Housing options

linds07

Hello I am a daughter of a mother with Alzheimer’s. I am trying to get advice on living situations. She’s living alone in a big house and I don’t know what type of housing she should move to. Some of the communities I’ve seen are insanely expensive..!! She’s still independent but I’m seeing her progress… any advice would be greatly appreciated. Thank you.

Bandorino

Hi there! There is a service called "A Place for Mom" online that can help with referrals in your community. My mom also lived alone in a big 4 bedroom house with her two cats. She had been letting food spoil in the refrigerator, not remembering to take her meds, sleeping on the couch in the family room instead of going upstairs to bed, etc. As oldest daughter, I agonized and worried about what to do. My father-in-law has been in an assisted living apartment for the past two years and has thrived there. With the help from A Place for Mom I started to pre-screen some senior communities. They can help you narrow down what might be best for your mom after talking with you about her symptoms, needs, etc. If you have brothers or sisters be sure to include them in this discovery process and once you've narrowed it down to a few choices you think your mom may like then take her for tours and visits. We moved my mom into her assisted living apartment on Sept 1.

Bandorino

I should ad that there is quite a variance in the monthly rents, but with research and help from A Place for Mom you should be able to find something affordable. What she can afford depends on what kinds of pensions, 401k investments, IRAs, other savings and social security she has coming in monthly.

harshedbuzz

A Place for Mom is the devil. No stars. Do not recommend.

APFM will only give you options with which they have contracts-- not only will you miss out on very nice places that don't need to advertise-- the one-months-fee the facility will pay APFM per their contract is baked into the amount you will pay. It not "free".

Where I live APFM works only with facilities that are strictly self-pay for the most part. If dad lived long enough, he would have needed Medicaid as a safety net. When choosing care, unless you have excellent LTC insurance or unlimited funds, it best to limit your search to places that expect you to self-pay for a couple years before converting mom to a Medicaid bed.

The other downside is that APFM will share your contact information and you will lose control of that. I tried APFM and they gave my phone number out randomly-- even to places that didn't offer memory care which was specifically what I needed. Additionally, any time a facility changed hands or hired a new salesperson, they would reach out again. Once I got a call in my car while driving her to the doctor just after dad died and it took me weeks to convince her that I wasn't placing her imminently.

@linds07 I found the best recommendations came from word-of-mouth. I asked around-- folks at my IRL support group and dad's HHA. I also asked here about what to look for and then I toured a dozen or so places to get a feel. You can pretty safely disregard anything the salesperson/tour guide says. Ask staff how long they've worked there, ask about training, check out lunch and activities. Does the place look and smell OK-- it doesn't need to be fancy-- it's better funds go into staffing salaries and training than fresh flowers in foyer. I talked to families in the parking lot coming and going and I even checked out the employee parking to get a sense of whether staff was paid reasonably well. Ask about what's included-- some places game families with tiered pricing schemes. Also ask under what conditions she might be asked to leave or whether you would be expected to bring in extra aides or hospice. Other places will accept a resident into AL knowing full well that'll be a failure and they'll be moving your LO to MC within 6 weeks-- the old bait'n'switch for families who believe mom's too with it for MC.

There's an old saw around these parts that by a time family is willing to consider assisted living, that ship has sailed and it's time for MC. While it can be hard to picture your mom in a facility with PWD from mildy impaired to very progressed in the disease, it is best to plan her care for her very worst day/symptoms.

How aware of you of mom's abilities? If you live locally and see mom regularly at a time when she's at her best you may be under-estimating her needs. A friend did this. Her mom lived in the neighborhood. They spend most afternoons and dinner together. When she cleaned mom's house out to sell and moved her in to her place she was amazed at the out-of-date foods and general disorder in the house and at her mom's behavior in the late evenings. My parents lived at a distance, so while I didn't see them often a couple of days of seeing dad cycle through delusions and craziness gave me a better sense of his care needs. While dad could showtime really well as needed, he couldn't sustain it which was helpful in seeing where he really was in the disease progression.

IME, these facilities can vary in price regionally as well as between corporate and non-profit entities. Where you live matters a great deal. Dad was in a corporate "one-price" MCF in a MCOL area; another poster here had a husband the same brand facility in a LCOL area and paid almost $1400 less a month.

HB

towhee

harshedbuzz gave you very good advice.

If you contact your local Area Agency on Aging/long term care ombudsman, they should be able to point you towards a complete list of facilities for your state and any state info available about facility inspections or problems.

Care locations are basically the following:

Living at home with assistance- might progress through delivered meals, cameras, housekeeping services, to an aide several hours a day, to 24 hour a day private care. 24 hour a day private care is usually the most expensive option of all.

Independent Living level at a facility/retirement community- prepared meals, housekeeping, possible medication assistance, social activities available, basically same as living at home but in a smaller space, usually apartment. Not recommended for someone who already has a diagnosis, they will probably have trouble adjusting and will probably have to be moved quickly.

Living with a relative-

Adult day care-anywhere from 4 - 9 hours a day, 1-5 days a week. Meals, medications, social activities. Designed to help families keep Loved Ones living with a relative longer.

Residential Care Facilities- What these are called differs by state. These are small, usually independent facilities, often built like homes that care for a small number of residents, no more than 6. There is one staff member on site at all times who is often responsible for both cooking and resident care. They are the least regulated choice and often the least expensive but you have to vet them carefully. Some are assisted living level, some are mixed AL and memory care. They differ a lot.

Assisted Living (AL) - Meals, housekeeping, medications, social activities, residents will be checked on several times a day, someone on site 24 hours a day. ALs vary in what they do. Some may be very close to independent living, (often called hospitality model) others closer to memory care. Some have residents along the entire continuum of care needs. They may offer reminders and escorts to dining room, ditto for recreation activities, incontinence care, help in dressing, bathing etc. There are two price structures for these, one is a tiered structure, you pay for the level of care needs you are getting, the other is inclusive, the price does not change with care needs. The tiered structure will eventually nickel and dime you to death, but it is often the only one available.

Memory care - Usually more experienced in dealing with dementia, meals, housekeeping, medications. social activities, dressing, bathing, incontinence care, etc. Usually more supervision, more likely to have a nurse on staff, more likely to be a locked facility. However, there is such a thing as memory care "lite" where they are almost the same as a hospitality model AL but are locked.

AL/MC - Two levels of care in either the same building or the same campus. Can easily transfer between AL and MC

Continuing Care retirement community- Has all levels of care on the same campus, including a skilled nursing facility. Often requires that you are "healthy" and you must enter at either an Independent Living or Assisted Living level. Often requires that you have funds for your expected life span. Memory care and Skilled nursing section may sometimes be open to those outside the community. Lower levels of care can be more expensive to members but nursing home costs will be lower.

The newer the facility, the fancier the chandeliers, the common spaces, the size of the apartments, etc. that all contribute to a greater cost. Remember that your mom might not need or want what you think she would. Facilities market to what the children think is good, but that is rarely what is needed.

bjohnsen3869

I just put my dad in AL Last month because he was still physically fine but I had to move him to MC last week because he kept trying to leave because he is upset about leaving his home and GF. Everyone told me to put him in MC when I started this but felt like he wasn’t there yet. I should have gone with MC in the first place. It isn’t going to be an easy transition, no matter what you try to do to make it go smoothly and I feel like this extra move in less than 60 days has made it so much worse for him and me.

this disease only gets worse and change is challenging for them and us at any stage. I would definitely go to MC.

‘Hang in there. You are at the beginning of a tough road. Couple things I’ve learned is……..there is no such thing as a “perfect” transition, ask and accept help from others and try to make decisions for your LO based on needs/safety instead of emotion. Good luck and stay connected. You are NOT ALONE.