People who help you decide
You do not have to be the only person working on this. Three of these are free and independent of the industry, which is more than can be said for most of the advice online.
Official source the real list is public and we send you to it
Three services that are free, independent, and barely used
- Your Area Agency on Aging — or, in a few states, the state agency that does that job instead. There are 56 State Units on Aging, one in every state, DC and the territories, and beneath most of them more than 600 local Area Agencies on Aging. A few states are not divided up that way at all — Nevada has no Area Agencies on Aging and its Aging and Disability Services Division holds the role itself. So the reliable way in is the federal Eldercare Locator, which names whoever it is for her county in any state: eldercare.acl.gov, 1-800-677-1116, weekdays 8am–9pm ET. Whatever it is called where she lives, it answers in-home help, meals, transport, caregiver support and home modification, it knows your state's Medicaid rules, and it is not selling anything. Checked 2026-08-29. Direct numbers by county in Nevada and Oregon.
- The long-term care ombudsman. Every state has a program, supported nationally through the National Long-Term Care Ombudsman Resource Center. They advocate for residents of nursing homes, assisted living and residential care — free, and on the resident's side rather than the facility's.
- SHIP for anything to do with Medicare — see money, legal and benefits.
The single best question in this entire process, and nobody with a placement fee will suggest it: call the ombudsman before you choose a community and ask what complaints they see there. They will not rank places for you. They will tell you what they keep being called about, which is better information than any brochure.
Your rights when a hospital is discharging her
The discharge is the moment families are most often steered, and it happens in two days while everyone is frightened and tired. The federal rules for Medicare-participating hospitals are firmly on your side, and almost nobody knows them. The hospital must:
- Run a discharge planning process that includes the patient and her caregivers as active partners, consistent with her goals and treatment preferences.
- Provide a discharge planning evaluation on request — the patient's, her representative's, or her physician's.
- Give you a list of home health agencies or skilled nursing facilities that participate in Medicare and serve the area.
- Inform you of your freedom to choose among participating providers, and must not specify or otherwise limit the qualified providers available to you.
- Identify any agency or facility it refers you to in which the hospital has a disclosable financial interest.
So there are three sentences worth having ready: may I have the list?, does the hospital have a financial interest in any of these?, and we would like to choose, please. If you think the discharge is too early, ask the hospital how to appeal it — there is a process, and asking for it costs nothing.
A geriatric care manager, when you live 2,000 miles away
Usually a nurse or a social worker, working privately, paid by you. Medicare does not cover it. The trade is straightforward: you buy local presence and professional judgement by the hour.
Worth it when the distance is the actual problem — someone who can attend the appointment, do a real assessment in the house, and go round on a Tuesday when the phone calls stop making sense. The Aging Life Care Association lists members and publishes standards of practice.
Ask before hiring: the hourly rate and the minimum; who covers when they are away; what is in a written assessment; and — the one that matters — do you accept any payment from any provider you recommend? The answer should be a flat no.
Support, including for you
- Alzheimer's Association 24/7 Helpline, 1-800-272-3900 — staffed overnight, which is when this is hardest. alz.org.
- Respite, so the person doing the caring can stop for a few days. The ARCH National Respite Locator and state Lifespan Respite programs are the way in, and the free public agency for your county, the first item on this page, often subsidizes it.
- Caregiver support through the Older Americans Act — counseling, training and support groups, arranged locally through the same agency.
- Your own doctor. Caregiver exhaustion is a medical fact with measurable consequences, not a character failing, and "I am not coping" is a legitimate thing to bring to an appointment.
Who is paid by whom — read this before you call anyone
The most useful thing to know about anybody offering to help is where their money comes from. It does not make them dishonest. It tells you what their list contains.
| Who | Paid by |
|---|---|
| The public aging agency for her county, ombudsman, SHIP, Senior Medicare Patrol | Public funding. Free to you, and not paid by providers. |
| Geriatric care manager | You, by the hour. |
| Hospital discharge planner | The hospital. Their job includes getting the bed back. |
| A free "senior living advisor" or placement service | The community, when your parent moves in. Their list is the communities that pay them, not the communities that exist. |
| This site | Nothing, on any of the above. Our directory comes from the state licensing register and includes every community whether or not anyone pays us. When something here does earn money, the page that earns it will say so on the page. |
That last row is why the directory is worth what it is worth: completeness is only meaningful if nobody could have bought their way onto it, or off it.