Twenty years of this, mostly from the inside
I am Laura Giardina, an occupational therapist by training and a Regional Placement Advisor by trade. I have spent my whole career in Mid-Michigan senior care, which is why I can tell you what a community is actually like rather than what its brochure says.
Free to your family. I am paid by the communities, never by you.
What makes Laura different from a referral website?
Most of what I know about these communities I learned from working inside them, not from touring them with a brochure. A referral website matches you to whoever pays for the listing and then emails your details onward. I assess your parent myself, I walk the buildings with you, and I will tell you plainly when a community is the wrong fit or when no move is needed yet.
I qualified as an occupational therapist and spent sixteen years treating people in nursing homes and in their own houses. That is the job where you see exactly how someone manages a staircase, a shower, a kitchen and a medication list, and where you learn how quickly a small decline becomes a serious one.
From there I became a Rehab Director, which meant running a department and seeing the business end of care: staffing levels, turnover, who was well managed and who was quietly struggling. Then five and a half years as a Clinical Liaison at MyMichigan Medical Center in Midland, working with families at the exact moment a hospital tells them their mother cannot go home.
So when a discharge planner gives you a Friday deadline, I am not learning that process on your family. I have been on the other side of it for years.
What experience does Laura actually have?
Over twenty years of it, almost all in Mid-Michigan senior care, and nearly all of it spent inside the kind of buildings I now help families choose between. The useful part is not the length of it but the order: I did the hands-on clinical work first, then the management, then the hospital side, and only then the placement advice.
Occupational therapist, 16 years
Nursing homes and home care right across Mid-Michigan, assessing how people really manage daily life and rehabilitating them wherever that was possible. Sixteen years of watching how somebody handles a staircase, a shower, a kitchen and a medication list is the reason I can usually tell within one conversation whether a family is looking at assisted living or memory care.
Rehab Director
Running a rehabilitation department, which is where I learned to read a community from the inside rather than from the lobby. Staffing levels, turnover, whether the care actually delivered matches what is promised at the front door, and which places were quietly struggling behind a very good sales pitch. That is knowledge you cannot get from a tour.
Clinical Liaison, MyMichigan Medical Center Midland, 5.5 years
Working with families and discharge teams at the hardest possible moment, moving people safely from hospital to the right next place under genuine time pressure. Five and a half years of that is why a Friday discharge deadline does not frighten me, and why I know exactly what the hospital needs in order to let somebody go where they ought to be going.
Regional Placement Advisor, today
With Senior Placement Services of Mid-Michigan, helping families across Saginaw, Bay and Midland counties find assisted living, memory care and independent senior housing. Free to the family every single time, because the communities pay me rather than you. It is the same clinical judgement I have always used, now pointed at the choosing rather than the caring.
There is no bill at the end of this
I am paid by the communities, never by you. That is worth saying plainly, because most families assume help like this costs money they do not have and never pick up the phone. It does not change the advice I give you or the places I show you. If somewhere is not right for your mother, I will tell you so.
What does OTR/L mean, and why does it matter here?
OTR/L means registered and licensed occupational therapist. In placement work that matters because the central question is always a functional one: what can this person still do safely on their own, and what can they no longer manage? Assessing precisely that is what an occupational therapist is trained for, and it is why I rarely get the level of care wrong.
For scale: around 202,800 Michiganders over 65 are living with Alzheimer's, 11.2 percent of that age group, and 422,000 families in this state provide 682 million hours of unpaid care a year. Sixteen years of assessing exactly that in people's own homes is what I bring to a placement decision.
| Role | Years | What it taught me |
|---|---|---|
| Occupational therapist, OTR/L | 16 | How people really manage stairs, showers, kitchens and medication, and how fast a small decline becomes a serious one |
| Rehab Director | — | How to read a community from the inside: staffing, turnover, and whether the care matches the sales pitch |
| Clinical Liaison, MyMichigan Medical Center Midland | 5.5 | How hospital discharge actually works, and how fast it can move when the paperwork is right |
| Regional Placement Advisor | Current | Matching families to the right community across Saginaw, Bay and Midland counties |
Michigan figures from the Alzheimer's Association 2026 Facts and Figures. Further reading on planning for care: US Administration for Community Living and the National Institute on Aging caregiving guidance.
What can I expect from working with Laura?
I will tell you the truth, including when the truth is that you do not need me yet. I will not put your mother somewhere because it has a bed free this month. And I will not disappear once she has moved in.
I am also not going to rush you. Families make bad placement decisions when they feel pushed, and I would rather spend an extra fortnight getting it right than move someone twice. The second move is always harder than the first.
- OTR/L, licensed occupational therapist
- 20+ years in Michigan senior care
- Based in Freeland, Michigan
- Private pay and Medicaid Waiver
Where can I read the official rules myself?
Please do. I would much rather you checked me than took my word for it, and these four are the ones that actually matter when you are working out who pays for what. They are government and federal health sources rather than anybody selling senior living, including me.
- Medicare.gov, long-term care coverage — confirms that Medicare does not pay for long term custodial care.
- MI Choice Waiver Program, Michigan MDHHS — the Michigan route to Medicaid funded care outside a nursing home.
- US Administration for Community Living — the federal figures on how much care people actually end up needing.
- National Institute on Aging, caregiving — practical guidance for families caring for someone with dementia.
I did the care before I did the placing. Most of what I know about these communities I learned from working inside them, not from touring them.
The question is never which building is nicest. It is what this person can still do safely on their own, and what they can no longer manage. Everything else follows from that.
I have told families to go home and do nothing yet more times than I can count. If that is the honest answer, it is the answer they get, because I am not paid to move anybody.
Written by Laura Giardina, OTR/L, Regional Placement Advisor with
Senior Placement Services of Mid-Michigan. Licensed occupational therapist with over
20 years in Michigan senior care, including 16 years in nursing homes and home care
and 5.5 years as Clinical Liaison at MyMichigan Medical Center Midland.
Last updated .
Let's have a conversation
Fifteen minutes, no cost, no pressure and no obligation of any kind. Tell me what is going on with your parent and I will tell you honestly what your options look like, including the option of doing nothing just yet. If I am not the right person to help you, I will say so and point you towards whoever is. You can also simply ring me on 989-385-5239.