Need advice on getting in-law with Alzheimer's into nursing home in USA

[rokdog49]

Originally Posted by Neil K Walk

Unfortunately our elder care and special needs system is priced in such a way as to be prohibitive and the burden falls to the family. That often translates to a family member becoming the full time caregiver and any additional family support - such as respite for the caregivers is often farmed our to family members as well. Families who see this coming set up trusts years in advance and if a family member has to be the caregiver there are ways to get paid for it through social security by getting qualified as a nurse’s aide, getting hired by an agency in the patients health care system’s network and essentially getting paid by social security. It seems like an odd arrangement but I personally know families with disabled teenagers and adult children who are either mentally or physically disabled and they are paid caregivers.

The charges for these types of facilities can and do vary greatly.
They are based on a multitude of factors including:

The availability of facilities as in how many are around and who is the competition.
The types of facilities themselves. In Ohio, for example, you have several types:

Independent Living...no care and similar to a community of condos or townhouses for the elderly with extras, meals, therapeutic services and facilities etc. Big bucks.

Assisted Living (basic)
This can be with minimal care which means little assistance is provided the individual other than very minimal needs. In other words a room and food with limited supervision and maybe administration of meds.

Assisted Living (More Care)generally offers five levels of care up to the point of where the resident is bed-ridden. The costs for each level needed is an added charge per diem and will vary greatly depending on the facility.

Assisted Living with Memory Care.
This is generally the same set up as Assisted Living with an isolated dedicated wing or area for those who need to be monitored 24/7.
These facilities have to meet more stringent state requirements and are more expensive.

Nursing Home Care.
Some Assisted Livings offer this and residents can transition from level five care to Nursing Home Which may even be on the same campus or in the same building. This kind of care requires at least one registered nurse be on the floor 24/7 and perhaps more based on the number of residents.


My Dad is currently a “Level One” resident living in a very nice relatively new Assisted Living facility needing very little assistance. His income is entirely based on his SS and Veteran’s Pension. I won’t say exactly what he is paying except that is under $2500/ month.
This is a privately-owned non-profit facility. The care he receives is very good for his minimal needs from a group of good employees.
We and he are fortunate.

Privately-owned, non-profit facilities do not accept Medicare because they can’t. While they have to meet certain requirements, they are not under the control of the State of Ohio and therefore, no Medicare assistance is available.

What we have discovered at least locally, is there are no absolutes when it comes to the cost of many of these facilities. It all depends on a lot of variables.

BTW, we have all these facilities in spades within a 50 mile radius of where we live.

[Neil K Walk]

Originally Posted by Mandobart

My wife has been an RN for over 30 years. Her patients are all imuno-compromised. She is very well aware of the current status of COVID in our area.

Her advice? Don't put ANYONE in ANY type of senior care facility right now, unless you want them to die.

Unfortunately, unless the OP can board a live in personal care nurse with his mother in law then his family is between a rock and a hard place. If she is a flight risk with dementia the mortality rate is even higher than COVID IIRC.

Originally Posted by MrDB

If her or her husband served in the military during wartime she may also qualify for VA benefits. Be sure to check that out as well.

This is true. My father served in Korea and my mother has applied for it. It's quite a significant amount. The difficultly has been trying to locate the required 70 year old paperwork since he's been dead for 50 years.

[Neil K Walk]

Originally Posted by rokdog49

The charges for these types of facilities can and do vary greatly.
They are based on a multitude of factors including:

The availability of facilities as in how many are around and who is the competition.
The types of facilities themselves. In Ohio, for example, you have several types:

Independent Living...no care and similar to a community of condos or townhouses for the elderly with extras, meals, therapeutic services and facilities etc. Big bucks.

Assisted Living (basic)
This can be with minimal care which means little assistance is provided the individual other than very minimal needs. In other words a room and food with limited supervision and maybe administration of meds.

Assisted Living (More Care)generally offers five levels of care up to the point of where the resident is bed-ridden. The costs for each level needed is an added charge per diem and will vary greatly depending on the facility.

Assisted Living with Memory Care.
This is generally the same set up as Assisted Living with an isolated dedicated wing or area for those who need to be monitored 24/7.
These facilities have to meet more stringent state requirements and are more expensive.

Nursing Home Care.
Some Assisted Livings offer this and residents can transition from level five care to Nursing Home Which may even be on the same campus or in the same building. This kind of care requires at least one registered nurse be on the floor 24/7 and perhaps more based on the number of residents.


My Dad is currently a “Level One” resident living in a very nice relatively new Assisted Living facility needing very little assistance. His income is entirely based on his SS and Veteran’s Pension. I won’t say exactly what he is paying except that is under $2500/ month.
This is a privately-owned non-profit facility. The care he receives is very good for his minimal needs from a group of good employees.
We and he are fortunate.

Privately-owned, non-profit facilities do not accept Medicare because they can’t. While they have to meet certain requirements, they are not under the control of the State of Ohio and therefore, no Medicare assistance is available.

What we have discovered at least locally, is there are no absolutes when it comes to the cost of many of these facilities. It all depends on a lot of variables.

BTW, we have all these facilities in spades within a 50 mile radius of where we live.

The facility my mother is in altered their pricing in response to COVID which is partly why she has been able to move in. We're talking a decrease in nearly $1000 a month - as well as the discovery that she was eligible for additional VA benefits because my father served during Korea.

[rmp]

it's been a while, but I remember the process my mom had to follow for admitting my dad.

He was roamer too. Up at all hours, would leave the house and just roam the neighborhood.

More than a few times the police were called because the people who noticed him walking around the road did not recognize him, and knew he needed some help. The local police quickly got to know who he was and would return him to my mom.

The way it worked to get him in was he was admitted to hospital for a psych eval which was a several day process.

When he was to be discharged, my mom was told that she had to say that in the several days he was in the hospital for the evaluation, she realized she could no longer take care of him at home.

From there, the hospital started to work on placement, which took another few days,

It was a pretty gut wrenching process to watch. He was admitted into the nursing home the day before Christmas eve.

This is a very difficult and heart breaking process. I wouldn't wish this on any family. Good luck to all of you..

[Neil K Walk]

Originally Posted by rmp

it's been a while, but I remember the process my mom had to follow for admitting my dad.

He was roamer too. Up at all hours, would leave the house and just roam the neighborhood.

More than a few times the police were called because the people who noticed him walking around the road did not recognize him, and knew he needed some help. The local police quickly got to know who he was and would return him to my mom.

The way it worked to get him in was he was admitted to hospital for a psych eval which was a several day process.

When he was to be discharged, my mom was told that she had to say that in the several days he was in the hospital for the evaluation, she realized she could no longer take care of him at home.

From there, the hospital started to work on placement, which took another few days,

It was a pretty gut wrenching process to watch. He was admitted into the nursing home the day before Christmas eve.

This is a very difficult and heart breaking process. I wouldn't wish this on any family. Good luck to all of you..

Yes, it is. The mental health system needs to be fundamentally changed.

[rmp]

Originally Posted by Neil K Walk

Yes, it is. The mental health system needs to be fundamentally changed.

yes Neil, it's all a mess and especially bad for those who are in the most dire need, the elderly and "special" needs adults get the short end of the stick all the time.

[Neil K Walk]

Originally Posted by rmp

yes Neil, it's all a mess and especially bad for those who are in the most dire need, the elderly and "special" needs adults get the short end of the stick all the time.

I could tell you stories about trying to get services and support on the pediatric end of the scale that are equally if not more discouraging.

[rokdog49]

Originally Posted by Neil K Walk

The facility my mother is in altered their pricing in response to COVID which is partly why she has been able to move in. We're talking a decrease in nearly $1000 a month - as well as the discovery that she was eligible for additional VA benefits because my father served during Korea.

Has she applied for and received those benefits?
I applied for additional pension benefits for my Dad back in October of 2019 and He has yet to receive a penny. He fell and was badly injured as a result he required additional care. He qualified for the money so I did all the paperwork. I won’t go into the countless telephone calls and runaround I got. We’ve even involved our local congressman to no avail. The whole thing has been a nightmare and still no money.
My Dad is a 94 year old decorated WW II veteran who served in combat.
It’s a sad state of affairs.
Hope you have better luck.

[MrDB]

Originally Posted by rokdog49

Has she applied for and received those benefits?
I applied for additional pension benefits for my Dad back in October of 2019 and He has yet to receive a penny. He fell and was badly injured as a result he required additional care. He qualified for the money so I did all the paperwork. I won’t go into the countless telephone calls and runaround I got. We’ve even involved our local congressman to no avail. The whole thing has been a nightmare and still no money.
My Dad is a 94 year old decorated WW II veteran who served in combat.
It’s a sad state of affairs.
Hope you have better luck.

Rokdog the VFW has offices right next to the VA in Milwaukee. I contacted the VFW and sent the paperwork to them and they walked it over to the VA which seemed to help expedite the process greatly. This was in 2008 so I don't know if the same process is still being used but a phone call to the VFW couldn't hurt.

[Neil K Walk]

Unfortunately I have only recently acquired POA after she began the process. My mother tends to be overly optimistic and trusting but that’s not from her age but from the era she was brought up in. I’ve had to tell her that “gifts” she sometimes gets in the mail are usually just incentives for high pressure sales pitches. One time she told me she “won” a cruise and I nearly had a conniption because it was clearly a predatory marketing tactic targeted toward the elderly.

I need to contact her advocate. He was the one who pushed for me to get POA.

[AGF_Rita]

Hello everyone. I am Margie's daughter and her POA.

First of all, thank you all for replying. It was kind of you to do so.

To those who said to keep her out because she will die of COVID, unfortunately, that's not the easy answer here. My mom is a flight risk, period.

She has gotten away from three siblings and the last time it was by climbing out my brother’s bedroom window about 8 feet off the ground, (with an already torn rotator cuff), and getting lost in the woods for over an hour until SHE found a house and went up and asked for help. She will get herself killed if we do not get her into a facility that she cannot get out of on her own. She constantly thinks she is being held against her will at someone’s house she doesn’t know and is always looking for a chance to “escape”.

She can’t live on her own, take her meds on her own, dress herself appropriately on her own, bath on her own, use the bathroom on her own or remember to eat on her own. She does get around without a walker or cane in the house, but she could use a walker with a chair, for being out in stores etc. because she gets tired quickly. And every couple hours or so she needs another type of medicine, pill, cream, patch or shot.

She was denied in September 2019 by her insurance to get her in the door of a home, before she can file for Medicaid, because she wasn’t physically ill “enough”, and the home we want her in just told me they’re pretty sure she won’t be allowed in because she is “physically capable of walking around”.

Her insurance (Aetna Medicare) will not pay for in-home care more than a couple days a week of about two hours at a time. This is worthless. It is not possible to watch her 24/7 and sleep, and if you stay up all night you can’t watch her in the day.

This is only working out temporarily because my brother-in-law and his son stay up all night, and my niece watches her in the day while my sister works, and the kids are out of school.

I am dealing with SWIRCA in Indiana as of today. They actually said that part of the interview pre-approval process is to ask the patient if they are willing to go in a home. (And they really need them to agree) Are you kidding me? NO ONE is going to say they want to go in a home. So we will see how far this goes. I am her POA because she can't make decisions, but by all means, ask her if she's willing to go into a nursing home when she thinks there is nothing wrong with her, and she thinks she has a home on "Alice's old road but she can't get anyone to drive her there".

In Indiana, we MUST use this SWIRCA assistance to get her in so this otta be fun.

To everyone I say, please go get LT Care insurance immediately while you don't need it and can still buy it.

[AGF_Rita]

Originally Posted by Neil K Walk

Unfortunately I have only recently acquired POA after she began the process. My mother tends to be overly optimistic and trusting but that’s not from her age but from the era she was brought up in. I’ve had to tell her that “gifts” she sometimes gets in the mail are usually just incentives for high pressure sales pitches. One time she told me she “won” a cruise and I nearly had a conniption because it was clearly a predatory marketing tactic targeted toward the elderly.

I need to contact her advocate. He was the one who pushed for me to get POA.

OMG my mom lived with us for three years, and I can't tell you how many times I overheard her giving away her address and SS number to people before I intervened and took the phone from her.

[Neil K Walk]

This is kind of OT but I think I've gotten my mother to enter into this century. For decades she's patted herself on the back for using a flip phone, disposable cameras and having no cable - just an old DVD/VHS/CRT TV hooked up to a VHF booster for her rabbit ear antennas. She's so self isolated that she doesn't even understand jokes about wearing tin foil hats.

Again, this isn't just senility - this is a lifetime of living in blissful ignorance of technology. I won't talk about her views on hygiene but that's also been a long standing issue that I hope the introduction of peer pressure fixes.

When we talked to the administrator of the retirement home she mentioned that they had "free" cable. To my mother the only "free" stuff comes in her mailbox from Publisher's Clearinghouse so she was dubious and tried to get the cable package taken off her bill so that she could save money - which if our family history is any indicator would be in a shoe box under her mattress. Meanwhile, she was asking us if she could borrow movies because the library was closed due to COVID. She's lucid enough to understand that there's no more Blockbuster video anymore. When I told her to find a Red Box she got that blank "DOES NOT COMPUTE" look so my wife and I told her we'd give her one of our small LED TVs and that she should just get the cable. She'd been wanting to watch The Irishman anyway but still doesn't understand that it's not on DVD; she needs Netflix. We put her name on our account.

[rokdog49]

Originally Posted by MrDB

Rokdog the VFW has offices right next to the VA in Milwaukee. I contacted the VFW and sent the paperwork to them and they walked it over to the VA which seemed to help expedite the process greatly. This was in 2008 so I don't know if the same process is still being used but a phone call to the VFW couldn't hurt.

Sorry it took so long for a reply.
The V.A. has made a lot of changes in the past 24 months as to how claims are processed. As you might expect, it’s a mess. They are basically running 12 months out on some things. I have made about a dozen phone calls from the time I filed for my Dad’s extra pension benefits and I get the same response every time. “Your dad’s claim is in the process of being reviewed.l
I can’t get to anyone higher up the food chain. My sister got our congressman’s office involved and they were told that unless the Assisted Living Facility is planning on throwing him out, the process will have to run it’s course...around 12 months.

[Neil K Walk]

That’s about what I’d expect from the VA. If I point that out to people I’m told I’m a “grump” - but that’s how the government functions: slow, if at all. I’m fully expecting my own mother will be burning through her savings.