My dad lives in an Assisted Living, and has an aide with him for 12 hours a day. The costs every month are getting so high, and we are running low on finances. I don't know how to keep up with everything, and he is having more and more episodes where he needs increased care. How do I deal with all of the costs while ensuring my dad has the right care he needs? None of us kids can take him in, and he has no place to go if we cannot afford the Assisted Living.
Is he Medicaid-eligible? It sounds like he needs a higher level of care than AL, so maybe he needs a Nursing Home (NH)?
Most likely he needs to be placed in higher level service, like NH, if he doesn't have the money to self pay, apply for Medicaid.
You shouldn't be paying for this in the first place, it is his responsibility.
Memory Care or a Nursing Home can be quite expensive. As others have written, it is time to see if your Dad can qualify for Medicaid [which is different from Medicare]. If your Dad qualifies, Medicaid will pay the bill for nursing home care. Call your State Medicaid office to get the ball rolling.
Seek guidance from an elder care attorney about Medicaid requirements in your state BEFORE dad runs out of money. He can go to a Skilled Nursing Facility under Medicaid when he runs out of money if everything works out.
Wishing you the best of luck.
Your doctor doesn't need to write a prescription for this.
Again, why the aide? In AL, the aides are the employees, if he needs more care he can be moved accordingly.
Since there is confusion here I would seek some guidance perhaps through a social worker, all AL have a referral list.
Your Dad needs Longterm Care. Start looking for a nice facility. Then take whatever money he has left, and pay privately. With my Mom she was in an AL and money was running out, she had 20k left. I started the Medicaid application in April. She was placed in LTC May 1st. She paid for May and June. June I confirmed with her Caseworker that they had all info needed and Medicaid started July 1st.
My neighbor got an aide for her dad in a Brookdale because they told her it was that or he’d have to leave.
Her time there was completely awful. It seemed that about half the residents in her wing were in the same situation. She was left to sit in her own feces because the nurses "were not paid to clean that up". She was covered in crumbs. Her food was not cut up for her. Her like-new Haywood Wakefield bedroom set was damaged from the staff spilling liquids and food on top of it, and the entire space smelled of human waste and trash. Housekeeping -- if there was any -- must have consisted of vacuuming the room she was never in. The only saving grace was that she declined so quickly that she was basically unaware of her surroundings for most of the time she was there, but it was still a few months before my parents finally found a small group home for her where she received 1 on 1 care. Granny died 3 weeks later. Because my mother was her 'caretaker' at the time and I found it too 'uncomfortable' to visit more than a few times (each of which resulted in my placing an emergency call to management because of the state I found her in), I will never forget leaving my own grandmother to spend her last months in that terrible condition.
Beware. Assisted living facilities may well attempt to sell you whatever service level you seem most comfortable paying. While the individual people we spoke to there -- from staff to the manager -- truly seemed to mean well, the low pay and low skill level combined with pressure to profit from their residents placed them in the position of never being able to live up to their promises. You may tell yourself, each time you visit, that it was a one-off, that they were just short staffed "that day". Don't fool yourself. Don't let a family caregiver fool themselves. A caregiver who is exhausted and burned out may not really comprehend the situation for an awfully long time.
I think these places and the financial agreements entered in to with them require open, objective, caring eyes from the family who make the arrangements. I really wish I had stepped as caregiver in place of my mother, who would probably have resisted but appreciated it all the same. Granny would have ended her days in her own cottage with 24 hour care on top of hospice supplemented by our family. It would have been cheaper, and it would have been better for her.
Whether for supervision or hands on mobility assistance, it sounds like AL is no longer enough care.
"He does not have the specific diagnosis"
Parkinson's listed on profile. This awful disease brings cognitive changes as well as the physical.
Are you (or other family) Medical POA? To have the authority to get an up to date medical checkup, diagnosis & updated care plan arranged?
I live in Florida and I visit what is supposed to be the best assisted living in Florida. It is really, really common for residents to have outside paid caregivers. I see caregivers wearing the smocks of agencies accompanying residents all the time in this assisted living facility in Florida.
You are already paying for 1 caregiver 12 hours per day. It may be cheaper to get an efficiency apartment (standard apartment) and get an overnight caregiver for the other 12 hours.
There comes a time when the Assisted Living facility is not the right match for your father's needs. As they age, they require more skilled care.
You don't want your dad to remain in a situation where his needs are not being met and you're being charge for everything, including the chocolate mints on the pillow.
Every Assisted Living is different, however, they are NOT government regulated like a Nursing Home--not that anyone wants to place a loved in a NH but sometime they need around the clock skilled care--your insurance should cover this.
Assisted Living in my humble opinion is real estate with everything a la carte. You pay through the nose for everything--laundry, prescription--ordered, filled and dispensed, hair salon, etc.
I am not in that social circle but I read everything and have been a caregiver to many people over the years.
Some AL have the next step which is a Nursing Home.
I don't know too many people who can afford the Assisted Livings. It sounds like he has exhausted this place in more ways than one.
Speak with your dad's primary care physician and do an assessment. Also contact the nurse practitioner at the medical office. They usually know a lot. A social worker or geriatrician if you find one in the area is another good resource.
I hope I was of some help but I try to speak the truth from my own experiences.
You are in my prayers...
I might add the Assisted Livings will often showcase there is an RN on duty. Again, my humble opinion--if there are 80 seniors who can't live alone, chances are more than one will be sick at the same time.
The nurse can only take care of one person at a time. It looks great in the brochures/contemporary websites your "Mom" and "Dad" will be treated like family (until their $$$ runs out).
Every investment book right now is stating--if you want to make money, invest in Assisted Livings.
I recently moved my mother to a nursing home from assisted living.
Unless you have nursing home insurance the cost is not covered. You apply for Medicaid once the funds run out. Talk to a specialist on this. Good Luck!🍀
of care determination.
AL is your own place, in my experience, with access to social activities and prepared food. It can be a good arrangement for moderately disabled people (walker, cane, some mild memory problems, etc.).A SNF (and I worked as a psychological consultant for years in ones) accepts disabilities. Often, the people are in groups, or as many preferred, sitting by the nursing station and watching the world go by (and, again, commenting on it as a group). They check on people frequently, they can handle physical care, etc. Be careful, because they have such a dependent population, you need a responsible, well-run place. When my MIL was in one, someone visited almost every day at different times to make sure they were doing their job. Very occasionally, they were not and were informed of it. This was the best in the area, by the way. I have seen quadriplegics in the hallways visiting with people in SNF. I have seen them alone in their rooms for hours in an AL. I doubt the price difference will be two great having seen what AL charges for more assistance. Good luck.
AL is your own place, in my experience, with access to social activities and prepared food. It can be a good arrangement for moderately disabled people (walker, cane, some mild memory problems, etc.).A SNF (and I worked as a psychological consultant for years in ones) accepts disabilities. Often, the people are in groups, or as many preferred, sitting by the nursing station and watching the world go by (and, again, commenting on it as a group). They check on people frequently, they can handle physical care, etc. Be careful, because they have such a dependent population, you need a responsible, well-run place. When my MIL was in one, someone visited almost every day at different times to make sure they were doing their job. Very occasionally, they were not and were informed of it. This was the best in the area, by the way. I have seen quadriplegics in the hallways visiting with people in SNF. I have seen them alone in their rooms for hours in an AL. I doubt the price difference will be two great having seen what AL charges for more assistance. Good luck.
Here’s one more: Talk to a certified eldercare attorney in your state for advice. They know all the in’s and out’s of paying for care in AL or NH. Their expert advice is not cheap, but you’ll get the correct info.
The other option is to visit an elder attorney because they understand Medicaid rules ( once he is living on monthly income only), what is counted in the Medicaid process, or if he would even need Medicaid. There are also trusts that can be set up to help with qualifying for Medicaid if he is slightly over income limit, but not enough income to pay the monthly cost of NH.
Bottom line is, the 'right care' is more about 'what he can afford care'. If he can no longer afford hired caretaker, he goes to a NH where all his needs will be met. However...someone needs to be going to visit random times and every day if at all possible. That's how you ensure he gets 'right care'. He needs an advocate at all times.
Get out and tour some nursing homes, (some offer memory care, but THEY will decide if appropriate). Put some applications in , make some calls.
You will need to know all his financials. Generally what happens is he might begin as private pay, then when money is dwindling, you apply for Medicaid. They can help you figure when that is. Once Medicaid is pending, you stop paying the gigantic bill and only pay Net Available Monthly Income.
My mom recently had to leave assisted living because she became a two person assist for transfers. The facility sent out a person to interview her to see if she was appropriate for memory care. After a little rough start, she is thriving there. They have more programs/ activities for her and she is getting the care she needs…Not just sitting in front of the TV.
Memory Care may be the solution, but he needs to be evaluated. You can call the care advisor here or contact, "A Place for Mom."
Take yourself out of the equation and do not offer to pay for anything. This is a great learning opportunity for you to see what you will need to plan for, for yourself.
If your father has no or minimal resources, he may qualify for Medicaid. There will be fewer choices of Medicaid facilities, but better choices require private pay.
It was extremely expensive, but the only way.
If I wasn't so burnt out from years of caring for him, I would have brought him back home and hired in home care providers. I never had peace-of-mind.
Today, facilities only provide the bare minimum of care. CNA's and nurses are run ragged. These facilities are run for profit and that's the problem.
If my Mom used the caregiver services of the Assisted Living area, she would be paying $50/hour for the services. If I hired from outside, the cost is more like $30/hour. At 12 hours a day, that is $240 a day and $7200 in a 30 day month, not including 1.5 cost for holidays.
The fact that I could use outside services for my Mom's care is something that I asked when I was touring facilities. I asked about it only because I wanted to ensure that I could use her same doctor, her same PT, etc. Some allowed, some did not allow. Then when I signed the forms, I saw the $50/hour charge on the price list. YIKES!
Take a look at the smaller homes that provide Assisted Living. Many of their prices are considerably less than the larger facilities and they do provide a better caregiver to resident ratio.
If your Dad is memory impaired and needing help with laundry, food, medication, etc, find out what the cost to move him into Memory Care would be. Then do the numbers. For me, it was cheaper to move my Mom to Memory Care than to allow her to continue to live in her condo and hire from the outside. When she went to respite, depending upon the level of services needed, there was a point where it is more cost effective to use Memory Care rather than Assisted Living.
If you are within reason of the lowest cost alternative, it is time to consult with someone to see about Medicaid. Your definition of "right care" will be different than the definition of the government for "right care". However, if you are this close to exhausting all his financial resources, then Medicaid may be your only alternative left.
Also reach out to your state's Office on Aging and ask for a counsellor. There might be some other alternatives available for your specific situation.
Good luck!
The caregiver was responsible for keeping mom engaged which is what she needed. She was a wanderer and once devised an escape plan with another client at a memory day care she once attended.
Some of those with dementia need the individual level of care. There were other residents in memory care whose care could not be decreased because my mom's care took extra time and attention.
Maybe he is ready for memory care, but he may still need a separate caregiver. Have that discussion with the facility. It could be that assisted living plus the caregiver is cheaper than memory care, and it works for now.
You will go broke trying to pay for his care out of pocket.