Resources
Elderly Care Providers
Understanding care options when estate and family needs overlap.
Why This Matters in Probate
Estate settlements frequently intersect with elder care needs. When a family member passes away, surviving spouses or dependents may need care transitions — sometimes suddenly, sometimes within days. The executor or administrator often finds themselves managing both the probate process and a loved one's care needs at the same time.
Understanding the local care landscape helps executors and families make informed decisions during an already difficult time. Whether you're arranging care for a surviving spouse, evaluating what services were already in place, or helping a family member transition to a different level of support, having a clear picture of your options reduces stress and prevents costly missteps.
This page is designed to give you a working knowledge of the care options available in the Texas Hill Country — not as medical advice, but as practical context for families managing both an estate and a care need simultaneously.
Types of Elderly Care Providers in the Texas Hill Country
Elder care is not one-size-fits-all. The right level of care depends on the individual's medical needs, cognitive status, personal preferences, financial resources, and family situation. Below are the primary categories of care providers you'll encounter.
In-Home Care Providers
Non-medical in-home care provides assistance with daily living activities — meal preparation, light housekeeping, medication reminders, mobility support, and companionship. These services are ideal for seniors who want to remain at home but need help with routine tasks. When evaluating providers, look for Texas-licensed agencies, consistent caregiver assignments, and transparent pricing by the hour or by the shift.
Home Health / Skilled Nursing
Home health and skilled nursing deliver physician-ordered medical care in the home — including nursing visits, physical therapy, occupational therapy, wound care, and medication management. These services are typically prescribed after a hospital stay or when ongoing medical needs exist. Verify that the agency is Medicare-certified and check their state inspection history before engaging services.
Assisted Living Facilities
Assisted living facilities offer residential communities with varying levels of daily support, including meals, housekeeping, medication management, social activities, and personal care assistance. These are a common option for seniors who can no longer live safely at home but do not require round-the-clock medical attention. Tour multiple facilities, ask about staff-to-resident ratios, and review recent inspection reports.
Memory Care Facilities
Memory care facilities are secured, specialized environments designed for individuals with Alzheimer's disease, dementia, or other cognitive impairments. They provide structured routines, enhanced safety measures, and staff trained in cognitive care. When comparing memory care options, ask about staff training credentials, elopement prevention protocols, and how activities are adapted for different stages of cognitive decline.
Adult Day Programs
Adult day programs offer daytime supervision, structured activities, social engagement, meals, and sometimes basic health services in a community setting. They provide essential respite for family caregivers and a safer, more stimulating environment than an empty house during the day. Evaluate programs for their activities calendar, health monitoring capabilities, and transportation availability.
Hospice & Palliative Care
Hospice and palliative care focus on comfort, quality of life, and family support for individuals with serious or terminal illnesses. Hospice is typically covered by Medicare and provides a comprehensive team — nurse, social worker, chaplain, home health aide, and volunteer support. Palliative care can begin earlier in the illness trajectory and focuses on symptom management alongside curative treatment.
Geriatric Care Managers
Geriatric care managers are professional advocates — typically nurses, social workers, or gerontologists — who assess needs, coordinate services, manage transitions between levels of care, and serve as a liaison between families and providers. They are especially valuable when family members live out of state or when care needs are complex. Ask about their professional credentials, local provider relationships, and fee structure during an initial consultation.
How to Evaluate an Elderly Care Provider
Choosing a care provider is one of the most consequential decisions a family will make. These are the practical criteria that matter most — and the questions worth asking before signing any contract or committing funds.
State Licensing & Certification
All assisted living and memory care facilities in Texas must be licensed by Texas Health and Human Services (HHS). Home health agencies require both state licensure and Medicare certification. Always verify a provider's current license status through the HHS Provider Lookup tool before committing.
Staff-to-Resident Ratios
Ratios vary significantly by facility type and level of care. Ask specifically about day shifts versus night shifts, weekend staffing, and how the facility handles call-outs. A facility that is well-staffed during your tour may operate with a very different ratio at 2:00 a.m.
Inspection Reports & Deficiencies
Texas HHS publishes inspection reports and deficiency histories for licensed facilities. Review the most recent surveys and look for patterns — a single minor deficiency is very different from repeated findings related to medication errors or resident safety. Reports are available through the Texas Health Data website.
Medicare / Medicaid Certification
For home health agencies, Medicare certification means the agency meets federal quality and safety standards. This is also what allows Medicare to cover services. If a family member is on Medicaid, verify that the provider is enrolled as a Medicaid provider as well — not all agencies accept Medicaid patients.
Questions to Ask During Tours
Beyond the basics, ask: How do you handle medical emergencies? What is your staff turnover rate? How are care plans created and updated? Can residents bring their own furniture? What happens if funds run out? How do you communicate with families? The answers — and the willingness to answer — tell you a great deal.
References & Online Reviews
Ask for references from current families and actually call them. Online reviews on Google and Caring.com can be helpful, but read them for patterns rather than individual complaints. Every facility will have a few negative reviews — what matters is how the facility responds and whether the issues raised are systemic or isolated.
Cost & Funding
In the Texas Hill Country, assisted living typically ranges from $4,000 to $7,500 per month depending on the level of care. Memory care often runs higher. Common funding sources include long-term care insurance, Veterans benefits (Aid & Attendance), Medicaid (for qualifying individuals), and private pay. An estate attorney or financial advisor can help determine whether estate funds can be used for a surviving spouse's care.
When Probate and Care Needs Overlap
In my experience working with families throughout the Hill Country, the intersection of probate and elder care is more common than most people realize. These are the situations executors most frequently encounter — and the ones that benefit most from early planning.
Immediate Care Transition After a Spouse's Death
When a homeowner passes, a surviving spouse may need to move from the marital home to a care facility quickly — sometimes before the estate is even opened. Executors should be aware that this transition may require court authorization to use estate funds for care costs, and the timeline for obtaining that authorization can affect when the property can be sold.
Using Estate Funds for Care Costs
Texas courts may authorize the use of estate assets for the support of a surviving spouse or dependents, but this typically requires a specific petition and court approval. An executor cannot simply decide to redirect estate funds to a care facility without proper authorization. Work with the estate attorney to understand what the court will and will not approve in your specific case.
Selling the Property to Fund Care
In many cases, the home is the estate's most liquid asset. Selling it to fund a surviving spouse's ongoing care may be the most practical option — but the sale must be handled within the probate court's requirements. Timing the sale to align with both court authorization and the family's care needs requires coordination between the executor, attorney, and real estate agent.
Coordinating Care Decisions with Estate Timelines
Estate administration follows a legal timeline — filing deadlines, creditor notice periods, court hearings, and closing requirements. Care transitions follow a human timeline — health crises, facility availability, and family readiness. These two timelines rarely align perfectly. Early planning and communication between the executor, estate attorney, and care providers can prevent costly gaps or conflicts.
Local Resources
This directory is being compiled. Contact Bill directly for a referral to trusted elder care professionals in the Hill Country area.
Provider Directory Coming Soon
Bill is compiling a curated list of trusted elder care providers throughout Boerne, Fair Oaks Ranch, San Antonio, and the surrounding Hill Country communities. Check back soon, or reach out directly for a personalized recommendation.
Navigating probate and care decisions simultaneously?
Reach out for a confidential conversation about your situation — I'll help you understand your options and connect you with the right professionals.
Important Disclaimer
This page is for informational purposes only and does not constitute medical, legal, or financial advice. The information provided is general in nature and may not apply to your specific situation. Always consult with qualified professionals — including physicians, estate attorneys, and financial advisors — before making care or financial decisions. Bill Ross is a real estate agent and Certified Probate Expert, not a medical professional, attorney, or licensed care provider.