OP- we hired a private elder care consultant and she was worth every penny. She knew all the local facilities, which were good, which to avoid, etc., and she had great contacts. She was able to get my mom, post-stroke, into the best rehab place in the region, and from there to skilled nursing. We actually had a great experience insofar as we were super-impressed with the facility (it was a non-profit). She also helped with insurance issues, etc.

Maybe consider hiring someone like that?

Anonymous wrote:OP - he has money for care, but hasn’t wanted to entertain modifications at either my house or his sisters house. I do have a POA but he is still wanting to make his own decisions. I don’t know much about skilled nursing facilities but have been pretty appalled where he is now - can’t imagine he would do well in such a place long term. The difference between skilled nursing and the memory care facility I am familiar with is night and day. I tried to get him moved to another facility but can’t even get someone to return my calls.

If they are not responsive then you should contact the local ombudsman assigned to the nursing home.

OP - If your Dad has the means, I would get recommendations on an Eldercare Manager or Lawyer to help you get the research done on option for center-based care given his limitations. The need for direct personal care daily will be a big one in terms of options. If you find the place that can provide the daily personal care, then I would also assess what is offered in terms of activities that he might enjoy given his interests. My Dad was in independent living due to my mother needing care, but he said most programming was for women! An Eldecare Manager could also help in checking in on the services he is receiving at random etc. And, also on connecting you with a reputable agency to provide any extra care. A friend did have 24/7 care for her mom at the end because she was a fall risk, but had a trust to cover expenses, and it ran about $22 an hour as she had a contract for the coverage. My SIL who has dementia end stage, but a myriad of health issues is going to move to a top-of-the line SNF where her sister lives. The cost will be $450 a day self-pay, but again she has the funds and the important thing is to see she gets the care that is needed as much as you can. It was also very important to her sister who is her primary support person that she be close by because the winters can be rough where she is. I do think this is a very important element for any family to have a person in a center care setting close to some relative if possible.

My mom had a stroke in 2011. She had weakness on one side and couldn't walk. She has been in a power chair ever since. She can feed herself but needs help dressing and bathing.

"Would he be able to live with family if he is not able to get out of bed and into a wheelchair - assuming we could find in-home cna?" - we tried this for a while after she left rehab and it didn't really work. She just needed too much help and it was too hard when we both worked and had to take care of kids as well. If they can't be at home by themselves all day (eg can't go to the bathroom unassisted) and you can't be at home, then it's just not do-able. Also, my mom started to think of us as "the help" and it caused negative feelings. And frankly, bathing your dad is something you don't want to do.

"Is assisted living an option for someone like him? Or would he have to go to a skilled nursing facility?" - hopefully he won't need to be in a SNF, that is basically "extended rehab" after you get out of the hospital. It's also insanely expensive. Assisted living is less expensive, but the level of expense depends on the level of care he needs. There are plenty of assisted living facilities in the area.

Anonymous wrote:Given that he is incontinent and unable to self transfer or walk, I doubt you’ll be successful with home care. And his level of care will be SNF. You’ll have options given that he can self pay. You probably want to tour a bunch - I’d start now. If he’s a smoker, it might be more difficult to find a facility and/or arrangements he finds satisfactory.

This.