Geriatric Care Managers…Providing a Full Spectrum of Choices

As a certified geriatric care manager, the code of ethics developed by our National Association of Professional Geriatric Care Managers, provides the guidelines under which I practice.  When it comes to helping a family select a senior residence, I look at all options. What is best for the client is my North Star, nothing less than that.

The article below recently appeared in the New York Times.  Would you buy a car based on pre-selected choices? Of course not. Likewise, I would hope you would not choose a senior residence based on commission driven options. As a geriatric care manager, I am ethically charged with providing a full spectrum of choices. No commissions, just a box of cookies at Christmas.

Online Reviews of Senior Housing Options, With Caveats


The operators of A Place for Mom, a commercial housing referral service for older adults, have introduced an affiliated Web site aimed at providing consumer reviews of senior care locations.

The site,, is aimed at helping families wade through the options available when going through the emotional, time-consuming process of finding suitable housing for older family members, said Sean Kell, chief executive of A Place for Mom.

The site lists care locations by type, like assisted living, independent living, senior apartments and skilled nursing homes. Users can write reviews of the locations and rank them on various qualities, like cleanliness, friendliness and activities, using a system of one to five stars.

But not just anyone can post a review on Mr. Kell said that to make sure that reviewers had actually visited the place they were ranking, they must meet certain criteria. But the rules may also limit the site’s scope.

The first category of “verified” reviewers are clients of A Place for Mom — that is, older adults or their relatives who are working with the referral service to find a suitable site. These reviews are expected to be tagged “APFM verified.”

But Mr. Kell said that clients can post a review of any property they visit, regardless of whether it is a participant in A Place for Mom’s placement program.

Alternatively, the properties themselves can solicit residents and family members, or prospective residents and their families, to post reviews — whether or not the site has an agreement to consider referrals from A Place for Mom. These reviews will be tagged “community verified.”

Before submitting a review, users must check a box stating, “I certify that this review is based on my own experience and is my genuine opinion of this community, and that I have no business relationship with this community and have not been offered any incentive from this community to write this review. I understand that has a zero tolerance policy for fake reviews.”

The site also incorporates rankings from the federal “nursing home compare” tool provided by the federal Web site, which ranks licensed nursing homes on a variety of quality measures.

I asked Mr. Kell how likely current residents of a given care site, or their family members, were to post critical reviews, given their dependence on the site’s staff. He said that reviewers don’t have to publicly post their names on their Web reviews and that many residents were honest about their dissatisfaction.

“Our business is to provide the best resource for families out there,” he said. “If a property is getting lots of negative reviews, consumers aren’t going to want to go to it.”

Some reviews are based on one-time tours of a care center, rather than from residents who actually live there, or families of those residents. When submitting a review, users choose a category, like “I live(d) there,” or simply, “I toured it.”

One recent review of an assisted living place in Minnesota read: “Toured. Liked the feel, very homey. Urine smell turned some family members off. Main reason we wouldn’t consider is totally private pay.”

The site recently began operation. So it is evolving. SeniorAdvisor says it has listings for more than 137,000 communities and has more than 17,000 reviews so far. But as yet, it’s far from comprehensive. I searched, for instance, in the city where a relative lives in an assisted living community, and it didn’t show up in the listings — nor did any other in that city.

While Mr. Kell said the aim was for the site to operate independently from A Place for Mom, it was clearly affiliated with the referral agency. A number prominently displayed on the Web site, which users are urged to call if they need advice, is answered by A Place for Mom.

A Place for Mom doesn’t charge clients for its services, but it receives a commission from participating locations when they accept a client referred for placement, according to a 2011 post in The New Old Age blog, in which my colleague Paula Span wrote about the risks of this sort of referral model. The main drawback is that if the best place for your relative doesn’t have a contract with the agency you’re working with, you’re not likely to hear about it from your referral adviser.

Ms. Span advised that, for the broadest range of advice, you check with your local Area Agency on Aging, which are federally financed and provide advice and assistance free, or go to Most states have elder services agencies that can also provide assistance.

How did you go about finding housing for an older relative? Does Senior Advisor’s approach to reviews seem helpful to you?

A Birthday Cake With Lots of Candles

This geriatric care manager has been to birthdays parties.  Some for the very young, you know, those who are very proud to announce their age….“four, five, eight and three months.” and then those who boast of their age as they enter their eighth or ninth decade.  In between, there have been those “special birthday parties.”  Jack or Jill has reached that “special age.”  You’re not quite sure what the special age is, other than it ends in a zero. Well, I recently attended a birthday party where there was no denying the age and the birthday girl was damn proud of it. Triple digits. My Cousin Sally turned 100.

At the party, Cousin Sally was surrounded by friends, all younger. No wonder, just three years before she gave up her daily game of tennis. She was afraid of falling knowing what the consequences could be. Nevertheless, her tennis coach was in attendance as well as the many tennis partners she has had through the years. A younger generation of cousins, myself included, were also in attendance. Some of us had not seen one another for many years. Cousin Sally had brought us together.

The morning after the birthday party, I had time, or I should say Cousin Sally had time,  to chat with me.  With failing hearing her only impediment, I spoke slowly and in a low voice. There was much I wanted to know about our family, questions I would not have thought to ask decades earlier.  I was too young then to think about what I now want to pass on to my children. Her recollections were vivid. I got to know about my uncle who never saw adulthood.  She told me of their aborted walk, each age seven, across the Williamsburg Bridge (connecting New York City with Brooklyn) until they were picked up the police. Stories of holiday gatherings intermingled with family personalities. Most amazing was a Veterans Day parade she viewed while perched on her father’s shoulders. In an open car sat veterans of the Civil War.

I left California, Cousin Sally’s home for the last thirty plus years, not only with a renewed feeling of connection to her and cousins, but a reminder of what it is that makes for a good life. Health, friends, interests, resilience during challenging times and in Cousin Sally’s case, a drink with a special friend at four each afternoon. So again, happy birthday Cousin Sally. It was your birthday, but I was the one who received the gifts.