Please help me with Senior care

[cheap traveler]

I'm going to try to keep this short. My Grandparents moved from NY to GA 16 years ago, when they were still very independent and active. All of their family is in the north.

Fast forward to this week: My Grandmother called my mother Monday asking for her help. (they rarely get along, this was a huge red flag) My mother drove the 18 hours, and had both of them admitted to the hospital. They have not been taking very good care of themselves, and with a host of other problems (body and mind), things aren't good.

My mother and I are trying to convince them to move back to NY (too cold) and get into some sort of assisted living. They have been big savers their whole lives, and are pretty well off. We have very good places here in NY for them, but these places tend to bleed their accounts dry very quickly.

I was hoping someone could give me another option to consider. They are both mobile (steps can give them trouble), my Grandmother is still quite lucid, but my Grandfather is having a lot of momory problems and is starting to get physical with people who try to help him. My Grandmother has a lot of medical problems that will require transportation to various specialists (but we could arrange transportation seperate from home care).

If you have dealt with this, please let me know what options you found that work for you? Assisted living would work but would drain their bank accounts. Maybe home care if they can find a house? Visiting nurses?

Thank you!

 

[got2sammies]

Look into home health care companies in the area. Granted you need to research these companies and get references. They might be able to send someone to the house a couple days of week to help out. They are probably not nurses but people who offer to sit with elderly and to help them with driving, shopping, ect. Not sure about the cost. Normally a home health care nurse will come to the house after a discharge from the hospital for an period of time if the doctor reccomends it. Talk to the case workers at the hospital. Ask them your questions and see what they can reccomend. Sometimes they can reccomend medical equipment that insurance might pay for.i.e. breathing machines, a hospital bed that might be easier to get into/out of. Your mom may need your help as well. Is the home elderly friendly? You may need to install handles in the shower/tub and around the toilet. Would it be easy for them to get around in a chair/walker? Maybe move furniture around to help. Make sure they have a neighbor who you can trust to look out for them and maybe have a spare key to the house just in case emergency personal need to enter the home. Trust me its a lot to take in, especially since there are some distance between you and them...Good Luck!

 

[clutter]

You say they're well off, but that assisted living will drain their accounts? Have you verified that?

Maybe look into a CCRC, Continuing Care Retirement Community. They generally charge an entrance fee (hopefully about the amount of equity they have in their home), then have a fixed monthly amount whether the resident is in independent living, assisted living or nursing care. (However, I don't know how they set it up when you have two residents with different needs.) Do they have any retirement income, SSI or pensions? Qualifications for entrance is that you have sufficient income/assets to pay for your base care until you turn 95.

Home based care is a PITA if you are not local to the elder. Depending on the amount of care needed (unless it is covered by Medicare), you could easily spend a lot more than in assisted living.

I'm sorry, it's really hard dealing with parents/grandparents getting older. We recently moved my 90 year old dad into a CCRC. He has never transitioned well, so we really expected him to hate it. Well, after only 2 months, he's doing GREAT!! Good luck.

 

[mom2jacob]

I can only tell you my experience. I live outside of Atlanta, Ga. I had to put my father in assisted living and then to a personal care home. The assisted living place was only about $700 cheaper that what I pay now for a personal care home but a lot cheaper than a nursing home. But love the quality of care at the personal care home better. A lot of assisted care places have tier pay which means you pay different amount depending on how much they have to be helped out. Getting transportation in very expensive.

Did your grandfather ever go into the military? If so I would look into aid and attending through the VA that will help offset some of the cost.

I would look at your local senior citizen centers too. Before I had to move my dad down here close to us into a home, he had people through his local center that would come to his house an clean every few days and do his grocery shopping, take his to dr. appt., etc. and the cost wasn't that much.

Hope this helps a little. It is hard to make these types of decisions.

 

[cheap traveler]

Thank you everyone for the quick replies.

My stepfather has a friend who had to put his wife in the best facility very near here (VERY high ratings and great reviews). It cost him $70,000 for her care, and she lived less than a year.

My Grandparents bought their house cash, so they have 100% equity, though the value isn't as high in GA as other places.

It looks like my Grandfather is going to be taken directly from the hospital to the VA in his area, but this means we can't visit him without a 18 hour drive. I'm going to work on my mother to get him moved up here before too long.

My Grandmother has been dead-set against moving back to NY for the last few years, but apparently she is so ill right now that she might be ready to admit that she needs to be near family. My mother doesn't seem to want to push for them to move north, so I might need to step in when my Grandmother is moved out of the ICU and I can talk to her.

There are so many horror stories about senior-abuse in some of these places, I would much rather be able to visit often and see for myself how they were being treated.

I'm going to look into the CCRC right now, thank you for that tip! This is my first walk into this mine field. I didn't expect to have to take over, but if my mother isn't making the right choices I will step in. I've already notified the boss that time off might be in my immediate future.

 

[Pigeon]

It all depends on what their medical needs are like. I'm near Albany and have looked at a lot of assisted living places last year.

My FIL and MIL sill lived in their own home in town. He had early Alzheimers, had a fall, broke his spine and couldn't walk. He ended up not living long, but when it was unclear what the outcome would be, I toured a bunch of places. Since he died, MIL is still living in the huge house and is determined to stay there. It's getting past what she can manage though and she really ought to stop driving. I wish she would give moving some thought, but it's not happening.

The nicer AL places are brutally expensive. Some of them require a huge down payment. You get some of that back if the person dies, depending on how long they live. The place we liked didn't require a big down payment, but would have been over $7K/mo for MIL (who had no chronic medical problems) and over $12K/mo for FIL, plus signficant additional costs depending on the level of medical care needed. The ones owned by religious organizations were as or more expensive as any others.

If your parents don't need a lot of medical management, but want a one-floor apartment, with some meals, housekeeping and transportation services, there are some nice, less expensive options.

 

[kaywoody]

If they need round-the-clock home care that can be very expensive also. My husband's grandmother has medicare covering 8 hours a day but that wasn't enough, so they finally had to move to 24 hour care and pay out of pocket for the remainder. It's costing them 100,000 a year and we live in Texas where the cost of living is a lot less than some other places.

 

[MrsPete]

I'm with Pigeon here. Do they NEED assisted living yet?

My grandmother stayed in her home an extra three years because she was able to get lunches delivered from Meals On Wheels and because she had some housekeeping help and visits from a home health nurse. The lunches were the biggest help; she had a visitor every day to deliver them, and she had one good, big hot meal each day -- she could manage cooking two small meals for the rest of the day. These things together cost much less than assisted living, and she was happier being in her own house. Of course, she also had the benefit of nearby family.

This may not be a forever solution, but it might work for a while. You'd be wise to have an emergency plan in place -- if one of them experienced a sudden downward turn, who would go stay with them? If they had to move in with one of you 'till a place could be found, who would it be? Does someone know about their finances, etc?

 

[jedijill]

Do they have medical insurance or Medicare? I thought there were provisions to help pay for nursing homes or assisted living or even some home health care. I would look into that as well.

Jill in CO

 

[StitchesGr8Fan]

Medicare allows you to have a house and a certain $ amount in savings. Anything over than that and you don't qualify. It sounds like they might have too many assets.

 

[Pigeon]

I'm with Pigeon here. Do they NEED assisted living yet?

My grandmother stayed in her home an extra three years because she was able to get lunches delivered from Meals On Wheels and because she had some housekeeping help and visits from a home health nurse. The lunches were the biggest help; she had a visitor every day to deliver them, and she had one good, big hot meal each day -- she could manage cooking two small meals for the rest of the day. These things together cost much less than assisted living, and she was happier being in her own house. Of course, she also had the benefit of nearby family.

This may not be a forever solution, but it might work for a while. You'd be wise to have an emergency plan in place -- if one of them experienced a sudden downward turn, who would go stay with them? If they had to move in with one of you 'till a place could be found, who would it be? Does someone know about their finances, etc?

One thing to keep in mind though, is that many places require you to be in pretty good shape to get into assisted living. Many of the nicer places have long waiting lists. If you have significant medical needs, they may not take you.

 

[Ephany]

You don't state which county they live in, so these are some general links that I hope will be helpful.

Georgia Cares - generally deals with Medicare issues, but our local person is an AWESOME resource about who to call if she can't help with a specific issue. You may have to leave a message if you call the 1-866 number.

http://www.mygeorgiacares.org/

Georgia Division on Aging - there's a drop down menu to help locate resources in your grandparent's county

http://aging.dhs.georgia.gov/programs-and-services

Resource Connection - from what I understand, this is the organization who helps put clients in touch with the right people when they don't know where to start.

http://www.georgiaadrc.com/

 

[CTdiznymom]

OP- I too can only give you our experience.

My mom will be 89 in May. She was just released from a nursing home where she was sent after a hospital stay for Congestive Heart Failure. She was in the home for almost 2 months recooping. She has always lived alone and has been self sufficient up until now. Her wish has always been to be at home and not in a facility on any kind. Luckily she has assets so it hasn't been a problem so far. It will run you approx. $20/hr. We have gotten her 24/7 care in her home. It has been a major adjustment for her and the rest of the family. Having strangers practically move in has been alot to digest. The nursing home helped a little in getting a hospital bed and some equipment. We had PT coming in and a visiting nurse for a few weeks. Having her go home has helped her a great deal but it is A LOT of work. Pills have to be monitered and laid out weekly, food shopping has to be done, and there are the dr. appts. that have to be driven to. Scheduling has also been an issue. Dealing with the agency whenever there is a problem is exhausting.

My advise to you would be to see a lawyer to try to protect their assets. You don't say their age, but if Grandpa is getting physical you need to look at how long he will be able to stay @ home before a nursing facility is better suited for him. You don't want to up root him again and again. If looking into assisted living, make sure you know how much assistance they actually get. How many times they get checked up on. Will they dose meds? Feed and bathe them?

I hate to say it, but when deciding what to do with my mom, it was like dealing with a toddler. Whatever I did to safeguard my kids, I now do for my mom.

Hang in there.

 

[MarthaJr.]

Just wondering if you aren't jumping to the worst case scenario too quickly?
It is natural to rush in and try to fix "it" for them. My personal experience is that older people need a little time for all of this to sink in and to understand that things can't go back to how they used to be,
but maybe you don't have to rush to the other end of the spectrum right away either. I mean this in the nicest possible way.

For sure this is a big life change for everyone involved. Perhaps you could try to slow down and really get an accurate assessment of what their health care needs will be in the next few weeks to a month before making any type of permanent decisions?

Is it possible for Grandpa to be transferred to a VA hospital close to you while Grandma perhaps stays with you for a short time until all of the health needs are really known? Then you all could come to an understanding of what truly is necessary and have a more informed decision.

We've used Visiting Angels for my mom and dad and it has worked out quite well. I agree with using meals on wheels if it's available. The best source of information for you is the hospital social worker. It's their job to help you wade through your options to do what is best for all concerned. They can make referrals and guide you. I wish you all the best!

 

[bumbershoot]

Medicare allows you to have a house and a certain $ amount in savings. Anything over than that and you don't qualify. It sounds like they might have too many assets.

Definitely.

My MIL has no home, no assets, and brings in just over 2K between SS and union pension, and it's too much for Medicare to pay for assisted living without working really really hard. since she's not willing to plead poverty to any officials (she pleads poverty to US all the time) and isn't willing to answer any given question more than one time, this is impossible.

Also, assisted living isn't appropriate for people with significant needs. Or really any needs. MIL needs someone to watch her take her medication twice a day and make sure she checks her blood sugar, and at an assisted living place, that's EXTRA. We're talking hundreds of dollars per month extra. And we can't get any home care people to do it, too, as they have 2 hour minimums. So...2 hours of sitting with her, watching and doing nothing, twice a day? For about $50 per hour.

Just wondering if you aren't jumping to the worst case scenario too quickly?

Because grandma called the OP's mom, when she doesn't get along with OP's mom, to ask for help. And when mom got there, her mom and dad were so bad off they were admitted to the hospital. Do you know how hard it is to get actually admitted to the hospital? MIL had a series of strokes, and EACH TIME it took *minimum* 6 hours, and more often 12, to be admitted. (so much for "time is brain", right? Took about 3 to even get her in to a CT scan or MRI to "see if" she had a stroke, and she wasn't treated in ANY way at the ER) And each time they "weren't sure" if they would be admitting her.

I would jump to the worst case scenario, too.

 

[valentine92]

The only advise I can offer you if whatever you decide whether it be a facility or at home care make sure someone in the family is there often to make sure they are being well taken care of, ask questions, stay involved. We have been down that road with my mom and I am so grateful that my mom had family visiting several times a week at all different times just to show that we were her advocates.

 

[tar heel]

It's Medicaid not Medicare that pays for senior care facilities over the long term. Medicare will pay for 21 days after a hospitalization. Medicare insurance supplements usually have a benefit but it's limited -- my parents' was 100 days. In my parents' case, home care was more than having one of them in a facility for $5,000 a month as they were not poor enough to get help with it. Continuing care communities are wonderful but not something most elderly Americans can afford to do.

I know way too much about this, unfortunately.

 

[karice2]

Sorry you are going through this. Would not wish this on my worst enemy.

My experience is a little different but here are the resources that I used. I did use care.com to look for a daily aide to come in and be with my dad while I was work. He was recovering from a stroke and a heart attack.

I found my person by networking though. There are people that are trained to be senior aides and will do in home work. Check with the local department of aging or Department of social serives. My aide is $11 per hour and has been with my dad since he came home from the hospital. She cooks his meals, takes him to his appointments, helps him bathe and works on his therapy. At one point she was feeding him through his tube and changing sheets a couple of times a day.

There are some good in home aides, you just have to make sure you vet them well.

 

[MomToOne]

If your Grandfather is getting physical, then it sounds like he will need Memory Care, not just Assisted Living. But I could be wrong.

As far as your Grandmother goes, she sounds a lot like my mother. We stopped her from driving years ago, because she was blind in one eye, and the second eye wasn't that strong either. We have someone that comes in once a week or so to take her grocery shopping and to run errands. She has Alzehmiers but is still able to function mostly independantly (although I suspect that will end in the next year or so). Two of my siblings live in the area, and handle her finances and check in on her physically every few days. One of the children checks in by phone every day.

I would say look into moving your Grandparents closer to you, if possible. You might be able to set your grandmother up in just a regular apartment for now, and setup an arrangement similar to what we have for my mother. But you really need someone in the area to pull this all off.

 

[Jajone]

I am a hospital case manager and deal with this often. Please feel free to pm me any questions you have. Also, make sure you communicate with the hosital case manger where they are, he/she is a knowledgeable resource and the one to help you make those decisions.