Care Facilities Placement

My parents had pre-selected a multi leveled senior residence that they reluctantly moved into when they were having a lot of difficulties living on their own. (The biggest difficulty was getting my parents AND my siblings to admit they were having difficulties. I was the one trying to keep up with their health and dietary needs, etc. because everyone insisted they were fine, but they weren't.) It helped that we had discussed this earlier in their lives. They cycled through residential, then assisted living, then memory care. After my dad passed, I moved mom to a similar facility near me. This was an excellent route for people with assets and they got wonderful care. The food varied, depending on the head chef, but I never had complaints about care in 7+ years. It's a great option for people with assets. Some of the places in both my town and theirs had the ability to convert to Medicaid after a certain amount of time if needed, although my parent's didn't. My Godmother was in a place where care converted to Medicaid after two years if needed and it was also a nice place. That's an important thing to watch for depending on assets available.

My MIL wanted to remain in her home and did so with a lot of family help and a few short-term rehab stays in a nursing home. The nursing homes definitely felt more like a hospital than a home and she didn't care for it. That said, I met people there that were there more long term and had made themselves a home there and seemed content.

So many choices when you get to that point, but we're definitely aiming for one that doesn't convert to Medicaid since they're the best choice in our town. In order to do that you probably have to have a decent monthly income, invested assets and/or a home to sell. If we move closer to one of our sons, which is our plan, so he doesn't have to go through what we did, we'll look at what's available in his town that meets our budget.

We plan on really starting to make plans in our mid 70's. Hopefully we won't NEED the plans until much later, but having toured some places and having some possible plans in place will help. We're in our 60's right now and concentrating on home organization and getting rid of "crap." Our parents had a lot of stuff they hadn't used in years and SOOO MUCH paperwork!! We're trying to simplify so our kids aren't left with as much work as we were.
 
Hug, WEDWDW, and to all with care facility experience, no matter the circumstance it's never easy. This is near to me because I was in such a place for way too long to regain walking mobility. My perspective is of a much younger and otherwise blessed to be healthy person than others in such an environment.

My main suggestions are absolutely to check out any potential places ahead of time and at different times of the day/week. As the day got later or over the weekend, things had a way of changing where I was. Talk to any willing residents/their family. Someone else recommended the Ombudsman, that can be wonderful resource. Know your loved ones rights and get any important promises from the facility in writing.

Remember, at any facility, there are a lot of truly kind people who work there. Administration and overall operations are crucial. I would also find out whether a facility is for or non profit as that can also factor in.

Peace and extra prayer to all.
 
I had to move my mom to a facility last year. Like a few others above, I chose a Residential Board and Care facility. There are currently only 5 residents (there is space in a double room for a sixth but they do not seem to be actively trying to fill that spot). She has her own room and everything that she needs is there. The caregivers are all amazing (although she does have a #1 favorite one that she looks forward to) and so caring. The food overall looks pretty good - there does seem to be a lot of Filipino dishes as all the caregivers are Filipino so like cooking their foods. She only sometimes complains about that. They decorate for all the holidays and have little celebrations for them and always have nice parties for each birthday. It is fairly convenient to me and I can take my dad (since he does not drive any longer) to see her each day. We have become very friendly with the other families and residents and all seem to be there for one another. Yes, it is expensive, but I am very happy with the place I chose. The hospital set up 3 places for me to look and only 1 was an automatic no.
 
The other thing to keep in mind, when one gets old, it seems their favorite word is NO. I was sitting with my Mom on hair cut day, the nice lady went to all 6 and asked if they were ready for their haircut, all said NO. Same with the physical therapy day, same with lunch time. You will hear no when they are asked if they are willing to move. You need to make the right decision, not one they agree with
 

Like a few others above, I chose a Residential Board and Care facility.

these can also be known as 'adult family homes' in some regions. they can be a great option but if considering one you really need to do your homework. dig deep on who the owner is-and then check your local/state databases under that owner's name to see what the status of their OTHER homes are. it's not unusual for a single owner to own multiple and reported issues/violations at one can be in existence at others. REALY explore their evacuation plan esp. if you live in an area where fires/floods/snow can be a concern-it's fine to say 'oh we have multiple vehicles...' but do they have lifts for wheelchairs/can residents be safely loaded in? if they have a lift van is it exclusivly for that home's use or might it be used by their other locations at points in time (and therefore not always immediately available in an emergency)?
 
My MIL had to go to assisted living when FIL died (he was 96, she was 95). It was decent, SIL is a nurse nearby so she popped in several times a week. $11,000 a month out in the boonies. She passed after a year which funds left over.
Wow! Assisted living is about $3000 a month here depending on the facility.
 
The other thing to keep in mind, when one gets old, it seems their favorite word is NO. I was sitting with my Mom on hair cut day, the nice lady went to all 6 and asked if they were ready for their haircut, all said NO. Same with the physical therapy day, same with lunch time. You will hear no when they are asked if they are willing to move. You need to make the right decision, not one they agree with

you have to watch out for 'yes'ers' as well-esp. at doctor's appointments. 'maam can you easily rise from a chair without assistance?' 'YES', 'can you walk steadily on your own?' 'YES', 'can you shop on your own/safely prepare your own meals?' 'YES'... I had a co-worker who lost it at her mom's doctor's appointment and said 'don't just ask her-make her show you'. her mom could NOT rise, could not steadily walk, could not get to a grocery store and when taken got incredibly confused-'food preparation' on her part was non existant (except for pushing the button on the coffee maker which someone else had to set up-the microwave had been finally removed after she insisted it was 'just fine' to put all kinds of metal cookware in it 😱). my mom was also good at what we called 'the sweet old lady nod and say yes honey' technique to avoid discussions she did'nt want to have (finaly clued in her PCP to ask open ended questions, to make her give an example of her last shopping trip/meal prepared, to demonstrate her mobility).

I get it that doctors are hesitant to deem someone incapable of independant self care but I lost it when my mom was in nursing care and about to be released (she was insisting to go back to her independent living situation) and the cognitive evaluation just consisted of some questions about who is the current president? what day of the week is it? what is the weather like today? the doctor was doing an evaluation of her in her nursing care room where 24/7 she had a tv on tuned to CNN-she heard the president's name every 5 minutes, hourly updates with the day of the week mentioned/regional weather updates. it was that way every time he had examined her in the months she was a patient-catch a clue doc! ask her who I am, does she have any grandkids, any living siblings, her home address. get a real picture of the person's functional capacities (and their version of reality).
 
these can also be known as 'adult family homes' in some regions. they can be a great option but if considering one you really need to do your homework. dig deep on who the owner is-and then check your local/state databases under that owner's name to see what the status of their OTHER homes are. it's not unusual for a single owner to own multiple and reported issues/violations at one can be in existence at others. REALY explore their evacuation plan esp. if you live in an area where fires/floods/snow can be a concern-it's fine to say 'oh we have multiple vehicles...' but do they have lifts for wheelchairs/can residents be safely loaded in? if they have a lift van is it exclusivly for that home's use or might it be used by their other locations at points in time (and therefore not always immediately available in an emergency)?

I agree - everyone needs to do research. I asked about a million questions. Part of the reason I chose the place I did for my mom was because the administrator answered all my questions and has been very helpful to me in navigating the whole process. The one I eliminated right away was going to be a new place and did not yet have any residents. I could not get a feel of how things would work there, whereas the place I have mom was finishing dinner when I toured so I saw quite a bit of action occurring. The administrator helps me with questions to this day as things come up.

Also a few months ago, the paramedics were there on a call for another resident (who was a problem already having a meltdown apparently). While they were sorting things out for the other resident, one of the other paramedics told me that they visit a lot of places like this and this was a very nice one. They have the emergency layout plan hanging by the door, all the bedrooms have sliders with a small ramp to exit in an emergency if they cannot go out the front door, there are plans in case of another covid situation with lockdown. As I said, I asked an insane amount of questions.
 


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