Need advice on what type of care FIL needs

[Anonymous]

Long story short, FIL has been paraplegic for the last 16 years with the last 2-3 years almost completely bedridden. He has also been going through cognitive decline within the last few years with rapid decline within the last few months. He does not know where he is or who my MIL is for most of the day. MIL has been taking care of him but is at her wits end from a mental and physical perspective. He often wakes up at 1-2 AM and keeps talking non-stop. We are exploring care options for him and do not know what type of care he needs. It seems like he needs nursing and/or memory care. However, we are not sure whether memory care is needed in his case since he has no ability to "leave." Please advise.

[Anonymous]

It might not be needed - it all depends upon the facility; their admissions coordinator can make the call. They’ll have particular criteria for each level of care.

[Anonymous]

I think this is for your MIL to decide. If she’s at her wit’s end memory care would be good just to give her a break. Especially now that he is declining. They will take over all his care: feeding, bathing, grooming, incontinence, etc. MIL can just visit and get a break. The staff would also be trained in caring for someone with cognitive issues. Assuming they have assets this would be private pay.

If she wants to keep him at home there are doctors that can do house calls like Inova Home Health — pretty sure they are covered by Medicare. At the very least he could get skilled nursing and someone to prescribe medication to help with the insomnia, etc. You could also hire unskilled private duty aides to help MIL for longer shifts.

Finally not to be grim but home hospice is also an option that will provide additional palliative care at home, but of course that also means forgoing some treatments. Medicare will cover it but you have to make sure everyone is on board before doing it.

Best of luck.

[Anonymous]

His doctor should be able and qualified to tell you what care he needs and should be able to connect you with a geriatric social worker who can help you further. You can also check with the senior center in FIL's town and/or in your town. They may have folks who can advise you. Make sure you're clear on what money and resources your in-laws have before you start researching care.