a move needed after geri psych inpatient treatment

jen ht

Hello dear community,

Dad seems to be doing better thankfully. Discharge back to his MC is planned for Monday.

His memory care has suggested that he may need a smaller environment now. Sounds like I need to add him to some waitlists.

The constantly shifting sands of Alzheimer's.

I think this may mean that they think it is time for skilled nursing or a smaller memory care maybe? I'm not sure. This will be Monday's task to figure out.

I was so glad to see him feeling better. And I also feel like I have another big "assignment" now.

His current memory care has 30 residents.

They have been struggling to care for him. I hope the med adjustments in the hospital for geri psych inpatient treatment will help that.

What are your thoughts on what to ask them and what to look for?

I know several of you have had to make moves from one MC to another or to nursing home care. I'd love to hear your thoughts on what to look for this round of placement searching.

School starts in 1 month. I'm not sure how quickly I can move on this. Feeling glad that he feels better but feeling weary to begin the search for his new home too.

Thanks all,

Jen

JulietteBee

@jen ht, I just wanted to say hi and tell you, "You got this."👏🏼

I am glad daddy is feeling well enough to be discharged. Here is to continued stability.🥂

ARIL

So glad your father is doing better!

And yes…another big assignment.

I think I’d start with quizzing the leadership of his current MC: Can you tell me precisely what he now needs that you cannot provide?

That answer should help you determine (a) whether he actually needs to move and (b) if so, what you need to be looking for. It is my impression that SNF is the only higher level of long-term care. A 30-resident MC already sounds kind of small… By “smaller,” are they thinking of a group home? Are there smaller MCs in your area? It is hard to guess what they might mean. Or, honestly, have they had such difficulties with him in the recent past that they are hoping you’ll move him? If that’s what this is, then they need to wait and see how he is after the hospitalization. A better med regime should help, right?

I did move my dad from AL to MC to another MC. The move from one MC to another was motivated by my dissatisfaction with the quality of care, not his own decline, so I just redid my original search with a more precise sense of what I wanted to hear and see. In that move we went from a stepped-care place to MC only, and the single focus has been better for us. But not every geographic area has that as an option.

I wish you well! And you’ll be fine. Systematic steps: Does he need to move? Why? If you decide “yes,” then you try to meet his needs in your search. Remember that YOUR needs should be part of the calculus too. Then you go through the process: evaluation, agreement, scheduled dates or estimates based on wait lists.

I too know the challenges of eldercare and the school calendar. You’ll do your best. If he needs to move, then you can probably get the search and decision done before school starts. A move-in date can happen later.

We are with you!

easy23

I had to move my DH from MC to a nursing home last year. My DH had surgery on his foot and during recuperation developed a stage 4 pressure wound on his heel. During this time the MC was unable to care for him any longer. He was sitting in his recliner all of the time wearing wet clothes. I decided to move him to a nursing home 11 miles away, which could care for his pressure wound and also had a dementia wing.

I honestly feel he has better dementia care in the nursing home. The doctor is always around and adjusts his meds as needed. He spends most of his time in the day room, where there are activities. My DH is now stage 7 and hasn't been to the hospital in a year because the nursing home can handle whatever medical issues come up.

I would suggest finding a nursing home with a dementia wing or specializes in dementia care. Good luck to you and keep us posted!

April23

When my dad needed a higher level of care, I moved him to a residential care home/RCF. It has 8 residents and two caregivers. It is a home in a residential neighborhood that has been converted to a memory care facility. It is wonderful in every way and an alternative to a SNF. I would add it to your list of options to investigate if something like it is available in your area.

harshedbuzz

@jen ht

The social worker at the geri psych should be able to give you some leads as to what is available in your area.

A SNF will likely cost considerably more unless he's already on Medicaid. Dad's MCF could have up to 48 residents if all beds were filled, but in reality it typically have 30-ish divided among 4 wings where residents spent most of their time. Perhaps a facilty like that would suit him better.

Anonymousjpl123

@jen ht like others I would definitely ask his current MC what specific needs he has that they cannot meet. I did the AL to MC to another MC.

The reasons her first MC gave for her needing a “higher level of care” were incontinence (they couldn’t manage it somehow) and “behavioral” - but not specific. It made no sense to me, but it did help me in talking to prospective MC facilities. I was able to ask places about these things specifically and how they would handle them. Their responses really helped me find the best fit. Her new place has, for lack of better words, a much higher emphasis on care. Staff genuinely care for and engage with residents - much less sitting on their phones.

In hindsight, her first place was not equipped to deal with people with more advanced needs. Her new place absolutely is - and runs the gamut from people earlier in the disease to very advanced. It is small - 25 people - but the other place was same size. The difference is her new place has a much higher staff to resident ratio, or maybe they just have much better training. It’s not chaotic. There is far less turnover in both staff and residents.

I was very clear visiting places about the challenges my mom had with her first MC, and the staff responses helped me know if they would be a fit. Best of luck - it’s not easy, but moving my mom was one of the best things I ever did.

jen ht

Thank you for your replies @JulietteBee @ARIL @easy23 @April23 @harshedbuzz @Anonymousjpl123

Dad has been back at his MC for a couple of days now.

It seems to be a watch and wait situation. I am going to go ahead and tour some other places to get him on some waitlists. If he would be given notice to move, it could happen right as school is starting. You all know alllll about keeping a plan B at the ready.

He seems to have a little more access to his language. We're noticing difficulty standing up from a seated position. While I was there he couldn't get back up from the toilet. A PT evaluation has been ordered.

One of the things dad used to say a lot was "hurry up and wait". I feel like I can almost hear him saying it about many aspects of our current situation.

I appreciate you all and your supportive input.

May we be well 💜

jht