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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
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Hi OP, as a quick differentiation between the three, in-home care allows seniors to stay at home while receiving personalized care. Nursing homes provide 24/7 medical attention and support, making it ideal for seniors with complex health needs. Lastly, assisted living is usually offered at retirement communities where residents get to enjoy an active and independent lifestyle while getting help with daily activities from professional staff as needed.
An assessment of care is necessary. So is an assessment of temperament. Does your mother rule with an iron fist? Does she demand you and only you? Or is she appreciative of help? Does she recognize her own needs?
I hired caregivers when I was no longer able to keep up with my mother’s 24/7 needs and demands. She was combative, demanded only me, tried to fire them, tried to block their entrance, lied to the agency about them (We’re rural, isolated, and she complained that one hosted a party with all her friends over. No - I was home at the time.), spit out her food and meds, and did everything she could to make things worse for herself. I was afraid she’d push them down the stairs or slam a door on them.
Now in care she thinks she’s at a bed and breakfast, and is more cooperative. Her care home is small and homey. I drop in randomly and am very pleased.
Avoid nursing homes if at all possible. Sometimes, it's not possible. There is no such thing as a "good" one. They are all bad. If it were up to me, I'd shut them all down and allow teams to come into the home to help families care for their loved ones. Nursing homes are horror-death houses, in my opinion.
If there is no choice but a facility, I highly advise hiring a sitter to be there when you can't. A hidden camera is also an idea. You have to have eyes there, or you will be worried sick. I worried constantly about my mom.
As an RN, I've worked in nursing homes and had personal experience when my mom was in three of them. I had to address the same issues at each one. My mom's dehydration. She was a huge water drinker. Hot meals were room temperature, and there were never enough fluids. They keep these places too cold, and the elderly are very sensitive to temperatures. When visiting my mom, the residents complained of being cold. So, I hunted down blankets for them. Imagine being cold, thirsty, and unable to do a thing about it.
This is why residents always end up with a UTI. They are not offered fluids between meals. They should be offered water throughout the day, but they are not. They only get a half glass of juice or other fluid at meals. Then comes the phone call that your loved one is not eating the cold slop they are served.
Most people have to sign up with Medicaid to afford a facility. If Medicaid pays to be in a facility, it should pay for in-home care, but it most likely doesn't or won't.
If possible, keep your loved one at home and have a team come in for care. You can also try contacting the county. They have programs and services that can help.
In home is best however may not be affordable / sustainable. I experienced this with my father in the last two years of his life. The last assisted living facility he was in was horrible, until he wound up in ER needing a blood transfusion and a severe UTi. He was in-home hospice for 6 weeks until he passed away. Unfortunately the level of attention and care required becomes overwhelming forcing families to turn over the care of a loved one into the hands of a money hungry, cold-hearted industry. So sad this happens in this country. Thoughts & prayers.
Great response; it all depends on funds available as well. So many aren't in the thick of the situation quite yet and don't have a realistic idea of how much in-home care costs. Even once/twice a week for a few hours (minimum four hours usually) can really add up. The VA would pay for a few visits a week but any more than that they said he needed 24/7 which they will not provide in the home but they do have VA nursing homes if assets aren't too much and the service years qualify the person. Logistically, it just makes sense for one-four or five people to be taking care of more than one person at a time and that's not including drive-time, gas money, mileage for one person to drive to each person individually.
Please look into in home care! The abuse and neglect in nursing homes is horrific! We have a wonderful program here called IRIS. It is through Medicaid, but they will help you pay for her needs. In our state they also allow family to be paid caregivers and she can choose who she wants. They also cover any costs not already covered by her insurance for things needed in the home and for activities or therapy outside the home. Every state should have something similar.
I pray she will recover soon. It can take time after a stroke ...do not give up!
When researching facilities visit several times preferably at different times of the day. Talk to residents or residents’ families - even people you run into in the parking lot.
This forum should give you a very real idea of what you are signing up for as a caregiver in home. They are not exaggerating. It is a full time job - do you have the bandwidth for that and is the rest of your family willing to make that sacrifice. If you use home care services - now you are not only a caregiver but an employer who is juggling employees schedules and emergencies that pop up.
You will still be a caregiver if you decide on a facility. Understanding insurance, attending doctors appointments and being your mom’s advocate with facility. The squeaky wheel gets the crease is so true - you will still need to be present and involved. If you establish a good relationship with the facility there will be lots of phone calls as issues arise day and night.
If you decide on a facility know that it will take mom about 6 months to adjust. Lots of info on this forum about the transition that I’d wish I’d read before I did it.
Good luck to you. My prayers are with you. We all know this decision is gut wrenching. Only you can make the right decision for YOU.
Caregiving is so hard! It's the worst job ever. Trying to figure out what is in my dad's best interest and next place to live will be. I need to figure out questions and start touring different homes and see what's out there. A relative had said an active loved one died after being in a home. So not sure what to do now.
In home care keeps you in control and near your loved one. If you had to hire full time help (24/7) the expense would be equal or greater than a nursing home. If you didn’t hire full time help, you would be doing some or all of the hands on stuff…it’s difficult, and at times unpleasant. For example, you need to be able to roll, lift or otherwise move a person to clean them if they are bedridden. You may need to feed them etc. it’s a lot.
Placement in a facility is expensive, you don’t have as much control, however it takes the burden off you and you can be a loved one to your loved one, rather than nurse, cook, maid etc.
Both have their advantages and disadvantages. Finances are usually the deciding factor for most people. Medicaid can pay for a facility if there are less than $2k in assets, but it’s complicated and you’ll need an elder care attorney to help navagate. Hiring care at home has its challenges…finding well trained, trustworthy people is a must, and it’s not always easy. If there are friends and family members to help, that’s great, however people have their own lives and it’s difficult getting some people to honor their commitment.
If she is still in NH. Enlust staff on a care meeting. They will give a good indication. Post stoke and still in NH is telling you somethingof her current status
In home care is limited. A personal care residence has aides 24 hours a day. If she has a house, sell it. Do research wherever you decide to place her. She can still use her health insurance. Some places charge extra fees and they have unnecessary amenities. Find an affordable and clean place with no filed complaints.
I would encourage you to take the good advice of igloo572 and get your mother a Needs Assessment. Have your mother's PCP do it if possible. If the she's in will be the assessment, make sure you're present for it. Sometimes rehabs work hand in hand with nursing homes (especially if it's one that also has a NH, or MC) on the premesis) to get rehab residents permanently placed. Don't fall for that.
If it turns out that your mother does not ahve to remain in residential care, homecare could be an option. If it's not you can have her placed in a facility of your choosing. One that you think is best. You don't have to go with whatever facility the rehab people suggest.
TK, so mom is post stroke rehabilitation patient in a NH. Right? if so, your mom is currently having her stay paid for by her health insurance. Post hospitalization rehab in a facility is a covered benefit for Medicare, which is her primary insurance. And her secondary health insurance tend to follow what her primary does. She s get regular assessments done as they are what is used in determining her progress. Progress entered in her health care chart is what’s needed to be happening in order for Medicare to continue to pay.
Medicare pays for rehab as it’s a term or time limited stay; it’s 100% first 20/21 days and then at 50% up to 100 days and with its care plan based on whatever codes* she exited the hospital with AND if she is progressing sufficiently within those codes. That she is there past the initial 20/21 is a really good sign that she’s progressing as most elderly do not get past the first 20/21 day block. If you need to go over and be a lil cheerleader or encourage her to go & participate at her rehab please pls do this. Both for what it will enable her to do for her future but also her being a rehab patient means health insurance is paying & at double or triple what the State LTC Medicaid program pays for a custodial care resident. So the facility is happy And it gives you some time to really plan out where she goes next.
Personally I’ve always found the therapy teams, the PT & OT in rehab unit, are very up front in discussing what’s what with family as to how things are going. Ditto for the SW. Both have their own licensing and both are sought after by NH to have to have on staff so they can be more frank on their talks with you as they can pack up and leave to another facility if this one gets to be bothersome with them.
* the codes are ICD-10 diagnosis based. Like I’m going to a sports rehab place to get outpatient PT for my knees and its codes M25.562 and M17.12. Covered by my health insurance as it’s related to past surgery and Euflexxa shots. And it’s a set # of PT sessions which I set up and done after the initial assessment by the PT. Stroke care will have lots of codes & you want mom to stay “progressing” in them so she stays on rehab for as l…o…n..g as possible.
I think that when eldercare becomes a for-profit business accountable primarily to investors who demand a 12%+ return on their investment, quality of care declines and problems proliferate. IMO, that business model encourages high fees and low quality of care. In my ideal world--which we definitely do not inhabit!--most eldercare (and childcare) facilities would operate as nonprofits, funded adequately through a combination of public and private income streams.
When eldercare becomes a profit center, the "care" part often goes out the window. However, it is what it is. When people need facility care they, and their families, will need to do the best they can to find a reasonably well-run facility that manages to strike some kind of balance between the two.
I agree. If only all healthcare was non-profit. The price of it would go down and the quality of service would go up. Not going to happen in our lifetimes though.
Look into faith-based facilities. My MIL is in a place called Presbyterian Homes (in MN). They have been running all types of elder care facilities since 1955 and receives additional funding through volunteerism, contributions and grants. They see it as a mission, not a business, and it is non-profit. You do not need to be of any denominatin or faith to be a resident. It is much less expensive than new, for-profit facilities. I know that the Catholic church runs facilities, and probably other denominations as well, so be sure to search in your area. My MIL's first AL facility was a small, single one run by the Moravian Church.
Personally, after my husband’s recent experience in AL for respite stay, I would say to avoid ALs. It was beautiful place, like high end hotel with nice lobby, bar, bistro, library, beautiful patios, gardens. Rooms were nice as well and comfortable. But that is just about all, there is no life at all in that place, everybody seems subdued and afraid. Assisted living as the name implies to me means there is assistance in most aspects of daily living. Not so much, almost none! And we paid extras! They did not help him with dressing, nor meds, he can do those, he paid extra for laundry! And all of this for $9,000 + per month or daily almost $300.00 Staff does not do anything, one day I stayed for lunch and sent my food back as not acceptable. Even my husband who is outspoken became somewhat subdued and asked me not to say much as he still needed to stay there for a few days. I noticed so many things, one at lunch most people needed some assistance as about 80% used walkers, nobody helped them. My husband told me he noticed lots of falls everyday. There were activities, almost nobody participated, one night my husband went to movie night and was the only one. Residents are told or at least encouraged to go to bed at 7.00 PM! Granted, most people were good decade or two older than my husband, so maybe that is normal not to stay up till 11pm. I called staff for something from my husband room, nobody came, went to reception near rec room, they were all sitting there doing nothing! Not one resident there! The problem is there is shortage of staff everywhere and just almost anybody can be hired or not fired. No, I would definitely avoid AL. I am sure some are perhaps better but some worse. I am sure my husband will be OK for temp respite stay at least for now as need arises. Home care could be better depends on level of care required. If there is dementia, incontinence, lost mobility and 2 persons transfer than it is too much for caregiver. As it happens with most progressive diseases most people end up in LTC as their needs become too complex.
My brother's ALF was WONDERFUL. Built on large and beautiful grounds, and a group of cottages with overall about 14 residents in each. Corner rooms had two rooms. The dining on one end of the middle, the a small resident kitchen, walk in tube and bathroom, and on other end activity and TV room. The cottages were clustered around the ground and one large cottage was MC. The residents often went to the main building where administration offices were where they typically saw and could speak with the admins, and there would have coffee, sweets in the a.m., comfy sofas for visiting, the daily activites listed (and there were always a good choice). It was a marvelous "village" atmosphere with good food. They went to films, on tours, to shopping if they wished, took transport to medical out of facility on Thursdays.
I loved that place. Were it not in the heat of Palm Springs it is where I would wish to end my days. They were so great in how they did it all. I can't say enough good about it. Should anyone wish to explore it on Facebook or online sometime I don't know why I always hestitate to give their name, but it was Pacifica Senior Living in Palm Springs. It has won awards and they are well deserved.
Sometimes it is a progression of all mentioned. Home care when a person needs propping up to maintain illusion of independence but not needing 24/7 care.
By your bio it appears you have passed that stage and moved on to NH. Is your mom there for rehab or is she a long term resident?
Your profile says your mom is only in her 60s and is in a nursing home. So I will start with your understanding that whatever choice you make stands good for about two decade of future.
Entirely individual decision: Some things to consider..................
1. Your own personality and adaptability. Your own independent lifestyle needs. Your elder's personality. The knowledge that the personality may change on a dime with a stroke or dementia.
2. Your capability of being absolutely honest about : a) How long you might do this b) What circumstances of illness and aging would require in facility placement c) What attorney you will see to make a care contract for shared living expenses d) How much privacy you will need e) How often reassessment of satisfaction of all involved with be done; when ONE isn't happy then placement in care will happen. f) Requirements of paperwork for POA, Advance Directive, Wills, and etc. g) Respite will be required for a month each year.
3. I would highly suggest full discussion about agreement that when care is 24/7 requirement there can really be no ongoing contract for care, as this would preclude having any life of your own.
4. Stay on a Forum such as this and read read read read read read until you just about fall over from reading. This is where you will learn what it's like.
5. Explore the assets and finances of the elder and explore care facilities available in terms of Board and Care and Assisted living to get a good idea of cost and amenities available as well as COMPANIONSHIP.
6. Have a clear understand that the day the elder enters your home you have made it THEIR HOME. Have a clear understanding that making yourself a caregiver makes you NO LONGER a darling daughter or son, but a caregiver. Be clear that the caregiver is NOT LOVED because of their need to set rules, limitations, and etc. They are in fact the ones blames, given responsibility, accused of all manner of nefarious acts.
7. Learn all you can online about caregiving and determine not to enable helplessness in the elder.
I could go on. But will end with "READ THE FORUM for an hour each night".
Get a Needs Assessment I’d suggest that as a very first step in all this is for you to have mom get an assessment for “Level of Care Needed”. Done usually by a SW & RN duo & done onsite whenever she is currently at. The Area on Aging will have a names.
If she’s in your home, then they will want you to sit outside while t hey do the assessment so that she is not relying on you or you start answering questions posed.
If she is in a NH right now as a custodial care resident, schedule an appointment with the DON aka the Director of Nursing to do a care plan review. So you can see what type of care they have her assessed at.
If she is in a NH as a rehabilitation patient that means her care is being covered by health insurance. & insurance will require the facility to do regular reporting as to her progress. So you speak with her therapy tr as to her capabilities and where best for her once rehab stops.
for any of these you then determine if u can do what’s needed and can afford extra care. If she has no $ then she files for LTC Medicaid and hopefully she’s eligible and the place she is currently in has a open LTC bed she can be in as Medicaid Pending
Well let's start with the terms Assisted Living would be in a facility where help is available if the resident needs help with ADL's, medications and possibly encouragement. The resident is free to come and go as they wish, usually they must sign out.
Nursing Home. General term used now is Skilled Nursing facility. this would be for a resident that has medical needs that can not be met by other facilities. It may be wound care, the fact that the person is not mobile and needs equipment to transfer, has "tubes" for any number of medical conditions.
Home Care. Any care done in the home. Can be done by trained caregivers or family. The family does any caregiving that is not done by paid caregivers. There are less restrictions in in home care. (can use equipment, can use restraints (bed rails, lap tables, we are not tying anyone down...at least I hope not))
What you did not mention is Memory Care Memory Care would be for anyone that is not cognizant. the facility is generally locked so the residents can not get out without proper supervision.
To figure it all out you have to be honest with yourself as to how much care you can do, what you will do, what you won't do, what you can do and what you can't do. And realizing that when you are looking at levels of care a person generally declines they do not improve.
All of that information is true. I had this same dilemma this past year for my Mother. It made way more sense to get her in an assisted living residence due to my home having 17 stairs, fear she’d fall and she was getting way more forgetful and I couldn’t do it any longer. My 92 year old Mother fell 3 times after the New Year and I couldn’t pick her up! For us, AL was my best option, though she’s still adjusting, than in home care, every situation is different . Good luck.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
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You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
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I hired caregivers when I was no longer able to keep up with my mother’s 24/7 needs and demands. She was combative, demanded only me, tried to fire them, tried to block their entrance, lied to the agency about them (We’re rural, isolated, and she complained that one hosted a party with all her friends over. No - I was home at the time.), spit out her food and meds, and did everything she could to make things worse for herself. I was afraid she’d push them down the stairs or slam a door on them.
Now in care she thinks she’s at a bed and breakfast, and is more cooperative. Her care home is small and homey. I drop in randomly and am very pleased.
If there is no choice but a facility, I highly advise hiring a sitter to be there when you can't. A hidden camera is also an idea. You have to have eyes there, or you will be worried sick. I worried constantly about my mom.
As an RN, I've worked in nursing homes and had personal experience when my mom was in three of them. I had to address the same issues at each one. My mom's dehydration. She was a huge water drinker. Hot meals were room temperature, and there were never enough fluids. They keep these places too cold, and the elderly are very sensitive to temperatures. When visiting my mom, the residents complained of being cold. So, I hunted down blankets for them. Imagine being cold, thirsty, and unable to do a thing about it.
This is why residents always end up with a UTI. They are not offered fluids between meals. They should be offered water throughout the day, but they are not. They only get a half glass of juice or other fluid at meals. Then comes the phone call that your loved one is not eating the cold slop they are served.
Most people have to sign up with Medicaid to afford a facility. If Medicaid pays to be in a facility, it should pay for in-home care, but it most likely doesn't or won't.
If possible, keep your loved one at home and have a team come in for care. You can also try contacting the county. They have programs and services that can help.
Blessings to you.
I pray she will recover soon. It can take time after a stroke ...do not give up!
When researching facilities visit several times preferably at different times of the day. Talk to residents or residents’ families - even people you run into in the parking lot.
This forum should give you a very real idea of what you are signing up for as a caregiver in home. They are not exaggerating. It is a full time job - do you have the bandwidth for that and is the rest of your family willing to make that sacrifice. If you use home care services - now you are not only a caregiver but an employer who is juggling employees schedules and emergencies that pop up.
You will still be a caregiver if you decide on a facility. Understanding insurance, attending doctors appointments and being your mom’s advocate with facility. The squeaky wheel gets the crease is so true - you will still need to be present and involved. If you establish a good relationship with the facility there will be lots of phone calls as issues arise day and night.
If you decide on a facility know that it will take mom about 6 months to adjust. Lots of info on this forum about the transition that I’d wish I’d read before I did it.
Good luck to you. My prayers are with you. We all know this decision is gut wrenching. Only you can make the right decision for YOU.
Placement in a facility is expensive, you don’t have as much control, however it takes the burden off you and you can be a loved one to your loved one, rather than nurse, cook, maid etc.
Both have their advantages and disadvantages. Finances are usually the deciding factor for most people. Medicaid can pay for a facility if there are less than $2k in assets, but it’s complicated and you’ll need an elder care attorney to help navagate. Hiring care at home has its challenges…finding well trained, trustworthy people is a must, and it’s not always easy. If there are friends and family members to help, that’s great, however people have their own lives and it’s difficult getting some people to honor their commitment.
let us know what you decide and how it’s goes.
If it turns out that your mother does not ahve to remain in residential care, homecare could be an option. If it's not you can have her placed in a facility of your choosing. One that you think is best. You don't have to go with whatever facility the rehab people suggest.
if so, your mom is currently having her stay paid for by her health insurance. Post hospitalization rehab in a facility is a covered benefit for Medicare, which is her primary insurance. And her secondary health insurance tend to follow what her primary does. She s get regular assessments done as they are what is used in determining her progress. Progress entered in her health care chart is what’s needed to be happening in order for Medicare to continue to pay.
Medicare pays for rehab as it’s a term or time limited stay; it’s 100% first 20/21 days and then at 50% up to 100 days and with its care plan based on whatever codes* she exited the hospital with AND if she is progressing sufficiently within those codes. That she is there past the initial 20/21 is a really good sign that she’s progressing as most elderly do not get past the first 20/21 day block. If you need to go over and be a lil cheerleader or encourage her to go & participate at her rehab please pls do this. Both for what it will enable her to do for her future but also her being a rehab patient means health insurance is paying & at double or triple what the State LTC Medicaid program pays for a custodial care resident. So the facility is happy And it gives you some time to really plan out where she goes next.
Personally I’ve always found the therapy teams, the PT & OT in rehab unit, are very up front in discussing what’s what with family as to how things are going. Ditto for the SW. Both have their own licensing and both are sought after by NH to have to have on staff so they can be more frank on their talks with you as they can pack up and leave to another facility if this one gets to be bothersome with them.
* the codes are ICD-10 diagnosis based. Like I’m going to a sports rehab place to get outpatient PT for my knees and its codes M25.562 and M17.12. Covered by my health insurance as it’s related to past surgery and Euflexxa shots. And it’s a set # of PT sessions which I set up and done after the initial assessment by the PT. Stroke care will have lots of codes & you want mom to stay “progressing” in them so she stays on rehab for as l…o…n..g as possible.
When eldercare becomes a profit center, the "care" part often goes out the window. However, it is what it is. When people need facility care they, and their families, will need to do the best they can to find a reasonably well-run facility that manages to strike some kind of balance between the two.
It was beautiful place, like high end hotel with nice lobby, bar, bistro, library, beautiful patios, gardens.
Rooms were nice as well and comfortable.
But that is just about all, there is no life at all in that place, everybody seems subdued and afraid.
Assisted living as the name implies to me means there is assistance in most aspects of daily living.
Not so much, almost none! And we paid extras! They did not help him with dressing, nor meds, he can do those, he paid extra for laundry!
And all of this for $9,000 + per month or daily almost $300.00
Staff does not do anything, one day I stayed for lunch and sent my food back as not acceptable.
Even my husband who is outspoken became somewhat subdued and asked me not to say much as he still needed to stay there for a few days.
I noticed so many things, one at lunch most people needed some assistance as about 80% used walkers, nobody helped them. My husband told me he noticed lots of falls everyday.
There were activities, almost nobody participated, one night my husband went to movie night and was the only one.
Residents are told or at least encouraged to go to bed at 7.00 PM!
Granted, most people were good decade or two older than my husband, so maybe that is normal not to stay up till 11pm.
I called staff for something from my husband room, nobody came, went to reception near rec room, they were all sitting there doing nothing! Not one resident there!
The problem is there is shortage of staff everywhere and just almost anybody can be hired or not fired.
No, I would definitely avoid AL. I am sure some are perhaps better but some worse.
I am sure my husband will be OK for temp respite stay at least for now as need arises.
Home care could be better depends on level of care required.
If there is dementia, incontinence, lost mobility and 2 persons transfer than it is too much for caregiver.
As it happens with most progressive diseases most people end up in LTC as their needs become too complex.
It was a marvelous "village" atmosphere with good food. They went to films, on tours, to shopping if they wished, took transport to medical out of facility on Thursdays.
I loved that place. Were it not in the heat of Palm Springs it is where I would wish to end my days. They were so great in how they did it all. I can't say enough good about it. Should anyone wish to explore it on Facebook or online sometime I don't know why I always hestitate to give their name, but it was Pacifica Senior Living in Palm Springs. It has won awards and they are well deserved.
Home care when a person needs propping up to maintain illusion of independence but not needing 24/7 care.
By your bio it appears you have passed that stage and moved on to NH. Is your mom there for rehab or is she a long term resident?
Entirely individual decision:
Some things to consider..................
1. Your own personality and adaptability. Your own independent lifestyle needs. Your elder's personality. The knowledge that the personality may change on a dime with a stroke or dementia.
2. Your capability of being absolutely honest about :
a) How long you might do this
b) What circumstances of illness and aging would require in facility placement
c) What attorney you will see to make a care contract for shared living expenses
d) How much privacy you will need
e) How often reassessment of satisfaction of all involved with be done; when ONE isn't happy then placement in care will happen.
f) Requirements of paperwork for POA, Advance Directive, Wills, and etc.
g) Respite will be required for a month each year.
3. I would highly suggest full discussion about agreement that when care is 24/7 requirement there can really be no ongoing contract for care, as this would preclude having any life of your own.
4. Stay on a Forum such as this and read read read read read read until you just about fall over from reading. This is where you will learn what it's like.
5. Explore the assets and finances of the elder and explore care facilities available in terms of Board and Care and Assisted living to get a good idea of cost and amenities available as well as COMPANIONSHIP.
6. Have a clear understand that the day the elder enters your home you have made it THEIR HOME. Have a clear understanding that making yourself a caregiver makes you NO LONGER a darling daughter or son, but a caregiver. Be clear that the caregiver is NOT LOVED because of their need to set rules, limitations, and etc. They are in fact the ones blames, given responsibility, accused of all manner of nefarious acts.
7. Learn all you can online about caregiving and determine not to enable helplessness in the elder.
I could go on. But will end with "READ THE FORUM for an hour each night".
I’d suggest that as a very first step in all this is for you to have mom get an assessment for “Level of Care Needed”. Done usually by a SW & RN duo & done onsite whenever she is currently at. The Area on Aging will have a names.
If she’s in your home, then they will want you to sit outside while t hey do the assessment so that she is not relying on you or you start answering questions posed.
If she is in a NH right now as a custodial care resident, schedule an appointment with the DON aka the Director of Nursing to do a care plan review. So you can see what type of care they have her assessed at.
If she is in a NH as a rehabilitation patient that means her care is being covered by health insurance. & insurance will require the facility to do regular reporting as to her progress. So you speak with her therapy tr as to her capabilities and where best for her once rehab stops.
for any of these you then determine if u can do what’s needed and can afford extra care. If she has no $ then she files for LTC Medicaid and hopefully she’s eligible and the place she is currently in has a open LTC bed she can be in as Medicaid Pending
Assisted Living would be in a facility where help is available if the resident needs help with ADL's, medications and possibly encouragement. The resident is free to come and go as they wish, usually they must sign out.
Nursing Home. General term used now is Skilled Nursing facility. this would be for a resident that has medical needs that can not be met by other facilities. It may be wound care, the fact that the person is not mobile and needs equipment to transfer, has "tubes" for any number of medical conditions.
Home Care. Any care done in the home. Can be done by trained caregivers or family. The family does any caregiving that is not done by paid caregivers. There are less restrictions in in home care. (can use equipment, can use restraints (bed rails, lap tables, we are not tying anyone down...at least I hope not))
What you did not mention is Memory Care
Memory Care would be for anyone that is not cognizant. the facility is generally locked so the residents can not get out without proper supervision.
To figure it all out you have to be honest with yourself as to how much care you can do, what you will do, what you won't do, what you can do and what you can't do.
And realizing that when you are looking at levels of care a person generally declines they do not improve.
For us, AL was my best option, though she’s still adjusting, than in home care, every situation is different . Good luck.