How to Find an eldercare provider that is right for your parents

When I began this column, I had no idea what it was like to write for a major newspaper. My first column, launched July 4, 1994, was short and came out once a month. Six years ago, I began writing weekly. What started as almost a hobby suddenly became, through the sheer relentlessness of the calendar, like a final exam each week.

I didn't receive much mail at first, but now it's an avalanche. I get several letters and 300 e-mails a day, much of it spam. But a tidy number come from readers and (how do I say this nicely?) public-relations professionals who want me to advertise their clients' services, books, programs and products for free. That is not my mission. As interested as I am in quality new products to help us age deliberately, most of what's characterized as "new" in the aging field is anything but.

One of the favorite parts of my job is to answer readers' questions. However, this is where I've been failing — the volume has become too much. There are also no geographic boundaries; I receive e-mail literally from all parts of our country and the world.

Many of the questions you ask are universal, so today I thought I'd give you a little of "this and that," perhaps providing an answer you've been looking for.

Q. My mother-in-law still resides at home. However, she may someday need to move to a nursing home. Which ones in our area do you recommend? I should add that my husband and his two brothers have a very negative picture of nursing homes in general.

A. I never recommend any specific brand or type of care until I meet the person and learn a great deal about them. Eldercare providers (home-care agencies, assisted living, adult family homes, nursing homes and retirement communities) vary significantly, and the one that best fits one person may be totally inappropriate for another. However, it sounds like you're trying to plan ahead, and I want to encourage that. Here are my suggestions.

Your husband and his brothers should know that their mother might die without ever needing a nursing home. There are many other options today, so they need to cast their nets wider.

To understand what these choices are, talk to the Senior Information & Assistance Office in the mother's area. This is a free phone service that can provide definitions and lists of services to help them start their search. (To find such offices anywhere in the United States, contact the Eldercare Locator at 800-677-1116 or go to www.eldercare.gov.) Then they need to visit, make phone calls, ask for marketing materials — kick tires and figure out what they're all about.

I also recommend getting professional help with these very complicated issues. Geriatric-care managers are independent experts who understand older adults and their needs. A good care manager will get to know the older person, then help her family make concrete plans for the short term and long term. You can find a care manager at www.caremanager.org.