Nursing home! I looked after an elderly relative for a few years before moving her into a supported independent living situation and then later, when she declined further, a skilled nursing facility. Turns out, the move out of "my hands" into the hands of the "pros" was the best thing for her -- and for me. She and I had many subsequent discussions about it. She and I agreed that there was simply no way I could have provided the level of care she needed at my home. Also, it freed up all my energy just to be the light hearted chatty family member - I wasn't probing her bed sores or taking her temperature, etc. Instead, when I visited, I was able to focus soley on being a cheerful, fun presence for her. She ended up being very content. Good luck OP!

Please move them with you.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How much is the nursing home for both of them? 10,000 a month each? So 20,000? Why isn’t there a 4th option you get a home health agency to send staff to their house for the next 2 months? Just to buy you time.

Nursing home is $10,000/month for both. If that is cheap, I'm shocked. They do live in a rural area so maybe that is cheap by DC standards.

We started with that 4th option but it was nixed after 1 week. They had aides 24/7 for 1 week before I got here and it was too upsetting for mom & dad to have strangers in their home every time they woke up from a nap or in the middle of the night.

That is very cheap. Assisted living here is more than that. I would do both in the nursing home there. You cannot managed 24 hour care. As much as your want to you just can’t.

+1 you are underestimating just how difficult caring for people with dementia will be. It sounds like an excellent option to have an affordable nursing home that will keep them together, near family who can visit regularly, and so close to your brother's work.

Option A.
Do not sacrifice your family.

Anonymous wrote:

Anonymous wrote:How much is the nursing home for both of them? 10,000 a month each? So 20,000? Why isn’t there a 4th option you get a home health agency to send staff to their house for the next 2 months? Just to buy you time.

Nursing home is $10,000/month for both. If that is cheap, I'm shocked. They do live in a rural area so maybe that is cheap by DC standards.

We started with that 4th option but it was nixed after 1 week. They had aides 24/7 for 1 week before I got here and it was too upsetting for mom & dad to have strangers in their home every time they woke up from a nap or in the middle of the night.

That is very cheap. Assisted living here is more than that. I would do both in the nursing home there. You cannot managed 24 hour care. As much as your want to you just can’t.

I posted in another thread about medicaid asset protection. Look into it so that they can eventually qualify for medicaid without losing all of their assets. When the time comes, you can always ask if you can supplement so they they don’t go to medicaid wing. Also, do NOT sign anything agreeing to be a guarantor at the nursing home.

I am anti-nursing homes as it is a fact that people receive better care and have better outcomes at home. In your case, however, your parents have more social ties in their community and you don’t have the physical means by which to care for them (OP my mom is at home with us in DC with nurse and aides but was living in the south). If you can, I’d hire a HHA or CNA to be at the nursing home with your parents esp in the night when the care falls down. We did this when my mom had a brief stint in a nursing home following an LTAC and it was worth every penny.

Just set up visiting schedules with family and friends and make a plan to travel to see your parents as frequently as possible.

Do not move your parents into your home. You have no idea just how difficult it is to live with a dementia patient, especially as they get worse.

how much money do they have? how much do you have.

if the in home caregivers were consistently the same people, they would get used to it. like someone said, to buy time.

other than that i think assisted living where they live is best. you will kill yourself trying to care for them, especially if it is for a long time.

OP here. Thank you all for your replies. I cannot reply to each one individually.

Where we are today: I talked to my parents and they "will think about" moving to the nursing home. They know its reputation and are willing to consider it. They said they do not want 24/7 caregivers in their home. That's a moot point anyway because 24/7 caregivers cost over $20K/month and they can't afford that. It costs half that to go to nursing home. So home healthcare is off the table.

About my mom living with dad in a memory care unit. We are not sure if she has dementia or not. No formal diagnosis.
It's possible but it's hard to tell because of her speech issues post-stroke. Dad has diagnosed early stage dementia. The facility we are considering has only 2 options- assisted living or memory care. No regular nursing home unit. Assisted living would not be enough help for them. This place would allow them to be together in one room in memory care. Also, brother 2 works across the street so he could pop in more frequently than at another place.

There is one other good nursing home in the county that has a regular nursing home unit plus a memory care unit but they would have separate rooms and be 30 miles from family. There is no way mom and dad would do separate rooms. They would be constantly worried about the other one if they were separated. The first facility is smaller and less residents. 2nd facility part of a large chain. Way bigger.

They each need a doc appt for a physical pre-nursing home admission so we are doing those this week & next in order to check that box. I also am getting the ball rolling on the POAs.

Anonymous wrote:

Anonymous wrote:Another vote for the nursing home. Getting parents to your home will take a huge toll for many reasons. Plus, very quickly, I believe, they will need more care than you can physically provide. You will either have to bring help in or find a nursing home near you.

As to POA, I would have it established now that you share it with whichever brother gets it. My sibling and I have POA for our 90s parents. Also, you need Medical Power of Attorney as well--and is almost more important in the high care years.

This. With both POA and Medical POA two agents can be named or one of you named primary agent and the second as back up (if the primary steps down as agent).
Also, and I urge you to seriously consider this as time is an issue: no attorney that is honest and of quality will draft these documents for your parents if one of them has dementia or is determined to be not able to understand, and I mean FULLY understand, the paperwork they are signing. An attorney can be disbarred (and should be) if they do. Time is critical here. You need to get that paperwork done stat.

This is a lot OP. Good luck to you and your family.

OP here. Thank you for pointing out this important necessity. I need to double check their paperwork and ask my brothers if there already are POAs in place (not that I know of). Dementia care place says they each need a POA before admission.
2 POA agents would be good for our situation, but I wonder what happens if a disagreement comes up.
Also- if it's too late for an attorney to draw up documents due to parents cognitive issues, what happens now if there is no POA and no medical POA in place? Who can make decisions for them?

Option A. Btw, I am 60+ and have had 4 elders pass.

Op, Option A. Without hesitation.

Anonymous wrote:Another vote for the nursing home. Getting parents to your home will take a huge toll for many reasons. Plus, very quickly, I believe, they will need more care than you can physically provide. You will either have to bring help in or find a nursing home near you.

As to POA, I would have it established now that you share it with whichever brother gets it. My sibling and I have POA for our 90s parents. Also, you need Medical Power of Attorney as well--and is almost more important in the high care years.

This. With both POA and Medical POA two agents can be named or one of you named primary agent and the second as back up (if the primary steps down as agent).
Also, and I urge you to seriously consider this as time is an issue: no attorney that is honest and of quality will draft these documents for your parents if one of them has dementia or is determined to be not able to understand, and I mean FULLY understand, the paperwork they are signing. An attorney can be disbarred (and should be) if they do. Time is critical here. You need to get that paperwork done stat.

This is a lot OP. Good luck to you and your family.

24/7 caregivers for two people will cost more than a SNF. And they will need more oversight from local family - are the nearby siblings willing to be onsite often to deal with the many issues that arise with in-home care? And what happens when one or both eventually do need a SNF - will you have the funds for full pay?

I'm one of the many PPs who said local nursing home. I know SNFs have a bad rap, and we were lucky that our parent could afford a high-quality one when the time came. But very few people can singlehandedly perform all the work for two aging parents with significant memory and health issues while preserving some form of a life for themselves and sanity. And you'd be surprised how quickly even people who are mortally opposed to a facility can settle in happily. For my dad, who didn't want to leave his house of 40+yrs, the sense of community and the comfort/safety of a continuing care facility surprisingly made him so much happier. We realized after the fact how frightened he must have been as he was declining and trying to hang onto his old life.

As to caregivers, it sounds like they can't really afford them if the nursing home situation will have to change to medicaid. You'll run out of money for the caregivers, then you'll have to find the nursing home that has medicaid. I would find out if the one you are looking at can be straight-to-medicaid.

And agreed with a PP that your non-dementia mother will have a hard time in a memory care unit. I would try to start them together in the regular unit.