confused about the different categories of care facilities

gampiano

Hello,

Although Ive been following a lot of posts I am still not clear on the different kinds of facilities. Assisted Living, Memory Care, Nursing Home, et al. Also, a lot of people who have placed someone still seem to be giving showers, and lots of other personal care. Can anyone break this down so i can save the information?

Are there different caregories from state to state?

I'm not even close to making this kind of a move, but trying to be informed.

Thanks,

Maureen

Beachfan

Wecome, Maureen, and sorry for the reason you needed to seek us out.

In a nutshell: I am in PA. I researched facilities for possible placement for 2 years prior to November, 2021, when my DH entered a MCF (Memory Care Facility). I settled on a “stand alone” MCF. They serve only residents with Alz./dementia. The monthly cost was all inclusive ($6200/month currently) and private pay (out of pocket- - Medicaid is not accepted). I chose the facility understanding that the monthly fee would not increase based on care needs, staff were highly trained, behaviors, wandering, aggression, hand feeding if necessary, any and all situations could and would be addressed. I wanted assurance that DH could “age in place” (die) there; I would not be expected to move him if he became bedridden or immobile. I was not disappointed.

My DH passed on April 21, 2023; he resided at his MCF for 17 months. I fully intended to keep DH at home until the end; that didn’t happen. Start your research sooner, rather than later. I am happy with the decision(s) I made; DH was well cared for, content and well loved in his MCF. I was able to survive caregiving unscathed; without having placed DH, I’m not sure what the outcome would have been. Best of luck with your research and eventual decision. Many on this forum will offer valuable information.

loveskitties

Assisted living is typically a small apartment with a mini kitchen...no oven or stove...with microwave. There is likely a "meal plan" you buy into which allows the resident to go to the dining area for allotted meals. Additional services such as cleaning, medication management and assistance with showering. Details vary by facility. Resident is allowed to freely move within and outside the facility. It is for residents who need some assistance, but cannot live independently.

Memory Care is typically a "locked down" area with either single or double occupancy bedrooms. There is usually a dinning area, activities area, a great room type area with seating and tv, and a secure outside area. There are aides and skilled staff to assist with all daily needs from medications to showering, toileting, feeding, etc. The residents are not allowed to leave the facility unaccompanied by either staff or family. Residents are watched more closely as their mental abilities are impaired. To become a resident in this type of facility one will be assessed by their professional staff to see if they do indeed meet their requirements for care. The amount of medical care provided will vary by facility. Some will not accept patients with major medical needs, while some will keep them (with assistance from hospice) until death.

Skilled nursing is typically more of a hospital environment, with the patient requiring more skilled professionals to deal with medical needs such as IV's and cathaters or additional medical equipment. Again the facility will review the patients medical needs to determine if their level of care is appropriate.

Most often the patient's doctors will be the ones to recommend the level of care needed. It is then up to you to find that type of facility in your preferred area, financial requirements, etc.

gampiano

thank you for clarifying, I would definitely choose the stand alone memory care facility, as I wouldn't want my DH to be forced to move . My state, MA, is exorbitant!

Even if i moved in with my daughter and rented out the whole house plus garage apt, it would still be a stretch. But, at least i would have the house with no liens or claw back. My family has been reduced to poverty in past generations due to illness , and i'm determined not to let that happen yet again because of the medical system here.

On to plan "B"...still formulating it

Maureen

toolbeltexpert

Maureen I am originally from Ma but have lived in tn 30 yrs. I sold our farm and downsized which was extremely hard on me, but I have a new home close to dw and I have banked about 5 plus yrs of $. I am already planning if I have to move again. But at least now I can breathe a little.

I was determined that she was going to be in mc, which I didn't see any Medicaid facilities that were actually mc. Every thing that was a"Medicaid facility" that I saw was a snf, rehab. I still have family in worcester and in Nh. I remember how costly everything was in Taxachusetts.

M1

Maureen another thing worth researching is what your state Medicaid plan will cover. In some states it will cover memory care as well as skilled nursing (nursing home). I don't know that any state will cover assisted living, but I don't know that for a fact. Many--like TN where toolbeltexpert and I are---will only cover skilled nursing facilities. This leaves a lot of people with dementia but no skilled nursing needs out in the cold, so to speak.

gampiano

Wow. This is excruciating isn't it? I will look into the state medicaid policies, though i have been through the spend down with my mother, who unfortunately outlived her funds. Just as she was finally going to qualify for medicaid, at the age of 102, deaf, blind, but not yet dying, i was told that there was a waiting list of more than a year to get any home health assistance due to lack of personnel. Ditto for nursing homes.The state goes through one caregiver agency for my area. So....i used my own personal funds, and took out a 30k loan to keep her in her apartment with her private caregivers. she lived for another year and we barely made it with the finances.The only help we received was through Hospice, and thank God for them. At least we could call the nurse in the middle of the night and she/he would come to the house.

Thanks for all the good advice and info. What a system we (dont) have here.

Jeanne C.

It may be worth talking to a medicaid expert in your state. In my state (DE) medicaid rules are very different for married couples as opposed to individuals (and the rules are very different from our prior state NJ). I'm working through the application process now and the "spend down" isn't needed for a couple, just a thoughtful use of an annuity.