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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
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Good point about the costs. The cost for the memory care apartment was shocking. The March bill is $7800. His social security, retirement income, half of his wife's retirement income and long term care insurance pay for more than half. The rest comes from savings and the IRAs, and once sold, the value of his condo. This has caused me to try to figure out how my wife and I would pay for ourselves should the need arise. We didn't get long term care insurance because we figured we could pay out of pocket. But not with these costs! We have enough set aside and in IRAs and the value of our home to pay for several years, but hoped to leave a nice estate for our son and his family to help with the grand kids' college costs and our son's eventual retirement. Hopefully more options will be figured out and in-home care will prove much less expensive. For my friends, 24 hour in-home care through an agency specializing in such help would run about $13,000 a month. That was part of my argument to convince them to go the the memory care apartment--it was less expensive and also a place to make new friends in the dining room and activities.
In caring for my friends as their POA, my first step was to tour 8 or 9 assisted living places to see what they were like and how much they cost and did they seem like a place my friends would like. They were in denial about their problems and thought they could live on their own. I found one place in particular that looked really good, with a choice of a two-bedroom, one bedroom or efficiency type apartment in their memory care floor--the only place with apartments large enough for a married couple to come to. When the wife became incontinent and started to wander and needed 24 hour care, I finalized the arrangements after convincing the husband he needed to do this for his wife's sake. The day of the move, another friend took them out for breakfast in a town about 30 miles away and then to have their nails done at their favorite nail place. We were just finishing the final touches in their new apartment when they arrived. The husband saw the same furniture arranged the same way, the same pictures on the wall, and sat in his recliner with a sigh of relief--and has been happy there ever since. I had become friends with the health care professional in charge of the wellness department and she willingly guided me through the different stages of the wife's decline with frontal temporal dementia, so I could get whatever she needed: depends briefs, a wheel chair, a hospital bed-- until she passed away. The husband is happy to stay there, seems physically healthy, but with such an impaired short-term memory, could not begin to take care of himself. I was told that once they were there, they would never have to leave due to their declining. And after paying 18 months at the regular rates, they would accept public financing. I can see my way to pay his bills for about another 3-5 years out of the assets he and his wife accumulated, and, as executor of their estate, I know what their wishes were if there is any money left over. Initially, the biggest challenge was in waiting for something to happen that would make if very clear it was time to move. They were so resistant to the idea they could not live on their own, even though they could no longer drive and were making a lot of mistakes with nutrition. When the husband was in the bathroom and his wife was looking for him, she walked into the next door condo to find him. That owner gave me a call to tell me what had happened. (Many people were on my side with this issue.) She needed to be able to see him and so that is why the memory care apartment had to be large enough for two people. I still go there once a week to visit him and observe things and check with the wellness people. Everyone keeps their eye on my friend and will alert me to anything changing or getting amiss. I feel very lucky in finding this place and I always thank them for their care.
In my husbands case he is not trying to escape but just can't sleep but walks back and forth. They tried medications but non worked at the right time. I was told by an assistant once that not sleeping is sometimes part of the dying process with ALZ. Eventually they will not eat, drink etc. and than the brain shuts down. We must all face death and pray that it is a peaceful passing.
My mthr's MC has locked doors 24 hours, but the windows are not locked for safety. When she started climbing out windows to get to "her" car, they moved her to an inner room on the courtyard - still with natural light, but with a protected area where she could not get away. We were out of town for 2 weeks, and the MC handled moving her furniture, putting up the pictures on the wall, and everything. I only had to come back and admire their work. It is a tremendous relief to know she's not wandering in the middle of the night.
I have observed that many Assisted Living Facility homes have residents that vary in stages of ALZ, dementia, some that require help to dress or use the bathroom etc. My husband has ALZ and is doing OK with assisted living, he does not know any family members anymore. The only complaint I hear is that he stays awake all night and walks up and down the hall. He is not waking others. I did pick an assisted living facility that said they have staff available 24 hours a day. I know someday he will need more care than they can provide but he has adjusted and seems at "home". I am relieved that he is being taken care of 24 hrs.
You might also want to explore the cost of Memory care VS having caregivers come in to the house to help her. This can be VERY stressful on you and other members of the house if others are living there. You also have to take into consideration is your house adaptable so as she declines she will be able to function as well as you and / or caregivers can function and care for her properly, easily and safely.
Tour facilities. Go to support groups and talk to people that have done both, placed a spouse in Memory Care and talk to people that have kept or tried to keep a person at home. I was VERY lucky that I was able to keep my husband at home. But he did not exhibit many of the common problems that so many others with Dementia have. He never got violent and was easy to care for. I did say that I would have no choice but to place him if he did become violent. So decision for placement is not just a personal choice but often a matter of safety. Discuss this with your doctor, her doctor as well as family but ultimately the decision is yours. And no matter what decision you make you will agonize over the thought that maybe I did not make the right decision. Remember whatever decision you make is the right one for you. And many people delay placement and then say ..."I should have done this 6 months ago, a year ago..." There are always what I call "shouldacouldawoulda's" but always keep in the back of your mind If you are doing the best that you can ..that is all you can do...Sleep well with that thought.
I take it that the lawyer assures you that you have the authority to place your wife in a care center even if she does not want to go.
Then you need to decide what kind of a care center is best suited to her needs. She has dementia. Perhaps that means a memory care facility, but she could also be served in a nursing home. Ask her doctor how to get an evaluation of her needs.
When you know what kind of place you need, then do the visiting that freqflyer describes. I would ask how they would handle her current major issue -- is that lack of appetite and not eating? Don't expect a magic wand (and if anyone claims they have one, be leery) but they should be able to give you some answers, because this is very common.
Often the person who shows you around is basically a sales person. Observe how the hands-on staff interacts with their patients.
Placing a spouse in care is usually a very, very stressful and difficult decision -- even when it is necessary and right. Be sure you have some support yourself as you are going through this transition.
Preview as many Memory Care centers as you can. Get all the information, such as the monthly rent, if there are extra levels of care and at what cost or is it already included in the rent? Can your wife continue to stay there and not have to move when her condition warrens a higher level of care? What is a normal routine day like for a person living there?
Then have the Rep show you a room so you can gauge what size. Ask if this is the only room size, or do they vary? Don't try to take the first room they show you, if it hasn't been taken by now, it could be too small, or on the dark side of the building with no sunshine. Small rooms are good for those with Alzheimer's/Dementia, that way the resident can see all of "their things" no matter where they are in the room. It gives them a comfortable cocoon feeling.
See if you can have a meal there yourself. Usually the places will give you a free lunch when you tour the facility.
Are the nurses/aides smiling or do they look frustrated? If yes, but you like the facility, come back the following week to preview the available rooms and see if you see the same thing. Maybe one of the residents had passed away and the Staff was sad on your first visit.
You can put your wife's name on many waiting lists if you feel you have time to pick and choose. The deposits are usually refundable. Also if you are using Medicaid to help pay for Memory Care, make sure the facility accepts Medicaid.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Initially, the biggest challenge was in waiting for something to happen that would make if very clear it was time to move. They were so resistant to the idea they could not live on their own, even though they could no longer drive and were making a lot of mistakes with nutrition. When the husband was in the bathroom and his wife was looking for him, she walked into the next door condo to find him. That owner gave me a call to tell me what had happened. (Many people were on my side with this issue.) She needed to be able to see him and so that is why the memory care apartment had to be large enough for two people. I still go there once a week to visit him and observe things and check with the wellness people. Everyone keeps their eye on my friend and will alert me to anything changing or getting amiss. I feel very lucky in finding this place and I always thank them for their care.
You also have to take into consideration is your house adaptable so as she declines she will be able to function as well as you and / or caregivers can function and care for her properly, easily and safely.
Tour facilities.
Go to support groups and talk to people that have done both, placed a spouse in Memory Care and talk to people that have kept or tried to keep a person at home.
I was VERY lucky that I was able to keep my husband at home. But he did not exhibit many of the common problems that so many others with Dementia have. He never got violent and was easy to care for. I did say that I would have no choice but to place him if he did become violent.
So decision for placement is not just a personal choice but often a matter of safety.
Discuss this with your doctor, her doctor as well as family but ultimately the decision is yours. And no matter what decision you make you will agonize over the thought that maybe I did not make the right decision. Remember whatever decision you make is the right one for you.
And many people delay placement and then say ..."I should have done this 6 months ago, a year ago..." There are always what I call "shouldacouldawoulda's" but always keep in the back of your mind If you are doing the best that you can ..that is all you can do...Sleep well with that thought.
Then you need to decide what kind of a care center is best suited to her needs. She has dementia. Perhaps that means a memory care facility, but she could also be served in a nursing home. Ask her doctor how to get an evaluation of her needs.
When you know what kind of place you need, then do the visiting that freqflyer describes. I would ask how they would handle her current major issue -- is that lack of appetite and not eating? Don't expect a magic wand (and if anyone claims they have one, be leery) but they should be able to give you some answers, because this is very common.
Often the person who shows you around is basically a sales person. Observe how the hands-on staff interacts with their patients.
Placing a spouse in care is usually a very, very stressful and difficult decision -- even when it is necessary and right. Be sure you have some support yourself as you are going through this transition.
Then have the Rep show you a room so you can gauge what size. Ask if this is the only room size, or do they vary? Don't try to take the first room they show you, if it hasn't been taken by now, it could be too small, or on the dark side of the building with no sunshine. Small rooms are good for those with Alzheimer's/Dementia, that way the resident can see all of "their things" no matter where they are in the room. It gives them a comfortable cocoon feeling.
See if you can have a meal there yourself. Usually the places will give you a free lunch when you tour the facility.
Are the nurses/aides smiling or do they look frustrated? If yes, but you like the facility, come back the following week to preview the available rooms and see if you see the same thing. Maybe one of the residents had passed away and the Staff was sad on your first visit.
You can put your wife's name on many waiting lists if you feel you have time to pick and choose. The deposits are usually refundable. Also if you are using Medicaid to help pay for Memory Care, make sure the facility accepts Medicaid.