First AL/MC tour was today
I didn’t tell my Mom that we were going until about 15 minutes before. I expected some kind of reaction from her. I didn’t get one. Tried to talk with her about it afterword. She didn’t have much to say about it then either. She seemed off today though. A friend wanted her phone number. She told her that she didn’t know it. Also didn’t know how old she was today when someone asked. We are touring 3 tomorrow afternoon. There is one more that we may add to the list.
We are touring with a senior advisor. I am hoping, and she thinks it is possible, that my Mom can enter assisted living and transfer to memory care when it becomes necessary. She is currently independent with ADL’s. Not sure how I feel about the idea of her going on outings though.
The one today was in her preferred location. I was not impressed. They are mid renovation - no one was there working but they were missing things like a ceiling in one area and furniture in another. Even though they were renovating, it looked worn down. It lacked common gathering areas. There wasn’t any warm, cozy or inviting. We didn’t see many of the residents - maybe 10 or so. I even asked about it. Answer was that most go back to their room after breakfast until lunch time. I didn’t think that was a good sign. The rooms weren’t bad, it just seemed sort of bleak.
Hoping that the tours tomorrow go better.
Comments
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I think you're wise to go to several. Sometimes people go visit one, perhaps like the last one you mentioned, and think, "oh, assisted living is too bleak—she might as well stay home as this," without realizing that places are different.
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@notequipped
I'd tour without your mom at first. Winnow the choices to 2-3 and then bring her if you absolutely must.
ALs can be all over the place. Some function more like an active senior community with residents who come and go as they please and are dropped off in town to run their own errands independently. Some are more like a bridge to higher acuity MC.
TBH, I would pay more attention to staff interaction with residents than decor. Dad's place spent more on staff training and retention. The place had a very 'lived-in" look which he never noticed.4 -
Agree with touring alone first.
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I agree with others that you should tour the facilities without her and only bring her to the ones you have narrowed down. Look beyond the decorations/condition of the facility and focus on activities, how residents are treated, food options, options such as physical therapy, doctors who are on a rotation in the facility for patient care. Is there skilled nursing? Can you bring in a skilled nurse if necessary?
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Day two was definitely much more productive. It worked out really well taking my Mom. We had some difficult conversations but I’m 99% sure that we found the one that we will be going with. Most importantly, she really liked it and is on board with it. It was warm and inviting, everyone was very friendly (staff and residents), they are just finishing up with renovations so it’s beautiful, too. One of the residents very kindly invited us in to see her apartment. She couldn’t say enough about the staff and facility. Their chef (an actual chef, not just a cook) has been with them for 17 years. The activities director has been there for a really long time, too. She started in housekeeping. I wish that it was a bit closer but it is otherwise as perfect as it can be. (There is no skilled nursing but they do have a MC unit.) I got all teary more than once - it just felt right. For both of us.
The one on Tuesday was pretty awful. The only redeeming quality is that it was in her preferred location. We’re both smitten with the first one from today. We are going to schedule a lunch and bring my husband along to see it. Hoping to chat with more of the residents. What had been my favorite, turned out not to be. Way too big, too much hustle and bustle and felt more like a hotel. All rooms were nice and spacious though with a separate living area and bedroom. And it is the closest to our home. The last one today was another dreary offering and it smelled bad. I don’t think we were there more than 15 minutes. Bringing her to all of them was the right decision for us. It made her feel more involved in the process. I was quite surprised to see her looking up additional facilities in her preferred location on her iPad this morning. She hasn’t done any type of search independently in quite some time.There is one more that we are going to try to see on Friday afternoon. And possibly another in her hometown although it is AL only. A friend of hers lives there.
It was a very eye opening experience. We have not discussed detailed cost information at any of them yet. Next up will be to discuss whether AL or MC is appropriate for her. I really want her to be able to go in to AL rather than MC. She is independent with all ADLs and is continent. She still goes to the gym 4 days a week, 2 of which are with a trusted driver. I don’t believe that she is a wandering risk. Her neuro psych evaluation indicated that she had severe cognitive impairment though. Does anyone have any insight as to where and how the line is drawn between AL and MC? I’m guessing that it probably varies from one facility to another.One of the things that we talked about yesterday is how she is in fantastic shape for her age. All of those years of going to the gym since she retired (~17 years) have paid off - she can really see that in an AL environment. Explaining to her that social engagement and activity is just as important to keep her brain healthy for as long as possible seemed to click.
I had such anxiety about the move to AL and I think that she did, too. It went better than I ever could have imagined. Never been more grateful for having parents that were such diligent savers to make this move possible.
Any tips or sources for specific questions to ask as we move to the next stage of the search?
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It’s good to hear that your Mom is involved in the decision making process. I toured a few facilities before I selected one. The only way I can describe why I chose this one is the “vibe.” I felt comfortable there. I felt a sense of relief. I felt a sense that my parents would be safe and well cared for. The comfort that I experienced had nothing to do interior design or amenities. The staff was responsible for this “vibe.” My plan was for my parents to start in AL with Home Health, and transition to MC. However, after an emergency at their home, they were taken to the hospital in separate ambulances, and spent some time hospitalized for pneumonia. We ended up skipping AL entirely, and the moved directly to MC. I was surprised to learn that our facility. AL + Home Health was significantly more expensive than MC + Home Health. I only assume it is because the suites are smaller and there are less activities.
Tips I would have for you at this point: (Otherwise titled “Things I didn’t have a chance to do”:
-Do they have a “MOVE IN CHECKLIST?” This was very stressful for me. Fortunately, I had two vacant “married couple suites” to chose from. I would have liked to have a list that told me the exact measurements of the exact suite that I selected, including closets, bathrooms and showers. I would have liked to know the location of electrical outlets, emergency call buttons, cable tv hook up, phone jacks, etc. What should I use to hang pieces on the wall? If you are getting any furniture delivered, where is the loading dock and what is the procedure for delivery?
-A list of suggested personal items would have been fantastic. I talked to the staff that actually do the ADL assists. I learned that a laundry hamper with wheels makes their job much easier than a “laundry basket.”
-The transition from DirecTV at their home to Spectrum Cable at the facility was especially difficult, for ONE reason only, the REMOTE CONTROL.
One thing I would clarify before the move, HOW do they want the first payment to be made? They gave me itemized information on the amount that would be due, broken down by each parent, etc, “payable by check.”I made the assumption that a “check” was the same as an “automated bank transfer from a checking account, or account with cash available.” They required an actual, physical, paper check. It caused me a lot of problems because of the way my parent’s accounts are structured.Don’t make assumptions. Ask questions, even if you think they might be self explanatory.
Talk with other residents and their family members, who are likely closer to your age and going through all of this too. These people can be the best people to go to for advice.Good luck with all of this. I had to stop regretting the way all of this happened for my parents by promising myself that I would tell someone else how I would have done things differently, if I had a chance.
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Choose clothes carefully, only wash and dry(nothing with special instructions), light colors stain easily and they will not be pretreated. If you’re buying new things I would avoid spending any more than necessary. Some clothes will get lost. I would avoid holiday type clothes and bring them in as needed and swap as them as the seasons change. My mil was always wearing Christmas sweaters in July. Mom also packed a few sheer blouses. She didn’t understand they needed something worn underneath. It was not good. If they do the laundry, do they mark clothes for you. If not I would strongly recommend you mark everything. Avoid bringing expensive nick nacks. Things sometimes come up missing. Be cautious about including your mom in the packing. My brother insisted mom was capable of packing herself and it was an absolute disaster. This process is stressful for anyone, for a person with dementia it’s even worse. Mom was an absolute wreck the day of the move. My suggestion is to do as much as you can without her. We didn’t bring much in the way of decorations. Again my brother insisted mom would tell us what she wanted after she had settled in. I eventually just brought things in for her. Make sure you understand their policy on her leaving the building. In most Al facilities they are free to come ad go as they please (even if they are unsupervised). If she decides to walk to the store down the road, are they ok with that. Al gives a lot more freedom than I had imagined. Is there a mc linked to the Al? How long will her money last? What happens when it’s gone? Some places will accept Medicaid after x number of years of private pay. If that’s not the case she may be forced to move if she outlives her money. Even if she has I hope everything goes well.
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This is exactly the type of information that I was hoping for - thank you. I’m completely with you on ‘the vibe’. I chose the places that we went to visit on a variety of factors - location, all of them had to have AL and MC available, reviews, etc. The one that we are going back to for a lunch date and a more intense Q&A (2 separate dates) when my Mom can join in on some of the activities was chosen solely on how we felt there. It felt like home. You could tell that the residents and staff were very comfortable/at ease with each other during interactions. The fact that employees have been there for such long periods of time says a lot, too. Staffing is such that they use no outside agencies. I literally teared up several times during the tour because it felt like we found ‘the one’. We haven’t even signed a contract yet and I feel such a sense of relief. I know that she will be in good hands there. The fact that it is beautiful as well is just the icing on the cake.
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Thank you - lots of good info there. Yes, they do have a Memory Care wing. I did rough calculations for strictly MC at the more expensive facility. Came up with roughly 10 years. I didn’t take into account any earnings or interest and forgot to allow for the cost of Medicare and her supplement. I don’t think that my estimate is far off. We are not doing a trust, spend down, etc. Foolish perhaps but I’m grateful that they saved it and want it to be spent on her. They will allow them to stay after a period (to be determined) should she exhaust her funds. As much as I want her to be in AL, the potential for wandering does concern me. They do a lot of outings. She would be OK if she had a buddy or stayed with a group but if left to her own devices at Walmart or wherever she lacks awareness of her surroundings and would forget where she was supposed to go and when. The facility currently has 1 larger unit available with a separate bedroom. We would be able to set that up very similar to her home. Since she has been living with us for the past 6 months, I would have her furniture moved in from her house without her even knowing. The clothes that she has here would fit in a suitcase. Thankfully, my Mom isn’t big on Knick knacks or clutter. I think she would be more than happy with the pictures from her living room at home.
We stopped to visit her friend today at the AL only facility that is in her town. It was OK but according to her friend, there are no available units. Mom thought it was just OK, too. I did a little happy dance in my head, I’m pretty sure she likes the just about perfect one better. 💃🏻 She seems to be looking forward to lunch there next weekend with me and my husband.
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Did you figure rent increases into your cost? At least 5% a year- more if we have high inflation like we did a few years ago.
My philosophy for my parents was that they needed to be safely taken care of now. Using that criteria, I couldn't justify keeping them out of AL just to try to save money for later on. Step-dad died a few months before mom. When she died, it was with enough savings ( with monthly income) to have lasted her one more year in the AL. They had moved in exactly 5 years before she died.1 -
I did not. Good to keep in mind though. I will narrow down the timeframe for how many years they need to be there before they will commit to keeping them and accepting Medicaid if she exhausts her funds. When I factor in things like their house, I really think that she’ll be fine for at least 9-10 years, probably a bit longer. Part of what I need to do too though is to get their finances consolidated and at a minimum have their money start to reliably earn money. Most of what they have isn’t earning them anything at this point - literally nothing. Given her age and current level of cognitive impairment, I would really be surprised if we got to a point where running out of money becomes an issue.
Much like you, I really can’t justify keeping her out of AL any longer. I’m not even 60 yet and work in a very technical position from home. It is getting increasingly difficult for me to do my job effectively while at the same time listening to her and intervening as needed. We are well past the point where something’s got to give and she’s just not getting enough mental stimulation here.
On a positive note, my mom spoke to one of her friends on the phone this morning. She was telling her about the places that we looked at and came in to ask me where the one that ‘we really liked’ was so she could tell her friend. Sounds like we’re on to something.1 -
This is really good to know. A teller at my bank gave me the name of an advisor that they have some time ago. I have really been dragging my feet on finding someone (the damage done by Bernie Madoff). My Mom had done the same type of thing with CD’s. Going through their finances has been a bit like an Easter egg hunt - there were probably over 20 accounts at 3 different financial institutions with amounts as low as several hundred dollars up to significantly more. At times, I have felt like an investigator. My Mom was certain that my Dad did not have any 401k’s. It was a good thing that I looked at his bank account so closely. Turned out that he had 2 of them! My parents had separate bank accounts and my Dad’s earns less than $50 per month. I managed to get my Mom a promotional savings rate at her current bank (expired last week). With a similar amount, she has been earning over $500 per month for the last 6 months. Every little bit helps, their money could be doing so much better. It feels like such a big responsibility. My Dad also stashed envelopes with cash at their house. Given his state in the hospital before he passed, I was shocked to find every one right where he said it would be with the amount that he said would be in there. Never in my wildest dreams would I have imagined that they had saved up that kind of money. They never took inventory so they didn’t know either. Don’t get me wrong, it’s not like they were multi millionaires or anything but given my Mom’s age and stage, I don’t think that finances need to be a consideration in finding a place that we like. Just typing that literally brings tears to my eyes. It makes this part of it just a little bit easier.
The other thing that I need to do once she is settled in is to spend some time dealing with their vehicles and the house. I still haven’t sold my Dad’s truck. It’s not worth a lot but it’s something. And the car insurance for both is over $300 per month!! My Mom’s car is much newer with less than 20,000 miles but it’s been sitting since February. I can start with getting rid of cable/internet/phone - another $250+ per month. The taxes, electric, security system aren’t much for the house - I can absorb that cost for the time being but the house needs to be sold within 5 years to avoid capital gains. The insurance for the house is pretty expensive, too. Investing money from the sale of the house seems like it would be better than the whims of the housing market. The house will be difficult though. Other than a brief period after she married my Dad, she has lived in it since high school (her Dad passed away and her mom remarried. My Grandmother moved in to her new husband’s home and my Mom moved back in with me and my Dad). It’s not a big house and it’s not worth a lot but the years of earning interest before we would need it to pay for her care would make a big difference.0 -
Yes, this all sounds very familiar—although my dad’s house was only his residence for 50 years. I well remember the day I sold the car. What a relief! No more upkeep, no more insurance bills. Funnel it all toward his care. The house, the same. Not a big or very expensive house, but the proceeds paid for more than a year of MC. And losing all the bills for it helped too.
Your remarks about the envelopes of cash reminded me of my in-laws. They both warned us to “look everywhere” for money “if something happens to us.” When my MIL died not long ago, we looked carefully—in clothing, in the freezer, taped to the backs of dresser drawers…I found $300 in cash rolled up in the fingers of a pair of old gloves! It was a hard time, but the treasure hunt aspect of it did make us laugh.
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The cash in gloves made me laugh. My mom worked with someone many years ago whose cousin was a jeweler in Philadelphia on jeweler’s row. She got a great deal on a pair of diamond stud earrings from an estate. We went on vacation and she was afraid that if someone broke into the house while we were gone that they would steal her earrings. She put them in a wadded up tissue in the pocket of a coat. Completely forgot they were in there and sold the coat at a yard sale. 😳
We will be going through things very carefully for sure!
Our visit today went very well. Mom sat in on some activities while I went through a very long and detailed set of questions. I would have put down a deposit today. Most of their staff has been there for 10+ years. Staff and residents are all extremely pleasant and the residents appear well taken care of. I suspect that low maintenance walkie talkies are highly desirable. All of my questions were answered thoroughly and if she didn’t know the answer, she found the person that did know. I felt much more at ease about things that I had concerns about - mainly the appropriate level of care for my Mom. We are going back on Saturday to have lunch and get my husband’s opinion. They were extremely transparent with the pricing, went over what’s included, the different levels of care, etc. The biggest problem we have is that my Mom thinks all of the residents are much older than her. I don’t think that they are - they just have mobility issues. The other problem is that if we went with the larger apartment, she would need a bigger TV - the unit is huge! They only have 1 of the larger suites available and several of the smallest units - none of the in between. 🤞🏻
I had AI help with my questions. I was surprised by some of the questions it came up with and the answers. They do allow cameras in the rooms just not in the bathroom and you need to let them know that you’ve installed them. 🤔 Seems fair.
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If you need to move her in now - Ask them if you can rent the larger apartment but immediately move if an in-between unit becomes available. Hold off on the tv for a while in anticipation of this. Change her mailing address to yours 1) to avoid hassles if she moves within the building, 2) you can handle her mail daily and 3) you can control what she sees - no junk mail, no credit card offers, no charitable donation requests, etc. Some official contacts will want her physical address in addition and that’s ok. My step-dad was driving at the time. His license showed my address, but the internal database also had the AL address stored.
My parents moved into a one bedroom. Moved into a two bedroom instead during Covid because they argued a lot. Moved into a different one because the Internet didn’t work well in that one ( two different routers). The director couldn’t get the weak router changed out because the rules wouldn’t allow the technicians on the building then. When my step-dad died, we moved mom back into a one bedroom to save money.
There will probably be a different ‘feel’ in the building when you go back on Saturday. There won’t be as many activities going on so some of the weekday staff won’t be there. There will likely be weekend staff taking care of the residents as the full time staff gets weekends off. The nurse might not be there ( but will be on call if needed).
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Thank you, that’s really helpful information. We have already discussed changing rooms down the line. The larger room is available because someone downsized. There are no additional community fees if we should decide to do that.
I think that I like the larger unit better but all of this is such a guessing game where I’m trying to figure out how many years we need to plan for and how her level of care will change to figure out what she can afford. The larger unit has a bedroom and a separate living area whereas the small and medium sizes are studio apartments. Should MC be required down the road, it is small and medium studios only. The big question that I forgot to ask yesterday is will they accept Medicaid after a period of time if she exhausts her funds. They do but I need to know the period of time and ask if it is in writing? We should have 10+ years at this facility before it becomes an issue. I’ve had very long conversations with several different AI models trying to anticipate what the future might look like. We should be good but you never know. She has a large physical/cognitive disparity that adds a layer of complexity to the guessing game. Still a pretty important point to address now though.
Seeing the difference in the weekend was part of the plan. Would also love to see some family members that we could chat with. Thought that might be more likely on the weekend. 🤞🏻
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So glad you found the right assisted living environment for your mom. It feels like such a daunting task to try to find the right place for my DH in addition to everything else one must deal with as a care giver. Did you have help finding the place? Did you get guidance from a Geriatric Care Manager? Any suggestions on finding the right place is most helpful as I navigate through this.0
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Thank you. It really does feel like a daunting task. I’m not good at making my own decisions. Trying to make them for someone else is really difficult. We have been working with a senior care advisor
Our lunch today was nice. I’ve been second guessing though. Of the 3 things that I think are most important to my Mom - my original favorite does those 3 things better (exercise, book mobile and type of cable/remote). The one that we had lunch at just feels more like a home than a hotel though. Fewer residents and better safety protocols, too. I asked Mom why she liked it better. She said that the other one felt too high class - she didn’t feel at home there. One thing that I didn’t realize is that if she changes her mind at any point, only a 30 day notice is required to move. It’s a commitment but one that you can back out of without too much of a fuss.
Grateful that we have 2 that we like so well. And grateful that they had saved so diligently to make this move possible.
We put down a deposit today.
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Commonly Used Abbreviations
DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
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