Independent · Unaffiliated · San Antonio
You can't be there every week. We can.
Guardian RN is led by Jackie, a registered nurse in San Antonio. Families hire us to drop in on their parent, unannounced and with no ties to the facility, and tell them honestly how things are.
Jacqueline Medeiros, RN · Not employed by any facility or agency
- UnannouncedNobody gets a warning we're coming. Not the facility, not the staff.
- In writingA report in plain language after every visit, sent straight to you.
- IndependentNo facility, agency, or referral arrangement pays us. You do.
Five things a facility can't give you about itself
How we work
Independent
We don't work for the facility, the agency, or anyone who bills your family. Nobody there signs our paychecks, so nothing we tell you has to be softened first.
Unannounced
If people know you're showing up, they're going to act accordingly. Nobody gets a warning we're coming, so what you hear about is an ordinary day.
In writing
After every visit you get notes in plain language on what we saw: your parent, their room, their care, and anything we'd want to know if it were our own mother.
Plain language
No clinical shorthand and no jargon you have to decode. If we wouldn't say it that way on the phone, we don't write it that way either.
No conflict of interest
We take no referral fees and have no arrangement with any facility or placement service. We work for the families and that's it. We have to stay unbiased.
The distance problem
A phone call tells you how they sound. It doesn't tell you how they are.
Your parent says they're fine. They always say they're fine. From two time zones away you have no way to check whether anyone helped them shower this week, whether the bruise on their arm has an explanation, or whether the call button is somewhere they can actually reach it.
We go in person and look, then write down what we saw and send it to you.
For families who live out of state
What we do
Someone independent goes and looks, then tells you what they saw
Unannounced drop-in visits
A visit in person, at a time nobody has been told about, in assisted living, memory care, a nursing home, or their own home.
Written reports to the family
Plain-language notes after each visit, sent to you, not filtered through the people being observed.
An outside second look
They already have people who see them every day. What they don't have is anybody outside to verify it.
Someone there when you can't be
For families who live somewhere else and can only get to San Antonio a few times a year.
The facility already reports on itself
The difference
Your parent has people around them every day. None of them work for you.
- Who employs the observer
- The facilityThe facility, or the agency being paid for the care
- Guardian RNYou. We have no relationship with the facility at all
- When the visit happens
- The facilityOn a schedule the staff know about in advance
- Guardian RNUnannounced, including evenings and weekends
- Who the report goes to
- The facilityInto the facility's own records
- Guardian RNTo you, in writing, in plain language
- What happens if something's wrong
- The facilityIt's reviewed by the organization responsible for it
- Guardian RNYou hear it directly, with the specifics you need to raise it
The deliverable
What actually lands in your inbox
A written account of what we saw, in the words we'd use if we were telling you over the phone.
- 01
When we went
The date and time of the visit, so you know it was a Tuesday evening and not a Sunday lunchtime when everyone's family is already there.
- 02
How they seemed
Alert or drowsy, comfortable or in pain, groomed or not, talkative or withdrawn. Ordinary words, not clinical shorthand.
- 03
The numbers
Weight and vital signs, taken the same way each visit. One reading on its own doesn't say much, but six months of them will show you a trend.
- 04
What the room was like
Linens, laundry, water within reach, the call button somewhere they can actually press it, mobility aids where they can be used.
- 05
What changed
Differences since the last visit. This is usually where problems show up first. A slow decline looks like nothing on any single day.
- 06
What we'd ask about
Specific questions worth putting to the facility, each one tied to a date and something we saw.
How it works
Four steps, and you can stop after the first one
- 01
We talk first
You tell us about your parent, where they are, and what's been nagging at you. No medical details needed over email. We can cover that on the phone.
- 02
We go, unannounced
We show up, and whatever we see, we let the family know. We spend real time there, not five minutes in the hallway.
- 03
You get it in writing
A written report in plain language, sent to you directly, with what we saw and what we'd ask about next.
- 04
You decide what happens next
Some families want one visit and nothing more. Others want us in there twice a month, or four times. That's your call, and it can change.
Nobody moves into a facility because they wanted to
If they're still at home
Plenty of people flat-out refuse. “You can’t take me out of my house. I paid good money for this house.”
So they stay. And staying is usually the right thing. It's their house and their routine, and they know that kitchen in the dark.
But it means there's no aide and no front desk, and nobody down the hall who'd notice the weight coming off, the bruise on the hip, the fridge with nothing in it, or the pills still sitting in Tuesday's slot on Friday.
We come in as someone you hired. We're not there to move them, take over, or tell them what they can't do anymore. We look at how they actually are and write it down for you.
Staying home isn't the problem to solve.
It stays their house. We visit and write it up for you, and nothing about their independence changes.
Is this what you need?
Straight answer
Sometimes it isn't, and we'd rather tell you now than take your money and disappoint you.
This is probably a fit
- Your parent is in San Antonio and you are not
- They're in assisted living, memory care, or a nursing home
- Or they're still in their own house, where nobody checks on them at all
- You want an outside opinion, not a replacement for their care team
- Something feels off and you can't tell whether you're overreacting
This isn't what we do
- You need a nurse to provide care or treatment. That isn't what this is
- You need someone available for emergencies, which we can't be
- You're looking for someone to manage the facility relationship for you
- Your parent is outside the greater San Antonio area
Questions families ask
FAQ
Are you connected to the facility in any way?
No. We're not employed by, contracted to, or paid by any facility, agency, or care provider. We're hired by the family and we report to the family.
Do you need the facility's permission to visit?
In a facility we visit as guests of your family, the way you would. Visiting rules vary, and we'll walk you through how that works for your parent's situation when we talk. If they're in their own home there's nobody to ask. You and your parent decide, and we come when it suits.
My parent is still in their own house. Is this for them?
Yes, and for a different reason. In a facility there are people checking on them. They're just the same people being paid to provide the care. At home there's often nobody checking at all between your phone calls. Either way we come in, look properly, and write down what we found. Staying in their own home is theirs to decide; we're not there to talk them out of it.
Do you examine them, or do you just look around?
We examine them. Every visit is made by a registered nurse, so we take their weight and vital signs and check the things a nurse checks: skin, mobility, appetite, pain. What we don't do is take over their care or change anything their doctor has ordered. We assess, write it down, and tell you what we'd ask about.
Does that replace their doctor or their home health nurse?
No. They keep the people they already have. We're the ones checking that what those people are supposed to be doing is actually happening, and telling you straight if it isn't.
What if you find something wrong?
We tell you, specifically and in writing, and we tell you what we'd ask about. What happens next is your decision. You're the one with standing to raise it, and you'll have facts and a date to raise it with.
I live out of state. Does that make this harder?
It's most of our work. Your parent is in San Antonio and you're not, and the report reaches you wherever you live.
How often should someone visit?
It depends on the situation and on what's worrying you. Some families start with a single visit and decide from there. We can talk it through before you commit to anything ongoing.
What does it cost?
It depends on where your parent is and how often you'd like visits. Call or send a note and we'll give you a straight answer for your situation.
Not sure whether something's wrong?
That's usually the right time to call. Tell us what you're seeing and we'll tell you honestly whether a visit would help.