Communicating about Assisted Living during a Crisis

By Tim Hodge, CSA

Ideally, we have conversations with our parents while they are still young and healthy. The two references can help improve your chances of having those difficult conversations.

We’ve seen several examples where families were unsuccessful in having important conversations with their aging loved ones in advance of needing to make decisions. The unfortunate result has been a crisis (broken hips, getting lost [dementia] and malnutrition/dehydration) which forced decisions about elder care. Additionally, many caregivers face serious health risks when caring for a declining loved one. Caregivers are often too close to the situation to make difficult choices.

So, what do we do if it’s too late and Mom/Dad needs outside support? How do we bring up in-home care or assisted living? What if their health is so bad that they need 24-hour nursing care?

There are a few things to consider. Is there a family member who can provide the needed care and support? Do your parents have the resources to pay for care? If not, will you rely on public assistance? What is the timeframe; how long will he/she need support?

We recommend the following steps as you prepare for the conversation and carry out your plan:

Step 1. Research with an expert. It’s likely that you have a few days to a couple of weeks to find the right solution and convince Mom/Dad that this will work. Using experts is the most efficient way to begin your research. The case manager (social worker) at the hospital or rehabilitation hospital is a great start. He/she will know what the prognosis is and can give a list of providers. When it comes to finding assisted living or in-home care, the case manager has limited expertise on which companies provide the best service. I’d recommend using an outside expert whose sole job is to help seniors find housing and care.

Step 2. Visit / Interview. Though time is short, you are in the driver’s seat. If you are going to move Mom/Dad into an assisted living community or home, you should physically visit the top 2-3 locations. If you are getting in-home care, interview the top 2-3 companies. With either, you are interviewing them to make sure they are right for your loved one.

Step 3. Get your parent(s) involved. If they haven’t already been involved in the discussion, it’s time to get their buy-in. After all, they are the ones that have to live with the decision. Hopefully they are willingly considering their options. The unwilling parent can make it difficult for you.

Step 4. Make the move. If you are successful with step 3, then helping your loved one get the care he/she needs is fairly easy. The providers will help with the transition.

Let’s focus on Step 3. The techniques in the Crucial Conversation blog will be helpful and you should use them. However, it’s time to bring in some allies. The first is the medical staff. Let the doctor and case manager deliver the “bad news” and allow you to lovingly help your parent. Other medical staff must reinforce the need for assistance instead of saying, “you’ll be going home soon”. Those few words are confusing and really undermine your effort to bring your parent on board.

Your loved one probably trusts other people like the pastor, a neighbor, a close friend or other person. Prepare these allies by telling them the situation and what you have been doing to support your parent(s). Have them help by reinforcing the need to seek assisted living; and hopefully, with honest assurances that they will come visit.

I’d like to close with the idea that older adults are used to being in the driver’s seat when making decisions. They should understand that it is their decision to accept assisted living and we are helping them find the best option.


About the author. Tim Hodge is a Certified Senior Advisor (CSA)®. He served with the U.S. Army for 30 years, retiring with the rank of Colonel. Through two companies, he now serves older adults and their families in San Antonio and the surrounding counties. Aura Senior Management helps seniors and families manage appointments, transportation, in-home health care, budgets and other services. Assisted Living Locators provides expert advice to seniors and their families on Senior Housing and care. You can contact Tim at (210) 858-6989 or learn more by visiting Assisted Living Locators at


How to Say It to Seniors; Closing the Communications Gap with Our Elders, David Solie, Prentice Hall Press, 2004.

“Crucial Conversations”, Society of Certified Senior Advisiors Blog, June 2017,

Submitted By: Assisted Living Locators

Phone Number: (210) 858-6989