Hope Comes to Visit

From Guilt to Guidance: How to Talk About Senior Care with Shona McIntyre

• Danielle Elliott Smith • Season 1 • Episode 42

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Content note: This episode includes candid conversation about aging, dementia, and caregiver stress.

What’s the right time to talk about senior care—and how do you even begin? In this episode of Hope Comes to Visit, I sit with Shona McIntyre, a senior care advisor, social worker, and certified dementia practitioner with nearly two decades of experience helping families navigate complex decisions with clarity, compassion, and confidence.

We unpack the messy middle: noticing early signs of change, starting “the talk” without stripping dignity, and why planning before a hospital crisis protects both options and peace of mind. Shona explains the real differences between independent living, assisted living, memory care, and skilled nursing—and why modern senior communities look more like apartment living with support (think chef-prepared meals, robust activities, and on-site care).

We also dig into caregiver guilt, how to frame conversations around safety + independence, what actually determines a good fit (level of care, lifestyle, and budget), and the huge time savings of working with a local advisor who has walked the buildings, tasted the food, and knows the teams.

If you’re caring for an aging parent—or love someone who is—this episode is a steady hand on your shoulder and a practical path forward.

Guest: Shona McIntyre — seniorcommunityconnections.net
Resource: The Caregiver’s Advocate (Vol. 2)

Thank you for listening to Hope Comes to Visit. If this conversation helps, follow the show, share it with someone who needs hope today, and leave a review - it helps others find their way to these conversations.

New episodes drop every Monday, so you can begin your week with a little light and a lot of hope.

For more stories, reflections, and ways to connect, visit www.DanielleElliottSmith.com or follow along on Instagram @daniellesmithtv and @HopeComestoVisit



SPEAKER_00:

Most seniors are so isolated at home. Um, they everyone thinks about everything that they're giving up when they move to a community. They never think about all the things they're gonna gain by moving in.

SPEAKER_01:

Hi, friends, I'm Dionyelle. Here on Hope Comes to Visit, we listen deeply, learn boldly, and do the best we can to move forward with one small step. Thank you so very much for being here with me today. My guest today is Shauna McIntyre. Shauna is a senior care advisor, social worker, and certified dementia practitioner with nearly two decades of experience helping families navigate senior care decisions. Her work focuses on guiding families through complex emotional transitions with clarity, compassion, and confidence. Let's take a quick moment to thank the people that support and sponsor the podcast. When life takes an unexpected turn, you deserve someone who will stand beside you. St. Louis attorney Chris Duly offers experienced one-on-one legal defense. Call 314-384-4000 or 314-DUI help. Or you can visit Dulilawfirm.com. That's D-U-L-L-E lawfirm.com for a free consultation. Shauna, I'm so delighted you are here with me today. Uh, it's it's fun because the reason you're here is because I reached out to you for my own help and was so touched and moved by your compassion, your care, your ability to help me start to navigate through some decisions with my own family. Thank you for being here.

SPEAKER_00:

Thank you so much for entrusting me and having me here today. That's that's wonderful. Thank you.

SPEAKER_01:

So, you know, hope comes to visit, right? The my my goal on the podcast is always to be offering people stories of hope that can guide them through whatever it is they are walking through. How did you end up in this line of work?

SPEAKER_00:

Oh gosh. Well, I feel like it found me right out of um college when I started working in social work. I worked with development disabled adults and I worked as a job counselor, and then I fell into senior housing emplacement um working for a rehab center, and I did that for about 20 years. Um, and I just fell in love with the senior population and helping them navigate this overwhelming process of trying to find appropriate care. So I feel like it found me and it was my niche, and I fell in love with it, and I've been doing it ever since.

SPEAKER_01:

So I reached out to you. My dad, I recently moved my dad from Florida up to the St. Louis area. And my dad has always been one of the most brilliant people that I know, but I recognize that I'm spending a lot of time caring for him, taking care of him, making decisions for him, um, helping him navigate. And one of my biggest motivations is wanting him to socialize more. Um, but I know that there are so many emotions I have wrapped up in all of this. How do you help people navigate, begin to navigate any of this process? When, let's start here actually. I'm gonna start, I'm gonna I'm gonna back up a little bit in my in my own questioning. When is the best time for someone to reach out to you?

SPEAKER_00:

You know, the the again, that that question is so loaded when it comes to families because no two seniors are alike, and everybody's situation is so vastly different. I prefer working with families in the beginning stages where they're noticing maybe a physical decline or a cognitive decline, and they just want to start a conversation where we don't want to be as at bedside at the hospital and the social worker or the doctor saying your loved one isn't safe to be home any longer, and then we're scrambling last minute. So actually, the way you called me was perfect because we weren't in crisis mode. I mean, for your dad, it's crisis mode in a way, but we're not, you know, a lot of your decisions get taken away from you when you're in that crisis planning piece. And um, so I feel like if you can do it in a calmer way and you're not everything's, you know, right there happening to happen at that moment, calling in advance and just having a backup plan in case things aren't working at home is the perfect time to call and start thinking.

SPEAKER_01:

I feel as though this time in my life is so interesting, right? Um, and I know I've been watching online. Uh Facebook, social media allows me to stay connected to friends all over the world. And there are so many of us transitioning from kids going away to college and moving into a place where we're starting to care for our parents. I have a number of friends who have been caring over the last couple of years for parents who have dementia and Alzheimer's. Um, and there has been a lot of painful, honest conversations I've seen online. And so many emotions wrapped up into that. I know that you have contributed a chapter to a particular book that touches specifically on one of those emotions, which is guilt.

unknown:

Yes.

SPEAKER_01:

Absolutely. Yes.

SPEAKER_00:

Um I I was uh a writer on the Caregivers Advocate Volume 2, which was which was an amazing project. Um, and I wrote on guilt because I feel like when I talk to families, that is the number one barrier, um, the one number one thing that holds the adult child back from even talking to their parent about, you know, maybe you're struggling a little bit at home and we need we need to bring in home health or some kind of you know person that can check in on you and make sure you're doing okay. There's so much guilt involved because we've all made those promises to our parents, hey, we'll never put you in a nursing home. And, you know, and it can be really tough and it can be very challenging just to get over that hump of the guilt. Once you get past that hump, it's usually because they've waited too long because something catastrophic has happened in the household and they're no longer safe to be there. So then the guilt kind of goes away and then we're in crisis mode. So I do like to talk to families um and help them work through that guilt because there's a lot of it. We're human and we're gonna have those feelings that come up, and it's going to be a huge barrier on why we don't make the best decisions for our loved one, unfortunately.

SPEAKER_01:

So let's talk a little bit about that guilt. How, because that has been a a huge piece for me, right? Um, the the thing that my dad has always been the most tremendously proud of is his mind and his intelligence and his quickness. And as especially as he isolates and has a lack of communication with other people, that's the thing that is not as quick for him. Um and my guilt in having to walk, like I there's so much guilt in in all of it, right? How honest do I be with him about what I'm noticing? How like what do I tell him about what we should do? What how do I have a conversation with him?

SPEAKER_00:

Ah, all the things. Absolutely. It's so hard to navigate it. And, you know, and what that's why I sit down and talk individually to each family and talk about the their their history, their backstory, because we, you know, the no two senior is alike. Everyone's gonna be a little bit different, and how you approach one senior is not how you're gonna approach the other. And they get their defenses up immediately if you start talking about taking away any of their independence, taking away their vehicle. Um, most seniors don't realize that when they move into a community, a lot of the things they're struggling with in the day-to-day are gonna be removed for them. So they actually are gonna be more independent because they don't have to worry about making meals anymore. They don't have to worry about the upkeep of their house and mowing the lawn and all those things, those barriers that come along when you're a senior. Um, so that guilt that the adult child has and how to navigate that, it's it's really hard to sit down and decide when to have that talk. I call it the talk. And um, because everyone's gonna relate a little bit differently, everyone's gonna respond a little bit differently. Um, and you know your parent better than anybody, that parent-child dynamic flips and all of a sudden you're almost the parent and they're the child and they don't, they don't want to have that conversation with you. Um, if you have to talk about finances or, you know, bad spending habits and things like that. They they look like, well, I'm your parent. Why are you telling me anything? And it can be really tough. And that's why I go in and I sometimes help mediate the I'm a neutral third party that could come in and talk to the senior and answer all the questions. I'll be the bad guy and let your child go back to being, you know, no longer being the caregiver, but being the savior basically. Um, when they move into a community, the visits go a lot differently than the visits are when they're home.

SPEAKER_01:

So can you explain to me a bit about a community? Because I think that the the term we always used in in terms of nursing home always sounds so that's the last stage. Whereas community and and some of the things that I've seen and and and what what you and I were talking about feels far more vibrant. Um, and I and I do know that there are some seniors who choose to move into communities of their own volition to make life easier. I feel as though senior communities are far more advanced, wonderful things than they used to be, or at least they can be, assuming that you're finding the right fit for the senior in your life.

SPEAKER_00:

Absolutely, yes. I think a lot of seniors are still hung up on the convalescent home that their their great aunt or their great-great-grandmother was put into, and they hear all the horror stories about. And there are plenty. When I was nine years old, I used to work in a skilled nursing facility and volunteer, and it was the typical you walk in, you were knocked down by the smell of urine, it was terrible. Assisted living communities and skilled nursing facilities have come a long way since then, and they haven't been back to visit. So seniors are actually pleasantly surprised when they go on a tour. I usually try to schedule a lunch tour so we can go in and try the food and maybe participate in an activity, and they are they're mesmerized because it's almost like being on a cruise ship. Um, the meals are they're getting a lot savvier about what they're bringing in for the senior. You know, the meals are prepared by a chef, not just somebody in a cafeteria. You know, you sit down and it's restaurant style dining. There's activities that are going on throughout the entire day that keep that are, you know, balanced your mind, your body, your spirit, everything. So it's a lot different than what it used to be. And it's just getting seniors in that that environment to take a look around and say, oh my gosh, this is not what I thought it was. Um, it's really apartment style living with a caregiver on site, is what I like to tell people.

SPEAKER_01:

And the work you do, one of the things that I that I'm finding incredibly beneficial is I can be completely honest with you and say, this is where we are financially, this is the category that I'm looking for, this is what my dad likes to do. You and I mentioned my dad used to work in radio and my dad loves to talk. And and one of the facilities, the facilities, one of the apartment style livings that we're taking a look at, they have a men's group and they do TED-style talks, which could be something my dad could contribute to. And you know that my dad misses working, and so maybe my dad can can work on site, you know, like so. I feel as though it's almost like coming to you as a recruiter and helping you and having you help us to navigate uh the right fit for where an individual senior should find themselves in all of the uh the the places, personality, financially, all of that, because we have limitations.

SPEAKER_00:

Absolutely. There, and just in the St. Louis metro area alone, gosh, there's about over 500 different types of assisted living communities, facilities, independent living. And my job is to talk to the family or the senior and just help them first narrow down what level of care do you need? And second, you know, what is your lifestyle and what what's important to you? And then third, actually, the most important is fine financial. What can you afford? Because when you walk into a community and you it's beautiful, um, and they all the bells and whistles are there, and then you see that price tag, it can be shocking. Sure. And a lot of people think that unfortunately Medicaid will cover assisted living level of care, and in the state of Missouri, it does not. Um, other states, it might. So you definitely want to look at that in your particular state that you live in. Um, but my goal is to really find something that fits all of those parameters for you. And, you know, if someone is super social, they're not gonna get along in a community that doesn't have a lot going on activity-wise. We're gonna want to find a community, you know, that is going to have the TED Talks and all the things that they can do and stay active. If someone's a little bit more reclusive, it's not gonna matter if they're in a community that has a lot of activity, you know, so we can find a smaller, more quiet community. So my goal is to get to know all of the communities in this St. Louis metro area and really help understand, you know, what each community can and can't offer. And financially, the bottom line is what can we afford? So I help you narrow that down so we're not wasting all of your time spinning your wheels. You know, the average family spends about 80 plus hours call making phone calls and showing up and touring and trying to figure out what's the right fit. And then they move in just because the sales director was said all the right things, just to find out later that it wasn't the right fit. So my goal is to help just alleviate that, narrow it down to two to three locations that are gonna check all your boxes, and then you can just focus on the hard part, getting them to move in and all the other things because it's a lot, it's a lot you have to focus on.

SPEAKER_01:

We hear horror stories about elder care. Yeah. How do we navigate that fear as a child? Um, worrying that our our parent will be in a community that is providing appropriate supervision, care, love. Um and and how do we find someone I I can obviously direct anyone in in the St. Louis metro area to you, um, and we will do that at the end of the podcast. But how does someone find a you in California or in New Jersey or in Florida or in Texas?

SPEAKER_00:

Yeah, I you I you definitely want to start with asking around, finding a local person that is actually in that community that have that have been in and out of those communities, that have seen it, smelt it, tried the food. That's so important. There are these the big box 1-800 numbers that you can call, and they're great too, but they're physically not in that area. They're kind of just sending your information and you're still doing all the footwork on your own. They're not narrowing it down. Um, is they don't pinpoint it quite in the way that a local person that's actually been in the community. They customize it to your specific needs because one community might be great for one of my other clients, but it's not going to be good for the other one. So, you know, narrowing it down and trying to ask around in your local area for a senior care advisor is so key. Um, just because it's going to save you so much heartbreak and time and money. And they can negotiate for you and they can, you know, try to get you a deal sometimes. And there's just a lot of things that they can do that maybe the big box 1-800 numbers can't do for you.

SPEAKER_01:

Well, one of the other things that I noticed, because I tried to look on a couple of their websites as just looking around before you and I spoke, and there, you know, the pop-ups come up, like enter your information. And I was hesitant to like, there's a 27-second wait before you hear from us. And I thought, I'm gonna enter my information in that. And within seconds, someone's gonna call me and they're gonna call me and they're gonna call me. And I thought, I I can't. And then you said to me, Let me be your advocate on this, which I again that that goes towards the 80 hours that the average person is investing in trying to do all of this work solo. And so I yet another reason that that you are offering me the hope in this because you made me feel like this was possible, and that it wasn't necessarily just this big, scary, awful thing that I'm doing, but providing an opportunity to someone I love to put more years in their life and life in their years.

SPEAKER_00:

Yes. Absolutely. Yes, giving giving them hope, giving the family hope. Because again, you know, this is what I do 24-7. You know, most of the people that come to me are doctors, attorneys. They're great at what their own profession and what they do, but they don't know how to be a senior care advisor. They don't even know where to start. And that's the that's the reason why I started my company because that was the first thing every family would say was, I'm so overwhelmed. I don't even know what questions to ask. You get a crash course on something you never thought you don't want a crash course in. Um, so when you rely on a senior care advisor to do all that footwork for you, they already know just by talking to you in the back of their mind what communities could be a good fit or what is absolutely not going to be on the table. Um, saving you a lot of stress because having to sit down and figure that out for yourself and you're making decisions based on, you know, you would never go buy a house without a realtor, you know, and most people don't even realize that my services exist. Um, I never have to talk anyone into working with me. Once they find out what I do, they're like, oh my gosh, yes, here. And my services are free. So it doesn't cost any money to work with me, which is another thing that people are like, well, how does that work? How do you get paid and compensated for your time? Um, and how and it's I get a percentage of the first month's rent, any, you know, whatever whatever community they move into.

SPEAKER_01:

But it's much like working with a recruiter.

SPEAKER_00:

Yes.

SPEAKER_01:

Absolutely. And I mean, it makes perfect sense to me. I'm paying, you're getting paid for your knowledge and for finding the right fit.

SPEAKER_00:

Absolutely.

SPEAKER_01:

Yeah. Yeah. And it works out for everybody. What is the most beautiful part of your job?

SPEAKER_00:

Ugh, you know, I there's so many. Um it moves in phases. I think that one of the biggest is taking, you know, seeing the stress, hearing the stress, seeing the stress in the adult child's eyes. What am I gonna do? I don't even know where to start. And then just have as soon as that one phone call that we have, just hearing the lightness in their voice when I say, it's gonna be okay, we're gonna get through this. It's not as scary, it's not as bad as people make this out to be. This can actually be fun. Um, seeing the relief on their face after that first initial phone call, like, oh my gosh, I don't have to know it all. I I've got someone that's in my corner. The other thing is once their loved one is placed and I'm following up, and I'll I'll go visit, um, I'll bring them a little welcome basket and just check in with their loved one and just to see how. Things are going and just seeing the light in their eyes again. You know, most seniors are so isolated at home. Um, they everyone thinks about everything that they're giving up when they move to a community. They never think about all the things they're going to gain by moving in. So once I visit them and they've been there for a few weeks and they're getting their meals more regularly, their medication is actually being given and on time. They're not overdosing themselves, or they're not lost and wandering around their home. They have a purpose to their day. They're cognitively actually better, they're happier. No one goes in wanting to really ever go. No one ever admits that they're ready to move into a community. But I've never had one person say, you know what? I wish we would have waited a little longer. Everyone is relieved, everyone is happy. You know, there's going to be those outliers where, you know, no matter what, they're not going to be happy. But for the most part, the biggest, the biggest uh love for what I do is just seeing the senior just light up again and they're happy and they're active and they're social and they're not scared anymore. So that I feel like that's my my favorite part.

SPEAKER_01:

I love that so much. How do you define hope, Shauna?

SPEAKER_00:

Oh gosh, that's a great question. Um, how do I define hope? Well, with specifically with what I do, I think just knowing that you're not in it alone and there are people out there that probably know a little bit more than what you do and reach out to them. And um you're not in it alone, I think. You've got someone in your corner, you've got someone that can help guide you. And to me, that's hopeful. That's amazing.

SPEAKER_01:

How can people get into contact with you if they are in the St. Louis area? And then are there any other resources nationwide that you recommend people seek if they're beginning this process?

SPEAKER_00:

Yeah, actually, you can go on my website at www.seniorcommunity connections.net. And then um, if you are in another state, you can I hate to say the word Google, but you can Google a community, you know, a senior care advisor local in your area or call um your local senior resource company or office, and they should have a good list of people that do what I do. Um, we're a little bit further and farther between, but there are folks out there that, you know, do what I do. I you can call me and I'll find someone for you in the state that you're in as well. Um I do that all the time. Um, I'll just I have I belong to a huge network of other folks that do what I do, and I'll just get online and say, hey, is there anyone in California in this area that can help I can hand this family over to? So you can call me and I'll be happy to help you find somebody in your area.

SPEAKER_01:

Oh, you are such a good human being. Talk to me a little bit more about your the book that you contributed to, because it seems to me like that is an incredible resource for all things as well. And I feel as though you are you are the book in person. But if people want to have that in hand.

SPEAKER_00:

Absolutely. Yes, you can get it on Amazon. Um, it's called The Caregiver's Advocate. There's actually two volumes. The first volume I was not a part of, I was asked to be a part of the second volume. So there's two books, and it's a it's an amazing resource for anybody that is caring for a loved one at home. It topics on dementia, um, guilt, on you know, how to look for a community, be your own senior care advisor. So there's a lot of information in there from 20 different authors in each book. And I it's a really great resource. If you're just beginning your search or you're just thinking about starting that conversation with your loved one, I would read it just because it can give you a lot of great tools and get you thinking about the future. And, you know, they may be doing well now, but it just takes one fall, one major medical event and you're everything's gonna change. So it's good to have backup plans just in case.

SPEAKER_01:

I'm so grateful to you for spending time with me and for the hope that you're giving me minute by minute through this process, but also that you've been willing to share your knowledge and your heart and your compassion with our community. Is there anything that I didn't ask you that you'd like to share?

SPEAKER_00:

I don't think so. You did a great job. Thank you. Thanks for the opportunity to reach people and let them know that they're that services like mine exist out there.

SPEAKER_01:

I'm so grateful for our mutual friend Joe that connected us. Um, and I'm so grateful that you do this work. Uh, I think everyone has a specific heart and a specific gift, and this is very clearly yours. And I'm so grateful and I'm grateful to you for spending time with me today. Thank you. Thank you. And friends, thank you for joining us on this episode of Hope Comes to Visit. I certainly hope you will find a nugget in what Shauna and I have been talking about. And if this applies to you or to someone you know, that you will turn around and share it with someone. And until we chat again next time, please take very good care of you. Thank you so much for being here. Naturally, it's important to thank the people who support and sponsor the podcast. This episode is supported by Chris Dulley, a trusted criminal defense attorney and friend of mine here in St. Louis, who believes in second chances and solid representation. Whether you're facing a DWI, felony, or traffic issue, Chris handles your case personally with clarity, compassion, and over 15 years of experience. When things feel uncertain, it helps to have someone steady in your corner. Call 314 384 4000 or 314 DUI Help, or you can visit Dulilawfirm.com to schedule your free consultation.