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Katcat

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Denise1847

Because of the possible longevity of the disease, I would wait as long as you can before placing him. In that way, you will have the financial resources (2 years of LTC insurance). Please look at the stages of Alzheimer's via the search function on this site. It may help you to gauge what stage he is in and allow you to watch and wait. I hope that this has helped.

Ed1937

You are doing the right thing when you look at possible options for MC. Depending on your financial condition, you might want to consider if paying for cable TV is even worth it. You will typically find common areas that have a TV or other sources to give them something to do. Have you toured the facilities yourself? Your most important consideration is the quality of care, not the beautiful fountains and gardens. Those are there as selling points for the family, whereas the PWD won't typically care about it.

Sometimes the wait lists are quite long, while other places might not even have a wait list. But you don't want to wait until something drastic happens, forcing you to take whatever you can get. Being on a wait list does not mean you have to take the opportunity to place him. Typically if you don't think it's time, you can wait for another opening while keeping your place on the list. Just make sure you have all your questions answered before choosing a place.

There won't be a ton of furniture required for placement. Just a bed, a couple of comfortable chairs, and a dresser will probably do it. Do you have family or friends who would be willing to help with setting it up, then removing it when needed? I would recommend a recliner in case you might want to spend a night or two there.

harshedbuzz

@Katcat

This is a question for a CELA who could explain Medicaid planning to you. It may be possible for you to be a "community spouse" and keep the house, the car, pre-paid funerals and some assets for yourself during your lifetime. Now is the time to have the conversation to avoid anything that would bar him from qualifying. Timing placement is so difficult as it is difficult to predict progression or whether some other condition impacts life expectancy. On one hand you don't want to waste money, on the other you don't want to compromise his care or your own running a nursing home for one.

FWIW, the MCF was able to take better physical care of dad because he cooperated better seeing them as the healthcare professionals they are vs fighting mom. Mom was able to go back to being his wife which was nice. There's also the notion that it might be easier to transition before a PWD's cognition is very poor-- easier for him to bond and easier for staff to get to know him. That said, mom held off and had some life-altering health issues as a result. We were prepared for several years, but dad was there less than 2 months.

Furniture and paying for cable are just about the least important criteria in selecting a MCF.

If you don't have unlimited assets, I would eliminate any MCFs that don't accept Medicaid when a PWD's funds run out. A common business model if for a resident to self-pay (LTC is considered self-pay) for 2-3 years before needing to convert to Medicaid.

I would ask about staff training and steps taken to retain a quality team. Dad's MCF used strategies from Teepa Snow and Validation. Pay was a bit higher, the DON drove a massive Suburban which he used to collect staff who didn't like to drive in bad weather and they would sometimes let staff bring children to work on school holidays to volunteer with the activities lady.

Look at the food. Some places will even offer you a meal. Does it seem appetizing? Are they accommodating? Dad's MCF offered the day's entree and if refused could instantly rustle up a soup and sandwich instead. My aunt's MCF had a kosher kitchen, but arranged weekly lunches out at which their gentile residents could indulge in BLTs and lobster rolls.

Look at the activities. Is there a nice mix and are they actually happening? Dad's place had stuff 7 days a week from religious services, musical performances, games, movie matinees and nights, crafts. Because MCFs often have more women than men, it's important to check for things your LO might enjoy. The activity director at Dad's broke out a putting cup, balls and a putter when she heard he'd been a golfer.

Different MCFs have different philosophies of care. We were actively discouraged from putting a TV in dad's room. I was OK with this as dad confused what he saw on TV which meant we had to monitor content. He believed everything was happening to him from news and deadly storms to crime dramas. They liked to run the place as a home with an open dining and living area in each hall and activity spaces in the hub. Rooms are meant to be more for rest and sleep.

We had the option to provide furniture or not. Since we got dad into MCF using a fiblet that it was rehab it made more sense to use their stuff and zhuzh it up with some attractive linens and throws. If you decide to use your own stuff it will get beaten up, so don't send something nice. There are senior moving services that specialize in this; the MCFs can probably give you a referral. A few days after dad died, I went to clear out his room. I donated his clothing, sheets, supplies and left with a single box. On the drive home I passed the MCF that wouldn't accept him and saw a couple loading up a U-Haul with a massive breakfront, boxed, clothing and what looked like a full size poster bed. I felt badly for them.

HB