Posted by: Jacqueline O'Doherty | July 10, 2010

Overseeing the Care of a Loved One in a Senior Residence

As a Patient Advocate, I am often retained to oversee the care of a loved one in an assisted living or nursing home. From experience, I cannot reiterate enough how important it is to have an advocate overseeing your loved one’s care.
I have a client who resides in an assisted living facility; it’s a nice building, in a nice town, with a nice staff and cost tons of money. You’d think everything there would be hunky dory. You’d think. After all, this is the best case scenario. Imagine what happens when the facility is less than stellar!
However, the reality is, no matter how much money you spend, how lovely the facility is and how well meaning the staff is, your loved one needs to have someone watching over his/her care…if you still live in the area, you can oversee their care, but if you’re a long distance caregiver, this becomes much more difficult. If you have friends or relatives in the area, enlist their help. Or, if you have to, hire someone. But somehow or another, you need to have “feet on the ground.”

Things will fall through the cracks. Hopefully they will be just small things, but small things can sometimes snowball into big things. This can be troublesome, especially when it comes to communication and coordination of care. In order to minimize anxiety, issues and problems, have a plan.

Make sure whoever is acting as your advocate visits the facility on a regular basis, at least every other week. They should meet with both your loved one and the staff. There should be weekly check-ins with the caregivers, either by phone or email. When the caregivers know the resident has family or others involved with her/his care, they will be both appreciative and attentive.

Make sure you have a file or notebook that contains any information needed if your loved one has to see a doctor or go to the ER.
This information should include contact information for you and your local advocate, the patient’s insurance information and a copy of the card, his/her medical history, current list of medications (this should be updated on a weekly basis) and any health directives. This information should be with the facility, the resident, the advocate and you.
I would also include a signed HIPPA release form, the last thing you need during a trip to the ER, is to have HIPPA used to block medical information. I am not tech savvy enough to attach the HIPPA form here, but I can send it by email if needed, just leave a comment below. Don’t navigate the healthcare or senior care system alone!



  1. I am so glad that this issue is being addressed. I was the main caregiver for both of my parents and even though I was dealing with very helpful and kind people, a lot of issues did come up that I was not prepared to deal with. Often descisions had to be made on the fly and I really don’t feel that I was always properly informed. Looking back I wish that I had known and been aware of more of the things I could have/should have done. I was all alone and worked full time. If I had known that I could have contacted a patient advocate to help me, things would have been very different and much less stressful for all involved. I feel that I did the best I could for my parents however, I now wish that I had been more informed so that I could have been sure that I made the best choices for my parents. In reality, many decisions were made because of a knee jerk reaction, rather than informed decisions that I would have been able to make calmly and not while under duress. Thank you, Jacqueline, for getting this message out there…It is important that people know they are not alone when dealing with an aging/ailing family member.

  2. Jacqueline, you have really hit on so many important points. There’s a saying, “The squeaky wheel gets the oil.” This has great truth and applicability to caring for loved ones in an assisted living or nursing home. The hired staff is spread thin and sometimes they get lax in their jobs because no one is looking. Having a “patient advocate” can make a big difference in getting optimal attention and care. I had a client in a nursing home who was initially sedentary and the staff “could do nothing with her.” I stepped into the picture and within six weeks the person had made a 180-degree turn for the better, both emotionally and physically.
    Sheryl Kurland
    Orlando (FL) Patient Advocates

  3. I have never worked in a nursing home as an RN, but I worked as a CNA when I was in school. I vowed never to work in a nursing home again. That was 20 years ago and I still feel the same way.

    One is in deep trouble if they do not have an advocate! The same is true in NJ state run developmental centers! Hospitals are not far behind.

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