Assisted Living

[Anonymous]

I am at the beginning stage of helping my mother look for an assisted living facility for my grandmother. My grandmother currently lives alone with the help of a part time care taker (3 hours per day, 7 days per week). However the care taker believes my grandmother needs full time assistance due to dementia/cognitive issues and since she's almost 90, it's probably time. She does not live in DC but does live in an area that seems to have a lot of options.

I'm just looking for tips or advice. There seems to be a large variety of options with differing levels of care. I don't even know where to start. She's definitely passed the point of just needing a senior community but she doesn't need a nursing home.

Any help is greatly appreciated.

[Anonymous]

OP's! Where does she live?

Does she have enough money to pay for assisted living?

[Anonymous]

Could she do independent living still with her own apartment and kitchenette but cleaning service, laundry and meal plan or assisted living with studio apartment or room, no kitchen, dr/nurse on staff who manage medications?

I'd definitely check only licensed facilities - you can get a list from the state office of the aging. If you and your mom are not near you might hire an elder care consultant to help you choose and facilitate the move. We did this and the woman was a god send. Good opportunity to get powers of attorney and access to bank accounts all squared away.

[Anonymous]

Go to Medicare.com and search nursing homes. They are rated on thesite

[Anonymous]

Anonymous wrote:OP's! Where does she live?

Does she have enough money to pay for assisted living?

She lives in California, in the Sacramento valley (cot of living is lower than the SF Bay Area or LA area, and probably DC) and I believe she gets about 4k a month from retirement (or other fund from her employer) and social security (not sure how much this is). She also has some savings but with the price of some of these places, that could go fast! I think about 4-5k per month could be within her budget.

Anonymous wrote:Could she do independent living still with her own apartment and kitchenette but cleaning service, laundry and meal plan or assisted living with studio apartment or room, no kitchen, dr/nurse on staff who manage medications?

I'd definitely check only licensed facilities - you can get a list from the state office of the aging. If you and your mom are not near you might hire an elder care consultant to help you choose and facilitate the move. We did this and the woman was a god send. Good opportunity to get powers of attorney and access to bank accounts all squared away.

Thank you for the advice. I'll look into a consultant. We've already taken care of power of attorney and all that, thankfully.

As far as the level of care she needs, definitely your second option, as she will need someone to check in on her at least once per day (ideally 2+) and she needs help with meds.

[Anonymous]

Everyone like to think their elder needs assisted living but it sounds like she needs a nursing home. Look for one that specializes in dementia so that she can stay there long term. Good luck.

[Anonymous]

Anonymous wrote:Everyone like to think their elder needs assisted living but it sounds like she needs a nursing home. Look for one that specializes in dementia so that she can stay there long term. Good luck.

I understand but she's still very high functioning and she's stated that she does not want to go into a nursing home. Until last year she was fully taking care of her self, it wasn't until then that we hired a family friend to come to the house a few hours a day. Trust me, I'm really not in denial, just being realistic. For now she's not in need of a nursing home. She will be in the next few years though.

I've found a few places near her that provide assisted living and also nursing care as needed. I think this is likely what she'll be ok with for now.

Another option is live in care.

[Anonymous]

If possible, I'd get more help in the home if she owns her home. My MIL is in a nursing home and it sucks. We have to move her as the administration is horrific.

[Anonymous]

Find an assisted living place with a "Memory Care" ward that they can move her into when the time comes. IME, they will want some assurances that she will be able to pay for it for 5 years. (EG. Income statements and bank balances). Is your mother in the area? If not, it may be better to move her to be closer to your mother.

[Anonymous]

OP - Agree your Mom should look for a place ideally with all levels of care -- assisted, memory and nursing because the reality is if skilled nursing is not available and she falls or has other ailment that needs skilled nursing then your grandmother will be shipped out to an unfamiliar rehab place AND you continue to pay for other setting. Also ask if they do take Medicaid participants and how long does one usually self-pay if assets were a question before one could then slide into a Medicaid spot - if there is one. If your grandmother owns a home, expect that this asset will need to be sold at some time to qualify for medicaid coverage. You do not just want to do assisted living at age 90 with some dementia. Also get the hours of coverage in an assisted living center and see if it can definitely be divided between morning and evening as evening is sometimes harder for seniors as memory declines.

A geriatric case manager not connected with the facility might be a great resource if no one lives close to GM because at her age she is going to need someone to go with her to any doctor's visit just to get there and back and more importantly to get clear information on what is going on, meds etc. An assisted living place does not provide this kind of direct service so you may need to also engage an agency that the CM could work with. All of this I have learned from a close friend with two parents in Assisted Living, and she is called for any trip to the ER. If one is out of the area, your Mom might want to check on the procedure.

[Anonymous]

People tend to react strongly to phrase "nursing home," but they are often overestimate how much care "assisted living" can provide.

Do you know anything about the continuing care places near your grandmother? They offer a range of care, as 10:20 describes.

Old but useful:
http://newoldage.blogs.nytimes.com/2011/06/10/assisted-living-or-a-nursing-home/?_r=0

[Anonymous]

We went through this with my grandfather in FL last summer and found a wide variety of options available. The place we settled on is a Assisted Living facility specifically for Memory Care and is most definitely not a nursing home. This is working very well for him. The VA doctor visits weekly and they also have other doctors come in (dermatologist, etc) on a regular basis. They have 34 beds and while they don't have nursing available, they do have hospice set up which means that barring any major issues he should be able to remain there for the rest of his life.

I think a consultant would have been helpful, but my mom was able to do a lot of the leg work of looking at different places ranging in size from 100s of beds to tiny places that only had a dozen residents.