Many caregivers complain that the senior living communities where their parent lives don't do a very good job at bookkeeping. I often hear that payments are not properly recorded causing duplicate bills to be sent or late charges to be applied. Since many of these caregivers are working long distance, it is not as simple as walking into the facility to sort things out. How can better communication be implemented with the facility?

I recommend that upon move-in, the person (or people) who will be responsible for overseeing Mom's care make an appointment and go in to meet with the various department managers at the facility. The person who will handle paying the bills should meet with the person who generates the bills for the facility. The person who will handle medical issues should meet with the Director of Nursing. The purpose of these meetings is to establish open channels of communication. This is usually better done in person than over the phone. We are all more likely to respond positively to someone we know than to a frustrated stranger on the other end of the phone.

Then, keep a close eye on every bill and make sure that the payments are posted properly. If you have a question, take the time to call and ask, and document the date, who you spoke with, and the outcome of the conversation. When necessary, put things in writing. If there are chronic errors, speak with the billing manager and ask if there is a better way for you and she to communicate so that the errors will be reduced, taking less time for both of you.

If you are already well into your relationship with the facility, or you've tried these suggestions to no avail, then you are in a tougher spot. If you can find someone on the other side that seems willing to help then make friends with her. Find out when her birthday is and be sure to send a card. Try to catch her "doing something right" and then say thank you or write a brief thank you note. You might even write a note of praise or thanks to her boss and send her a copy. The idea is to have someone who will be willing to go the extra step to try to solve problems on your behalf. Develop a personal relationship because it's harder to be rude to someone who has been nice to you in the past.

Another suggestion is to assume the facility is "innocent" until proven otherwise. That is, instead of calling with a huffy tone of voice about the error you are sure they have made, try calling and saying that you are confused by the bill and asking for it to be explained. Even if you know that you are correct, if the other person can see the error, he might simply acknowledge it and make the correction, thereby avoiding an argument.

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The key lesson is to keep a close eye on things and act on them immediately if you have a concern. The newer the possible error, the easier it will be to solve.