Dear Carol: My mom, 78, has some physical disabilities because of severe arthritis. Even so, she’s fully able to manage the two medications that she takes. She can also fix the simple meals that she enjoys and entertain herself with music, TV and reading. She needs some assistance, but we’re skeptical of assisted living because her friend, also well able to take care of her immediate needs, got burned.

This friend liked living in her apartment except that the facility mandated taking over her medications and that she attend a certain number of meals. Their requirements made her angry and miserable. I understand that facilities have rules, but this seems inflexible. Mom’s always found being around a lot of people stressful. She needs help with showering as well as cleaning, but she won’t even try assisted living because of her friend’s experience. How do we help her stay safe but not take away her independence? — MS.

Dear MS: Thank you for bringing this important topic to our attention. Your mom seems to be an example of an older adult who’s developed physical problems yet remains clear in both the decision-making process and working memory. Assisted living might still be an option, but not the only one.

A strength of assisted living facilities (ALFs) is the fact that they offer a variety of activities and opportunities for daily socialization. This is one reason that I often recommend them for older adults who feel isolated and lonely. Your mom doesn’t seem to fit into this category. Likely as not, she has friends and/or family members with whom she shares her life to her satisfaction, but she highly values her privacy. Therefore, her need for assistance is primarily for a few practical matters.

ARCHIVE: Read more of Carol Bradley Bursack's Minding Our Elders columns

WDAY logo
listen live
watch live
Newsletter signup for email alerts

If the idea of a non-restrictive ALF appeals to your mom, carefully vet the facilities in her community, touring them if you can. If you don’t have time for this, you could contact your local Area Agency on Aging and ask for their help. They may suggest a company that vets them for you. Make your mom’s requirements known from the start so that there is no misunderstanding.

An alternative would be hiring an in-home care agency. Like ALFs, in-home agencies vary in quality and requirements, so you’ll have to vet them. Look for one that does solid background checks on their personnel, has a good overall reputation (ask for references and check them) and is large enough to have backup caregivers for emergencies. Some require that you commit to a certain number of hours weekly, but you could bundle bathing and some light housekeeping to meet that requirement.

Be aware that like assisted living, you may have to try more than one agency to find a good fit. You might also need to hire a housekeeping agency to come in every couple of weeks. In your place, I’d investigate both options.

Consider her present needs since there’s time enough to arrange for more help if or when her health requires it.

Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of “Minding Our Elders: Caregivers Share Their Personal Stories.” Bradley Bursack hosts a website supporting caregivers and elders at She can be reached through the contact form on her website.