It's time for placement in a facility. How do I start?

msmithserious

Hi. I am not sure I have chosen the correct category, but here goes.

It is time to place my wife's aunt in some kind of long-term care facility. She has been diagnosed with vertebrobasilar and carotid insufficiencies and she is an amputee. She is 88 years hold, and otherwise in pretty good health. She is getting much more confused everyday and she is frequently violent (verbally not physically at this point). My wife's father (aunt's brother and himself 81 years old) is having a very difficult time taking care of her. We are especially worried about physical care, especially as we aren't sure what will happen if she were to fall.

They live in Rock Island County in Illinois. We have no idea where or how to start looking for some kind of facility. We are afraid that something will happen and that she will need to be placed faster than we can be prepared. Where can we go to get help navigating this process? Specifics to Illinois would be great.

Thanks.

MP8

Hello, msmithserious. Not a joyful task but it's great that you are looking ahead.

My mother's doctor's office referred me to a "senior locator" who was knowledgeable about communities in my area and helped narrow down the possibilities based on multiple factors including location (close to me), dietary needs (some facilities are more flexible than others), types of activities/care needed, etc. She was also aware of staffing levels. This helped a lot because I live in a major metropolitan area, so there are many facilities.

I also asked friends and colleagues for suggestions both about specific properties and about what factors they considered for their LO.

The Alzheimer's Association information under Help and Support on the menu bar was also a big help. There's a lot there, but the page on long-term care was especially helpful and has questions to ask when you visit.

https://www.alz.org/help-support/caregiving/care-options/long-term-care

It was surprising to see the wide variety of environments. Interestingly, the most expensive one was also my least favorite. The staff didn't know all the resident's names and when someone greeted them, they responded with complaints about their health. Everyone just seemed unhappy. (Beautiful facilities, though, and fancy names in the programming.)

Definitely helped to start early, as learning about each place and visiting took time.

JeriLynn66

Hello and welcome to the Forum

This website has a 24 hour Hotline providing access to Care Consultants who may assist you. You can also contact your local Area Agency on Aging for guidance.

Others will chime in with more information…

Anonymousjpl123

One thing I will say is don’t be afraid to just start calling places and telling them your situation. I did that and I’m so glad I did. Most places have an outreach/sales team (depending on if they are for profit or non profit) and want to meet potential residents’ families. I was amazed at how quickly they responded.

because you are acting before the crisis (great job, by the way) you have a little time to do a few visits. When placing my mom we visited about 6, and that was plenty. The tours will also give you a chance to ask about financing, levels of care, etc.

post here when you need to: it was enormously helpful to me when I was in your shoes.

Emily 123

Hi msmithserious,

You can use the search function here to review prior threads for what to look for during a move. There's quite a few, as well as tips for the move. I made a spreadsheet because there's a lot to compare. Your family does not have to involve the aunt in the decision making process about facilities. She's losing her ability to retain information and use reasoning --the world isn't making much sense to her right now. The gaps in information that the disease causes are likely creating a lot of confusion for her, making her angry and upset. It would be better to keep her calm. At some point in the disease the goal needs to pivot to working around her, rather than involving her in the moving decisions and getting her agreement. Many people end up with anosognosia, which is the inability to be aware of the changes caused by the disease. You may see changes, but she might not, and she'll get angry when it's brought up--to her mind she's fine. The more you try to show her the changes you see, the more angry and resistant she will become.

When you look at finances, be aware that when/if the personal money runs out for your aunt, she will have to transition to Medicaid--you may want to ask facilities if they would take her as private pay and continue through any conversion to Medicaid payment. If so, get that in writing in her contract.

Her POA can go to her provider and discuss her outbursts-those will need medical management for a successful placement. They can also request a referral from her doctor to a social worker, who can assist with the hunt for a facility, and they can discuss whether a nursing home (where medicare or Medicaid might pay more costs) is an option, given that she's an amputee.

Most state's websites for the Department of Health or Social Services will have a section where you can review the inspection reports for various facilities. The different types of facilities are licensed based on the level of care provided. Mostly it concerns what is and isn't covered as 'nursing care' by the state. For instance, having to eat pureed foods, or having to hand feed a resident might be considered nursing care, but a resident being able to assist with their own feeding would not. Having to move a patient with a lift or more than a one-person assist may make a difference between levels of care. Most facilities are still struggling post-covid to be fully staffed, and that too may make a difference in what they can offer. Ask what behaviors could get the person ejected from care, and how quickly. Think about if it might be easier on her elderly brothers to let the in-house healthcare provider take over her healthcare, rather than toting her to appointments (Many facilities will have a provider on staff). Ask about staffing ratios-who covers the facility at night--RN?, LPN? What is their process for healthcare emergencies? Some larger facilities may also have rehab or nursing care on site, or they may just be an AL/MC model. That might make a difference if it's anticipated that she'd be in and out of hospitals and needed rehab--- less moves.