Bunnyo Asked July 2014
What about Assisted Living?
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My doctor want us to go to assisted living and we want to stay home. My husband and I live at our home and my doctor wants us to go into assisted living. I have short term memory loss from Alzheimer's. I can still get around pretty good with a walker after a fall. I can take care of myself, but don't cook.
Cleaning & wash are done by a lady that comes in. I am 75 and my husband is 80. He still drives good, but is type 2 diabetic. We do very well on our own but she is worried in the event someone falls.
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My dad passed away after nine years and my mom still lives there, 13 years later. I help her quite a bit and have people come in to give her her meds. She has a pendant that she wears in case of a fall. We both have peace of mind that she's in the best place possible for her. It also forced them to downsize and get rid of 35 years of "stuff" that will make it easier for me when the time comes. If you have children, please consider the impact on them.
I'd say at least investigate it and consider it while it's not an emergency situation. For many folks, it's a great move.
P.S. We took an apartment in order to get higher on the waiting list for a cottage but when the cottage became available we decided to wait another 18 months for a brand new apartment now under construction. I'm fully on board with that but one of the reasons was both of us, but especially my husband, felt if left alone we would rather be in an apartment where we'd be closer to others, running into people in the halls and elevator. We're in independent living but we have made friends -- and kept them -- that have moved on to assisted living on this same campus. We can have dinner with them and share activities. If either of us eventually need AL, memory care or skilled nursing, it's all right here and the staff and fellow residents won't be strangers at a time that is likely to be challenging for both the spouse that is ill and the one who is not (or not AS ill). The food here is wonderful and they even change the lightbulbs for us!
I am putting my husband in a memeory care facility that is a three minute walk from our house. But I would stay in your house for as long as you can. I hope you have family that will check up on you IN PERSON frequently.
As for your Doctor's concern that you might fall, she is living in the land of "What If". "What if" is a fear tactic and it sells much better than sex ever did. Pay attention to how people are playing into your fear. DO NOT MAKE ANY DECISIONS BASED ON FEAR.
Best wishes
Nobody can know with 100% certainty what's in their future, so planning for a reasonable level of "what if" is smart and reduces the risk of something really sad and catastrophic from happening. What if my kitchen catches fire? I have a fire extinguisher and fire insurance. Is it 100% certain to happen? I hope not, but until it does happen, it's just a "what if". A what if that is planned for.
These places do get to charge what they want. They are for-profit businesses just like hotels and other apartment landlords, unless they are a non-profit (e.g. the Masonic homes). Non-profits may offer less expensive rates, but you have to shop around and compare what you get for the money.
The doctor talking to you about fall risk is not fear-mongering. Falls are a huge risk to the elderly and can cause other really big and expensive problems. I can attest to that with my own mom. She fell quite often in her home, and had a bad one in April, and is now in a care center for the rest of her days. She never returned home after that, and never will.
My advice as the adult child of mother who REFUSED to plan ahead for her aging is to expect changes, plan for services you don't need to today but might need to use, and downsize your stuff now.
Do not expect family to pick up the slack. People have to work to earn a living and should not be expected to drop their lives and income. Those days are gone and it's really smart to plan to be in a place that can provide the extra help when you need it.
Also consider that by the time you need help, you may not be able to do any searching or comparing, and you'll have to take whatever's open at the moment. Wouldn't it be better to be in a place that has add-ons right there, so you don't have to move again when needs change?
You have the luxury of choice now, but it won't last forever. Get on the stick and look ahead, assume that you are both going to need MORE care down the road, not LESS.
Good luck comparing apples to apples-- they all have a different way of charging for their various menus: one place will do eyedrops as a separate charge, another place only as one of 3 other meds, etc. All of these places have liability insurance---if you have ANY medication assistance, or they see you a little out of breath on the way to dinner, they will record these and their RN will then upgrade your level of "service"....to be billed to you.
DO NOT sign any contract with an AL without having your attorney review it: and keep in mind COSTS WILL INCREASE. It is not like your 30 yr mortgage with a fixed cost--most palces say to expect 5% increase per year, and that is just for the rent portion; the medical portion could all depend on who services your AL.
Meals---some AL include only 10 meals per month and cloak it with suggesitions that if you are on vacation for a couple weeks, you're not losing money....but the reality is, if you want 3 meals a day, it might be another 8+8+12 dollars /day, for each of you.
My point is, YES these AL are beautiful....so is Pandora's box....they want you to move in, and they will do their darndest to keep you living so they can suck all your money out of you.....they are for profit and must charge a premium price, or seemingly small prices for many items.
If you do find a non-profit AL, and get a nice 1BR with a view....keep in mind, when you run out of money, they will MOVE YOU to a dormitory-style room (2, 3 4 or more residents) overlooking the delivery bay, because when you're on Medicaid they need to free up your nice room with a view for someone else who is paying the full price.
I am not making this up, I have personal experience which has taught me all of this is true. My spouse & I have purchased LTC policies but even then, we have a "healthy fear" of getting into a situation where the facility is more interested in building a beautiful building than delivering personalized care.
As my sibling said upon visting one of these luxurious hotel-like AL's, "I ought to invest in one of these places"..... because they are cash cows.
But if you don't behave according to their standards, you get evicted (have a friend whose parent is on their 4th AL, medications are helping finally).
And if you run out of money after paying $60,000/year for all the luxuries, you get evicted--they don't wait for you to find a place via Medicaid, they don't take Medicaid.
Thankfully, I have located two of the nicest AL nearby that do accept Medicaid, for my folks. However, if/when they go on Medicaid, they won't get to keep their apartment---they go down to basement/lookout window level to a semi-private room (2, 3, or 4 people per room). So much for luxury, but I guess if you are on Medicaid you're not going to complain too much.
My point is, these AL centers are really, very expensive and the rent goes up every year (or more with month-to-month lease).
How many people of average means in the US can afford $60,000/year for 10 or 15 years? add another $15,000 for your spouses costs (it costs extra for extra meals and additional medication help, etc).