Senior Living -- More Expensive, More Rules??

[Anonymous]

I am basically the next of kin for my 87yo uncle by marriage. I will have power of attorney if he loses his mental faculties, executor of his will, etc. He is in a very nice senior living facility. He is quickly losing his eyesight and his meds are losing their effectiveness for his various health issues (e.g., congestive heart failure). He is not happy in his current facility, because they call him out when he yells at them, he calls them about many gripes (eg, why doesn't the management adjust the building temperature every day so it is not too hot or cold), tells him he needs to dress for meals in the eating area (eg., you can't come down in your pajamas), other residents only drink water with their meals (e.g., won't have cocktails), etc.

He is a good person generally but he is A LOT. He calls me to complain regularly, but I empathize a lot with the staff. Not all the time, but more than half the time. Other residents have complained about him. He's been in this place less than a year and wants to move to a better one. He'd like one with a pool and fewer rules, and is willing to pay more for it. I'm thinking that if he thinks a more expensive facility is going to let him come down in his old PJs for meals, he has another thing coming.

He has money, but not that much money. The current place required me to agree to pay if he couldn't. I had a virtual heart attack when he'd sold his house and expected me to agree to this when I have kids in school, and an elderly 80yo parent and 80yo in-laws -- all out of state as well. To be honest, I will be in trouble if my uncle runs out of money and can't pay. My mom needs assistance too. Moving my uncle was not easy for a multitude of reasons and trying to get people to help (even hired ones) is going to be difficult. He used up pretty much any good will he had with former neighbors and others. He lives out of state and I've already traveled to help multiple times (and he's changed plans on a whim like moving up the sale of this house by 4 months and expecting everyone to hop too at the end of November). I cannot handle another move unless it is to assisted living for various reasons.

What I'm looking for is input on the relationship between the cost of rent and residential rules. Maybe these aren't the right words. I'm not sure how to phrase my question. Maybe it's more like, are more expensive senior living places more tolerant of high maintenance residents? My uncle expects staff to be his own immediate on-demand personal team. I wish I were joking. He told me his current standard operating procedure is to act like everything is an emergency, so people will do things quicker.

Sorry for the long, meandering post. I'm just tired and I'm trying to figure out how to respond to him. He's now told everyone (except the senior living facility yet) that he's moving at the end of his lease in November. It didn't work last year when I told him people are busy at Thanksgiving and Christmas time, and it didn't matter. OK. I'll stop for now.

[Anonymous]

I would tell him you looked but haven't been able to find a place with less rules. Because there isn't one.

I think if there's money, you can hire him a personal aide for daytime. Some places allow that. Then he can at least have more attention, which is clearly what he wants. Re the pajamas, I would think he's having difficulty getting dressed. Sometimes with older people, "I don't want to" means "it's becoming too hard".

[Anonymous]

I feel for you, OP - my late mother became increasingly more irrational, irritable and impatient at 87 with CHF and in and out of skilled nursing-assisted-hospitalizations-and finally independent living with 24/7 aides.

She was in a continuing care community and moved about every 2 months within the community. I know exactly what you mean about rules and being unable to have meals communally in pajamas. My mom skirted those rules several times and was so proud - I think staff picked their battles carefully with her.

The solution is NOT relocating your uncle but rather as PP mentioned, seeing about hiring a sitter-type aide. Someone who will be more of a companion type sitter: can accompany him/push his wheelchair (or spot him) for fresh air and time sitting outdoors just chatting or greeting passers by, or maybe chaperoning him to site events he’d otherwise hesitate to join (bingo, travel talks, movies, etc) and fetch him snacks, lay out his clothes for the next day, help with ADL.

Start with a daytime aide. You’re looking for an independent contractor. The facility will likely discourage this hire and refuse to provide recommendations but your freedom of choice. Guarantee if you ask around you can find an aide who’s looking to take on more hours and a new client.

[Anonymous]

PP above and expect to pay this person weekly.

[Anonymous]

PP again and shut down talk of relocating him. Too complicated, expensive and too great a stress on all involved.

Truth is, even in skilled nursing, the resident is alone and only sees a nurse to get vitals checked, meds delivered, perhaps meals delivered to the room, dressed and undressed and basic ADL to include toileting in a.m. and p.m.

Anything else they must ring the call bell - and that’s often ignored for a shockingly long time.

My mom fell in the skilled nursing unit in private bathroom - shattered her pelvis and sat on the floor in the dark crying and by all accounts waited 10 minutes for a response. Then a nurse wandered in and tried to move her/urged her to pull to a stand. Rescue squad called by another nurse. All this to say my mom was in a “fancy” Sunrise facility - you don’t get what you pay for.

[Anonymous]

OP - You need to get the advice of an Eldercare Lawyer how you can help this relative, but how you can be clear with any arrangement made for him that you will not be responsible for his bills! You need to protect your family and step back if needed to do so.

[Anonymous]

Anonymous wrote:I would tell him you looked but haven't been able to find a place with less rules. Because there isn't one.

I think if there's money, you can hire him a personal aide for daytime. Some places allow that. Then he can at least have more attention, which is clearly what he wants. Re the pajamas, I would think he's having difficulty getting dressed. Sometimes with older people, "I don't want to" means "it's becoming too hard".

I thought that initially, but he really has a "I don't GAF" attitude. Why should I have to dress when I'm just at home. He dresses fine on his own and has a service (with a pre-arranged time -- he hates having to wait for a certain time -- and to pay someone just to put on a sweater. Grr.)

[Anonymous]

Anonymous wrote:I feel for you, OP - my late mother became increasingly more irrational, irritable and impatient at 87 with CHF and in and out of skilled nursing-assisted-hospitalizations-and finally independent living with 24/7 aides.

She was in a continuing care community and moved about every 2 months within the community. I know exactly what you mean about rules and being unable to have meals communally in pajamas. My mom skirted those rules several times and was so proud - I think staff picked their battles carefully with her.

The solution is NOT relocating your uncle but rather as PP mentioned, seeing about hiring a sitter-type aide. Someone who will be more of a companion type sitter: can accompany him/push his wheelchair (or spot him) for fresh air and time sitting outdoors just chatting or greeting passers by, or maybe chaperoning him to site events he’d otherwise hesitate to join (bingo, travel talks, movies, etc) and fetch him snacks, lay out his clothes for the next day, help with ADL.

Start with a daytime aide. You’re looking for an independent contractor. The facility will likely discourage this hire and refuse to provide recommendations but your freedom of choice. Guarantee if you ask around you can find an aide who’s looking to take on more hours and a new client.

So, he has some people he has paid, but he's pissed about that. He just expects that someone he sees passing by his door should want to get him his sweater so he doesn't have to get up. My aunt died last year and she did this sort of stuff for him. He's spoiled (and I'm sure still mourning her death), but his demands are ridiculous. Also, if he needs a 24/7 person, the SLF has told me that would indicate to them that he no longer qualifies to live there. What a mess.

[Anonymous]

Anonymous wrote:OP - You need to get the advice of an Eldercare Lawyer how you can help this relative, but how you can be clear with any arrangement made for him that you will not be responsible for his bills! You need to protect your family and step back if needed to do so.

The facility would not let him move in without a co-signer, and his house was already on the market with several interested buyers. He had a contract on the house within a day or two. I think this co-signer arrangement is becoming more common, because that's what other local facilities required too. He's got good but not infinite money for an 87yo. His argument is that he can afford all this and he won't live much longer. (His mother lived to 100!) Things seem fine now, but assisted or other increased medical assisted living will cost significantly more. If he gets down to $0 on the day he dies, so be it. It is his money. But if he goes negative before then, I'm going to be lit, because then it's my money and I like I said I have immediate family to look out for too.

[Anonymous]

Anonymous wrote:PP again and shut down talk of relocating him. Too complicated, expensive and too great a stress on all involved.

Truth is, even in skilled nursing, the resident is alone and only sees a nurse to get vitals checked, meds delivered, perhaps meals delivered to the room, dressed and undressed and basic ADL to include toileting in a.m. and p.m.

Anything else they must ring the call bell - and that’s often ignored for a shockingly long time.

My mom fell in the skilled nursing unit in private bathroom - shattered her pelvis and sat on the floor in the dark crying and by all accounts waited 10 minutes for a response. Then a nurse wandered in and tried to move her/urged her to pull to a stand. Rescue squad called by another nurse. All this to say my mom was in a “fancy” Sunrise facility - you don’t get what you pay for.

I am so sorry that happened!

[Anonymous]

I am sorry you are having to dealnwith all of this. The only advice I have for you is DO NOT sign that you will be responsible for a relative who can't pay- just say no. They can't make someone co-sign for their places, they can either accept the resident with what they have or not (we didn't sign for FIL, and he's in a fairly swanky place put of state)

[Anonymous]

You should never have signed that agreement that required you to pay in his place.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP - You need to get the advice of an Eldercare Lawyer how you can help this relative, but how you can be clear with any arrangement made for him that you will not be responsible for his bills! You need to protect your family and step back if needed to do so.

The facility would not let him move in without a co-signer, and his house was already on the market with several interested buyers. He had a contract on the house within a day or two. I think this co-signer arrangement is becoming more common, because that's what other local facilities required too. He's got good but not infinite money for an 87yo. His argument is that he can afford all this and he won't live much longer. (His mother lived to 100!) Things seem fine now, but assisted or other increased medical assisted living will cost significantly more. If he gets down to $0 on the day he dies, so be it. It is his money. But if he goes negative before then, I'm going to be lit, because then it's my money and I like I said I have immediate family to look out for too.

Wow. That sounds scary. I’ve never heard of forcing families to sign on to pay. My parent pays rent month to month. If he could not pay, I expect he’d be evicted.

[Anonymous]

Yikes. Sorry, OP.

Personally, I think it's asinine he can't come to breakfast in his PJs.

Could you get him some clothes that he can sleep and lounge in that are PJ-like but considered ok to wear to breakfast? Like sweats or something?

[Anonymous]

Anonymous wrote:Yikes. Sorry, OP.

Personally, I think it's asinine he can't come to breakfast in his PJs.

Could you get him some clothes that he can sleep and lounge in that are PJ-like but considered ok to wear to breakfast? Like sweats or something?

Yes, we got him nice sweats that he'll wear, but it's all the same to him. Although the sweats at least don't have a front opening (yikes!).