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I've spent the better part of the week looking for alternatives to my dilemma with financing Dad's continued care.

The VA social worker got back to me, and I have toured the VA approved facilities. They are ALL dumps. They would definitely be a step down from the private pay ALF where Dad currently lives, and I'm struggling with the decision to uproot him from where he is and put him somewhere like that. I just don't know what to do.

The team at Hospice was gracious enough to meet with the director of the Adult Day Center (who was on his best behavior -- of course), and despite him saying how much he "misses" Dad, I learned that Dad was never eligible for the free VA program in the first place because he is in ALF.

I didn't mean to throw the director under the bus, but when I was speaking with the VA social worker she was shocked to hear that Dad was in ALF. It looks like the director of the Adult Day Center conveniently omitted this fact which is a shame because now we're both screwed.

Dad seems to be adjusting to staying at the ALF though he doesn't come out of his room much, so pulling him out to put him in the stinky, dingy VA nursing home is a decision with which I'm struggling.

I would really struggle with moving him in with me (sorry if that's mean), but its not like I have a life anyway. I could quit the second job since I would be splitting rent, BUT I would need to hire help and that would cost extra. I worked out the finances today, and even with that option and a different ADC ($75 per day with Dad's health issues), I wouldn't be saving much.

I was raised to BE the best and DEMAND the best. Dad NEVER let me do anything half ass so I recognize I'm personally shouldering self-inflicted burdens. I have no idea what I'm going to do. There's definitely no win-win here.

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Tinyblu, try not to judge the nursing home if it is dingy.... it could have THE best of help there. Plus Dad will eventually enjoy talking to the other Vets, thus have a lot in common.
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Tinyblu, Dad was in a very nice, upscale MC. At first I thought he was pretty high functioning mentally, but he was confined to a wheelchair and just needed too much help for ALF, and I didn't want him in a SNF. His rapid decline proved he was in the right place. Anyway, he had a nice 16x18 private room and private bath, furnished with his bed, tv, lift chair, etc. I could take him out to the ALF dining room, which was like a high-end restaurant, also to the bar/club for live music, anywhere inside or outside of his unit, tho he couldn't go alone. He was allowed to spend some time in his room, but the staff brought him out to the main area for most of every day. Tho he didn't participate much in activities, there were many of them, along with weekly entertainment brought into the unit. There was also a beautiful courtyard that he had access to anytime, and he was able to navigate thru the doors even in his wheelchair. He formed a couple of friendships, as he was able with his limited communication abilities. The staff to patient ratio was very good at his too, and I spent enough time there to believe that this facility hired some of the most caring people. I know your plate is already very full, but you might want to take another look at MC. Best wishes.
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Thanks everyone. I found this article that shed some light on my "snooty" attitude about everything.

aplaceformom.com/blog/assisted-living-search-top-mistakes-to-avoid-1-22-13/
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Tiny, project ahead to when Dad needs someone there 24/7. You won't be able to quit all jobs and stay home, hiring fulltime care won't be an option financially. If you had a caregiver only while you're at work, you're still on duty 16 hours a day and fulltime on weekends. Plus you'd be doing additional housework with cleaning, cooking, and laundry. Please pause and analyze before you take this step.
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That is a very interesting article, Tiny, with some good advice.

Shortly after my husband developed dementia I was hospitalized. Our kids were worried that I would not recover enough to continue to care for him, so they began a search for a care center. They rejected the VA center they toured because it was kind of dismal, and a staff member told them they were short staffed at the moment so they could only give residents a shower once a week. And yet their staff turnover rate was among the lowest and the residents seemed content. Well, I did recover so that decision never had to be made, but looking back on it now I think maybe the kids were searching for the wrong things.

My sisters found a nursing home for our mother. I was bummed when I first saw it. It was clean and kept-up, but the building was 50 years old, and 50 years ago it didn't have to accommodate the various equipment available now. So it seemed crowded. It was adequate but definitely not lavish. But it turned out to be excellent for Mother. There was staff turnover, as there always is, but there was a large contingent of long-term staff. A lot of staff had or had had family members there. There is a reason for that kind of loyalty. My three sisters and I were able to make good connections with key staff. One of us always attended the quarterly care meetings. Our concerns were always acknowledged.

Mother was content there.

You should continue to be the best and demand the best. But realize that you need the best within the constraints of what Father can afford, and best in what matters most. Very few of us can find/afford the best of absolutely everything. So we need to prioritize what matters most. And that may not always match our "snooty" attitudes!
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I'm really trying to be rational about this, but honestly, the places are DUMPS!!!!! I went back today and tried to look with a more open mind. The places are just gross. Think of a hospital from a horror movie...like the Shining. I was expecting a kid to ride by on a tricycle.

The ONLY way I would even be remotely OK with this would be if Dad was too out of it to know where he was. The room was tiny and of course, the VA only pays for a semi private room. There was ONE chest of drawers and ONE small closet for two people. The residents sleep on old, rickety hospital beds with very little cushion (dad sleeps in a recliner anyway). The toilet is shared, and the communal shower room was DISGUSTING!! Cracked caulking... scuffs on the wall... the floor needed to be buffed. The dining room was a bunch of plastic tables and chairs...

I just CAN'T!!! For a moment I thought there was a ray of hope when I found a VA Family Caregiver stipend program... BUT that is only for vets that served after 9/11.

I'm going to try the place that is actually near the VA hospital (over an hour away), which appears to have been renovated a couple years ago. I'm PRAYING this last one is better. Otherwise, I'll just have to figure something out.
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Tiny, I can't recall from your prior posts -- is Dad getting VA Aid and Attendance? If not, that may help with future costs and especially if you want to look at MC.
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talkey, we have traded messages on other topic boards. Did your dad get VA Aid and Attendance to support MC costs? I have found it impossible to find out if people qualify for that or not. So much contradictory info out there.
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Karsten, I didn't apply for A&A for Dad, due to assets, though that was my intention after a spend-down. (My understanding is there is an asset limit, tho I'm not sure it's published or the same for all areas of the country.) I did end up with a friend, a daughter of another resident at Dad's facility, who had applied for her dad, and he was collecting. If you poke around on the VA website, you'll see a list of qualified "agents?" (not sure if that's the term they use) who can help you apply. The guy my friend used was on that list. Best wishes.
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