placing Mother in a memeory care facility

jojoH

Hi there,
I think we need to place my Mother in a memory care facility. She ahs been with my brother and sister in law but my sister in law is having her own health issues and my brother works. How do you know what to look for? How much Medicare will cover?....

harshedbuzz

@jojoH

Hi and welcome. I am sorry for your reason to be here but glad you found this place. The site here was recently redone and this board doesn't always get much traffic, so cross posting on Parents or General Caregiving might get you more input.

Medicare only pays for medical needs, not custodial care. So it will continue to pay for mom's doctor visits, prescriptions, hospitalizations, and such, but not memory care. Medicaid does pay for long term care under certain circumstances-- there are financial limits and some states only cover care in a skilled nursing facility. A CELA (National Elder Law Foundation (nelf.org)) can explain the rules in your state and help prepare you to transition to Medicaid for care.

In terms of finding a facility, unless she has considerable wealth, I would restrict my search and tours to those places that accept Medicaid. Sometimes there's an expectation that a resident will pay out-of-pocket for 2-3 years before converting to a Medicaid bed.

I would avoid using a service like A Place for Mom. They only share a list of places curated solely on the basis of a kick-back scheme in which the LTC pays them a fee of about one month's rent. It's advertising and once these places have your contact info, they will call regularly.

Sometimes nicer places have waiting lists; best to know this and get on several if needed.

Ask about pricing. Some places have a one price covers everything but incidentals like incontinence supplies while other have tiered pricing based on the amount of assistance they will be providing. The latter can be a kind of bait'n'switch with a resident admitted under tier one and then ramped up within weeks of arrival. This sometimes happens because families don't realize all the scaffolding they do and because PWD can show more symptoms when removed from their routines.

Ask under what circumstances mom might be asked to leave and also under which ones family would be expected to provide additional private help or hospice services.

It's generally best to place the PWD near their POA. If mom has a fall and is turfed to the ER to be checked, you'll want to be able to get there as the ambulance arrives as the MCF will not send an aide with her.

Tour and verify. Remember that the person taking you around is a sales person and not someone who will be involved in care. Ask to talk to the DON. Ask about staff training and retention. Ask about what kind of training staff have. Teepa Snow and Naomi Feil are good names to hear. Talk to the aides. In the parking lot, ask other families how they feel about the place. Tour places on your short list at different times of day to see what care looks like in the evening. Make sure the activities listed are actually happening. Does the place smell OK mostly? Does the food look good-- some places will offer you a meal if you ask.

HB