Spiders and Finances, Oh My!

ALCA’s Corporate Partners are a vital part of the equation that makes the Aging Life Care Association as strong as it is. They offer advice and insights to members via our listserv to help members find solutions for their clients. And members feel confident choosing one for their clients’ needs because ALCA’s Corporate Partners also adhere to a Standards of Practice and Code of Ethics. One such partner is Harmoney Bookkeeping Company which helps ALCA Members with their finances, so they can focus on their care management practice.

Harmoney owner, and frequent speaker at ALCA events, Deborah Vogt writes:

quotesI really, really hate spiders. I recognize they have an important place in the circle of life; however, my preference is to pretend we do not exist in the same world.

Yesterday morning, a spider appeared in my bathroom sink. He wasn’t doing any harm, just hanging out enjoying the cool surface of the porcelain. Regardless, I immediately reached for the faucet and washed him down the sink – admittedly feeling a bit bad when I saw the panicked reaction that the rush of water caused the spider. After a few seconds, he was washed away.  That evening, however, he greeted me once again, relaxing in the same exact spot in the sink. I repeated my less than hospitable greeting from earlier in the day and down he went. This morning he was back in the same place. Huh.

Seeing him for the third time gave me pause. Rather than flooding his world yet again, I found myself wondering if his persistence was meant to be taken as a lesson of some sort. I decided to look at the thrice appearing spider as a representation for something unpleasantly persistent but with a greater purpose. But what? Being the owner of a bookkeeping company, there’s never a big leap from anything I’m thinking about to bookkeeping.

My recoiling at the sight of a spider is very similar to the reaction some business owners have when I suggest we review their financial reports. During my career I’ve heard the audible catching of one’s breath at the suggestion, I’ve seen crunched up faces, shaking heads and been given dirty looks, and I’ve been asked to put it off to “another time”. Financial reporting is their spider.

Like spiders, the way to appreciate financial reports is to accept that as a business owner, you and your financial reports exist in the same world. Whether you see them or not, they are there and they serve a greater purpose. Financial reports tell an entrepreneur about their financial environment in the same way a spider tells a scientist about the environment it inhabits. Financial reports can protect owners from unexpected ebbs and flows in cash and they can provide a buffer against cash-seeking pests. While their goodness may not be evident to the untrained eye, their value cannot be overstated.

Three ways to squash a Financial Reports phobia:

  1. Realize there is a structure and a purpose to each report. Its purpose is to share with business owners how to understand, grow and profit from their businesses.
  2. Ease into the reports. Get to know them a little at a time by looking at either the Profit & Loss or Balance Sheet monthly. With regular and increased exposure, an owner’s comfort and confidence will increase. Owners and their financials become good friends over time.
  3. Believe in the ability to understand and to professionally benefit from financial reports. In no time the reports will become an important part of managing your business.

Business owners new to financial reporting may wish to read the SEC’s Beginner Guide to Financial Statements

About the Author: Deborah Vogt is the founder of Harmoney Bookkeeping Company in Wayland, Massachusetts. Debbie presented at the 2021 ALCA National Conference. She and her staff provide monthly bookkeeping services to small and medium-sized businesses around the country including many ALCA members.

A Corporate Partner Shares The Value of Working With ALCA Members

ALCA’s Corporate Partners are a vital part of the equation that makes the Aging Life Care Association as strong as it is. They offer advice and insights to members via our listserv to help members find solutions for their clients. And members feel confident choosing one for their clients’ needs because ALCA’s Corporate Partners also adhere to a Standards of Practice and Code of Ethics. One such partner is Grandma Joan’s Live-in Care Staffing. Grandma Joan started out as a state-licensed home care agency in 2010. The home-care model was born from an exit survey with one of their original home care agency clients. The client was distressed about the need to continue their professional live-in services for his mom. She was living alone and had Alzheimer’s; however, he was no longer able to afford their agency rates. It was from this client’s need that the concept of live-in care staffing service was born. They helped him find, screen, and contract with a qualified independent live-in, all for a one-time set-up fee. He paid the independent provider directly and, on the books, cutting out the agency overhead. Grandma Joan’s service model was an overnight success, and within a year of its launch, they went nationwide.

Founder David Petroski shares his experience of ALCA membership and working with Aging Life Care Members.

quotes “When I joined ALCA as a Corporate Partner a few years ago, I was already working with a dozen or so care managers scattered around the county, and at that point, 9% of my new clients were referrals from ALCA members. While I don’t remember which one of them suggested that I join ALCA,  I am so glad that they did. I joined in 2018.
Over the last 3 ½ years I have:

  • Networked, networked, and networked.
  • Exhibited at two ALCA National Conferences
  • Utilized advertising options made to corporate partners, like their members-only newsletter
  • Wrote a piece for the ALCA blog
  • And attended lots of ZOOM one-on-ones with curious care managers

And as a result, my business has grown by double-digits for three years in a row.

In 2020, a whopping 55% of my new clients were referrals from ALCA members. I cannot be more thankful and cannot speak highly enough about how much joining this organization has helped me get the message out to families in need–that there is another option out there for them to consider if they don’t want to relocate to an assisted living facility or skilled nursing facility.

When the opportunity arises, I happily recommend ALCA to peers, and always recommend my clients to utilize a certified care manager from ALCA. In the over 10 years I’ve been in the senior care industry, I honestly feel there is no better referral network for a reputable senior care service than ALCA, especially for a company with a national footprint. I have heard local companies do equally well with membership at the regional Chapter level.”

Thank you to all the Aging Life Care Professionals, for all that you do for your clients –  David.

Grandma Joan

About the Author: David Petroski is the Founder of Grandma Joan’s Live-in Care Staffing. He is a Human Resource Specialist that has helped staff over $15 million in household payroll. He has helped hundreds of families across the country safely navigate the challenges of the consumer-directed live-in care market. David’s work has helped Grandma Joan earn five national awards of recognition in the senior-care industry. He has been working in senior care since 2010, when he started a home-care agency in Montclair NJ. David has been an expert panelist for CPE-accredited webinars educating hundreds of senior-care industry professionals about private-hire live-in care. He is a Certified Senior Advisor (CSA)®, and has been interviewed on radio and is quoted in the 2018 book Aging with Care. David lives in New Jersey with his wife Cathy, who is also in HR, and their three children, Danny, Sofi, and Blake.

Hydration: How Much Water Should You Drink Every Day?

Glasses,Of,Water,On,A,Wooden,Table.,Selective,Focus.,ShallowRecent weather and above-average, record-breaking temperatures have me wondering if I drink enough liquid, especially water. The human adult body is approximately 55 to 60 percent water. Staying hydrated is essential to our health and helping our bodies function optimally.


How does water function in our bodies?

  • Regulates body temperature
  • Lubricates joints
  • Flushes body waste
  • Nourishes brain and spinal cord
  • Helps deliver oxygen

Water is vital to our survival. Decreased hydration can result in drops in mood, skin moisture, blood pressure, and energy level. It can also contribute to symptoms of cognitive impairment.

How much fluid should you consume each day?

Past guidelines have advised eight cups per day, but new recommendations suggest higher intake. Our individual needs differ based on gender, age, where we live, activity levels, and overall health. The National Academies of Sciences, Engineering, and Medicine determined that adequate daily fluid intake is:

  • About 15.5 cups (3.7 liters) of fluids for men
  • About 11.5 cups (2.7 liters) of fluids a day for women

How do you make certain that you are consuming enough?

There are various healthy habits you can adopt to be certain that you drink enough liquids. Here are some simple, effective ideas that I’ve found helpful:

  • Buy a water bottle that is easy to clean and comfortable to tote. This way you will always have water or some other hydrating beverage at the ready. Put rubber bands around your water bottle to track consumption. Remove one each time you finish the contents. Example: my water bottle is 32 ounces = 4 cups. I should be drinking at least 11.5 cups of water per day, so I put three rubber bands on my bottle, removing one each time I finish a bottle, before refilling.
  • Keep a pitcher of chilled water in your refrigerator. Add slices of strawberry, cucumber, citrus fruits, or sprigs of a favorite herb to add flavor without calories. If the water tastes good, you are more likely to drink it. (I keep mine on the counter as I prefer my water less chilly.)
  • Make sure you have plenty of fruits and vegetables handy, as most are 90 percent water. Apples, cucumbers, strawberries, celery, spinach, and melon (especially watermelon) are popular choices. They also add nutrients and fiber and are a great excuse to visit your local farmers’ market!
  • Take sips throughout the day. Don’t consume large quantities all at once.
  • Drink a glass of water with each meal and between each meal (and yes, coffee and tea consumption count).
  • Drink water before, during, and after physical activity.

 What are the symptoms of dehydration in adults?

  • Extreme thirst
  • Dry, cool skin
  • Headache
  • Rapid heartbeat
  • Dizziness and/or fainting
  • Confusion
  • Infrequent urination
  • Dark-colored urine
  • Fatigue

How do you know you are hydrated?

  • You don’t feel thirsty often.
  • Your urine is colorless or pale yellow. If it is a deeper yellow or amber, then you know you need to increase your level of hydration.

Hydration tips for caregivers

According to the Mayo Clinic, “Thirst isn’t always a reliable early indicator of the body’s need for water. Many people, particularly older adults, don’t feel thirsty until they’re already dehydrated. That’s why it’s important to increase water intake during hot weather or when you’re ill.”

If you are caring for an older person, you know that hydration can be a challenge. It is important to remind older people about drinking water, as signals for thirst in the brain change over time, especially if someone is living with dementia. Proper hydration can also help keep urinary tract infections (UTIs) at bay and counter the dehydrating effects of some medications.

Be mindful that an individual concerned about incontinence or bathroom access when in public may use this as an excuse to not drink adequate amounts of fluid (though they may not articulate it in that way). Encourage regular sips of a beverage. Be aware of how often bathroom breaks occur.

If outings and potential accidents are a concern, consider using a public bathroom finder app such as Flush. When you have a planned outing, call ahead to find out about bathroom access and locations, and subtly scout the locations of facilities when you arrive. If an individual needs assistance with toileting, have a change of clothing and extra incontinence products (if they are regularly used by the individual) handy as back-up.

No single approach works for everyone. Experiment and explore your options. With a little planning and new habits, you will soon be hydrating appropriately and experiencing the benefits.

About the Author: Contributor Juliet Powell leads Creative Engagement at Aging Wisdom, an Aging Life Care practice based in Seattle. Juliet is a certified home care aide who has worked in the field of aging since 2012. She facilitates Professional Boundaries Training and is involved with hiring, training, and supervising Aging Wisdom creative engagement specialists.

Founder’s Story: Parkinson & Movement Disorder Alliance

At the very heart of Parkinson & Movement Disorder Alliance (PMD Alliance) is a deep desire to meet people where they are at in their movement disorder journey. We roll up our sleeves, hold your hand and remind you that you will not walk alone.

Whether you’re someone living with a movement disorder, or a care partner, an adult child, a friend, a doctor or a support group leader, PMD Alliance is a uniquely people-oriented community designed to care for you. We cannot do this important work alone. Together, alongside donors, corporate partners, volunteer Ambassadors, doctors and advance practice providers, the uniquely supportive PMD Alliance community provides innovative and inspiring programming and resources to those navigating a devastating diagnosis.

Because at our very core – that’s just who we are. That’s why we do this work.

In 1992, we noticed Wayne was having tremors in his right hand. We didn’t think it was anything serious, so we continued our normal, busy schedule. Wayne was an early riser and ran three miles every day! But by 1998, the tremors were more significant and were accompanied by constant fatigue. Just one year later, he was diagnosed with Parkinson disease. – Helen Squires

Helen Squires and her husband, Wayne, were married for 55 years before he died from complications due to Parkinson’s in 2016. At the time, there were limited resources for people living with Parkinson’s, let alone support for care partners and families navigating this disease with a loved one.







It was watching her mother-in-law struggle to keep up with her husband’s declining health that pushed Sarah Jones, CEO and co-founder of PMD Alliance, into action.

Some memories are forever etched in our minds and hearts. I was standing on a moving walkway in the Denver Airport. My wife and I were returning from a visit with her parents. Her father’s Parkinson’s was stealing his very existence and simultaneously breaking my once fiercely energetic mother-in-law. We believed she would die before him because of the stress and strain she was experiencing in caring for her husband,” says Jones.

“As former ministers, my in-laws were active and social – rarely without people. Yet as the disease progressed, their world shrunk. They were told by doctors there was nothing more to be done. Their souls were crushed, and they were alone. And I was outraged.

Millions of dollars were pouring into research in attempt to change the future and meanwhile, no one had a service model focused on the people living with a degenerative disease today. In that moment I knew an organization needed to be created to attend to the tens of millions of people – not just patients – whose lives are impacted by Parkinson’s and other movement disorders.”

Sarah’s vision was one that was shared with co-founder, former colleague and friend, Judy Talley who had spent the previous 15 years working in long-term and residential care settings. She and Sarah met in 2015 when working for the American Parkinson Disease Association in Tucson.

“Motivated by a deep desire to help people trying to keep their heads above water every day, PMD Alliance was born. Having run nonprofits for nearly 25 years, I was determined to create a new set of services that offered real, honest, and empathic services that moved the needle on quality of life and reduced isolation,” says Jones.

Judy Talley adds, “Sarah and I have an amazing ability to quickly and clearly communicate with each other, and together have always been aligned in our aspirations for the organization. For me, the scariest part was the most fun part. Starting something new. Developing new events and new ways to engage people. Coming up with a new paradigm to support people in their daily lives and that honors them in the entirety of their living and was about more than the disease.”

One of the “new” things that PMD Alliance has introduced to the movement disorder space is its unique Movement Disorder Care and Support Ecosystem© which focuses on strengthening all persons affected by a diagnosis. When everyone involved is better educated, better supported and more connected, the person with the movement disorder has more opportunities to live more fully.

At PMD Alliance, that translates into support groups for care partners, a Facebook group for adult children, a unique catalog of programming that focuses on everything from physical activity to medication options to end of life care. Just ?ve years since its start, as the organization continues to grow and serve people not only nationally but internationally, PMD Alliance still strives to meet people where they are at in their journey and to ?ll needs when they are seen.

I am amazed how strong people with the disease can be; accepting, resisting, and adapting as they cope through the years. – Judy Talley, Co-Founder PMD Alliance

The reality is there are 40 million Americans living with movement disorders. 40 million. While there is still no cure for Parkinson’s disease, with PMD Alliance there is hope. There is partnership. There is community. And there remains a deep desire shared among everyone involved in the community to touch the lives of many.

Oftentimes among its staff, PMD Alliance asks each other – “what is our ‘why’?”

It’s a good reminder to check-in. To make sure the programs and resources offered meet a need. To search for unmet needs and to innovate. To remember why it is that this work is so important not only to people living with movement disorders, but for those who care about them.

When we do that, we are reminded of Helen Squires and why PMD Alliance was started in the first place. We are all trying to navigate and live our very best lives despite this devastating disease, and if we work together, we have a better chance at doing just that.

Will you join us?


About the Author: Sarah Jones, MPA, MS Strategic Design, CEO. With more than 25 years of experience leading non-profits and healthcare programs, Sarah is a visionary leader. As a dyed-in-the-wool dynamo who continually seeks opportunities to impact and address unmet needs, Sarah has designed programs and led training for local, national and international audiences, including groups in Canada and Botswana. Called upon to solve issues of efficiency and develop a culture of innovation, she has also acted as a consultant for global brands, including Campbell’s Soup. Sarah holds two master’s degrees: Master of Science in Strategic Design Management and Master in Public Administration. She has consulted with large health care systems, integrative medicine clinics teaching utilization of strategic design principles to innovate and change end-user experience.  Sarah is driven to create a world that people are excited to live in.

The Power of Breath

I have always been fascinated with the power of breath.

We carry it with us at all times. We breathe somewhere around 20,000 breaths every day. Most of us barely give our breath any thought at all. Yet how we breathe can have everything to do with our health and well-being.

Try it for yourself:

Close your eyes (after reading this of course!) and simply watch and feel your breath, without changing it or judging it in any way.

Notice the length of the breath, the temperature, where it moves through your body, if it’s smooth or rough. Do this for just a few minutes or as long as you like. How do you feel? Relaxed, calm, peaceful, more present?

Help Reduce Stress: Bringing awareness to our breath, even for just a few minutes, can help us feel calm and reduce feelings of stress and anxiety. Research shows that stress is a contributing factor to many diseases.

Maybe while you were breathing you noticed the different qualities of the inhale and exhale. The inhale literally lifts and expands the body and provides inspiration and energy. The exhale contracts the body and provides a sense of release and grounding.

Which do you need more of?

  • Need a boost of energy? Increase the length of your inhale.
  • Need to relax and ground? Increase the length of your exhale.

I lost my mother to Alzheimer’s about ten years ago. While sick, she didn’t want to get out of bed in the morning. I’d sit with her and encourage her to breath in her right nostril and out her left nostril. Right nostril breathing, also called sun breath for its activating nature, stimulates the left side of the brain – the more logical, get up and go, side of the brain. Three rounds of ten would be just enough to get her to re-focus and provide that little boost of energy she needed to start her day. Try it if you feel sluggish yourself at any point during your day.

Trouble sleeping? Try the opposite. Left nostril breathing, or moon breaths for their more cooling and calming nature.

Bottom line: The way we breathe can have a tremendous impact on our energy, mood, stress level, focus and attention, and sleep. These are all factors in healthy aging. If you care for someone, personally or professionally, breath can be a tool to take care of both of you.

Have you paid attention to your breath today?

About the Author: Jane Stelboum is a Yoga Teacher/Trainer, a Certified Brain Longevity® Specialist, and founder of Sarasvate (sar-as-VAH-te´). Through workshops, private sessions and speaking engagements she shares how the tools of yoga, and other lifestyle choices, help maintain brain longevity and healthy aging.

Overcoming Technology Hurdles to Sign up for the COVID-19 Vaccine

While the COVID-19 vaccine has been available for several months – there are still many adults who have yet to receive their first dose.

Aging Life Care Association Corporate Partner CandooTech offers technology solutions for seniors and their families, and has some initial tips to aid those still looking at, or beginning to consider vaccination.

Please note there can be changes in vaccination locations as the variants evolve and conditions change locally, regionally, and nationally.

Each state has its own system for sign up and distribution, many require signing up online. For most people, this has been confusing at best and, in many cases, impossible to navigate. For older adults who don’t feel comfortable with technology in general, this can be an insurmountable hurdle to getting a potentially life-saving vaccine.

Here are our top tips:

1.     Get information to learn if you are eligible:

Find out what your state is offering. This may be different by county or city. You can get an overview by going onto the AARP site.

2.     Get information about where you can get the vaccine and how to sign up:

For example, in California, you can sign up for alerts by county.

In New York state, in addition to adults over 65 years old, the vaccine is now available to healthcare workers, transportation workers and more. You can find out if you are eligible here. Each site has a separate way to register and separate availability. Here’s a list of vaccine locations. For New York City, you can find a location here.

3.     What information you will need to register for an appointment

In order to sign up, at a minimum, you will need to include:

  • Your full name

  • Your date of birth

  • Your address

  • Your insurance information: name of insurance, name of insured, member ID and Group ID

  • Your phone number

  • Your email address if you have one

4.     Getting an appointment:

This can be a challenging and frustrating process. It sometimes requires hours of refreshing a page to see when an appointment is available and/or going to multiple different websites to see what’s available. Don’t give up! Did you know that you can download an app on Google Chrome to help you automatically refresh the page?

5.     Once you get an appointment:

When you get an appointment, you will receive a confirmation by email or text message. You will have some paperwork to fill out. You can either fill it out online, or you can print it out and fill it out on paper. You will need to print this with you to the appointment. You will be asked questions like: “have you ever had a serious or life-threatening allergic reaction before?” “Do you take medication that affects your immune system?” Please be prepared to answer these questions.

If you need help going online to get this information or fill out some of the forms, please call us at 646-758-6606 or email us at We can arrange for an online session to help! To sign-up for an online session, go here and use promo code VACCINE.

This blog originally appeared here:

About the Author: Liz Hamburg, Candoo Founder. Liz is a high energy, entrepreneurial executive who is passionate about making an impact in the world. She has over 20 years of experience starting up and growing innovative organizations both in the U.S. and international markets.

Summer Safety for Seniors

With the pandemic now hopefully behind us, how can seniors most safely enjoy and celebrate this summer?

There are two priorities to keep our community’s elders safe:

  1. avoiding the dangers of excessive summer heat and humidity, and
  2. preventing falls, a year-round need, but one where summer presents some special challenges.

Keeping Cool During Our Hot Summers – Unfortunately, heat exhaustion and heat stroke, which can even lead to death, are much more common in the aging.   Simple prevention includes staying out of the direct sun between 9 am and 3 pm, exercising in air-conditioning or during the cooler times of day, staying well hydrated with water & electrolytes (sports drinks), and wearing loose, lightly colored clothing.   Non-alcoholic iced drinks can also help keep you cool, and be careful consuming alcohol – too much of it can be dangerous, for everyone.

How Do You Spot and Treat Someone Who is Over-Heated?  People with heat exhaustion or heat stroke can display weakness, dizziness, headache, confusion, a fast pulse, heavy sweating or red, hot, dry or damp skin, and lose consciousness (pass out).   Treatment includes moving them to a cooler place, using cool cloths or a cool bath to lower their body temperature, sipping water, and if they do pass out or symptoms get worse, get immediate medical attention or call 911.

Preventing Falls Outside – Falls are one of the major reasons seniors go to the Emergency Dept, get hospitalized, and even suffer an early death.   Along with falling from heat exhaustion/stroke, many summer activities can lead to falls.  This includes falls while hiking up in our beautiful Blue Ridge Mountains or at other area attractions.   Along with taking a sturdy walking stick to navigate curbs and other uneven surfaces, be sure to pack all the supplies you need to stay well hydrated and safe from the heat and sun.  Be sure as well to take a charged cell phone and let someone not with you know where you’re going and when to expect you back.

Closer to home, other activities that can cause a fall includes yard work and anything involving a ladder.   Rather than risking an injury or maybe even your life climbing a ladder to clean a window or paint some trim, hire a college student or a contractor to do the work.  It can save you in the long run, literally!   Yard work can also involve lifting heavy bags, rocks, or other items, all of which can contribute to joint and back pain, one of the most common reasons seniors go to the doctor and use pain medication.   Again, hire someone else to do the work to avoid it becoming a pain in the neck, or your back.

Fall Prevention in the Home – although we all know how important it is to prevent falls, we often avoid or delay making needed home safety modifications.   Right now, during the summer, is as good a time as any to finally make those necessary changes.   Start with a home safety assessment for which there are many good lists online, including from AARP.   Then follow-thru on the priority items, to keep you and your loved ones safe this summer and then the whole year through.

About the Author: Fred D. Jung, RN, PhD is the founder of Blue Ridge ElderCare Advisors, LLC. He has expert knowledge and experience in disease management, infection control, healthcare insurance, geriatric & end-of life care. With a PhD in Adult Health Nursing from the University of Texas, he developed one of the first on-line case management courses for the University of Colorado. Fred began his career in long-term care & has held positions as an RN, clinical specialist, faculty member, Director of Quality & Case Management, and as an Administrator at the UVA Health System. He now focuses on improving the quality and effectiveness of care for the aging and elderly in central Virginia and the Shenandoah Valley.

SELF-Compassion is a Gift

Gift of Compassion eventAfter the last year and a half of living with a pandemic and beginning to see the signs of improvement, I was more than ready to listen to the June 6th virtual event by Dr. Lori Stevik Rust, “Compassion is a Gift.” As Aging Life Care Professionals in the human service field, most of us would say we are “compassionate” with our clients and families.

Dr. Stevik Rust pointed out that most people are in favor of offering compassion to others, but less able to offer self-compassion, and reminded us that self-compassion is a gift we bestow on ourselves (e.g. Put on our own O2 mask before helping others.)

She shared a poignant story of her first case during the Aids epidemic in the 80’s and how unprepared she felt. Her uncertainty led to self-criticism and the fight or flight response. She reminded us that the antidote to self-criticism is self-compassion (recognizing we are not perfect) which results in authenticity.

Self-compassion makes authenticity possible. According to Dr. Stevik Rust, research has shown that people who practice authenticity are more successful, resilient, motivated, emotionally stable, accountable, and better leaders.

Compassion Fatigue was discussed which can result in low energy, guilt, anger, self-isolation, feeling burdened, poor self-care, or denial of symptoms as well as the risk for post-traumatic stress disorder in ourselves and others. She asked us to acknowledge and have enough self-awareness that things might be escalating with compassion fatigue and to stop and say “it’s ok to take a break and care of myself.”

Easy quick self-care options were shared: massages, sexual activity, laughter, music, bubble baths, journaling, exercise, reading, etc. These can all help reduce the stress hormone cortisol.

While much of what she shared was not new information for those of us in the field, it was a good reminder of the importance of self-care for the 50 attendees.

I came away being impressed with her warm, engaging manner, and as one attendee said, “I love the fact that you present in a non-saccharine fashion. Very authentic and honest.”

About the Author: Susan Wack started SW Professional Care Management, LLC (SWPCM) in 2007 after working for over 20 years in hospitals, home health, disability services, and long-term care. She is a Certified Advanced Social Work Case Manager (C-ASWCM) and a Licensed Clinical Social Worker (LCSW). Susan received her Master’s Degree in Social Work (MSW) from the University of Iowa and her Bachelor’s of Science in Social Work (BSSW) from St. Louis University. She is a member of the Academy of Certified Social Workers (ACSW), the National Association of Social Workers (NASW), and the Aging Life Care Association (ALCA). Susan provided training on Elder Care Mediation to attorneys and social workers in Indiana, and serves on ALCA’s Midwest Chapter Board of Directors.

How to choose a Skilled Nursing Facility

people in skilled nursing facility

When families have exhausted other options sometimes the decision is made to move an older loved one in a skilled nursing facility.

Usually, this decision is made under stress, without much time, and/or without a lot of information. You do not need to do this alone. Having a partner in this process, i.e. a professional who can help guide, support, and facilitate a good move to the best possible skilled facility is critical.

This decision can be made easier with more information that an Aging Life Care Professional® — certified professionals with degrees in geriatric care management, nursing, social work, or other professions related to aging — can offer, and sometimes even be avoided.

Aging Life Care Professional® and ALCA Board Member Steve Barlam offers advice for families considering a skilled nursing facility (SNF) for their loved one.

When considering a skilled nursing facility, there are gross and fine screening issues to look at. There are several questions to consider to help in the selection process.

Let’s take a look at the gross screening considerations first: 

Gross screening

…has to do with basic issues:

  • Geography / Location – where is the skilled nursing facility located? Close to you? Far away? Will you need an Aging Life Care Professional® (ALCP) to help check in on your older family member?
  • What will be covered by insurance / HMO — Insurance issues can be daunting. An ALCP can help navigate complex insurance guidelines and forms.
  • Open beds – ensuring there is space at the facility is another initial concern that must be cleared up before you can proceed.
  • Basic skills / specialties tied to the condition and diagnosis – what skills or specialties does the staff have? Will they be able to address issues you need dealt with for your family member?

Fine-tune screening

…has to do with items that are important to you.

Not everything will be important, so you would want to be clear on what is important to you:

  • The reputation / record / licensing deficiencies – does the facility have a good reputation? Is it up-to-date on its licenses?
  • The look / feel / smell of the place – How is the lighting? Is it well-lit and welcoming?  Is there an outdoor space available for residents? Visit at two different times if possible, once during the day, and once during the evening to get a sense of the facility for a fuller perspective.
  • How is mealtime handled? Are meals served communally or in the patient’s room? What would your family member be comfortable with?
  • The ability to visit / access the patient? Is it convenient, accessible? What are the visiting hours? During the pandemic, are there more stringent requirements?
  • Staffing – What is the ratio of staff-to-resident? How many patients does the C.N.A. have on the day shifts?  Night shifts?  Who is ultimately responsible for the care?   Director of Nursing? The Administrator? How long have they been in their position? Are they there on-site daily?
  • Communication – If you have identified a need, who will you be able to speak with? If there is a problem, with whom will you be able to speak? Get their name and phone number.
  • Roommates – If your family member will be placed with a roommate, how are they matched? If there is a problem, how is that resolved?
  • Social needs? What is done for the patient’s social needs? Are there activity programs tailored to the individual?
  • Other events – Are religious services accessible? Cultural events?
  • Medical Doctor – Ask who would be the medical doctor following my family member? How long has s/he been there? What’s their bedside manner? Ask “How often will my family member be seen? How does information get communicated with his/her primary care physician and me?”
  • Interdisciplinary Team Meetings? How often does the team meeting? Is the family invited? How often is the plan reviewed?
  • Cost – What is covered and what isn’t.  Is it certified by Medicare / Medicaid?
  • A specialty? What does the facility specialize in? – Dementia care?   If so, is it distinct/separated?
  • Additional Services – If additional services (chemo/dialysis / other specialized rehab) are not provided in-house are needed, how is transportation arranged?

These questions and considerations can help a family get started when considering a skilled nursing facility. However, engaging an Aging Life Care Professional® can help even the savviest family navigate these questions, and can help in the coordination process. Time and money invested in engaging a qualified, certified Aging Life Care Professional® can be a time and money saver in the long run.


About the Author: Steven Barlam, MSW, LCSW, CMC. As a Licensed Clinical Social Worker, and after 30 years in the private sector, Steve has assumed the CEO role at JFS Care in Los Angeles, which provides quality eldercare solutions for seniors and their involved families including in-home care, and professional coaching/guidance through Care Management Services. His driving motto is, “It has to be good enough for my mom,” as he is all about ensuring quality care experiences for clients and their families. Steve values both tradition and innovation as he leads his team to grow JFS Care’s presence to deliver better care solutions in Los Angeles. Steve has been a member of ALCA since 1991, was Board of Director’s President in 2003, is currently on the Board of Directors and serves as Co-Chair of the Chapter President’s Committee.