Hello, my mom is 86, dad is 84. Mom has early cognitive decline, as of yet undiagnosed but could be lewy body disease. She takes care of herself, remains active and wants to stay social, but has a hard time expressing herself and can get confused. My dad has heart failure, recent pacemaker, very low engergy, history of depression and fairly weak/deconditioned. All he really wants to do is sleep. PT/OT come to home, but he very seldom does the exercises. Says he wants to, but then doesn't do them. No recent falls, uses a walker or a cane.
I'm trying to decide on whether they should do to "independent" living (from home), with added on cares, or go right into assisted living. The assisted living place is next door to the indpendent living place, so they could eventually transfer there. I want as much engagement for my mom as possible, since she is essentially "alone" with my dad who sleeps so much. I will continue to help with meds. Both communities are less than 10 mins from our house. They don't really want to go to either, but are warming up to the idea. There are pluses and minuses to each place (they are both in "Brookdale" communities, with overall good, but mixed reputations. The option for an eventual Medicaid spend down is part of the selection process)
Anyone have any insights? Thanks....
If the community is set up to be a GUIDE facility (or the medical director is a GUIDE provider), you could get some added caregiving services in which could potentially save some dollars too. GUIDE is a CMS program that provides 72hrs of covered caregiving services a year along with other supports. The program is for those with dementia that aren't in a long term care setting. You'd have to have your mom officially diagnosed with dementia, she would need to have Medicare part A and B, and the ALF has to be apart of it (which seems like most places are). 72hours isn't a lot of caregiving hours- breaks down to about 6hrs/month if used consistently each month. However- you could reserve that for times where maybe you're out of town and you need someone to come in a few hours a day to do medications and other tasks you'd normally do for them. That would be free, and would help protect your parents personal funds a little while longer.
I would also truly consider getting that diagnosis for your mom because depending on how advanced things are, there are good infusion therapies that help depending on the type of dementia. But if it is Lewy Body, you might want to discuss with the ALF what safe guards they have in place when/if that advances to a stage that has some challenging symptoms.
If they aren't equipped for that next stage of that, you might have to consider an ALF in which is a memory care (if a memory care- the GUIDE model is no longer an option).
Quite a bit of information there, but you sound like you're doing good investigations and are looking at the big picture.
The facility you choose will definitely assess them and make recommendations about their needs. Like others on this thread, based on what you have shared I would also vote AL.
A move is always difficult and the fewer times that has to happen it is better for all involved...including you
I run a support group and occasionally I take the entire group to visit places. We as a group bring a bunch of written questions. At the last two times. My next door neighbor( no memory issues but has heart disease) came and decided IL was right for him. Another couple of women visited a continuoum of care and immediately decided to put in on the wait list. They will share the rent and entrance fees..
My mom was in a Brookdale community AL, and my friend moved to a Brookdale community a couple of months ago. Mom was there for five years. No complaints from either. Of course, you will always find someone who is complaining if you look hard enough, especially when dealing with people who are in eldercare. Ignore it. Some of them love the attention they get by telling others that the place served them fried iguanas yesterday and Mookie from down the hall keeps stealing their toothpaste. Who cares? I mean, really?
I suggest that you take the lead on this and don't pay much attention to mom, whose brain may be broken enough that she may not be able to make rational decisions. She's confused, maybe more than you realize. Don't pay attention to dad, either. It doesn't matter where he sleeps as long as he is comfortable. You're now the parent, strange as it may seem.
They are lucky to have you to advocate for them. I hope it goes well.
Do your due diligence and place your parents in an AL where the RESIDENTS give the place good reviews. Ask THEM how they enjoy living there, that's what I did, and found my folks a wonderful AL that way. But make sure it has a Memory Care attached or you'll wind up moving them at some point, most likely.
Best of luck to you.
I would say an Assisted Living. Neither can care for each other. They will have 24/7 around the clock care. You will have some weight taken off your shoulders.
1. I think mom would be more engaged.
2. Sounds like dad needs help, maybe a bit more than you suspect.
3. With the dementia you say mom has (diagnosed or not) a move may be more difficult for mom and she may have a bit of a setback cognitively so she may need AL until she adjusts.
Does either facility also have Memory Care? That may not be that far off timewise if mom declines.
And be sure both accept Medicaid if that is a possibility.
If remaining at home is an option it can be ideal IF...
They both accept the help coming into the house that they need.
The house is set up so that they can safely remain there. (no stairs, low or no carpeting, wide halls in case there is need for Walkers or Wheelchairs, at least 1 accessible bathroom that can fit a walker, wheelchair and at least 2 people...the caregiver and a parent...
And while caregiver at this time might be needed for just daytime there may be a time when they will need care 24/7/365 when that happens is that in the budget?
thanks for your ideas
After they have their PoA assigned THEN you take them for medical exams where the goal specifically is cognitive testing and evaluation so that it is in their medical records.
I don't think your parents are candidates for IL. This would be no different than if they lived in any random apartment complex. AL will get them the help and encouragement they need on a daily basis -- especially for your Mom. But you cannot project what you think your Mom should be wanting or doing for herself ("engagement"). When we transitioned my MIL into a very excellent facility with lots of offerings, she wouldn't participate for years until the staff finally coaxed her to start eating dinner with others, and then eventually attended activities and events. Go into this with no expectations.
As for Brookdale... I don't have personal experience with for-profit facilities but please know there may be other excellent non-profit options in your area, even ones that may be a slightly longer drive, but worth it. My MIL was in one run by Presbyterian Homes, so it was faith-based. Ebenezer is another one is you're in the upper midwest. Look for ones run by the Catholic Church. Most of the time these facilities do not require residents to share the same faith, or any faith at all, but they see the care as a mission rather than a business model.
Join Nextdoor.com and ask for facility recommendations -- you will get more current and accurate input to help you make a decision.
You can consider hiring a companion aid to help both your Mom and Dad first. I've done this with a lot of success, until my elders needed a hirer level of daily care (like medical).
Most of all, remember to keep your own self a priority if you intend to manage care for 3 people (and you are one of the 3)!
preparation is the key in whichever direction you take..
do talk to the residents and their family members to see how they line the facility..
do take a tour of the places with your mom and they will give you lunch abd answer any questions..
if you're not in a hurry visit mire places so you can compare..,
Edith and husband lost their home and their life savings because of that.
In-home care is very expensive where we lived. Please take that into consideration and look into all your options
From what I interpreted, it seems the more you move them the more confusing it can be.
I know you said that they will in the same facility with a different layer of care and that's very important. How much CARE do they actually need and you may also want to hire a personal caregiver for a couple days a week in the facility where will be living when the time comes?.
These are things to think about how many times do you want to actually move them from one facility to the other? Do you jump the first option?
What quality of Medicaid step down is there from one facility to the other??