independent living/assisted living place versus comprehensive care place

[Anonymous]

I'm new to all the terms, and it is my MIL we are talking about not my own parent.

My husband's mom can no longer live on her own. She's not local to any of her sons. She's been offered to move in with two of her sons but doesn't want to leave her own town. She's 85 and in good mental health, just frail.

The sons have located a few places in her town were she could move, but both are limited in the help they can give. They have assisted living options but if you need more than that you need to move out. There's no buy in involved; you just pay rent. (She can afford the monthly rent).

What is the drawback of going to a place like above, that doesn't have a nursing care or memory care option? Down the road, will it become difficult to place her somewhere (again all of us are quite far away) if she needs more care, if she isn't already set up with a situation? Or maybe at that point she'll be easier to just move to a location closer to us. She thankfully has the money for either option but right now she's very opinionated about wanting to stay in her own town.

[Anonymous]

it's a cognitive issue. When you're older, it's hard to move, let alone move twice. You're used to getting up in the middle of night and going to the bathroom on the right, if it's now down the hall on the left, believe it or not, that's a big deal. And moving twice after age 85 sounds nuts to me...

You need to move to her to a place that has assisted living and nursing and or memory care all on one. So that she can go from one to the other in the same place, in the same Community, with the same people.

I don't see the benefit of moving her from wherever she is now to this new apartment. What's the difference?

[Anonymous]

Based on your description it is difficult to understand the program. But generally speaking a licensed facility cannot make an unsafe discharge. Again it isn’t clear to me what type of facility this is. If it’s a boarding home, I don’t know regulations.

That being said it doesn’t sound like there are other options.

The biggest issue for getting into a nursing home with a memory care unit is ability to pay. How will she pay for that when the time comes? If she has the money for it, it shouldn’t be hard to get her in.

[Anonymous]

The places we are looking at are designated as "Independent Living + Assisted Care". She would move into a full apartment and live independently, but would have easy access to help for cleaning, taking out the garbage, cooked meals if she should want it, organized activities and transportation to places, etc. If at some point she needed more help she would move into the assisted living rooms that are just a bedroom with a small kitchenette, and have all her meals cooked and more care. But not nursing home type care.

Prior to this week, she had been living on her own in a condo and doing her own grocery chopping and cleaning and so on. She just wasn't able to keep it all up.

I would prefer to have her in a community where she could move into memory care or nursing home care if she needed it, without having to go through the process again!! But yes, she has money enough for either option.

[Anonymous]

Anonymous wrote:

The biggest issue for getting into a nursing home with a memory care unit is ability to pay. How will she pay for that when the time comes? If she has the money for it, it shouldn’t be hard to get her in.

How much would it cost? I think she has about $4 million plus a rental home, plus the townhouse she currently lives in. I don't know how long she will live but she's in relatively good health for a 85 year old and her mother lived till her late 90s.

[Anonymous]

Even with the places that allow you to move from assisted living into nursing care, you still have to move. And sometimes moving so visibly away from your friends in the assisted living area over to the greater level of care area can be embarrassing to an older person.

I wish there were easy answers.

[Anonymous]

Well, she's agreed to move into the Independent Living/Assistive Living location at least for now, once she is out of rehab for her injury. I hope this is good enough for a while.

[Anonymous]

You said she can’t live alone. There are requirements for assisted living. Doesn’t sound like they will even take her.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

The biggest issue for getting into a nursing home with a memory care unit is ability to pay. How will she pay for that when the time comes? If she has the money for it, it shouldn’t be hard to get her in.

How much would it cost? I think she has about $4 million plus a rental home, plus the townhouse she currently lives in. I don't know how long she will live but she's in relatively good health for a 85 year old and her mother lived till her late 90s.

She has plenty of money.

[Anonymous]

Have you looked into paying someone to stay in her house? How does the cost of that compare? Either 9 to 5 or 24/7 in her house.

[Anonymous]

Anonymous wrote:Well, she's agreed to move into the Independent Living/Assistive Living location at least for now, once she is out of rehab for her injury. I hope this is good enough for a while.

It sounds like it should be good enough at least or awhile. I wouldn't move her into Memory Care or a nursing facility unless she absolutely needed that. You don't want to move into those environments too early.

[Anonymous]

If she has enough money for either option, definitely do the continuing care facility - especially since you're far away. We were in a similar place with my dad and it was such a relief not to have to deal with a second search/move. Remember that you often don't the luxury of time when it comes to nursing care - a crisis happens and you're dealing with the ER and insurance and god knows what else. Having an assured spot in a place you know and trust is a godsend at that moment.

[Anonymous]

Anonymous wrote:Have you looked into paying someone to stay in her house? How does the cost of that compare? Either 9 to 5 or 24/7 in her house.

Her house probably has stairs and just the routine maintenance, yard work on top of being older with mobility issues can be too much for them, even with a caregiver living in the home with them and helping her with shopping, errands, bills, etc. That's a lot of work for one caregiver.

The Independent/Assisted living facilities are usually offer them their own private apartments, meals in a dining room, transportation, activities. She wouldn't be so isolated.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Well, she's agreed to move into the Independent Living/Assistive Living location at least for now, once she is out of rehab for her injury. I hope this is good enough for a while.

It sounds like it should be good enough at least or awhile. I wouldn't move her into Memory Care or a nursing facility unless she absolutely needed that. You don't want to move into those environments too early.

I completely agree with this. If she is in the independent and assisted living care place, then she can keep whatever independence she is capable of, with the knowledge that the safety net of the assisted living is there if/when she needs it. She will have meals provided, cleaning, friends nearby (her own town), all of which will help her stay sharp and capable for as long as possible.

I would be comfortable with this.

FWIW, that's what we did with my mom - she was in assisted living for several years, until it wasn't working any longer. We didn't like the memory care available at that facility, so moved her to a better one.

OP, when you do need to look for a memory care facility, make sure it has a skilled nursing (nursing home) attached to it - if she eventually needs that, she would not need to move.

[Anonymous]

Anonymous wrote:If she has enough money for either option, definitely do the continuing care facility - especially since you're far away. We were in a similar place with my dad and it was such a relief not to have to deal with a second search/move. Remember that you often don't the luxury of time when it comes to nursing care - a crisis happens and you're dealing with the ER and insurance and god knows what else. Having an assured spot in a place you know and trust is a godsend at that moment.

That definitely would be my choice, but she needs to find a place right now, and these were the only ones she would agree to. No, I wouldn't want her to move into nursing care right away -- for one thing that would be phenomenally expensive when it isn't what she needs! When she recovers from her injury she should still have several years of ability to live on her own, just with some extra help.

I don't think she'd enjoy living with someone in her townhouse 24-7.