Sometimes the need for eldercare arises quickly and unexpectedly, creating a crisis situation for families. While it is a stressful time, it can be made less so by experts who specialize in senior placement services. And according to Nick Puente, founder of Total Care Connections, more of these companies are popping up, especially in Arizona.

Puente’s background in ministry work and as a family liaison for Heartland Hospice exposed him to the senior health care industry. He witnessed the hurry-up mode families are often forced into when making decisions about care for a parent or spouse.

People “scramble” to find a place quickly. They’ get a list of licensed adult care facilities in Pima County, which numbers around 350, according to Puente, and are overwhelmed.

“We help people narrow that down dramatically,” he said.

Assisted living facilities, retirement homes, Alzheimer’s care, hospice and home care are examples of options where Total Care Connections places clients. Puente and business partner Daniel Stringer market the company online, attracting out-of-state calls, and they make themselves known to doctors, social workers and those in skilled health care positions.

An example of where Puente might receive referrals from medical staff is in a nursing home where a person is receiving short-term rehabilitation treatment. When the patient runs out of Medicare days, he is either well enough to go home or needs alternative care.

The search process starts with an in-person meeting.

“We go to the home, meet with the power of attorney, the son or daughter or spouse,” Puente said. “Sometimes we have to act immediately. We can do a placement in 24 hours.”

A nurse who’s been involved with the client’s care may also be present. They discuss the person’s medical situation and budget. If the need is not urgent, Puente or one of his employees will take the family on tours of various facilities.

Tucson’s larger care communities house 50 residents or more, such as the Fountains at La Cholla, Amber Lights, Freedom Inn at Ventana Canyon and the Forum at Tucson. Assisted living can easily run $3,000 to $4,000 per month, said Puente, so “if that’s over their budget, we’ll refer them to smaller adult care homes that are local, not corporate, with under 15 people. We negotiate rates with them and make offers.”

One of Puente’s foremost goals when placing a resident is to select a living arrangement where the client will not have to relocate in the future.

“If you live in a senior apartment and develop memory problems later, you’ll have to move. We don’t want to re-place people; it’s rare for us,” he said. His staff also follows up after a client moves in to make sure the caregivers are doing what was promised.

Most senior living facilities pay a referral fee to Total Care Connections and other such placement services. Nursing homes are an exception. Since they’re Medicare funded, they can’t pay a referral fee. He pointed out that Arizona is a pioneer state in senior placement services, mostly due to the large number of choices here. His company recently began expansion into the Phoenix market.

Total Care Connections is the only eldercare placement agency in Tucson that also provides in-home care.

“We have 20 to 30 staff at one time that are certified caregivers. A lot are part-time, some are full-time,” and various levels of care are offered, Puente said. He and his partner are flexible in that they can hire according to a client’s requirements.

Since Medicare doesn’t cover home care or most other assisted living arrangements, a majority of Puente’s clients are private pay. Less than 5 percent of his clients have long-term care insurance. Until recently, he said, these types of policies only covered nursing home care. It’s possible now to find insurance plans that include assisted living and home care since that’s where the trend is going.

Puente is surprised by how the recession has impacted the senior living industry because it is need-driven. People who planned to move into retirement communities had difficulty selling their homes, so they put it off. Overall, though, he’s seen an increased need for his type of services in the past three years.

He recognizes the difficulties families face when assisted health care becomes a necessity.

“It’s always tough. Our vision is to work with families and make the transition as stress-free and as seamless as possible,” Puente said. “We don’t just give them a list, we like to personally bring them places and be an advocate for them.” 

Biz Facts

Total Care Connections

2482 East River Road, Suite 100

(520) 546-1554

Christy Krueger is a Tucson-based freelance writer.