For Profit Memory care

2parents/brain change

Hello wonderful people,

Our father is suffering from a type of dementia stemming from brain concussions (falls).  He is 94 years old.  Worked all his life until he fell too many times.

The family is still working through shock and grief.  He is in a non-profit rehabilitation center.  The family is considering searching for the right long term care facility.  Yesterday we looked at a for profit memory care center.

I am not familiar with these types of facilities.  Does anyone have any experience with these facilities?  The place we looked at appeared 'charming' but I was uncomfortable with the sales pitch approach.

Any thoughts or experience?

Thanks so much!

J

Anonymousjpl123

It really depends on your situation. I have had great experience with a for profit place, but we looked at A LOT of facilities before choosing it. I can’t speak to difference in care between for profit and not for profit, but we based our decision on cost and fit. 

I would confirm three things: are you confident he can get  maximum level of services he needs, can you visit easily, and can you afford the maximum level of care? 

It also helps  to speak with others who are there/have family there - hearing first hand experiences we as super helpful  to me. I knew a few people at several places, but also asked everyone I could about their experiences with MC.

Also, I highly recommend checking in with the Alzheimer’s Association hotline to be sure their services align with what other quality facilities provide. They can’t give a specific review but CAN tell you if available services seem comprehensive.

I’m so sorry about your father. I hope this helps.

harshedbuzz

JenandBob-

It's hard to make generalities about MCFs. There are excellent for-profit places and mediocre ones that are religious affiliated or not-for-profit.

I toured a dozen places looking for dad- religious, a community owned nonprofit, corporate chain communities and even a state run veterans home. I live in a very well-served area so I had a lot of options.

There does exist a kind of chain MCF that does seem to put pressure on families. Often these are the newer, purpose-build facilities that obviously put a lot of capital into designing the space to be appealing to those touring rather than on staff retention and training. Generally, these are not facilities that will accept a resident on Medicaid or allow one to stay after they've run out of funds. Local to me, these tend to be very nice but will cherry-pick their residents which means a resident who becomes agitated will be asked to leave. And almost all of these places have a contract with "A Place for Mom" which means they pay about a month's rent for each new resident as a commission. 

Dad did end up in a corporate facility but not one of the "fancy" places. It's wasn't as slickly decorated and staged looking but the care was awesome. This place was reputed pay higher salaries than most in the area. When I toured, I always checked out the employee parking lot, if the cars looked like something I would be happy to drive it meant their people were paid relatively well for the industry which leads to an experienced staff. Dad's 2 main caregivers had 28 years between them in the same facility. They also invested in training for staff and were wizards at managing the more common behavioral issues that can crop up. 

We had mom's CELA read the contract for dad's MCF before she signed it.

HB

zauberflote

Hi Jen&Bob-- my mom went from a non-profit AL to a for-profit MC. The results were mixed. The corporation that owned the MC managed it very poorly. I think the place must have been independent previously, for decades, as the building was so old that the residents' pathetic half-baths had pathetic fixtures which were grandfathered in, as were some other features. 

Our criteria for MC were: central in the city and to a good hospital (we knew we were going to move but hadn't decided where yet), small (she'd come from a 60-bed AL), and affordable (she was almost 91 when she moved, but showed no signs of dying of anything but dementia). I only looked at two. I toured the genteel and historic CC facility, which was enormous and the courtyard for MC boasted wall-to-wall pavement, a picnic umbrella, and trees in the distance if one could see that far. The fees were large, and for every little thing one needed, an extra $100 was added monthly. Mom couldn't have afforded it for as long as she ended up living. Then I went to a very small (45 residents of 60 beds filled), very central, also historic AL+MC age-in-place facility "Under New Management". The courtyard had a giant veranda, grass, birds, plantings.....The price was absolutely right, and was one straight fee monthly no matter how far along you went. They did raise rent a small percent a couple of months before Mom, but it was negligible.  

The good points of this place ultimately outweighed its multitudinous bad points, at least as far as Mom was concerned. The long-time staff were devoted to their charges, and while they may not have had formal dementia training, were much better at it than the perky-but-low-ability management. The kitchen was hampered only by state law and budget. The food would have been really good if access to the high-priced goods were there. The chef cooked out of her head as her mama raised her to do! 

The "upper management", however, was sometimes less than useless. We had 5 "directors" in 17 months. Some of them spent their work days looking like the deer in the headlights, and hired mire of the same. There was never an RN within the building except for hospice personnel. 

Going back to the "boots on the ground" staff-- 87% of them were phenomenal. They did the best they could with what they were given. They certainly trained me! 

Mom died in late February 2020, weeks before the state went into covid times. The facility was already short-staffed, and some of the brave caregivers took back-to-back 12-hr shifts. The facility was on probation with the state. The oldest residents all reached their ends together, before covid hit. The place was shut down within less than a year, and is now slated to be demolished for a huge ritzy mixed-use complex. I am glad we had the use of it while we did.  

loveskitties

These days with staffing shortages, the ratio of working staff to patients is certainly a big consideration.

Don't be taken in by the glitz and fluff you may see in some.  Most of that is beyond the patient's concern.  Cleanliness and organization of the facilities and staffing are more important.

Ask directly if the patient can remain for the rest of their days or if there is criteria which will cause them to have to leave.  Also ask about Medicaid...will the patient be able to transition to Medicaid at their facility or will they be asked to leave when the money runs out.

Visit at several different times if possible...mealtimes, late afternoon...to see how they handle those things...late in the day they may be dealing with more patients with sundowning which can tax the staff.

Find out if they have beds available or if there is a waiting list.  If a list, how many are on the list.

Hope you can find a place which meets your needs and desires.

HollyBerry

tthe very best advice we got when we were looking at places for my mom was to choose the place you'll be able to visit most often and on short notice.  I realize that's really hard in some parts of the country, but around here it was excellent advice. I actually got there before the ambulance one time.  We had a similar experience to yours with salespeople we didn't like or trust and chose the less polished place with lots of long term staff (until they hired a bunch of new admins and the long term staff left).

MN Chickadee

We utilized both, mom was in a for-profit facility for the first few years and then moved to a non-profit one with Christian ties, though would have been appropriate for someone of any faith; religious stuff was very optional and not blatant. Both were good so it's hard to make a blanket statement about either being better. Assessing facilities based on staffing ratios, activities, quality of the food etc and word of mouth recommendations is your best bet.

CanyonGal

When it was time to look at ALF, I looked at all of them in the area, but ended up choosing the one in the same town my mother was living in. She refused to leave the area. I guess there is something to be said for looking out your window and recognizing the area of town. There was a waiting list so we had to wait 2 months before we could get her in the ALF. Later, we moved her to the memory care wing, where she was NOT happy but unable to stay in assisted living due to her dementia. The facility is old, not flashy, and most of the staff and residents had been there a long time. After 2020, the facility that was originally more of a mom&pop organization, was bought by a company who own a number of ALF, and changes were made (not good evidently by the number of staff turnovers and additional costs for this and that), and quality dropped in food and services.

When my mother needed to go to rehab after her surgery, I was given a list of places that had a bed available. I spent an evening marking off places I would not take her (asked a few people those they liked and those they said "don't go there") and then spent the next day calling and immediately visiting facilities, which narrowed down the list. (I don't want the facility to pick the day because they tend to pick days where activities "shine" or show you what they want you to see. If you can walk in at any time, that's a good selling point to me.) I used medicare.gov ratings somewhat, to narrow down the list as well.

My mother may need a nursing home, due to the number of health problems she now has, and becoming bedbound, means she cannot participate in any activities, so the skilled nursing care seems a bigger factor. I am going to review the rehab facilities that I looked at and liked to see if they have a LTC opening.

I don't care for the hard sell tactics that some of the "chain" facilities tend to use (call or email you to death) and the "A Place for Mom" were the worst about calling and emailing me after numerous "no, thank you, we have already selected a place".

Ed1937

I think the best place for you to get information is from a local caregiver support group. Contact the Alzheimer's Association for local groups. You might have to ask other caregivers in the group, but that information will likely be your best bet for local information.