Home Health versus Assisted Living
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Anonymous
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WWYD?
Mom is at stage six of Alzheimer's. She is incontinent and needs help to dress but is still mobile. As a single mom of preteens, I work full time and the kids are on my insurance plan. I thought the time was now to put Mom into assisted memory but I am second-guessing myself. Mom has a home health aide. The home health aide is okay but I don't like how isolated Mom is at home. The assisted living facility seems nice enough but I am starting to have second thoughts as they seem slightly disorganized on the administrative end (although they have high ratings on Google, Yelp, and A Place for Mom). It has been mentioned here and no red flags were mentioned. However, I am questioning the type of care she will receive upon moving in. The home health aide shared that she used to work for such places and how they changed once the resident moved in. I believe this to be true but I still can't decide what to do anymore. I had been spending Mom was a very social person before the dementia but she has lived very isolated since the death of her husband. What are some pros and cons of each? |
Anonymous
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Hi OP.
The benefit of Home Health Aide is that your mom is getting one on one attention and responsiveness to her needs. I imagine that her living in her familiar home is a benefit. It is quite expensive to have round the clock Aides, but maybe money is not an issue? Have you had issues with the Aides canceling or not showing up? That is a risk with Home Health, but maybe you aren't having that problem. If isolation is the issue, could you task the Home Health Aide with taking her out of the house more? Could she do an adult day care program a few days a week? Memory Care would provide more oversight of her care, but she would get less one-on-one attention. Perhaps she would benefit from social interaction but that depends on her ability to connect with others at her stage of Alzheimers. Her care would be guaranteed with a large revolving staff. I imagine it would be less expensive than 24/7 Home Health, but Memory Care is still quite expensive. |
Anonymous
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My mom is stage 5/6 vascular dementia and is in assisted living. I should call it “assisted” living. It’s a highly rated, very expensive community but they don’t have a dedicated case manager to really figure out the needs of the residents, so it’s up to the residents to ask for help. There’s a lot of “not my job” responses to ask for assistance (with things like remote controls, thermostats and opening a can). My mom is safe there but not the happiest.
I’m not thrilled with it but the memory care places I toured, and that she’ll need eventually, are full of people more advanced than she is. So I think in her case I’m going to keep her where she is until memory care is absolutely necessary. Memory care is a scary place. I’m also beginning to suspect that the ratings for many of these places are employees. I don’t know the answer, I wish you got what you paid for in elder care. The one on one with the home health aide may be better than the socialization with her peers, as her care definitely won’t be as personal. |
Anonymous
| I’m a visiting nurse and I am seeing more assisted living residents have private aides (sometimes around the clock) to be sure all their needs are met. This must be quite expensive. |
Anonymous
| Alzheimer’s might not be applicable here, as it’s harder to manage, but my mother moved into assisted living and one thing I noticed is that their health policies are hugely based on liability. We would like my mother’s anxiety drug evaluated (she’s still on the loading dose) and the NP keeps saying that ‘we don’t’ want to over drug her’. Meanwhile, she is having massive panic attacks every time she needs to move out of a chair. She also needs to have her meds upped for the horrible neuropathy pain she suffers at night, and they won’t do that either. She is nowhere near on the upper end of what she could take of Gabapentin in the evening. Lastly, she has a tendency to fall out of bed, but they took the bedrails off the hospital bed so she would not be ‘confined’. But we can use a slide under the mattress bedrail, which makes no darn sense! |
Anonymous
| We found memory care much better. Hired a personal aide as a supplement toward end. Issues aging at home with 24-7 care were endless and could give you a nervous breakdown. |
Anonymous
Did your parents plan, financially, for this level of care? I am horrified at how expensive all of this is. My in-laws are destitute and we are re-mortgaging our house to put them in a place for $12k/month. What if they live a few more years? It makes me want to throw up. |
Anonymous
| She’ll need a nursing home not assisted living. |
Anonymous
They can go on long term care Medicaid. |
Anonymous
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OP Here
We are looking at memory care. I was about to consider it a done deal but several administrative issues are giving me pause. I read that several people are supplementing memory care with home health. That is very expensive. The home health agency offers live-in care. I’m starting to really think about that option. |
Anonymous
| Some facilities offer “respite care”, where the person can move in for 30 days and basically try out living in the facility. Might that be an option? I’m sorry, none of this is easy. |
Anonymous
This facility does not offer that option. I wish I could feel better but here are the red flags I’ve encountered thus far: *First visit I went to tour. Receptionist was very passive to me as she thought I was there to visit a resident. Attitude totally changed when she learned I was going to tour. *Had to follow up several times regarding next steps once I decided to admit Mom. *Several confusing issues with their online portal. *Slow follow through on call backs *During home evaluation I was told Mom’s medicine was expired. Assessor was reading the day the medication was issued. I pointed out the expiration date on the bottle. I do not have any type of medical background whatsoever. How would someone evaluating people not know this information? |
Anonymous
| All of that would give me pause to OP. Are there other memory care places you could tour? Once the need memory care they just need to be kept safe and their physical needs need to be met. They won’t need the social interaction as much. Live in care would accomplish that. I’m still touring memory care places because I haven’t found one that I’m comfortable with. One place smelled like urine and had no natural light (apartments were on the outside of a square so the interior common areas were were dark). It’s crazy because for the amount they charge the care should be absolutely top notch. |
Anonymous
| Don’t do memory care. We did for my Mom. Horrific. Call hospice and start in hospice. Keep the home health aide or get a new one. One that your trust, treat well and pay well. |
Anonymous
Exactly! This place is a highly rated chain. I really liked it at first until all these red flags popped up upon trying to get my LO admitted. They have several locations in this area, my brother said I should try another location. |