Anonymous wrote:NP here trying to decide between Independent Living and very few hours of home care. Their home is paid off so it seems much more affordable if they just need few hours of care. Basically things that I do when I'm over there, but on a schedule.

Are there not home carers that have, say 2-3 places to go on a given day and don't expect all their salary from one client? Surely agencies schedule that up the same way they would house cleaning services and the like?

Bayada will send a CNA to do anything around the house—not just health related. The rate was maybe $30/hour? The main catch was the minimum (had to be at least 4 or 5 hours per day), but if you need that much coverage, it might be worth checking out.

NP here trying to decide between Independent Living and very few hours of home care. Their home is paid off so it seems much more affordable if they just need few hours of care. Basically things that I do when I'm over there, but on a schedule.

Are there not home carers that have, say 2-3 places to go on a given day and don't expect all their salary from one client? Surely agencies schedule that up the same way they would house cleaning services and the like?

We paid $30 an hour in Maryland for CNA's and paid legal, private duty. They drove Mom to grocery and appmts etc.

Occasionally I had to supplement with agency CNA's. They ran $32 and hour.

When I toured assisted living facilities many residents had private duty CNA's that they paid personally in addition to the assistant living monthly fee.

I went through this decision over the summer.
My mom wanted to try the in-home care route, but her main issue – fall risk – could not be addressed by a person coming for a few hours a day, and around the clock care is obscenely expensive and honestly – not needed beyond “she might fall”. We tried the fall detection necklace but she hated it and refused to use it (much longer story behind this…)
We went with an independent living facility with meals and activities that offers a continuum of care. We have someone come in 2 times a day for 30-45 minutes to help her as needed (medicine, if she wants help in the shower, etc). And there is staff on duty around the clock that can assist if she falls (which she has…).
It really depends on the amount of care required and ability to pay for it.

Thank you for posting this. I’m also just getting into this question, so it’s been helpful to see the responses.

My little bit of research + my parents’ personalities/preferences suggests that assisted living will be less expensive and more sustainable/tolerable. Also they will be selling their house of 30 years and moving 40 miles to be closer to us. I think one move and being settled is better than moving with home care then possibly having to move again if their situation requires something more intensive.

Anonymous wrote:

Anonymous wrote:We have been through both with my mom in the last year, echo everyone above who says there are many variables. Including - importantly - personality. My mom had a stroke, spent month in rehab and then went home with in-home care through an agency that was actually quite affordable. The model is having a CNA level person living in home, providing all needed help with ADLs, cooking, light housework, can take to appointments if they are licensed driver etc. The cost this agency ended up being something in the neighborhood of 10K per month.

What agency was this? My parent needs 24 hour care and the cost is much higher than $10K per month. Any info appreciated, thanks

We looked into this, but it didn’t work because you have to guarantee that the live in aide gets a certain number of hours of uninterrupted sleep off the clock. That wasn’t possible with the level of disability we were dealing with. Just something to keep in mind.

Anonymous wrote:

Anonymous wrote:We have been through both with my mom in the last year, echo everyone above who says there are many variables. Including - importantly - personality. My mom had a stroke, spent month in rehab and then went home with in-home care through an agency that was actually quite affordable. The model is having a CNA level person living in home, providing all needed help with ADLs, cooking, light housework, can take to appointments if they are licensed driver etc. The cost this agency ended up being something in the neighborhood of 10K per month.

What agency was this? My parent needs 24 hour care and the cost is much higher than $10K per month. Any info appreciated, thanks

Agency is called FCP In-Home Care. We're in New England and I'm not sure how broad their service area is but they were the agency recommended by the rehab where my mom stayed after her stroke.

Anonymous wrote:We have been through both with my mom in the last year, echo everyone above who says there are many variables. Including - importantly - personality. My mom had a stroke, spent month in rehab and then went home with in-home care through an agency that was actually quite affordable. The model is having a CNA level person living in home, providing all needed help with ADLs, cooking, light housework, can take to appointments if they are licensed driver etc. The cost this agency ended up being something in the neighborhood of 10K per month.

What agency was this? My parent needs 24 hour care and the cost is much higher than $10K per month. Any info appreciated, thanks

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:“ If you are in assisted living, are there additional fees aside from the main fee of paying for the room/apartment? ”

No but as the level of care increases so does the monthly cost of care.

This is only partly correct. There may be additional fees. For example hair services may be extra. Doctors may be extra. You really need to ask so you u destined what is included.

Yes, and my mother is completely disabled to the point that I think we will have to hire private aides even if she is in a nursing home. If anyone knows if there are specific care homes that provide a high level of care I would love to know what to research.

My mother is in a place that seems to do just about anything so long as you are paying for that level of care. Some people hire aides for a few hours a day to do extra things like tidy/organize the apartment, drive around doing errands, companionship, etc.

Anonymous wrote:

Anonymous wrote:“ If you are in assisted living, are there additional fees aside from the main fee of paying for the room/apartment? ”

No but as the level of care increases so does the monthly cost of care.

This is only partly correct. There may be additional fees. For example hair services may be extra. Doctors may be extra. You really need to ask so you u destined what is included.

Yes, and my mother is completely disabled to the point that I think we will have to hire private aides even if she is in a nursing home. If anyone knows if there are specific care homes that provide a high level of care I would love to know what to research.

Can folks recommend good assisted living places in Northern Virginia?

PP here, forgot to answer some of your questions.

My mom started in assisted living level zero and went to level 2, which is medication management and help with showering/bathing. Each tier costs more money. There were more tiers in assisted living, but she needed to move to memory care for safety.

In her memory care, she is at tier 4 level which is 10.5k/month. I think the highest is Tier 7 which is around 13k/month. That is for someone who is pretty much bedridden and needs assistance with moving, eating, etc. Usually by that time hospice is involved and some people never quite get there. My mom is physically fairly healthy and mobile, but needs assistance with bathing, dressing, brushing teeth, sitting to eat meals,and following any directions for activities. She also sometimes needs assistance toileting and, of course, taking medications.

OP, if/when your father's dementia progresses to the point that full time care is needed (whether for mobility, aggression, or general safety), then memory care is the best option. It runs us about 10.5k/month; whereas full time in home care is closer to 20k/month. Plus if a provider doesnt show up, gets sick, etc. It did take a while to find a really good place.

I would not bother with assisted living if dad has dementia, but keep at home until memory care is needed.

There are so many variables for making this decision:

Mobility
Memory
Personality
Availability of family members/impact on family
Resources
Financed

Hi OP - with regard to dementia, it's a little bit trickier. You don't say whether your mom is able to care give for you dad, but I assume she is part of the mix. If so, maybe you keep them in their home and hire aides to give your mom a break but you don't need 24/7 care. In this case, it's probably less expensive to keep them in their home for now. As you dad's memory issues increase, the need for constant supervision will increase, and it will get harder and more expensive. In my case grandma accidentally poisoned grandpa and the was the precipitating event to move them to the memory care unit.

It depends on how demential presents itself in your dad - is he childlike and easily steered, or is he volatile and potentially abusive? If it's the former, easier to keep him home for longer.

The benefit of moving them sooner is that you might be able to find a continuum of care place that will take them at the independent level now, and then he will be guaranteed a spot in memory care one he truly needs it, and in the mean time, your mom (assuming she is healthier) will be able to make friends and be less isolated. In this case, you would still need to hire aides to give her a break but she would be the adult in charge.

A big question is are they open to moving? Is your mom asking for more support? In my case, parents were dead set against leaving their home - freedom and independence more important to them than safety.

Regardless of what you do in the short term, definitely visit places and have a few you like in your back pocket so when there is a catastrophic event that makes moving inevitable you aren't starting from scratch.