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Mostly Independent
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mstrbill is correct that ALF and MC facilities have wider latitude and are not governed by the same rules. I agree that it is likely necessary now to move on to nursing home care. It is unfortunate, and the fact is that ALF/MC is often a business, and yes, they can and do often "cherry pick" residents. Do understand that if this is a matter of severe acting out the only answer often comes down to medication cocktails, and the elder is between the devil and the deep in terms of either being in a condition to act out and cause much disruption and potential danger to self and other residents or to be sitting in a state of withdrawal and near unresponsiveness. Some dementias comes with such cruel choices. I am so sorry you are facing this.
This happened with my mom, and it wasn’t for physical care (ie, fix it with NH level), it was the troublesome that you refer to. We had to do 24/7 people for about six weeks until I could find her another MC place (ouch $). At the first, she hated where the rooms were (partially underground, I think that’s old school, where they felt they could secure the doors better), and several people there were much further gone than her. The whole place freaked her out. I found another that was more bright and beautiful, ground level, had luck in that the wing with a vacancy had people in as good or better shape than her. The administration at mom’s first one was mixed AL, MC and NH. The one she’s in now is a dedicated MC. That made a big difference, for her and for me. Here I feel like MC is not just an advanced level of AL to them, they’re more ready for outbursts and such. Also I think the first MC was just a shock to her; moving to a second, she maybe subconsciously understood that this IS the type of way she has to live now. Also, we upped the medication a bit. :/ I hope this helps, and maybe you too can find one that may be more to her taste, and maybe better at doing MC. Use their dedicated geripsych to help with meds. Sending you all best wishes in this. 💐
I would ask WHY does my loved one require 24/7 sitters. If my moved one is in memory care, the staff should be able to handle minor issues. If he/she is displaying troublesome behavior I would want to know right away, The primary care doctor or a geriatric psychiatrist can be consulted to deal with troublesome behavior. Also, most problem behaviors would require changing some handling by the staff and probably some medication changes.
If the memory care facility is unwilling to work with you or give more details, it seems like time to find another place.
What is the "trouble" that they say your LO is causing? Some dementia patients, even though elderly, can be a physical or sexual threat to other residents and staff. They can only hire and schedule so many employees to mind a single person. Most likely it is not financially feasible to do this.
He gets up and falls or doesn’t user walker/wheel chair. When in a bad mood will yell at staff. He’s definitely not a model resident as some are. But the monthly fee is high. I just wonder how they could get all these well behaved dementia patients to pay the required fee plus a charge for meds. The staff is minimum and sometimes the main phone line goes unanswered. I have since moved my LO to a SNF who is well staffed and tolerant to ill tempered dementia residents. The building is clean and well maintained although not as fancy as former one. I definitely made the right move at the right time.
Yes, unfortunately it is likely legal. ALF'S and MC facilities have wider latitude in deciding who they want to keep as residents than SNF's. It sounds like it may be time to transition your LO to a nursing home, and to start the process of applying for Medicaid. You can contact your ombudsman for guidance, and also it may be beneficial to hire an elder attorney if you haven't already.
You don't mention why the MCF wants your LO to have 24/7 care? The LO a threat or nuisance to him/her, staff and other residents? Is the facility totally secured against wandering residents. AL and many MC units are geared to provide an "assist" to the activities of daily living. They can not provide 24/7 care (somewhat questionable with staff ratios if many SNFs (skilled nursing facility) can do that either) but in many states if that is what a resident needs the AL is required to ask the resident to move because they can not "meet the resident's current and probably future needs". This is where many people have to transition to a higher level of care ie nursing home level of care and why many people try to locate a facility that can accommodate multiple levels of care on the same campus.
If that is indeed the case, see if the facility has a social worker who can give you guidance on researching new SNF's. You may also want to get in touch with the states Office on Aging for guidance and assistance. Be aware of the fact that Medicare will not pay for custodial care at a SNF. State Medicaid pays for about 80% of the custodial care provided in SNFs in the United States but each state has it's own criteria so this is where the Office on Aging can definitely assist you if you need to apply. Good luck on this journey.
Good point on getting guidance. In my case the social worker at the present facility was less than zero help. In Richmond, VA we have A Helping Hand, a consultant who knows all the facilities in town, sees who has space, arranges the tours/meetings, and his fee comes from the facility you choose. GOD-send!
This memory care seems not to have the ability properly care for your LO. Maybe time to transfer to longterm care. Yes, LOs money will go faster but you then apply for Medicaid to cover their care.
Read your contract with them about limits this memory care has in regard to her abilities. It may be spelled out in the contract. You can also call the ombudsman's office for your area and ask them about level of care and being in memory care facility.
Memory care is specifically for people who have dementia issues and sometimes that means the behavior changes for the worst, too. What kind of troubles is she creating that staff can't handle? Seems that if you pay for 24/7 care - the facility isn't really providing care, so are they going to reduce the cost of facility to just a bed?
For anyone still reading, I see several queries about why the facility isn’t providing 24/7 ‘care.’ I can’t speak for the OP, but the order for 24/7 for my mom was as a guard/sentry, not for care. It was to contain the potentials of her behavior issues. Certainly, the people were caring and there to assist with whatever, but they were guards.
If he's violent or otherwise a danger to the other residents, they certainly would be smart to require extra care for him. My mother's place had a great big man who had a violent temper and would punch the glass doors. Fortunately, they got him out of there quickly, because the caregivers couldn't have handled him much longer.
It sounds like you moved him, so you definitely did the right thing. Some nursing homes are better than others, so you were correct to find one that could handle him.
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.
At the first, she hated where the rooms were (partially underground, I think that’s old school, where they felt they could secure the doors better), and several people there were much further gone than her. The whole place freaked her out.
I found another that was more bright and beautiful, ground level, had luck in that the wing with a vacancy had people in as good or better shape than her.
The administration at mom’s first one was mixed AL, MC and NH. The one she’s in now is a dedicated MC. That made a big difference, for her and for me. Here I feel like MC is not just an advanced level of AL to them, they’re more ready for outbursts and such.
Also I think the first MC was just a shock to her; moving to a second, she maybe subconsciously understood that this IS the type of way she has to live now.
Also, we upped the medication a bit. :/
I hope this helps, and maybe you too can find one that may be more to her taste, and maybe better at doing MC. Use their dedicated geripsych to help with meds. Sending you all best wishes in this. 💐
If the memory care facility is unwilling to work with you or give more details, it seems like time to find another place.
If that is indeed the case, see if the facility has a social worker who can give you guidance on researching new SNF's. You may also want to get in touch with the states Office on Aging for guidance and assistance. Be aware of the fact that Medicare will not pay for custodial care at a SNF. State Medicaid pays for about 80% of the custodial care provided in SNFs in the United States but each state has it's own criteria so this is where the Office on Aging can definitely assist you if you need to apply.
Good luck on this journey.
Memory care is specifically for people who have dementia issues and sometimes that means the behavior changes for the worst, too. What kind of troubles is she creating that staff can't handle? Seems that if you pay for 24/7 care - the facility isn't really providing care, so are they going to reduce the cost of facility to just a bed?
It sounds like you moved him, so you definitely did the right thing. Some nursing homes are better than others, so you were correct to find one that could handle him.
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