Identify the tasks your elderly parents need to live comfortably. Do they need your help?

If you are asked to help with meals, it could mean anything from weekly grocery shopping to actually feeding someone who cannot manage utensils. If you are asked to help with medication, it might simply mean counting pills and putting them in pill dispensers once/twice per week. But do elderly need an oxygen machine? A hoyer lift for bed transfer? Diabetic injections?

Options other than staying at home?

Assisted living facilities: suitable for people who can generally take care of themselves independently but may need some help with routine tasks such as preparing meals, housekeeping and getting around. Any/all additional tasks required by residents comes with a price tag attached. However, many offer community benefits such as transportation, social gatherings, religious services, and recreation opportunities.

Nursing homes: designed to house and care for very frail or disabled people who are not capable of caring for themselves, and generally require medical surveillance.

Things to look for: Visit and monitor the atmosphere and quality of life provided to residents. For example…

— Size and general layout of the facility. Look at living quarters, the dining area, recreational facilities and group activity spaces. What is overall cleanliness of the facility? Where is the physical location of the facility? Busy streets may make it easier for visitors to gain access, but the noise may be intrusive. Is it nearby so you can visit elderly parents?

— Are there organized activity programs for residents? Most facilities attempt to provide social, educational, or religious gatherings for family and resident.

— Are your parents safe in their room? Is the physical building up to local building codes? Look for adequate lighting, smoke and fire alarm systems and clearly marked exits.

Other factors: Is there a medical care clinic on site? What is proximity to local hospital? Is facility in an area which provides access to green space, libraries, theaters and shopping? Are pets allowed?

Finally, consider financial factors associated with remaining at home with care assistance, compared to costs for assisted living facilities and nursing homes. What, exactly, is being charged as a base rate, and as an optional expense? Understand the billing arrangements. There may be a requirement to set up a cash reserve to finance any optional costs or services. Will you receive advance notification on any rate adjustments?

– John D. Miller is the founder/owner of Home Care Partners, LLC, a Massachusetts business providing private duty, personalized in-home assistance and companion care services to those needing help in daily activities and household functions. He can be reached at: (781) 378-2164; email: ; or online at: