I didn’t plan on geriatrics — it found me early. My grandfather died of melanoma when I was young. He was on home hospice, and what I remember most isn’t anything anyone explained to me — it’s the hospital bed set up in my grandparents’ living room. Years later, my grandmother started declining from dementia while I was in medical school, and for the first time I understood enough to walk my family through what was happening to her. Most people going through this don’t have someone in the room who can do that.

The desire to be that person for others inspired me to focus my training on internal medicine and geriatrics. Stanford provided me a comprehensive education, and one of the most important lessons I learned was how much of medicine gets done to people rather than for them. I watched people push for every intervention available at the end of a life, often without anyone laying out the real odds, the burden it would put on the patient, or what would actually be gained by it. Geriatrics is the field built around asking a different question first: what matters to you, and what are you willing to go through to get there? That’s the question I trained to ask in the clinic. The Geriatrician’s Guide is my attempt to bring the same question to the tour, the paperwork, and every decision in between.

Caring for older adults in their homes gave me an inside look into dozens of assisted living and memory care communities. I rounded on the same hallways, signed the same orders, and sat in on the same care conferences that decide how someone actually lives day to day. That vantage point taught me to read a community the way I examine my patients: I look past the surface — the lobby and the chandelier — to the vitals underneath, the overnight staffing, the medication list, how fast someone responds when something goes wrong.

Along the way, being inside those communities taught me something else I didn’t expect: how many people navigate all of this with little or no support — no clear information, no training, no one to tell them what to ask or what to watch for. Much of what fills that gap is free to use, which sounds like a gift until you notice who’s actually paying for it — the very communities it recommends, not the people relying on it. The recommendation you’re reading was shaped by a relationship you never see.

So here is the commitment that anchors everything published here: I do not accept commissions, referral fees, or sponsorships from senior living operators or placement services. Not now, not later. When I tell you what to ask on a tour, the only interest I’m serving is your loved one — because that’s the only interest I have.

If you want to see what that looks like, start with the free chapter on what senior care actually costs.