There is no more accurate measure of a society’s progress than how it treats its elders.

Despite the importance of eldercare, most of us are ill-prepared intellectually and emotionally to make sound decisions involving our loved ones. This certainly is not due to a lack of information or opinions on the subject.  In fact, there is a data overload. The critical element that has been missing in the process, however, is a knowledgeable and unbiased means of (1) interpreting that data, (2) evaluating what frequently are differing points of view and (3) applying the right criteria to our own personal decision-making.  Providing that missing element is the fundamental purpose of this website.

This website is different.  It has been developed by well-experienced people who not only have been “inside” the eldercare business, but who also have dealt personally and professionally with the consequences of poor care. The “10 tips,” advice and checklists on this site reflect years of knowledge and experience – good and bad – and are designed to help you make a sound decision for yourself, your family and your loved one. 

My name is Steve Brigance, and I am a lawyer.  But I am not trying to “sell” you legal advice.  In fact, my hope is that you can keep lawyers out of your decision-making process and out of the care-giving process for your loved ones. I have established this website as an active advocacy for the two most important populations in eldercare.  First, for those who need care and the families who support them – and, second, for those caregiver-heroes who keep a very challenging yet critical business focused on one primary goal: the best care and service for our elders and others reliant on this facet of our healthcare system. I want to give consumers access to “inside information” so that from the bottom-up we all can accelerate improvements.  So, don’t slog needlessly through dozens of websites and hundreds of pages searching for useful and practicable information.  It’s right here.

For better or worse—and at times it has been both at once—I have devoted the past 12 years of my life to three principal roles.  First, I’ve been the under-qualified and at times remote (in terms of distance) caregiver for both my elderly parents, who resided in assisted living facilities in Alabama and then Arkansas.  Second, I’ve served as a staunch defender of the industry, having been the head of litigation for what was then the largest provider of long-term care in the country, as well as chief outside counsel and business operations advisor for what was then the largest assisted living company. Third, I’ve served as a personal representative of my parents’ estates in suing the facility and others who were responsible for their care when they each suffered mortal accidents in their new apartment -- accidents in 2009 that occurred seven feet and 10 months apart.

I would not want to impose this unusual if not unique combination of roles on anyone. I have seen many things that even I would not have believed if I had not actually experienced them myself I will share some of these experiences very briefly in the 10 tips below to try to give you a context for and understanding of why what I am suggesting has real relevance. I can help you avoid pitfalls. And, best of all, it will cost you nothing but a little time and an on-going commitment to ensuring the excellent care your loved-one deserves.

As a result of my experience in the eldercare industry, when it came time to work in the system on behalf of my parents, I thought I knew how to protect them. After all, that was my business, and I was good at it. I defended nursing homes across the U.S. and more to the point made a career out of identifying poor care and remedying it. But even with all of my experience, there was much more I should have done. I hope you learn from my experience and go that extra mile so that your journey with your loved-one in the elder care industry will be better than mine. If that happens for even one user of this website, I will view that as a success.

Let me be clear, I am NOT attempting to discourage use of the eldercare industry or of any particular owners or operators.  Few, if any, are all bad.  The problem is that too few are all good—and fewer still are great. Unfortunately, most people facing a decision about eldercare have insufficient time, few if any choices and limited resources upon which to rely. So, a forum such as this modest effort for people to share their “learnings” seems long overdue.  The best way to secure positive change in such an important segment of the healthcare industry is from the inside out.  It is to have informed consumers who insist everyday that the system delivers the best care and services possible. Our loved-ones deserve nothing less.

What follows are my 10 Tips for anyone who is considering placing their loved-one in any type of eldercare environment—Independent Living, Assisted Living, Skilled Nursing Care, Memory Care or even a short-term Rehabilitation facility. My tips go well beyond the basic things one hears and might expect to do—such as visiting at odd, unannounced hours; eating regularly with the resident; being respectful and vigilant with staff; looking at survey results and government websites, and reading whatever books you can find on the subject. By the way, in my next update to this site, I will offer my own reading list/bibliography, which has helped me.  And I look forward to others offering books and articles they have found helpful. . We need to learn more from people who have first-hand experiences.

I want to stress, however, that most data on various websites and in “official” reports are regrettably out-of-date. These data by their very age -- 5, 7, even 10 years old or older -- are useless and sometimes even harmful in your decision-making process. For example, administrator and caregiver staff turnover in the eldercare industry generally has often exceeded 200% annually.  And, at some facilities I have had experience with, this turnover has exceeded 350%. This means that there is no continuity of care.  And when there is no continuity of care, I can almost guarantee you a bad outcome. I cannot recommend any data older than 6 months as a benchmark for making decisions when the goal is the best care and service for your loved-one.

Let me make it simple. In my experience, there are three general things you MUST know before choosing an elder care facility—1) caregiver satisfaction; 2) resident and family satisfaction and 3) the Administrator’s worthiness to be in the role he or she is in. These three indicators will tell you 90% of what you need to know before you choose your or your loved-one’s next home. Here’s how to find out this information, information that some facilities regrettably don’t want you to know.  In the first tab—Ten Tips-- you will find out exactly how to find out this critical information yourself although the facility does not want you to have any of the information and they certainly won’t volunteer it. Please read these Ten Tips and they will give you the best roadmap anywhere for finding the best residence for you or your loved-one.