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This article by Barbara Fox was prepared for the May 19, 2004 edition of U.S. 1 Newspaper. All rights reserved.

From a House to One Room

Emotions run high when a family buys or sells a house, and when the transaction involves moving an elderly person from a house to an institution — no matter how excellent the institution — that is an even bigger jolt.

Up to now, Paul O’Brien has been an administrator of institutions, and it has been his job to persuade families to place their loved ones with him. But on June 1 he will leave his position as director of an assisted living center and go off on his own as a consultant. O’Brien will offer his services to help place individuals into an assisted living residence or nursing facility. He will advise elders and the families who face the tough decisions — whether to leave their homes which institution to choose, and how to flourish in the new environment.

“Expertise and an insider’s view can alleviate the stress on a family in making the ‘right’ decision,” says O’Brien. “We will follow the individual once placed in a facility (or utilizing home care services) and assure the family and the resident that appropriate care is being delivered. I know what questions to ask and when to show up to inspect.”

O’Brien knows it may take a long time to establish his practice, but he thinks the time is right. At age 36 he is not married, but he hopes to settle down and, in his carefully chosen words, “spend more time with the people who are important to me.”

The son of a business forms designer and a department store buyer, he majored in psychology at Pace University, Class of 1990. Intending to be a psychologist, he was accepted for a doctoral program at the University of California at San Diego, but lacked financial aid. “Instead, I went for my master’s degree in health administration, and the way reimbursement for psychologists is now, I think I made the right decision,” he says.

He ran programs for the traumatic brain injured, the developmentally disabled, those with spinal cord disabilities, the mentally ill, and those with mental disabilities. He ran a Sunrise property in northern New Jersey, and until June he is executive director of Bear Creek Assisted Living, an assisted living and retirement community for 100 residents on Village Road East ( in West Windsor. But this 24 x 7 responsibility has taken its toll.

On the night before a telephone interview, for example, he got a call at 1 a.m. that the fire alarm was faulty. “Compounded over time, it builds a certain level of frustration to know that there are only so many things you can control. No matter how well you train staff, things happen that boggle your mind.”

“In the position of executive director you frequently are involved in resolving conflict. That takes away energy from your soul and leaves you less in your life,” says O’Brien. “And I am tired of working for someone else. Since I gave a month’s notice, I slowly began to feel the energy coming back.”

O’Brien has factored a couple of other potential income streams into his decision. He has hung his real estate license with Century 21 Carnegie Realty at the Route 1/Washington Road circle. Residential real estate can be symbiotic with elder care consulting, he points out. “Quite often folks are selling their houses in order to afford the care.”

He is also a certified personal trainer for fitness testing, experienced in working with seniors. “I can come to an individual’s home, conduct a senior fitness test, and develop a program based upon the client’s goals.”

The healthcare consulting industry is dominated by women, O’Brien admits. “I think that my approach is a soft approach, even though I tell people the things that sometimes they don’t want to hear,” he says.

He has learned how difficult that is. “You sell peace of mind. You make them aware of all of the options and repercussions of the decision.” Sometimes he suggests a two-week trial. “The hardest part is breaking the idea that they are going into a dungeon. Often they flourish in the assisted living center because they can develop meaningful relationships. They have been isolated in their home without stimulation. Once they can break the stigma, they can feel better in the placement.”

When placed in an institution, some elderly people find that their health deteriorates quickly. That’s because, O’Brien says, the family waited too long to make placement. It may also be due to a chronic health problem that had not been addressed properly. “The children are accustomed to listening to their parent,” he says. “It is a very emotional decision for the family and the individual going to be placed. Rarely does the person go through the door saying sign me up. It represents giving up a portion of independence, downsizing, and dealing with possessions that give them fond memories. Children are taking role of caregiver against their parent’s will.”

Paul O’Brien, Senior Care Consulting, 4444 Sayre Drive, Princeton 08540. 609-243-0334.

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