Time for a nursing home?(1)

Jim-TX

Our 93 year old mother, in the late stages of Alzheimers, has been living in a memory care / assisted living facility for 2 years.  She is an extreme fall risk, and does not realize she should not walk anymore.  Because of this, we are paying extra for round-the-clock personal caregivers to prevent her from trying to walk.

We are trying to cut back on the expense of the additional caregivers.  Mom's memory care facility won't allow restraints in her bed, and won't even allow an alarm if she falls or climbs out of bed.  The best they can do is lower the bed to about 18" from the floor and put pads around it.  We have not tried that yet, but I'm concerned once out of bed, Mom will attempt to stand and walk by grabbing onto other furniture in the room.

At this point in her life, I'm wondering if she would get better care in a nursing home.  They would allow alarms if she tried to get out of bed, and would even allow restraints if necessary.  (I hate the idea of restraints, but we don't have a lot of good options).

I'm interested in hearing other peoples' opinions of memory care facilities vs. nursing homes for someone like my mom.  Any comments would be appreciated.  Thank you!

dayn2nite2

No facility will allow "restraints."  Honestly, the place she is she is getting the same care she'll receive in a SNF.  Lowering the bed to max and pads around the bed are standard.

What extra or different care are you expecting at a NH?  And have you visited any local NHs and talked to staff about what different care she would get with them?

Jim-TX

We have not yet visited any nursing homes.  One hospice nurse mentioned that sometimes nursing homes can provide more appropriate care for someone who can no longer walk (like my mom).  We are just trying to figure out how to get her the most appropriate care.  Thanks for your comments.

harshedbuzz

Jim-

Most MCFs that allow a person to age in in place have the expectation that family will provide additional caregivers as their LO's care needs increase, so many families choose SNF at the end. Dad died in his MCF, but both of my aunts with dementia were transferred to a SN unit. One after a fall in AL in which she broke a hip and one because she needed better hands on care; in MC she was assisted in, say, toothbrushing, in SNF they brushed her teeth and got them clean.

I don't think you're going to find restraints used. A bed alarm and lowered mattress may be the only real option available for getting out of bed. Often, SNF will put PWD who have forgotten they can't walk in a semi-reclined Broda chair (sometimes a wedge cushion is added for the more determined patient) which is parked in a area staff can see them. While this generally effective, it is far from an ideal fix.

When you tour ask specifically how they handle this situation. Also, if mom is self pay compare the costs. Locally, a SNF is about twice the cost of a MCF. YMMV.

HB

Jim-TX

Thanks for your comments, HB.  Very helpful!

kmasenact

Jim-TX wrote:

Our 93 year old mother, in the late stages of Alzheimers, has been living in a memory care / assisted living facility for 2 years.  She is an extreme fall risk, and does not realize she should not walk anymore.  Because of this, we are paying extra for round-the-clock personal caregivers to prevent her from trying to walk.

We are trying to cut back on the expense of the additional caregivers.  Mom's memory care facility won't allow restraints in her bed, and won't even allow an alarm if she falls or climbs out of bed.  The best they can do is lower the bed to about 18" from the floor and put pads around it.  We have not tried that yet, but I'm concerned once out of bed, Mom will attempt to stand and walk by grabbing onto other furniture in the room.

At this point in her life, I'm wondering if she would get better care in a nursing home.  They would allow alarms if she tried to get out of bed, and would even allow restraints if necessary.  (I hate the idea of restraints, but we don't have a lot of good options).

I'm interested in hearing other peoples' opinions of memory care facilities vs. nursing homes for someone like my mom.  Any comments would be appreciated.  Thank you!

I work in the industry and I am a Dementia Practitioner.  Most nursing homes will not allow alarms, as they may be considered restraints.  

Memory Care Facilities and nursing homes (now called Skilled Nursing Facilities or SNFs) are often one in the same.  I've worked in both.  At this point, you may not have an option but to place her in a SNF.  That way, she would have around-the-clock care at no extra charge.  Plus, there would be opportunities for her to socialize with staff and other residents.  

Some facilities specialize in Memory Care, you might want to  take a look at placing her in a place like that.  These facilities often use cutting-edge technology and innovations to help combat the effects of ALZ.  There's also trained staff that can assist both you and your mom as needed.

harshedbuzz

kmasenact wrote:

I work in the industry and I am a Dementia Practitioner.  Most nursing homes will not allow alarms, as they may be considered restraints.  

As I understand it, alarms may be used so long as they are not audible to the resident. That said, I understand the trend away from using them in some places. My aunt's nursing home used alarms. My dad's hospital bed was alarmed. 

Bed and Chair Alarms Restraint For Elderly in Nursing Homes (rcareinc.com)

Memory Care Facilities and nursing homes (now called Skilled Nursing Facilities or SNFs) are often one in the same. 

This is not the case where I live nor in the state where my two aunts with dementia resided. The level of care offered in SNF is much more comprehensive, much of the staff has more medical training and staffing levels are higher. Dad's very nice MCF had a single LPN each shift; the DON was an LPN although he was in school to complete an RN. This results in a high monthly cost. Dad's MCF was ~$7K/month; the SNF that was my plan B before mom agreed to MC was about $13K. He'd been there for rehab and they said they'd take him on the fly if something happened to my mom while I found MC for him.

I've worked in both.  At this point, you may not have an option but to place her in a SNF.  That way, she would have around-the-clock care at no extra charge.

This was not the case when my aunt broke her hip and was supposed to stay off her feet. She was agitated and didn't recall the doctor's orders so family had to provide 1:1 sitting services. She didn't have money for this, so her DD and DIL covered most shifts with her 85 year old sister filling in where she could. The rest of the time was covered by someone they hired who was paid $20/hr. 

  Plus, there would be opportunities for her to socialize with staff and other residents.  

Some facilities specialize in Memory Care, you might want to  take a look at placing her in a place like that.  These facilities often use cutting-edge technology and innovations to help combat the effects of ALZ.  There's also trained staff that can assist both you and your mom as needed.

What is this cutting edge technology of which you speak?

Jim-TX

Thanks to everyone who responded to my question about Memory Care vs. Nursing Home/SNF.  Your answers were very helpful!