I’m not sure what level DH is right now, top AL or bottom MC so I’m looking for a facility with both. But if he should eventually need nursing home level care, having to move him again would be difficult and upsetting. There’s also a pretty big jump in price for all levels, across the board, in facilities that have an onsite nursing home.
i first started looking … years ago … for assisted living and found one with inside access to memory care so whoever in assisted would not have to go outside to visit their LO. Now there are several.
but it has occurred to me that it is more likely that one of us might not need memory care and found an assisted living facility with inside access to long term/skilled.
often there is a memory care section inside the long term section anyway.
BUT this particular facility is not as ethically nice as the assisted/memory care facilities which offer meals all day, van rides, games, movies, other activities. (For instance no holiday festivities at this one for residents and family and interested visitors.)
but since it offers combined assistance living and skilled i’ll put up with the on-the-way-to-being-outdated facility.
Altogether, the cost of the facility and personal companion was cheaper than the ALtoMC facilities we looked into. We are in Texas, so I'm not sure of the prices you're looking at, but check with the AL and see if they have step-ups which allow him to age-in-place.
The only real difference we saw in the AL and a MC is cost and the size of the facilities. I didn't notice a significant difference in the care level, only that the MC is required to have a RN on staff 24/7. The AL RN was on staff 5 days/8 hours, then on 24 hour call. This meant that whenever a fall that involved a head injury (not sure if this wouldn't be the same at a MC, though), an emergency visit was required by law. After she was in Hospice, their nurse and doctors came out and made the call. Even brought in an xray machine one time!
That said, I'm sure you know that everything depends on the facility. Do your research until you're comfortable with your decision. I agree that moving them after they've become familiar with a place can be extremely detrimental.
As you can see, you are not alone. I feel for your situation and wish you all the blessings that come with a caregiver's crown.
Any change for a person with dementia is going to create difficulty for a bit. The goal is to create consistent environment and consistent routine. Knowing and re-creating those is half the battle.
i first started looking … years ago … for assisted living and found one with connected access to memory care. Now there are several.
but it has occurred to me that it is more likely that one of us might not need memory care and found an assisted living facility with inside access to long term/skilled.
often there is a memory care section inside the long term section anyway.
BUT this particular facility is not as ethically nice as the assisted/memory care facilities which offer meals all day, van rides, games, movies, other activities. (For instance no holiday festivities at this one for residents and family and interested visitors.)
but since it offers combined assistance living and skilled i’ll put up with the on-the-way-to-being-outdated facility.
SNFs (nursing homes) are covered if your LO has a medical need. Check how long they are covered. Often, they are limited to X days after discharge from the hospital. Unless medicaid is your coverage, you probably cannot use this as a Federally paid care plan.
I HIGHLY RECOMMEND Board & Care facilities. They cost close to the same as MC, but the ratios of care givers to residents is lower and more personalized. I moved my LO to one a year ago. I wish I did it sooner!
You didn't share the diagnosis, but if your LO has a cognitive diagnosis and conveyed interest in MAID, you will not get support at a SL/AL/MC. It's in their financial interest in keeping your LO alive and needing their care as long as possible.
My LO doesn't qualify for MAID, but our hospice is aware of this and supplied "comfort" medication. While the owner of our BC has conveyed that they do not support MAID, the care staff and our hospice LVN gets it and has been helpful. Otherwise, I would have needed to move her to my home and manage all this myself.
Board & Care is the way to go!
Yes, DH is heading toward a dementia diagnosis and no, we will not qualify for Medicaid. Thanks.
Nursing homes (skilled nursing facilities) on the other hand are regulated by the Federal Gov and are Medicare and Medicaid approved. That means that the rules and requirements for what is covered, staffing requirements, other quality metrics are required across all states so it is more of an apples to apples comparison. Nevertheless, that does NOT mean they ALL are the same quality.
Then there are so-called "continuum of care" or "life care" facilities that one pays a high fee to inter when one is independent. As one might need care for Al or MC, in theory, it is guaranteed. Some have arrangements with SNF or Rehab facilities to take that on if needed. But other than the SNF/Rehab aspect, these too are state regulated. Some have had solvency issues, and went under. The upfront fee is lost and if the facility goes under, one still has to move.
I would strongly recommend engaging a licensed elder care attorney in your state to help navigate this. They often know the best facilities and can help with planning for Medicaid if that may be needed later on. They too can help review the paperwork one has to sign as that is a binding contract and many facilities have "trick" language. Once one signs the paperwork there is no do over. Get legal advice on this before signing anything.
If DH gets placed, be sure to find out what their policy is on keeping residents till death. Of course, you cannot anticipate behavioral issues but a good MC will work with a geriatric psychiatrist to get the right meds prescribed. The docs come into the MC, along with lab techs. Its very convenient and a Godsend. I even had travel dentists come in to extract teeth for mom. Very high prices, but very convenient as they work on the resident in their own recliner!
Best of luck.
I moved my mom from 1 MC to another in a different state with multi levels. She passed in MC so she did not need the last step. However when moving things out, a single bedroom only required a small UHaul and less than 3 hours with sorting out what goes to donate and what goes to trash and those 2stops plus 1 to drop items to my home we're all completed in that final trip.
As far as services within her multi facility, each unit ran independent of staff with the exception of med techs. If a higher level of nursing care was needed, mom would have to move to the next unit to receive that care or I would have had to hire outside help.
As far as increasing costs, yes, I am familiar. The more your husband needs, the costs go up. Expect this with yearly cost increases as well.
It is a matter of what you an find, what can work for you.
My parents in Missouri had basically a Village, where they started in IL in a condo, moved to apartments, then to ALF and then for my mom briefly to MC. Worked wonderfully for them. Again, private pay and a matter of affordability.
I wish you the best.