The many challenges facing senior citizens as their needs change and health problems arise can be daunting, even if family members are close by. From downsizing from a family home to finding the right fit for elder housing, the sheer number of tasks can be overwhelming to those new to the world of caring for the elderly. Helping seniors and their families navigate the challenges of aging are three Harvard businesses whose services are designed to help people make positive transitions into new homes, help seniors and families navigate the world of eldercare, and care for the comprehensive needs of those near the end of life.

Marie LeBlanc, president and founder of Transitions Liquidations Services, just marked the fifth anniversary of the business she started after leaving the world of high-tech sales. The idea was sparked from both her personal experience helping her mother and the observation that the aging baby-boom generation often needed help downsizing from family homes and making smooth transitions into smaller quarters. The process is a delicate one, LeBlanc said, and involves empathy for the client as well as a clear plan to help someone organize a lifetime of memories. She works with an average of 50 households a year, and although the process is unique for each client, she has refined a process that alleviates a lot of the stress that goes along with moving. When working to help a client downsize, she might do everything from sorting through paperwork to pricing household goods for an estate sale to making sure that someone moving to a new home has the creature comforts of familiar bedding and a full refrigerator the very first day. Simple logistics are a huge part of the business: finding good homes for treasured objects, sorting items for sale or donation, and readying a home for sale down to the final sweep of the broom. In addition, to give clients a positive visual of their future home, LeBlanc will draw up a floor plan of the new setting that shows the location of particularly meaningful pictures, furniture, and other objects.

In addition to the physical side of a move, emotions are a huge part of the process as well, LeBlanc noted, particularly when older children find themselves switching roles with an elderly parent. “Moving means redefining and changing boundaries,” she said. And while it’s impossible to take all the emotion out of transition, Le Blanc said that the role families find most valuable is the one she plays as manager, helping everyone cope with changing roles, needs, and the new environment.

Finding the right new environment for a client is often one of the main tasks Anne Marie Rowse takes on in her position as an independent consultant offering care management and caregiver support for seniors and their families. Rowse, who worked in the nursing home industry for many years, sees her primary mission as an advocate for seniors. Her main goal, she said, is to provide seniors with the medical, physical, and social resources they need to maintain the best quality of life.

Rowse, whose clients often come from a referral from a large network of eldercare providers, begins by making a detailed assessment and evaluation of each person’s physical, social, and medical needs. Based on her assessment, Rowse might work on identifying the next step, whether it’s a move to a nursing home or assisted-living facility, a retirement home, or the family home with additional caregivers available. In addition, she said, she will work with the medical community to coordinate ongoing care, and will even accompany a client on a doctor’s visit to offer support. “I’m really an advocate for them,” she said.

Because she has been in the eldercare business for so long, Rowse said she has great confidence in the network of local caregivers she has built over the years. These networks, as well as the game plan she creates for each client, become particularly important when working with people who have experienced a sudden health crisis, she said, when clients and family members have to make important decisions quickly. “There’s a lot of emotion when a health crisis occurs,” she said.

Rowse also has a personal perspective on the business. After graduating with a degree in rehabilitation counseling, she helped coordinate care for her father, who suffered from Lou Gehrig’s disease. “I realized that people need a lot of help in the other end of things, making the right decisions on their health-care needs,” she said. It’s a profoundly personal business, she noted, and one that comes from a lifelong commitment to caring for the needs of the elderly. “I view my business as a mission,” she said.

After running the guardianship services program for Family Services of Boston for many years, Regina Towne Bragdon launched her own business, Nashoba Valley Elder Care (NVEC), with one mission: to help seniors preserve their lifestyle, their dignity, and their ability to choose. Bragdon, who is certified as a registered guardian by the National Guardianship Association, works primarily with clients whose mental or physical health is so compromised that intervention is needed to help them into better circumstances. While most of her clients are elderly, Bragdon also helps those who have been disabled by stroke or other incapacitating illness, or those with severe mental health disorders. In concert with her “two right hands,” licensed social workers Mary Jo Boynton and Trisha Lane, Bragdon creates a care plan that assesses the clients’ immediate and future needs on every level. The ultimate goal, Bragdon said, is to create a care plan that best reflects the client’s personal and spiritual beliefs, and incorporates appropriate concerns voiced by friends and family members.

The role of a guardian is all-encompassing, Bragdon said. Once appointed by the court, a guardian is responsible for making all decisions regarding medical care, housing, and financial affairs for a client. Most of her clients are referred by Elder Protective Services, she said, when they come to the attention of state social workers as being at great risk of harm to themselves in their own homes. Bragdon spends a great deal of time thoughtfully creating a framework of legal documents to give caregivers direction about medical treatment and end-of-life decisions, she said, as well as assessing a client’s overall financial picture to determine the best home setting that fits within that budget. At the moment, she said, she is helping several parents of disabled children provide for them after they are no longer able to do so by helping them write wills, trusts, health-care proxies, and designate successive guardianship. Sensitivity is the quality she relies on most when handling delicate matters like these, she explained, whether she is making decisions based on her own judgment for a client in her guardianship, or guiding a family through the process with a loved one. Bragdon is gratified by the difference she makes in people’s lives, she said, and the personal relationship she develops with each person she helps. “In every single case I’ve ever had, from the day we were appointed our client’s quality of life has improved.”

While Bragdon handles the financial and legal side of a client’s life, Boynton and Lane get involved on the physical, day-to-day level. Both are social workers with many years’ experience in geriatric care, and work for NVEC creating and implementing health-care plans. “We take very complex situations,” Boynton said, and each client can have widely varying needs. Her involvement with them can be intense, too: she may need to accompany a patient to the doctor’s office, arrange for additional medical care based on the doctor’s recommendation, buy special garments for clients with specific physical needs, and work to ease the transition to a new home. The relationship is very personal, she said. “We’re often referred to as a surrogate family, but we’re a surrogate family with a professional touch.” She was quick to add that even after stabilizing a client and spending less time with them, they continue to keep in close touch.

Seconding Bragdon’s idea that sensitivity is of the utmost importance, Boynton said that one of the most important roles NVEC can play is helping individuals, and other family members, cope with what can seem like a series of overwhelming tasks. Hearing advice from a professional often soothes what can be troubled family waters, Boynton explained, and although their work is often fraught with complex decisions and high emotion, the positive impact they have benefits everyone involved. “And it feels so good to be an advocate,” she added.