do every day. Help people find solutions and find the how,” says Granigan.

What is an Aging Life Care Professional?

The Aging Life Care Professional assists clients in attaining their maximum potential.  The individual’s independence is encouraged, while safety and security concerns are also addressed. Aging Life Care Professionals are able to address a broad range of issues related to the well-being of their client. They also have extensive knowledge about the costs, quality, and availability of resources in their communities.

Aging Life Care Professionals are engaged to assist in a variety of areas, such as:

• Housing – helping families evaluate and select appropriate level of housing or residential options
• Home care services – determining types of services that are right for a client and assisting the family to engage and monitor those services
• Medical management – attending doctor appointments, facilitating communication between doctor, client, and family, and if appropriate, monitoring client’s adherence to medical orders and instructions
• Communication – keeping family members and professionals informed as to the well-being and changing needs of the client
• Social activities – providing opportunity for client to engage in social, recreational, or cultural activities that enrich the quality of life
• Legal – referring to or consulting with an elder law attorney; providing expert opinion for courts in determining level of care
• Financial – may include reviewing or overseeing bill paying or consulting with accountant or client’s Power of Attorney
• Entitlements – providing information on Federal and state entitlements; connecting families to local programs
• Safety and security – monitoring the client at home; recommending technologies to add to security or safety; observing changes and potential risks of exploitation or abuse
• Long-distance care – coordinating the care of a loved one for families that live at a distance; including crisis management

Discover solutions that work for your aging loved one by connecting with an Aging Life Care™ Expert. Find one here at aginglifecare.org.

When Slowness Isn’t the Problem in Aging Care

By Amy Pierce, RN, CMC

Fifteen years ago, long before I became an Aging Life Care Manager®, I was working as a nurse in a busy, insurance-driven medical practice. Like many offices, we were constantly behind schedule. The pace was fast, the pressure was real, and efficiency mattered.

One morning, a nurse I worked with was escorting an older woman from the waiting room to an exam room. The patient was using a walker and moving slowly. As they made their way down the hallway, the nurse kept glancing back at me, clearly frustrated.

Eventually, she got the patient settled and returned to the nurses’ station visibly irritated.

“She was so slow,” she said. “We are never getting out of here.”

I remember pausing and thinking, “Is the problem that she is too slow, or is the problem that we are moving too fast?”

That moment stayed with me.

In traditional healthcare settings, older adults often do not fit the system designed to serve them. Appointments are short. Schedules are tight. Questions take time. Stories unfold slowly. In an environment driven by productivity and volume, aging bodies and aging minds can be perceived as obstacles rather than individuals.

I had begun to notice a pattern. Older patients were frequently told that their symptoms were simply “part of getting old.” Concerns were brushed aside, time was limited, and no one was tasked with stepping back to see the full picture.

Even then, I knew there had to be something more intentionally designed for older adults. A model of care that allowed for time, patience, and dignity. A system that recognized complexity rather than rushing past it.

Years later, while working in hospice, those early observations came into sharper focus. I watched families struggle to coordinate care, manage medications, understand medical recommendations, and make decisions without clear guidance. Everyone was doing their best, but no one was responsible for holding the whole picture.

It was during this time that I discovered the Aging Life Care Association®.

For the first time, there was language for what I had sensed years earlier. A professional role built around coordination, advocacy, and understanding the medical, functional, emotional, and family dynamics that shape aging. A role designed not for speed, but for clarity.

Looking back, I can trace my path to that moment in the hallway. To the quiet realization that older adults were not the problem — the system was.

Aging Life Care Management exists because aging requires more than efficiency. It requires presence. It requires someone willing to slow down, ask better questions, and honor the full story.

For families seeking this kind of support, an Aging Life Care Manager can be found through the Aging Life Care Association, where a national directory connects you with experienced professionals in your area, visit aginglifecare.org.

For those called to this work, I encourage you to connect with the Aging Life Care Association. Individuals come to this career from many different paths. Whether you are looking for guidance or inspired to provide it, this profession offers a path grounded in compassion, expertise, and a commitment to seeing the whole person.

About the Author:

Amy Pierce, RN, CMC, is an Aging Life Care Professional with over 20 years of nursing experience and is certified through the National Academy of Certified Care Managers. She works with families navigating complex aging care decisions and is a co-founder of Coastal Care Partners, a Aging Life Care Management practice in Savannah, Georgia.

Life is demanding. More so when you are caring for others.

The responsibilities of caring for someone who is older or has special needs or disabilities can be demanding on your physical, mental, financial, emotional, and social health.

Just as flight attendants advise at the beginning of every flight to “put your own oxygen mask on first before helping others,” the same advice applies to family caregivers. Putting your own oxygen mask on first is a metaphor for self-care.

We all need a break from the demands of daily life. This is especially true for family care partners. Respite is an important yet often overlooked aspect of every family care partner’s self-care.

As Aging Life Care Managers we focus on the older adult (or client) who needs support and services, but we also pay attention to their direct support system, be it family or friends. Your health and well-being are equally important. 
 
 

What is self-care?

Self-care is the practice of taking steps to improve or maintain your own physical, mental, emotional, social, and spiritual health. It involves caring for yourself through healthy boundaries, managing stress, exercise, proper nutrition, rest, hydration, engaging in practices that bring joy, and taking breaks.

Self-care is not selfish. It is an essential, proactive approach to managing your own well-being and quality of life.

Navigating the care of another, in addition to the complex systems of health care, social services, and family support, can be stressful. It is around-the-clock and overwhelming. Stress and its impact on health often goes unnoticed until it’s too late. Caregiver burnout is real. Take this quiz to find out if your flame is about to fizzle.
 
 

What is respite care?

Respite care includes the supports and services you put in place to cover the needs of the person in your care when you are taking a break—a respite—from caregiving responsibilities.

Benefits of Respite and Rest

• Prevents Burnout and Reduces Stress: Regular breaks, particularly for caregivers, are crucial for lessening emotional and physical exhaustion.
• Improves Physical Health: Rest provides time for necessary physical recovery from the demands of caregiving, such as lifting or constant activity.
• Enhances Emotional and Mental Well-being: Respite can help reduce tension and irritability, improving patience and reducing anxiety.
• Relationships Strengthened: Time off can lead to a more positive, patient, and appreciative relationship with the person in your care.
• Peace of Mind: Utilizing respite services provides assurance that your person is safe and well-cared for, allowing you to truly relax.
• Shift Perspective: A break can help you gain new perspectives and find better ways to handle daily challenges.

Respite care can be provided in many ways:

• Informal. Family, friends, or neighbors can step in to care for your relative for short periods—either at no cost or a small fee.
• In-Home Care. Caregiving support can also be provided by home care agencies or independent professional caregivers. Home care aides can assist with activities of daily living (ADLs) such as bathing, dressing, toileting, medication management, and eating, and serve as a companion.
• Adult Day Centers. Adult day health and other centers and programs offer a variety of social and creative engagement, as well as some light physical activities and nutrition. You can find an adult day program at the National Adult Day Services Association: www.nadsa.org
• Residential Settings. Some long-term care communities offer short-term respite stays. A respite care stay can be up to 30 days, depending on the provider. Care is provided 24-hours a day.
• Volunteer Programs. Many community organizations offer volunteer programs for companionship or to help with tasks.
• Area Agencies on Aging. Explore the Eldercare Locator for programs, services, and options in your area.
• Veterans Administration. Check the Geriatrics and Extended Care / Respite Care eligibility and services to see if you qualify.

How do you coordinate respite care?
If the thought of navigating and planning for respite is too stressful, consider engaging the guidance and services of an Aging Life Care® Manager like myself. We know the specifics of the local resources, including respite care options, in our communities and understand how services are accessed.

“Caregiving is stressful, difficult work,” reflects my colleague, Lisa Mayfield, founder and principal of Aging Wisdom and a past president of the Aging Life Care Association, “And with a little research and some thoughtful planning, you can take some time away. You’re investing in your own health. You can confidently leave the person you care about in caring hands and get refreshed. If you’re not healthy, you can’t be your best. Remember—your health is as important as that of the person you are caring for.”

About the Author:  Lauren Wandler, BS, CMC, is a Certified Care Manager at Aging Wisdom®, an Aging Life Care™ practice based in Seattle, WA. Lauren is a passionate professional whose work experience and expertise encompasses care management, life enrichment, senior living, hospitality, and healthcare. Lauren brings a decade of experience working with older adults and their families. Lauren is an advanced professional member of the Aging Life Care Association.

Mr. Smith is 79 years old. A week ago, he had a stroke while home alone. Thankfully, his youngest son arrived minutes later and got Mr. Smith admitted to the hospital.

After a week, the hospital discharge planner contacted Mr. Smith’s oldest son, Paul, who is listed as his healthcare POA (Power of Attorney). The discharge planner emailed Paul a list of rehabilitation facilities. He was to select the top three places in order of preference for his father’s rehabilitation. Paul would need to make his selections by the end of the day, as the plan was to move Mr. Smith the following day. Naturally, Paul was overwhelmed; he wanted to pick the best place for his dad but had no idea what any of these places are like. One place is listed as a nursing home; another as  a health care campus. What are the differences? A nursing home is the last place Paul wanted his dad to be.   

First, it is helpful to understand the terminology. It can be very confusing, as multiple words are used interchangeably to describe similar services and places:  Skilled Rehab, Skilled Nursing Facility, Long-Term Care Facility Continuum Care Campus (CCC), Health Care Campus. Generally, all these places offer skilled rehabilitation services in addition to long-term care. Further, some offer Independent Living, Assisted Living and Memory Care. 

Skilled Care and rehabilitation typically refer to inpatient, medically necessary services offered by licensed nurses, physical, occupational and/or speech therapists. Skilled services or rehabilitation are temporary, time sensitive and expensive. Usually, rehabilitation is partially covered by Medicare, Medicaid and private/supplemental insurance.

When patients arrive at a facility for rehabilitation, they are assessed by the skilled services team, often referred to as the therapy department (PT, OT, speech and nursing). The therapy or skilled team determines the person’s needs and goals. A plan is developed to meet the intended goals within a determined period. An individual will either progress, stay the same or decline. 

Let’s suppose that Mr. Smith has made little progress after three months of rehabilitation services at a Skilled Nursing Facility. He remains paralyzed on his left side and requires assistance to do most things… getting dressed, hygiene, cutting food, getting in and out of bed. All these activities are referred to as Activities of Daily Living (ADLs).  

At this time, Mr. Smith will no longer qualify for skilled services or rehabilitation. He still is not able to go safely home, as his needs are too great. He will now require what is called custodial care. Custodial care means an individual needs assistance with ADLs but does not require or qualify for skilled care or services. A caregiver/aid can provide custodial care to meet all his ADLs, and his ongoing medications and medical needs will now be considered part of his custodial care needs. Mr. Smith has completed his rehabilitation and is now moving into a long-term care situation.  

 Long-term care refers to a facility providing custodial care. Individuals for many different reasons are not able to receive custodial care safely in their homes, therefore require a long-term care facility (often called a nursing home). Long-term care facilities offer services which include Skilled Rehabilitation. Mr. Smith started out in short-term skilled rehab. After a period, he no longer showed improvement, despite receiving skilled services (physical, occupational and speech therapies). He then required custodial care. His family would not be able to safely provide the care he continued to need 24/7. 

Mr. Smith then “moved” to Long-Term Care within the same facility. Sometimes a facility will divide their building into sections with skilled services and rehabilitation in one area and long-term care in another. Others may provide skilled care and when the person requires ongoing custodial care, those services continue in the same room. What changes between skilled rehabilitation and long-term care are the type of services and costs? 

Considerations

The first step in making informed choices about where to go for rehabilitation is to understand the differences in services offered at a facility. Other considerations include: What happens if a person is not able to return home after receiving skilled therapy services? Are long-term care services or custodial care offered and what are the costs? Does the person have a good transition plan?

It is important to understand how the process works when making decisions about where to go for skilled rehabilitation. For most people, the goal of skilled rehabilitation is to get stronger and return home. Unfortunately, things do not always go as planned. It is worth the time to know what questions to ask from the start.

Getting Outside Help

This is where an Aging Life Care Manager® can be an invaluable resource for families like Mr. Smith’s. Aging Life Care Managers are experienced professionals who understand the full continuum of care and have firsthand knowledge of local rehabilitation facilities, nursing homes, assisted living communities, and in-home care options. They can help families evaluate facilities beyond a list of names, considering quality, staffing, outcomes, costs, and how well a setting truly matches a loved one’s needs. Just as important, they serve as an advocate during hospital discharge and transitions, helping families ask the right questions, avoid rushed decisions, and prevent costly mistakes that can lead to unnecessary moves or inadequate care.

Aging Life Care Managers also coordinate care, communicate with medical teams, and support families through complex decisions. To find a qualified Aging Life Care Manager, look for professionals who are members of the Aging Life Care Association® (ALCA) and use the “Find an Aging Life Care Expert” directory at www.aginglifecare.org, which allows you to search by location and specialty.

About the Author:  Jennifer Beach, LSW, MA, C-SWCM established Advocate for Elders in Rocky River in 2010. Jennifer has 25 years of experience in working with and advocating for older adults and their families. Jennifer is a licensed, insured Social Worker and an Advanced Aging Life Care® Professional. She has served as the Midwest Chapter President of the Aging Life Care Association and additionally served 7 years on the Board of Directors. In 2018, Jennifer was honored as the recipient of the ALCA Midwest Chapter Outstanding Member of the Year Award. Learn more at advocate4elders.com.

Jennifer is also a monthly contributor and author of Caregiver Corner for Northeast Ohio Boomer and Beyond blog and magazine.

By Jill Poser, CGCM, CMC, CDCP

When a parent begins to experience the inevitable changes that come with aging, families often feel a mix of urgency, uncertainty, and emotional conflict. Even in close, supportive families, shifting roles and increasing care needs can create feelings no one expected. It can be difficult to know how to respond or how to plan for what comes next.

“When families work with a professional Aging Life Care Manager, they no longer feel like they must navigate these decisions alone or get everything exactly right. Our role is to ease fear, help prevent crisis, and support families in making thoughtful, informed choices they can stand behind.”— Jill Poser, CGCM, CMC, CDCP

Navigating change is never only about logistics. It affects identity, relationships, and the emotional well-being of the entire family. Without experienced guidance, families may find themselves overwhelmed by decisions, emotions, and responsibilities that can escalate quickly.

Here are key insights families should understand as care needs evolve, along with why partnering with an expert Aging Life Care Management team can provide clarity, stability, and peace of mind.

1. Embracing Loss: Recognizing What Is Changing and What Remains

Aging often introduces forms of loss that are not immediately visible. Seniors and their families may grieve the gradual decline of abilities, independence, or personality traits that once felt permanent. These emotions deserve acknowledgment and support.

Expert Aging Life Care Managers recognize that loss affects both the individual receiving care and every family member who loves them. Through clinical assessment and steady communication, we help families understand what changes are expected, which symptoms may need medical attention, and how to differentiate grief from fear or guilt. This clarity allows decisions to be made with confidence instead of uncertainty.

2. Shifting Roles: When Adult Children Step into New Responsibilities

One of the most challenging transitions occurs when adult children must take on responsibilities their parents held for decades. This shift can create resistance, worry, or a feeling of imbalance in the parent-child relationship.

Without professional guidance, families may struggle to determine how much help to offer, how to maintain respect while ensuring safety, or how to create boundaries without feeling disloyal. Aging Life Care Managers support families by providing structure and realistic expectations. They bring clinical insight into what level of assistance is appropriate, and they offer communication strategies that preserve dignity and strengthen the relationship rather than strain it.

3. Conflicting Emotions Are Normal and Meaningful

It is natural for families to experience conflicting emotions during moments of change. Love may be accompanied by frustration, hope may be mixed with fear, and relief may bring unexpected guilt. These reactions are meaningful and deserve attention.

Aging Life Care Managers understand how emotional complexity influences decision making and family communication. Through ongoing support, they help families identify emotional triggers, navigate disagreements, and keep the focus on their parent’s safety and well-being. This allows families to respond with intention rather than react under stress.

4. Facing the Reality of Mortality with Compassion and Preparedness

Few conversations are more difficult than those that address the later stages of life. Avoiding these conversations, however, often leaves families emotionally and practically unprepared when health changes occur.

Professional Aging Life Care Managers with strong medical backgrounds help families recognize early indicators of health decline, understand what changes may suggest a higher level of care, and begin thoughtful discussions about wishes and values. When appropriate, they coordinate hospice, palliative care, and medical support to ensure comfort and dignity. Facing mortality with preparedness is an act of love and a form of protection for everyone involved.

5. Planning for What Comes Next

Change is rarely a single moment. It is a progression that benefits from careful planning. Families often underestimate how quickly needs can shift, especially when chronic illnesses or cognitive changes are involved.

Aging Life Care Managers guide families through proactive planning so they can anticipate needs instead of scrambling to respond to emergencies. This planning may include:

• identifying future care needs based on clinical assessment
• preparing for transitions such as hospitalizations or rehabilitation
• review of home safety and medical equipment needs
• creating communication plans among siblings
• understanding/referring to financial and legal considerations related to care

Effective planning protects families from crisis-driven decisions and provides a sense of control during unpredictable times.

6. The Unspoken Stressors: Decision Fatigue and the Fear of Getting It Wrong

Beyond the emotional layers, families often carry the weight of constant decision making. They may wonder whether symptoms are being monitored closely enough, whether medical needs are understood correctly, or whether care decisions are happening too quickly or too slowly.

Working with a professional Aging Life Care Manager can remove the burden of guessing. With medically trained professionals overseeing care, monitoring health changes, and coordinating with providers, families gain reassurance that every step is supported by clinical expertise. This reduces stress while protecting the senior from risks related to missed symptoms or delayed interventions.

7. How Expert Aging Life Care Management Helps Families Navigate Change More Smoothly

Change may be unavoidable, but feeling lost in the process is not. Partnering with an Aging Life Care Manager provides:

• comprehensive clinical assessments that clarify what is happening
• oversight that keeps care aligned with both medical and emotional needs
• collaboration with physicians and other service providers
• ongoing evaluation as conditions evolve
• help managing emotions, communication, and family expectations
• crisis prevention through proactive planning
• a coordinated team ensuring safety and continuity

This level of support helps families move from uncertainty to stability and from overwhelm to confidence.

Conclusion: Change Will Come, but You Do Not Have to Navigate It Alone

Aging brings transitions that affect every part of a family’s life. These changes can be meaningful and deeply challenging. With expert guidance, families can move through them with clarity and compassion rather than fear or uncertainty.

When families face the layered challenges of aging, physical or mental illness, or cognitive decline, they need more than just referrals or resources. They need a professional partner who brings both clinical insight and emotional understanding, someone who sees the whole picture and knows how to navigate it.

Aging Life Care Managers help families feel supported, prepared, and confident in the decisions they make for their loved ones. With expert care management, families do more than navigate change. They grow through it.

To find an Aging Life Care Manager near you or your loved one visit aginglifecare.org.

The blog was originally published by Life Care Concierge of South Florida and was reposted with permission

About the Author:

Jill Poser, CGCM, CMC, CDCP is a nationally recognized leader in Aging Life Care Management, Private Duty Home Care, and Life Care Planning. With more than 15 years of experience in aging services, she brings a compassionate, patient-centered, and evidence-based approach to helping individuals and families navigate complex care needs and successfully age in place.

Inspired by her own caregiving journey, Jill is the founder of Life Care Concierge of South Florida a comprehensive Aging Life Care Management and Private Duty Home Care Concierge practice. Jill is an Advanced Professional member of the Aging Life Care Association® and holds multiple nationally and internationally recognized certifications, reflecting her deep commitment to excellence, integrity, and person-centered care.

The holidays can often be a time filled with high expectations, requiring lots of energy and engagement in non-stop activities. For the individuals and families living with Alzheimer’s or other dementia, it can be challenging and a time of high anxiety. Festivities can agitate, confuse, and overstimulate persons living with Alzheimer’s or other dementia. Meanwhile, caregivers can feel anxious, frustrated, and lonely.

Tips to Help Someone with Dementia Enjoy the Holiday Season

By Lisa Mayfield, MA, LMHC, GMHS, CMC – Fellow of the Aging Life Care Association® 

To minimize anxiety and encourage a happy holiday season for the entire family, a little advanced thought and planning can go a long way in ensuring everyone has a wonderful time. Remembering that the holidays, at their best, are a time for enjoying one another’s company and sharing gratitude for each other can make some advanced planning go a long way.

Feeling Comfortable

• Keeping rooms well-lit and bright is the best way to help those with low vision. To reduce the chance of falls, be mindful of lighting, inside and out, and clear pathways of potential tripping hazards.
• Offering and assigning a “buddy” to assist with navigating the house can also be helpful for guests with low vision, poor mobility, or cognitive change.
• Older adults appreciate a warm house. Encourage dressing in layers and be intentional about seating. Save the “hot seats” for those who prefer being cozy.

Making Conversation

• For those experiencing hearing challenges or memory changes, navigating multiple conversations can be tough. Strategically sitting older family members at the end of the table next to one or two family members who will be intentional about including them in conversations can often be the best way to ensure they feel engaged and included. Shouting across a room or even the dinner table, is rarely effective. More important than speaking loudly, is speaking clearly and sitting close.
• Don’t be shy about sharing stories and beginning conversation. Living with memory changes can make it difficult to initiate a conversation. It’s okay to take the lead with starting conversations.
• Focusing conversations on the present or sharing favorite memories is a great way to keep the conversation going.
• If an older family member has low vision or is living with memory loss, having family members introduce themselves can be helpful, “Hi Great Aunt Jane, it’s John. It’s so nice to see you.”

Taking it Easy

• Less is often more.  Families sometimes over plan their time together, so schedule plenty of down time. The best memories are often made while simply catching up and taking time to be together. “Being” vs “doing” might be the best approach.
• If your planning on an evening gathering, encourage taking an afternoon nap. Later afternoons or early evening can be a time that someone living with memory changes become even more confused. Having an early dinner can help ensure aging family members are more engaged.
• Integrating family traditions with new family activities can be an effective way to bridge the generations.
• This is the time to be especially gentle and kind with yourself. This is also a great time to practice saying “No” and pace yourself.

For more ideas, consider engaging an Aging Life Care Professional® to be your guide for navigating the changes with aging family members. Aging Life Care Professionals are experts in aging well and can help your family successfully strategize solutions to challenges of aging. You can find an Aging Life Care Professional at aginglifecare.org.

By setting realistic expectations, involving others, maintaining a routine, and keeping activities and traditions to a select few, you can ensure yourself, your loved one, and family and friends a low stress, memorable, and successful holiday season.

About the Author:  Lisa Mayfield is the founder and Principal of Aging Wisdom®, an Aging Life Care™ practice based in Seattle, WA. Trained and licensed as a Mental Health Counselor, Geriatric Mental Health Specialist, and a Certified Care Manager, Lisa brings over two decades of experience working with older adults and their families. She has been a member of the Aging Life Care Association since 2003.

Whether you live down the block or across the country, holiday visits are a great opportunity to take a closer look at your older loved one and their surroundings.

Take time to observe any changes in an older family member’s behaviors or lifestyle during dinners, gift exchanges, parties, etc. Changes may vary widely, from outwardly visible to subtle shifts in habits. Here is a list of simple things to look for and questions to ask when spending time with aging adults to get a sense of their current physical and mental well-being:

ENVIRONMENT

• Do you notice signs of damage or disrepair around or in the home? Piles of trash that haven’t been tossed out? Burned out light bulbs?
• Any decline in cleanliness, especially in the kitchen and bathroom? Is there a large amount of unopened mail? Are items being stored in unusual or hazardous places?
• Does their car have scratches or other damage?

FOOD

• Is there adequate food? Check the refrigerator and pantry for expired or spoiled food items.
• Do you notice they’ve lost weight, or suspect your loved one is skipping or forgetting meals?

MOOD OR BEHAVIOR

• Has mom or dad stopped socializing and/or given up hobbies they once enjoyed?
• Do they have any new friends or organizations who they have a lot of contact with? Is anyone or any organization asking for repeated or large donations or loans?
• Are you noticing increased confusion? Do you notice your aging loved one repeating themselves more than they used to?
• Are they showing increased irritability or apathy? Does he or she seem more withdrawn or sad?

PERSONAL HYGIENE

• Does your loved one seem more unkempt, not dressing during the day like they used to, not showering – or wearing dirty clothes when they do get dressed?
• Do they have bruises that may indicated they’ve taken falls?

Examining these four areas and answering these questions may help you determine if your aging loved one needs assistance. This is not an exhaustive list and should be used as a guide to help you check-in.

By starting the conversation early and getting support and information, you can help your loved one as they navigate this stage of their lives. Observe, listen, and spend time together!

Aging Life Care Managers are an excellent resource for support. Working with families, an Aging Life Care Manager is a strategic planner offering options and solutions that best fit a person’s individual needs and resources. Their guidance leads families to the actions and decisions that ensure quality care and an optimal life for those they love, thus reducing worry, stress, and time away from work for family caregivers.

Survey Reveals Families Wait for a Crisis Before Seeking Senior Care Help

When it comes to planning for senior care, most families are waiting until it’s too late. A new survey conducted by the Aging Life Care Association® – New England Chapter reveals that the majority of families don’t reach out for professional guidance until a crisis strikes — leaving older adults and caregivers vulnerable during emergencies.

Key Findings: Families Wait Until Crisis Hits

According to the survey, 59% of Aging Life Care Professionals® report that families typically engage their services only after a serious event such as a fall, hospitalization, or medical emergency.

Even more concerning, 55% of professionals said families lack advance care directives, leaving critical medical and financial decisions unaddressed. These two findings underscore a troubling reality: too many families are reacting to crises instead of planning ahead for aging care needs.

“We often hear from seniors and families that they only seek help and advice once they are in a health crisis,” said Jennifer Pilz, MS, PT, CMC, President of ALCA NE Chapter. “Proactive planning, research, and guidance are not a priority, which can often lead to a more difficult — and much more costly — journey.”

About the Survey

The ALCA NE survey was distributed to over 200 Aging Life Care Managers® across the six New England states — Massachusetts, Rhode Island, Connecticut, Vermont, New Hampshire, and Maine. Respondents provided valuable, real-world insights into the trends, challenges, and innovations in supporting older adults, their families, and the professionals who serve them.

“Our goal was to elevate our members’ voices and share their collective expertise with aging adults, families, and the professionals who serve them,” said Pilz. “By gathering and sharing this data, we’re not only supporting our members but also informing the public about critical issues such as mental health support, caregiver resources, and home-based services.”

Why This Matters

The findings reflect what many aging life care managers see every day: families struggle to navigate the complex world of aging care. Without early planning and professional guidance, families face increased stress, higher costs, and reduced quality of care.

By highlighting these gaps, ALCA NE hopes to encourage families to act early — engaging professionals before an emergency occurs. The Chapter also plans to use the data to shape future programs, strengthen advocacy, and guide best practices within the field.

“We believe this survey strengthens regional collaboration and amplifies the voices of our members,” added Pilz. “Ultimately, it’s about helping aging adults across New England — and the U.S. — live with the dignity, independence, and quality of life they deserve.”

How to Find an Aging Life Care Manager Near You

If you’re ready to take a proactive approach to aging care—or you’re already facing a crisis—connecting with a qualified Aging Life Care Manager® is one of the most effective steps you can take. Aging Life Care Professionals® are trained experts in navigating medical, emotional, financial, and long-term care challenges. To find a professional in your area, visit the Aging Life Care Association’s searchable directory at AgingLifeCare.org.

Written by Barbara Levison, MA, MSW, CMC, Aging Life Care Manager

Being There: Advocating for Comfort and Dignity at the End of Life

When it’s time to choose hospice care for a loved one, families are often focused on one thing: reducing suffering and pain. For long distance caregivers, this can be especially difficult, worrying that the person they love might be in distress without anyone nearby to help.

As an Aging Life Care Professional, I often serve as an advocate for my clients when they transition into hospice care. One common misconception is that hospice provides 24/7 in home care. While hospice agencies do offer access to 24/7 support, someone must be present to recognize when help is needed and call for it. Hospice care can be provided at home, in assisted living, or in long term care settings, but families often need guidance to understand how it works in practice.

End of life care looks different for every person. Some individuals prefer not to talk about what their final days might look like, and that choice is valid. Others meticulously plan and communicate their wishes. Most people fall somewhere in between.

When I work with clients, I follow their lead, supporting them as they navigate conversations with family, caregivers, and doctors. My goal is always to honor their wishes.

Hospice adds a specialized layer of care to the existing team. A hospice nurse evaluates the client and collaborates with the hospice doctor to create a plan of care. Caregivers visit briefly to assist with personal care. Social workers offer emotional support, and chaplains provide spiritual care. Some agencies even offer music therapy, which can be deeply meaningful.

My role as an Aging Life Care Professional often includes serving as a liaison, connecting the hospice team with the client, their family, and private or facility, based caregivers. By the time a client enters hospice, I often have a long-standing relationship with them. I know their values, preferences, and routines, and I can share this information to help the team care for them in the most personalized way. I’m also able to recognize subtle signs of discomfort and work with the hospice team to address them.

It’s a privilege to walk alongside people during their final days. I’d like to share two personal stories that reflect the depth of this work.

The first is about a client I had grown very close to. She didn’t have children, and her husband had passed away suddenly less than a year earlier. Though she had family who lived far away, she had a small circle of trusted caregivers, and she knew her husband had trusted me.

In her final months, she lived in a memory care facility. When she entered hospice, I worked closely with the hospice nurse and facility staff to ensure she was comfortable. I visited every day, brought in her favorite music, arranged for a priest to administer last rites, and made sure friends and family had a chance to say goodbye. I held the phone to her ear so her distant relatives could speak to her.

One morning, I arrived as usual. My client was resting peacefully. A new caregiver was with her, and I spent a few minutes telling her about the incredible woman she was, a smart, compassionate doctor who had been one of just four women in her medical school class of 100. As I leaned towards the bed to say goodbye, I realized she had quietly passed while I was speaking. Her family found comfort knowing she died peacefully, with someone who truly cared for her nearby.

The second story is closer to home. My mother-in-law was admitted into hospice care at a local memory care facility. The last time I saw her open her eyes, the day before her admission, she smiled and winked at me.

I visited daily and worked closely with the staff and hospice nurse. One afternoon, my daughters and niece joined me to visit her. My daughter, a music therapist, brought her guitar, and together they sang Hebrew songs, songs that held deep meaning for their grandmother. Although her eyes remained closed, she hummed softly and tapped her fingers. Hospice sent their Rabbi, who gathered our family and led a deeply moving reflection on her life. We knew she was listening. She passed away peacefully, surrounded by love.

Many people have never witnessed the end-of-life process. Even though I have supported many clients and family members through this time, each experience is unique. Every person deserves to be seen as a whole person, honored for who they are, what they value, and the life they’ve lived.

At the end of life, my goal is simple: to bring peace, dignity, and personalized care. It is an honor I never take for granted.

About the Author:

Barbara Levison, MA, MSW, CMC is an Aging Life Care Manager® with nearly 30 years of experience supporting older adults and their families. A Certified Care Manager since 2007, she has provided care management services with Proeger & Associates since 1997. Barbara serves on the Board of Directors for the Aging Life Care Association® and holds the Fellow of the Leadership Academy designation, recognizing her as an advanced practitioner and leader in the field.