How do you find a GOOD memory care facility/ nursing home?

I'd echo some of the comments here, such as using your nose when visiting, as Ahmijoy said. Or as ThePianist said, the sales person and brochures are not indicative of reality.
When Mom was discharged from the hospital, they gave me less than 24 hours to pick one from their list. Btwn further discussions with doctors and nurses, Dad's needs at home, our animals, and traffic, that period of time only allowed me to visit 2 facilities.
One was right behind that hospital so I walked over. The building felt old and outdated inside and it was going to be a 25 min drive each way, which was okay for 4 days in the hospital but not for twice daily trips for several weeks.
I'd already been in the one a mile from our house. No one there was interested in giving me a tour or even acknowledging my presence so I just walked around on my own. The urine smell was pervasive. That's not a dealbreaker because I think urine smells occur in all facilities at times. However, the female patients sitting out front looked very depressed. I heard one ask a sitting staff member who does her hair. The staff member just looked at her and there was a long silence before she replied "Who does my hair?!!" as if she was insulted. All of that combined was enough for me to leave and decide never to come back.
I chose a facility that was only 2 yrs old. It felt clean and there was no offensive odor. They even had their own hair salon and a coffee/ice cream cafe', two things important to Mom. They also had daily activities, which I suspected she wouldn't partake of (I was right) but one of them was visits with a dog, which I thought she'd like. She ended up liking none of it, not even the coffee house.
Though Mom's determination to be unhappy there had a lot to do with some of what went wrong in the bigger picture, I wish I'd done more observing of the staff before choosing that place.
We had a difficult time overcoming the distractions from Mom's care that my niece created with her incessant drama. The staff spent too much listening to her and not enough time taking care of Mom. Part of that blame certainly falls on my niece but part of it is also about being professional, which means not getting wrapped up in rumors without getting facts.
I pushed Mom's alarm one time when I arrived, as she had soaked through her clothes and the sheets. A CNA arrived within 5 minutes and I asked if she could change Mom. She was flustered and said she was busy feeding someone. I apologized, adding "oh sure! No problem...when you can". About 15 min. later I walked down the hall and saw her standing in a doorway of a room laughing and chatting with a family. She saw me and quickly looked back at that patient asking "are you eating okay?". I kept walking but wondered if she was just politely staying and talking with them, or was she only interested in helping them because they are of her own race?" I let it go.
Then, 15 more minutes went by and I walked by the nurses station where I saw her sitting in a chair with her feet up on the desk. I kept walking.
Still trying to give her the benefit of the doubt, I asked the nurse who was charting in the hall if there was a specific time of day they're supposed to change them. She said no, they should do it as needed and she came in and did it herself.
There were a few too many similar incidents with CNA's who were lazy or had a chip on their shoulder.

My Mother was fine in her home till she fell.. All her tests came back normal but the hospital sent her to rehab and Rehab said she couldnt go home alone. She winded up in Memory care. My brother and I went everyday. but she winded up catching pneumonia in there and one thing led to another and she passed away.. I do feel her being in the home killed her because she would have never caught pneumonia if she was in her own home.. So I know I wouldnt do it again. But of course its too late for my Mother.

Not all Nursing Homes are what they seem. The one my mother was in killed her.

I read about your situation and it reminded me about my own Mother. I am glad that your Mom is home now, and I hope you can find some way of keeping her at home. IMHO no Nursing Home is a holiday inn. Nothing of value should be left in a NH or you risk it missing or find it broken. No matter what a place looks like on the outside it is not the same inside when you are not there. It is very hard to find a good facility unless you already know of one, and maybe it will not be nearby. Maybe your State Dept. Of Aging can you help you get the help you need to take care of your Mother. The medical gastritis situation you describe, do you think a NH would handle it as good and quickly as you did? It sounds very serious.

Foleydaughter doesn't mention any dementia in the profile, so AL may be what is needed? Some of her mother's behavioral issues *could be* due to the UTI (as can the diarrhea/antibiotic) , but she also might be on the edge (early stage) of dementia. I would consider a place that might let her start in AL and transition to MC, unless you feel it best to go with MC (moving can be difficult once dementia starts in.) You know your mom best (if she might be a flight risk, dementia or not, go with MC.)

TNtechie's comment (and several others) was/were great! List all your questions and concerns. Check out and compare places, what they offer, cost, what is included in the cost, what extra charges might be, etc. Highlight the ones that interest you and then check them out. Bring your list, ask a lot of questions, take notes. Wander around after your "interview" if they allow it (if not, I would cross them off the list!) Ask questions of various staff and if possible family members of other residents. Visit the places that you feel have potential (those MOM would like, not necessarily you!) several times, at different times of the day to see more of what goes on. Your initial visit might be "prearranged" and therefore offered at an "optimal" time, so go again unannounced - morning, afternoon, mealtimes, etc.

Online reviews *can* be helpful, but I don't put a lot of store in them - what might be 5 star for someone might be 1 star for someone else. I find more people tend to complain than those who praise places. Although there might be for-profit places that are okay or even good, do consider the non-profits. The home based places might be good, I have no experience with them, but if you have those as an option, check them out too.

Also know costs vary even in similar areas, but very much so from one region/state to another. From postings in other threads, the NE (including the wider NY/NJ area) and CA seem to be among the more expensive. However, you'll have to inquire as to what is covered in the cost quoted. In our mother's case, the regular monthly fee includes all and up to one hour of personal care (i.e. if she needed help showering, etc.) After that, the cost increases per hour at some hourly rate (even if she needed only 15 min!) So far the only "extra" we have been charged is for deep carpet cleaning when she can't get undressed fast enough to use the toilet :-( One brother checked into a place nearer to him in the south, and questioned the higher cost here - I had to check it and found that the $ he was quoted was for the room only - everything else provided was ala carte (bathing, cleaning, laundry, medication, etc.)

We checked 3 places based on location. One didn't really give us a good tour or "interview" and I was not impressed with the set up. Another was more expensive even going with a double room/shared bath (she wouldn't like that but could get private room, for even more $!) Also, the front rooms looked out over a parking lot and 4 lane highway - nope! The one we settled on was non-profit, in the process of rebuilding, so we had to wait and hope it would be nice (couldn't view it at the time.)

As for items that "disappear" - unfortunately this does happen. There are no locks on the MC rooms. Never leave anything of value there. Clothing, bedding, etc should be done separately for each resident, but I have seen clothing show up in her drawers that are not hers! Pictures should be hung (hopefully out of reach) or kept securely in an album to protect them (not 100% safe.) The hearing aid issue I can relate to. Often she wouldn't be wearing it (I find it on end table, under or in the bed, etc), would forget she even wears one, battery would be dead, etc (also stone deaf without it.) Worst fear came true when it went through the laundry. Lucky for us her 3 year insurance was available, so it cost us about 275 - this one is chargeable so I have them "manage" it now (and bought 2 for same ear so we have 1 spare.

Sympathy and understanding for your dilemma.  There are some actual articles about Memory Care if you click above on the 'Care Topics'.  Lots of suggestions in them, as well as in the answers here.  It takes time.  Do what you can while still caring for yourself.  Prayers for you both.

I'm glad that that chapter has closed for you, for now.

I went through something very similar with my mom last summer. She was in the hospital, then this seemingly friendly and helpful buzzard from a "nursing home/rehab/ memory care" placement swooped down in our hour of need, ie, time for discharge, and mom ended up in XXX Manor. I felt very much taken advantage of.

There was pilfering among the residents; an unpleasant general smell of urine; the bedclothes were worn out as was the bed. The bathroom in the shared room was tiny and uncomfortable. Someone usually was screaming all.day.long.

It was a locked ward for dementia etc inside a nursing home. Frankly, it was just depressing, and my brother and I felt like we were in a George Romero movie with zombies. There was even a lecherous old man masturbating on the back "porch".

(These behaviors are not out of the norm for people with dementia. What is happening is that there is not enough staff to re-direct and watch over people, and there are too many residents for the number of staff members, which creates chaos.) Ditto on the incorrect medication list; insufficient staff to manage all aspects of care. There was a lot of roaming around. Unpleasant to say the least.

Also, be careful what you sign when you are tired or stressed out. I unwittingly signed over my mom's SS payments, and then I had to untangle that. That page was in the middle of a bunch of other pages....

By chance, the lovely place she ended up and where she is now was right next door. Go figure.

Back to your question. If you need to enlist family or professional help, do it. Gather your list via Google. Then ask yourself these questions.
Can we afford it?
How far away is it? or what is the best place that is closest to me?
What services do they offer?
How many resident live in the Memory Care unit?
Is it clean and cheerful? (You will have to visit to determine this)
Is the staff kind and responsive? (Again, answer this during your visit.)

You can get in touch with a social service agency in your area, or an agency that deals with elder issues, and ask for someone to help you. I've mentioned before on this blog that the Jewish Federation of America will help anyone. You can also ask any member of the clergy for recommendations to either find someone to help you with your search or assist you with the actual search.

I went on FB and asked for friends/family in my area to PM me names of places nearby that they had positive experiences with and/or negative experiences. Then I called “A place for Mom and spoke with a consultant and asked them for places rated well in my area and things to look for. Then I did some online homework. Then I took a week and visited a ton of places and started narrowing it down. The next week I took DH on the weekend to check my top choices. We were not pressed for time, just doing our homework. 4 mos later we were able to strike while the iron was hot and got them in to an independent living with assists available-medication services, meals, housekeeping, transportation, etc. 18 mos later they were ready for AL. We were able to get them in to a place only 5 min from our house that had been my first choice place. After only a month in AL it became clear to the staff and us that MIL actually needed MC, not AL. She and FIL were fighting constantly and she was threatening him. The place they are in has separate houses that each house a max of 12 people. They are set up with individual bathrooms, and a large community bathroom with roll in shower for those who need help. They have a nicely furnished living room, dining room and large kitchen. The AL buildings have 2 staff members at all times and the MC has 4-5 depending on the capacity of residents. They provide activities also. It’s very nice and we couldn’t be happier. When we had to separate them, MIL moved 2 houses down, so he can walk down to see her daily.

Wow. This is difficult. I would recommend visit as many as possible before placement and not just one visit, if possible, to try to see how things are going during different times of day on what would be her unit. It's very hard. The SNF my Mom was in during her last yr. was pretty bad. We had to hire sitters to be there . Could only afford 4 hrs/day. Still she had 3 very bad falls & staff totally missed symptoms of a stroke which delayed hospitalization. Sometimes I don't know where they find their employees. And this place was pretty highly rated. If not for the sitters who were very attentive, and positive and friendly, her stay would have been totally negative for me. At the same time, I wasn't physically up to having her at my house. Sometimes you just have to do the best you can. In my heart, I know Mom would have understood. BTW She was at an Assisted Care Facility prior to that for 2 yrs.. We would find her Imdur on the floor in her room (3x) Her cable box was stolen, 3 necklaces went missing. They practically never brushed her teeth. When I visited, I really ended up with direct hands on care/work while I was there, doing things that staff should have done but didn't. It wasn't a relaxing visit like it should have been. So my sister & I started visiting other places. I think I went to at least 6 facilities. Finally chose one I liked a lot & even though it was going to cost more, we made the decision to move her. Then 1 week prior to her move date, she had a massive heart attack & lung clot (probably due to a spike in blood pressure as she wasn't always getting her meds) After hospitalization & amazingly surviving, she required SNF & could not move- in to the AL facility that we liked. Had to make do with the SNF & sitters compromise, and she lived about 14 more months. We were always blessed that Mom's behavior was always pretty good, except for some delusions. Hang in there. It isn't easy for any of us, as people are living so much longer now and there are more "older" children with their own health issues taking care of their parents

I got a hold of “a place for mom”
I was given an actual person who became my mentor he looked in my area and I went to visit those places with his recommendation.....it was nice to have somebody on my side and understanding
I actually got the phone number on this site
Mom did end up staying in a place that was recommended by “a place for mom”, near my home for three years till she passed away in March.
good luck to you and your family
Sissy

I reread your post and I’m so so sorry. It’s too familiar. Another thought is, and it’s sad that one would have to do this, to have an outside caregiver come in to help with home visits, doctor visits, companionship and one of the best things... an advocate in a facility when you aren’t there. I hired one because memory care was lacking at mom’s facility and didn’t know where to move her as she was comfortable with her surroundings. So her new caregiver companion ending up with us for over 3 years and was like a “granddaughter” to mom. Mom thought she was so it was great.
Just a thought and it is an added expense but it helps and brings peace of mind.

Finding a good place is hard. Be diligent and if you are able, tour and meet the caregiver leads prior. I had a similar issue and decided a small board and care was best for my mom. That was the best choice ever as she flourished and was so much happier there. (And she was one very needy lady!)
Try this site and search for license and deficiencies for your state.
http://dph1.adph.state.al.us/FacilitiesDirectory/(S(ip1xtdq0omnwy5452zszhvu3))/default.aspx
I used this for my state and it helped tremendously in finding the best care. Noting tho... not all things are reported.
Check a small home board and care. It was recommended by my mom’s doctor and after I interviewed and toured a few, I just knew which one was the right one. I, thankfully, was correct.

Getting medications managed is key. I would suggest a respite care facility for this first.

Thereafter, vetting these places and seeing how they operate is key. I'm more than happy to give you a list of ones I've vetted, in my almost 20 years of Eldercare.

Feel free to message me

It's been my experience that a lot of what is available, what is "good" and how to afford it depends a lot on the local (state and sometimes town or county even). So I would start first with her state agency on aging, often lot's of info on the state website to gather ideas and questions from. These sites will also often list the various facilities and sometimes have reporting and oversight info as well but start first with what assistance she might qualify for if any and the various types of options in her area. Federal funded programs/money are developed and run by the state and sometimes state money added so they aren't the same across the nation unfortunately (or fortunately depending on where you are) so doing some research into what is offered in her area can be well worth the time. In my mom's state for instance the first time I looked into programs for assistance at home the state had run out of money for that year and while there was a perfect program for us it wasn't available to us. Now a couple years later I did the leg work again a little deeper actually and found that not only has that program been stepped up but there are a variety of "housing/help" options available I never would have guessed might be.

The other thing to do is contact one of the services in your area that helps families find the right placement, there is bound to be at least one big enough to be easy to find, make sure they don't charge the family/patient for their services, in mom's area anyway they don't and you can decide after that initial consult as to weather or not you want to continue working with them or have gotten enough info from them to do the rest of the leg work on your own. The service of course has facilities it works with (pays them) most so you may not get all the options but you will get a good road map. If your LO is getting VNA/at home nursing or PT services they usually have a social worker who will come out and go over options with you as well and the other option is often the state or county/town agency on aging or elderly services (maybe connected to senior center), her primary's office might have someone to help with this too if they have a large elderly clientele check all of these out because while there will be cross over you will also get various views and information, suggestions, each person will have had experiences with various facilities and this is what they do so it makes for great info gathering and direction. Then after getting an idea of the possibilities and real option for your situation go visit them, talk to families and residents, really spend time noticing things as your given the "tour", talk to the people who work there as well as the director or whoever they set you up to talk with. Have a list of questions that you ask each place you visit and then jot down any you come up with for a specific place after your tour or first visit, facade or not you will get a gut feel for whether or not a place might be a fit when you walk in, just like visiting a collage campus. We did this with rehab facilities for Mom after her stroke and I am so glad we made time for it. Then maybe dig deeper into your top choices and take mom to visit and or do a respite week if they offer it to see how it works for her and help her adapt to the place and idea before it's decided. Give her some ownership of decisions or at least the impression she has some control and made the choice.

Reach out to the available resources around you but don't limit yourself to one or what they suggest. It's work and it's overwhelming especially if you don't break it down the process but for me increasing the likely hood of finding the right situation and easing the transition the first time is well worth the work. Just remember, you are not alone in feeling overwhelmed by this, I think most of us have and do feel that way throughout the process of caring for an aging LO. Lot's of positive energy coming your way!

I have been through this process a couple of times in the last two years now and feel for you. It seems the hospital suddenly decided to discharge then the Social Worker dictates where you LO will go, without giving you enough time to check out options. I have learned to always verify the SW choices, not that they intend to give you bad information, but I have in fact received bad information from them in the past. They act hurt that I don't trust them now, and its not that I don't trust them, but I want to verify their choices on my own. The SWs have many clients to satisfy - the hospital, insurance company, in addition to your LO. You are the only one to work solely for your loved one.

This past time I reviewed online reviews (which cannot always be trustworthy either as some one had a bad experience once and bash the place like its the worst ever) and call and ask friends whose parents have been in them.

My mom got in a rehab last time which wasn't the best, but only one open at the time her insurance covered, but we found out from other patients there it was not the worst in the area either, there were ones worst.

I think bottom line is there are no perfect ones. You try to avoid the really bad ones.

I went to them and was shown around. But, when mom finally went to one I thought was good, I learned there are different wings with different care. Hers was not a good wing. She was totally bedridden but the with the Alzheimer's, she still tried to get up. No rails on the bed and a cement floor , she was taken to the hospital twice and her face was so banged up and bleeding. They can't have folks sit with her. So with help from the family, we did all day. But, she fell again at night. Was put in hospice in my home and died three weeks later an awful death. I have a lot of problems now because of all of this.

One good place to start is the medicare website. It shows all homes in your area and their inspection ratings. You can compare to others in your area.
https://www.medicare.gov/nursinghomecompare/search.html

Good morning,
I am so sorry that you are having to go thru this....it is tough!!! I just went thru it with my Father n law. To find a good place takes a lot of prayer, research, visiting and talking with family members and residents. Once you place her then there needs to be a lot of you visiting at unexpected and various times. I don't know where you live but I am in Foley Alabama area. I found that the facilities actually range by the functional needs of the patient. When you interview the staff and talk to the marketing director draw your on conclusion if that facility is a good fit for her and for you. With my Father n Law the first place said "oh yes he will be great here". "We have high functioning people here with Sun Downers and we know how to handle them". In less than 3 weeks they are telling me to get him out of there! I had to hire sitters to stay with him until I could find the "right" place. Again, it takes lots of prayer, research, common sense and good judgement! I found a place that he has been at for 3 months and it is working out well so far. Praying that you will have the wisdom and gain the knowledge you need to find the facility that works best for you both.

Oh my gosh! How have you stayed sane?? I'm so sorry for you! :(

Adult Family Homes, are seriously, the way to go. My Dad went from assisted living (fell & broke his ankle). From the hospital, a couple of my siblings thought that the "memory care" (why don't they just call it what it is "Alzheimer's Unit") facility that was connected to this assisted living, would be the 'real deal'. NOT!
Residents come & go in others rooms, residents propped in front of the TV all day, residents are zombies during meals. My dad stayed there for 3 days before we got him the heck outta there. (me & my sisters have a name for this "asylum". We call it the "house of horrors"). HORRIBLE. I feel sorry for the people that have to live in this environment.
Anyway, get your Mom outta there. Please research Adult Family Homes, in your area. My Dad FINALLY is living a in loving, caring environment. Yes, expensive (his LTC insurance pays some). Yes, there goes our inheritance but we've MUCH have him live clean, secure, peaceful, happy in this adult family home we found.
I wish you the best!

In my opinion, the best place to begin your search is by reviewing the facility surveys through your state's department of health as well as reviewing the Medicare surveys for the facility. All facilities receiving Medicare or Medicaid funds are reviewed yearly. It also is helpful to tour facilities using the nursing home checklist as a guide. This document is available online and is printable. Hope this helps.

There is another kind of facility called Personal Care Home. They seem to
be difficult to find in some areas but are a wonderful idea. We found
one for my mom and she is doing awesome. It is a home- like next door to you- and the homeowner takes in residents to live there with them.
There are CNAs who come in, the Nurse comes in, the Doctor comes in.
It is just like home, with care. Regular facilities, I understand, the ratio is
1 CNA to 20 residents. In the Personal Care Home, it is 1 to 3 residents.
It is a "family" setting. I hope you can find a good one in your area. I
found ours on a list provided by the care manager.

I don't know if other States offer this but in New York, I could go on line to the Department of Health site and look up any long term care facility in the State to get the results of all inspections. It also indicated whether it was a regular inspection or a follow up due to a complaint. I paid particular attention to the complaints - both number of them and what they were about. After going through that initial review, I picked out several facilities in the area that fared well with inspections (or had no findings) and visited. I talked to the residents, watched how the staff interacted with them and paid attention to the cleanliness of the facility. As others mentioned, have a meal while you're there and/or check out the monthly menu to see if they offer food your Mom will like. Finally, if there is a one time "community fee", be as sure as you can that this is a good placement for your Mom as you most likely will not be able to get a refund if you have to move her - even if it's not your decision!

Rules can be different state to state, even county to county. My mother is right now in "enhanced assisted living with memory care." It's a private organization, not a chain. Nurses and doctors on staff. Nurses give daily care, doctors when more complex issues. Aides are trained in dementia. An administrator has an office with a glass door in center of living room area, so she keeps an eye on everything weekdays. Good food, lovely grounds, activities, layout more like a hotel than an institution. Costs about $9,000 per month in suburbs outside of city on east coast. My brother and I thought we could easily find a similar place with the same medical staffing in the state where he lives--we were wrong. In his rural area, there are only 4 memory places, all are full and they don't have nurses and doctors on staff. In his area, nurses come several times a week, but only from one agency, and you aren't allowed to hire your own private nurse to come more often. If the resident needs more medical care, they are sent to hospital, then some other rehab with skilled nursing, then back to the memory care. The sales rep at one place tried hard to convince us she could be cared for safely in assisted living (non-memory care). But the assisted living has a bus that takes residents to the mall twice a week--mom can't find her room in the current place, much less walk around an unfamiliar mall by herself! Definitely hire a geriatric care manager--they know the system and the choices in your area. In general, crappy places can be found in low-income neighborhoods. Better places can be found in better neighborhoods. Suburbs may be best as far as quality and price. Rural has fewer options and less oversight. Avoid big chain if possible. Go online and look up articles about facilities in your local newspaper. Good luck! Don't let this ruin your life for much longer!

No long-term care home is as good as their PR materials and sales manager claims it is: this is the sad truth. The ones that 'seem' best have invested a lot in their lobby and in flashy decorative items. You definitely can judge the cleanliness, so start there. And try to eat the meals the residents will eat; food is a major issue for residents. Often it's not that healthy, not fresh and tasty. Notice whether aides are engaging with residents, whether residents seem happy, alert.

Try to avoid the huge for-profit chains of care homes. If you can find a faith-based place these may be a little better. But in the end you will need to be your mother's advocate. In my experience, the more care the person needs (and over time more care will be needed), the less ideal things get because none of these places and I mean NONE has enough staff to give residents the care and attention they need as they become more dependent. They will tell you that they meet the state's staffing standards and they do, that is the underlying problem. The states' standards are woefully low. Forget about those CMS five-star ratings; it's all relative and CMS doesn't do a great job of monitoring the quality of care that they mandate.

I'm sorry to be negative but the biggest factor in ensuring good care is your new role as your mother's advocate. You will find aides who are very caring; but they are run ragged and are often exhausted themselves, so they may not consistently give the kind of care they would like to and that you want for your mother. Work with them, let them know you appreciate all they do, and make sure management knows when they are doing a great job and when someone is not. Get to know other family members and work together with management for high quality care. All the best to you and your mother.

Hi Foleydaughter -

Sorry you're going through this. It can be really hard to navigate for our parents.

In reading your letter, it's not clear if your mom needs skilled nursing or memory care. Has she had a thorough cognitive evaluation? Does she actually have dementia and, if so, what stage?

Memory care facilities come in all shapes and sizes. Some are stand-alone communities, while others are part of a continuum of care that starts with Independent Living, moving through Assisted Living and then Memory Care or Long-term Care if needed.

We've had my MIL in three different Memory Care communities and none of them worked out, mostly the way her Alzheimer's is progressing, she doesn't know she has dementia and she can't tolerate the MC environment. In the end, she's in AL with a night-time caregiver to make sure she sleeps. The AL community allows her to move and engage with people and activities as she desires during the day.

Most important is to determine what your mom's needs are for medical care, management of dementia behavior, social interaction and leisure interests. Then start researching communities in your area to see if there are any matches. And get ready to pay quite a bit of money.

One of the most critical pieces to this is staffing. It is essential that a community have enough staff to meet the needs and care requirements of their residents. This care includes medications, self-care, feeding, activities. Especially on the weekends. It doesn't matter how pretty a place looks if there isn't enough staff to adequately take care of residents.

A good place to start is with any elder services her community has. They may be able to provide you with a list of MC communities. From there, you can research them and tour any that seem like they would be a good fit. Visit at all hours of the day if you can. Especially on weekends, because staff often call off, activities aren't as available as during the week and although families often visit on weekends, it can get lonely and boring once those visits are over.

Regarding the medication list - my MIL has been in the hospital twice in two weeks. Both times, the medication list from the HOSPITAL was wrong. We had to correct it before she was discharged, and then correct it again at her community. I don't know where the drop-out was with your mom's Xarelto, but my advice there is to always, always check the hospital's medication list for the dosage and duration of each medication. And then make sure you're checking it twice/month at any community she lives in.

Wishing you all the best.

A memory center is different from a skilled nursing facility. A well designed memory center will offer small locked units- 8-12 people in size with all staff trained in dementia care and a program of activities designed to stimulate residents to maximize their abilities. Look for stability of staff as well as environment that is clean, clutter free etc. The price is not cheap- as most expect private pay for about two years. There are a variety of state and private certification/regulations that relate to memory care centers. For example, The Joint Commission requires:
1.Care coordination: Staff collaboratively assess, plan, and provide care that is consistent with current advances in dementia care practices.
2.Staff knowledge and competency: Staff have the qualifications, skills, training, and education to assess and provide care for a patient or resident population with memory impairment.
3. Activity programming based on abilities: Staff provide activities that match the patient’s or resident’s cognitive ability, memory, attention span, language, reasoning ability, and physical function.
4.Behavior management: The organization emphasizes the use of nonpharmacological interventions as an alternative to antipsychotic medications.
5.Safe and supportive physical environment: The organization modifies the physical environment to promote safety and minimize confusion and overstimulation.

Good luck...a good nursing home just does not exist. Institutionalized care really sucks. The outside can look really pretty even with waterfalls and well manicured lawns..but the quality of care. Forget it. Why do you think you are supposed to visit loved ones in nursing homes daily to ensure they are not neglected or abused.

Its becoming pretty obvious no one is going to find 5 star for under 4000 a month. You can live in a room sort of with a roommate best you can hope for in a coastal city is prob 3500 memory care in a 4 star. Prob 3000 in a studio 2 star. 2 star meaning no banquet hall 300 sq ft room and a simple cafeteria for food But memory care.

Talk to a Reputable Skilled Nursing Facility who may Know how to Direct you. Today, Sad as it is Here, Dear, It is getting Harder to Find some Place with a Kind Face..
God Bless and you ae Lucky to have your Mom. Mom passed away last December from her Own at Home Lung Cancer No Care.:((

We worked with a social worker at a local geriatric agency to find my Mom's AL. She was excellent knowing the ins and outs. We had already scheduled a visit to one place and she said to make sure we visited the memory care, because we might have some concerns. We probably wouldn't have at the time (because Mom only needed AL), but did at her suggestion. And it was problematic. She knew because she sees all the places.