Saturday, December 8, 2007


A number of newspapers recently reported on the list of the worst nursing homes in the country. Only one was listed in the District of Columbia, but the list should remind us to do a thorough evaluation of all options for housing for the elderly and disabled.

The first line of defense is to start early preparing for later disability, whether for yourself or a parent or family member. This includes developing a network of family and friends whom you can rely on. If you are a child, helping your parents think out ahead. If you are the parent, thinking about how to create or find a network of like-minded support family members and friends.

The second is to begin exploring a lot of options while you or your family member is still able to get around and make choices for themselves. There are many resources on the internet, including co-housing, elder co-housing or finding a vibrant community -- some empty nesters even return to city center to be near shopping, movies, lively restaurants and community centers -- to move into or live near.

The third, when one hasn't been able to do advance planning, is to research the assisted living and nursing home options where you or your family member wants to live. One of the best places to begin is with the ombudsman in your area who monitors these facilities. That person will have tremendous knowledge of the facilities and what level of care they provide, especially what quality of care.

Be prepared to look at a number of places. Also, identify what you or your family member is most interested in in terms of social interactions, setting, environment. Cost is only part of the picture. Expensive places can be sterile and cold; "poor" places can be rich with life and a caring staff. Ask questions of the staff and ask to talk to people who live there. Ask many questions about the things in life you care about. My mother would ask "how many people read the New York Times?"

Consult with experts who may know a lot about the various choices, such as geriatric care managers, the area agency on aging, and elder law attorneys, among others. Perhaps there is a local citizen commission on aging and city office on aging. When you visit, all nursing homes are required to have a book that records the record of performance. Read that.

The two most important things to do are 1. define what kind of a life you or your loved one wants to live and 2. do a lot of comparison shopping as early as possible before your choices are limited by disability or lack of money. And, check on the many resources in your community.