How much help do we hire for Dad in assisted living?

Let Dad adjust in the AL. Your trying to micromanage his care from afar when he is in a facility that has "caring staff". Your not his DPOA & really if your brother who was Dad's caregiver (which you said "did a pretty good job till now") & his DPOA made this decision, you & your sister need to abide by it. Not to sound harsh, but your Dad chose your brother as his DPOA, not you or your sister.

About your "hiring an aide". The facility has requirements for staff & liability issues for outside vendors that have to be abide by. Family just cannot hire their own personnel to take care of an resident.

At some point in the near future, there will be a "care plan meeting" for dad. For NH residents, the timing is set by Medicare requirements to be done within the first 30 days and then every 90 days. For my mom, the NH mailed out a letter 2 weeks in advance for her 1st NH and a month in advance for her second NH with a specific timeframe choice for the meeting for me to choose from. For AL I'd bet it's probably is more case by case as to the CPM. In the CPM, the DPOA meets with rep's from staff from the different departments to review Dad's care and the ability of the facility to meet his needs. There is a likely possibility that once staff has the ability to evaluate dad on a daily basis that your dad (at 96, blind, deaf, vascular dementia) will be evaluated to move from AL to NH as his level of care will require more skilled nursing services. Hopefully dad has 300/400K available as NH private pay easily 12K - 15K a month.

Have my dad in assisted living, memory care unit. He's 95, almost totally deaf and has macular degeneration. I would say is vision isn't legally blind but not good either. He only went in 2 weeks ago. I wondered about hiring an aide to be with him but I now see that my worry was unwarranted. He is doing beautifully there. The aides are wonderful and take wonderful care of him. There about 6 patients per aide. I was told not to visit the first week so he could get adjusted, but he keot asking fir me so they asked me to visit, but just before he went i to the dining room for lunch. When he went, I made my exit. He hadn't asked for me again. Feeling guilty, I went to visit yesterday. As soon as he saw me it was let's go now, I stayed here long enough. As soon as I left he was fine. The period of adjustment differs among patients. His short term memory is no good, but he can remember some things from the past. The short term memory will deteriorate. My point is to let your brother do his job with dad. It isn't easy to be the one who takes the parent out of their home and it does take time for the parent to adjust to new surroundings. I'm sure that the facility itself will tell your brother if they think dad needs his own hired aide. I feel for you as it sure isn't easy to watch our parent decline.

We have someone with Mom 3x/week for 5 hours each time. That person was my mom's part-time aide for 3 years prior to moving her to AL. I was doing the remaining portion of time. Like everything else, there are pros and cons to having her there. Biggest positive we see is to us, because there are another set of eyes and ears advocating for Mom's care. And it lets us all have our own lives, something I didn't have for 5 years while caregiving for Mom.

Please give him some slack. The decision to place your dad in AL wasn't made easily. I am sure your brother was being crushed by the responsibilities of (primary) caregiving and DPOA. He is smart to have the 2-week settling-in period before making any other changes. Wish we did. Though I do think the outcome would have been the same and we would have gotten the aide anyway.

When my client went into a (VERY posh) NH, she asked if I could stay on as P/T help. I was amenable, as was the NH, but the truth was, there wasn't really anything for me to do! She had all her housekeeping, laundry, etc., done by the NH. All she wanted me for was transportation to the hairdresser's once a week and just to get out. One of the main reasons she had to go into N was that she was having periods of dementia, and driving or shopping with her were tiring and often fraught with fall dangers, etc. Eventually she accepted the NH's shuttle service (at a MUCH lower cost than having a personal caregiver) and she adapted to the NH. To wean her off of continually having me around...I just "visited" a few times, did a few little things for her and then I actually went on vacation myself, when I returned, she didn't remember me. Sad, but it showed how quickly she lost that memory. The family was paying over $10K for her monthly care, why should they have thrown another $2k to my company for essentially another warm body? She was almost never "alone"....showing me that unlimited money can indeed buy terrific care. Also, many NH will not allow outside aides--just a liability issue.

I think your brother is not informed about dementia and if he thinks that your father's dependency can be weaned, then he is not dealing with reality. Regular Assisted Living can only do so much. And since dementia is progressive, he's not going to get better with that condition. The AL facility will alert the responsible party, who is your brother, about problems. I suspect that he will soon realize that dementia patients cannot be rehabilitated. Does he understand that it's brain damage?

Since your input is limited with the facility, you can't schedule team meetings, but I think I would still let the AL facility know my concern, his dementia diagnosis and that I was concerned that the level of care was sufficient. If you are right, they will notify brother that he needs more assistance.

I have never had a parent in an AL but what Igloo says seems how things worked for relatives.

From what I understand about ALs, the cost depends on the amount of help someone needs. The more assistance they need the higher the cost. Like mentioned, he will be evaluated by the staff. Their recommodations will be discussed with the MPOA. ALs are limited and will suggest longterm nursing care if they feel thats where the patient will be. Remember, most ALs don't except Medicaid. So when the money runs out, he will need to apply to Medicaid and go in a nursing facility if no one can take care of him.

I just need to say, POA are written up in case a parent becomes where they can no longer take care of themselves. It can be revolked by that same parent if of sound mind. It is also null and void at time of death then the responsibilies of the estate fall on the head of the executor which doesn't mean its the same person. I have never thought that having POA meant I "take over". Its just I'm the child who lives in same town as Mom so it made sense. I " do" keep my brother in the loop. Especially since we r selling Moms house.

I agree, give your brother time to sort things out. This all is probably new to him. The AL personnel may open his eyes that ur Dad cannot be left alone. If money is there, than use it for his care. It may take some burden off ur brother.

Please, don't assume because your brother "has money" that he has a financial responsibility. Having the POA does not make you personally responsible. I have a SIL that assumes everyone (3 of us) can each put money in for Moms care if she can't. My husband and I are retired. We are comfortable but not rich. Own a house that constantly has upkeep. Living in NJ, taxes and car insurance the highest in the nation. (SIL lives in NC with my brother). If my brother heard her say this, he would have a puppy because of their money situation.

No, ALs don't have aides on a one to one. What they have is a common area for residents to be with other residents. They eat meals together and have activities. Some elderly do well because they r more stimulated and feel they have more independence than sitting at home alone.

Don't hire anyone. You're dad is probably already paying big bucks for the AL that has a staff.

As noted above, since you are not POA, you don't have direct input, but I would cut your brother some slack.

Each Assisted Living Facility that I've ever looked at for my mom did their own assessment and determined if they could manage the client with their own staff and at what level. If Dad needs an aide, the facility will not be shy about saying that he needs more help.

To my way of thinking, if a person goes INTO AL needing an aide, they probably need a higher level of care. As someone else mentioned, dementia only gets worse (and he's not going to get less blind, Lord knows); so if he needs an aide now, he probably is a better candidate for skilled nursing care.

I would consult with the facility about making yourselves scarce the first week or two. I think that is very much dependent upon the patient.

Thank you so much everyone!!! It's been a week since Dad went in to AL. I found out that there is a staff member whose sole job is tending to new AL residents for 6 weeks! She helps Dad get to activities, learn to find where things are and how to use the facilities. She introduces him to people and yes, they have a staff there of nurses and helpers of all kinds. My brother visits Dad twice a week, at least, takes him to doctors, and calls him daily and poor bro has a demanding wife and demanding full time job.

My mother and I will visit Dad next week. So far he sounds like he is doing better and better.

Bro said Dad has a foot wound that is not healing: I think from Diabetes 2. Just learned that honey really heals such wounds! Found doctors success with it online in many good sources. Hope Dad's doctor goes with that route.

Will let you know what happens. I know it won't get much better: at 96 with so many obstacles and memory decline. But even if he has another few months of a pleasant life it will be worth the move before the NH phase sets in.

Bless you all.

Glad it all worked out. When I worked for our local Visiting Nurses, I received calls all the time from upset family members that didn't know what they were going to do with parent once discharged. I would explain that a Social Worker would talk to them before discharge. Options would be discussed about their continuing care. Rehab maybe even suggesting longterm care. Therapy at home. You are under no obligation to follow suggestions. But, if there has been a question concerning longterm nursing for a family member and its suggested, this is the time to do it. Medicaid is more likely to except a patient going directly from a hospital/rehab to longterm than if u take the patient home and find u can't do it.

juddubuddhaboo! Hope the honey helps. I take a mixture of cinnamon and honey each morning for arthritis in my joints And it works! The cinnamon is supposed to be good, too!
Bless You!~

Took my Narcisstic BPD mother to visit my father in his new AL. We spent most of the day with him: took him out to lunch, walked around the grounds with him, rested in his room with him, and ate dinner with him. My brother joined us for the evening.

Dad seemed to be doing better than I thought and he has days when he panics for a few minutes and then resumes his new life. His memory is not good at all, but we think his hearing is his worst enemy. My brother, God bess him, has tried different hearing aids, different doctors, different devices to help him communicate. My brother, in his new role as DPA, and now conservator, is a great problem solver and has built up trust while trying to wean Dad off of his (life long) dependent behaviors.

Bro uses an iPad to type in questions to Dad in big letters (Dad's sight is terrible too) and Dad can read that and respond. But Dad can't learn how to use the iPad and Henry is not there 24-7.

Dad told us a few jokes and smiled on several occasions, which was a real bonus!

What troubled me was my Narc mother's behaviors which I found repulsive, annoying, and offensive, although I am positive that SHE thought she was God's gift to Dad! Actually she pretty much told me that: "I know that God has helped me live just so I can help Dad be happy now." My word, how much delusion and BS can a daughter endure? By the time I got away from her I felt I had just showered in BS.

I hope that Dad found her more pleasing! He looked bewildered, but then he always has that look on his face these days. What Mom looked like and the way she acted, no playwright could have dreamed up! Picture Talulah Bankhead or Lady Gaga on Steroids at 94 visiting her x husband in the AL!

The same woman who had beat her kids, made my father cry, cheated on him throughout the marriage, and NEVER had a conversation with him of any substance or meaning during their 30 year marriage was now draping herself over him like a long lost pal, hanging on to the frail man (probably to keep herself from falling over), and cutting out any possible communication between me and my Dad by interrupting, putting me down, waving her hands and scowling at me whenever I tried to say anything!

Yeah I was blazing mad by the time I drove home by myself late last night and could barely sleep sorting all this junk out.

Trying to set a boundary to avoid this scene again soon I told her in the car on the way home that that all day visit and drive to and fro was too much for me and I planned on going down by myself the next visit. I'd take her every other time.

She got out her F.O.G horns with, "well you might change your attitude knowing we won't be here forever." I said, "No. That doesn't a thing for me."

Enough is enough. Now I will be curious to hear what Dad thought of that visit. If he really liked seeing her, I'll have to endure, but darn it, I'm going to see him on my own and not bring her often.

Several times, I the now senior babysitter had to order my mother to let go of my father because in her Narc way she was grasping his hand leading him without noting that he almost fell over from her forceful and oblivious lead!

I also didn't like that she was clearly demonstrating to everyone at the AL what a good "wife" she was. My father already is full of guilt and pain visiting his real wife in the nursing home dying of Alzheimer's).

Well, had to vent. Anyone relate to this stuff? How do I navigate this without having my own anger eat me up? I felt like my veins were going to burst yesterday watching her.

So sorry your visit with your Dad went the way it did. I realize mom was no help!!
A full day may be a bit long, but you would know that better than anyone! Seeing Dad on your own is a good idea, but be careful of talking "about" Mom in the time you have with him. There are lots of other things to visit about. Come here to vent, that is good. The only way your own anger will NOT eat you up is if you give this anger up. Nothing you can do to change Mom's behavior! Nothing you can do to change whatever hassles she is fighting with. She is fighting with herself.... Don't you do the same with yourself!! LET IT GO!! That way you can spend what time you have with Dad in Peace.
Yes, this is much harder than I make it sound. Anger is a powerful emotion and It can easily eat you up. Your taking your Mom to see Dad must have been an a monumental project!! I applaud you for giving it your best!! Now take care of you. Feel free to message me anytime!

To some extent, you would have to ignore your mother's UNACCEPTABLE behaviour!

Thanks you guys. My mother called me today to thank me for the "beautiful time she had!" Chuckle, chuckle. Yes, she had a great time. She did not notice how her behavior effected me or Dad. Well, that's mental illness. If she wasn't like that she'd had been a totally different mother, wife, etc. It's pathetic and some of me, now that I am home, can feel compassion for her own guilt trips that she is trying to fix by this tripy behavior.

Ah well, I wish I were one of those women who can be kind and unruffled by others. I am trying...

You have a 'win' for your side, if that is the way you see things. MOM is happy now. You have accomplished your goal. Both Mom and Dad are satisfied with the visit. I know you weren't, but they are the ones that matter as they have no filters to let them know when they have 'fouled up'. God Bless You for your very hard work in this caregiving struggle!!

The good thing about visiting Dad with Mom was since she took over I was off the hook for trying to communicate with him. But yeah, next time I go alone.

Hi Everyone. Dad is doing great so far. The place where he is has a great staff and all kinds of options for help that are reasonable in cost. He is slowly adjusting to this and the changing family situation. The person in the family who was stealing thousands from Dad is going to be in deep hot water because my brother hired a lawyer and is trying to punish her. I am just an observer: only the daughter who has no voice in this scene. Brother seems to be saving the Dad though doing all the right things for Dad and has established a good relationship with him: probably only time in their lifetimes that they had one. I am counting my blessings the brother who didn't look like a nice bro or good son is now coming into the light. Old wounds are being healed over the care of our father. Even between my divorced aging parents.

Meanwhile I am still riding the waves of being there for Mom. Luckily she is still taking care of herself at 94, has other helpers, and I have assigned myself to manageable roles without getting sucked into her often negative energy. Many times we have what could be fun.

I pray that both of them go out of this life in some kind of relatively painless fashion. But that's up to the Divine Director.