They are 83 and 75 (she has early alzheimers. They signed a contract at asstisted living, and they keep cancelling - He shouldn't be driving and one minute they say ok we will go - then the next day they are cancelling saying they are fine in their home for 2 more years. They eat one meal a day at the same restaraunt - if he doesn't feel like driving - or eating - she doesn't eat at all - could be 3 days before she gets her next meal (she doesn't remember and drinks ensure). He drives and shouldn't - she can't remember to call 911 in an emergency - can't remember conversations yesterday - and they both can't tell me what day of the week it is, or when Christmas is - We want to force this move but are not sure how - husband has POA
I had an aide for my father while I worked for about 3.5 years and added an aide (live in ) for the last 6 months when he could no longer walk etc.
The first 3 yrs I was the aide from 3 pm to 7 am the next morning when I went to work full time. On only home health aides (with having a small LTC insurance policy) I paid approx. $150,000. ($40,000. the last 6 months when more care was required). However nursing homes in my area (NJ) ran $90,000 per year and that was the basic cost, lots of add on costs --it would easily have run over $100,000./year for the nursing home.
The added plus was he enjoyed being in his own home and was the only person the home health aide had under their charge.
It can be done, not easily done and I lived with my father so I was ever present to supervise him and his care.
I know some of the local agencies have live in aides for approx. $180./day.
Also my father did not have to pay a mortgage as his home was long paid for, I covered the other costs as needed since I was living there. He had an adequate pension and being a union worker he had good Medicare supplemental policy and dental/prescription card and eyecare policy. These are very needed for the over 85 year old elderly--many lack these benefits from their former employers which leaves the elder with a very big problem.
I would suggest looking into "live in aide" costs, and if he is a veteran see if he can benefit from the VA's aide and assistance program which grants the veteran funds for home health aides and expenses to keep them out of the nursing home system.
Good Luck
I would LOVE to hire a live-in (i.e., full-time, 24-hour) person to come and just be there in case my Dad needs anything, and to make sure he doesn't wander, or set a fire, or fall. As it is, I am paying approximately $2200/month in Southern Oregon to have caregivers come in to supervise and support him for 3 to 4 hours every day ... and his need for support and supervision increases steadily, as he has a progressive dementia. His regular living expenses (e.g., housing, utilities, food) run about $3500/month. Formal memory care facilities in the area start at about $5500/month, so we're already spending more (about $5700/month) to keep him at home (where he really wants to be) than moving him to a facility. And that cost is going to go up as his need for daily supervision and support increases.
Hiring a live-in caregiver through the agency that supplies our current caregivers, according to my calculations, would cost us somewhere around $11K or $12K a month ON TOP OF his regular living expenses ... just not doable over the long run, given that he is only 75 and in reasonably good health, aside from the dementia. Hiring privately would save us $5 or $10/hour over the agency caregiver rate, but raises a whole host of additional risks and problems ... including the need to provide worker's comp insurance, withhold taxes, pay into Social Security, etc. And now that labor laws have changed so that personal care employees hired by individuals like us must now ALSO be paid overtime for any work over 40 hours a week, as if we were small businesses ... this would mean I'd have to hire three or four different caregivers to fill the "round the clock" care without going into the overtime rate I can't possibly afford.
How are you doing it for your Mom? Did you find a private person who is willing to work for minimum wage? Are you not withholding taxes or paying insurance or overtime? Do you just live in an area where in-home caregiving rates are way cheaper than in southern Oregon (we're paying $20/hr currently, up from $18 three years ago)?
Believe me, I'm not asking idly. I would really love to be able to hire a live-in person for my Dad. That would ensure he could stay at home (and not be lonely!) for years to come. But I haven't found any way to make "live-in" care come out as costing less than two or three times the monthly cost of a 24-7 memory care/assisted living facility ... and it sounds from your post as if that hasn't been your experience. If there's a solution to this that you've found to this scenario, I sincerely want to learn. Please share! :-)
While forcing someone out of their home may not be the best solution in many circumstances, they clearly need more of a plan, perhaps in-home help.
A facility never really is like your own home, no matter how good it is, your memories were not made there, and to some a facility of any kind is a holding cell for death...
Some value their privacy how can you be private with so many people, some people value their independence, they want to eat what they want, when they want it...many restaurants cater to seniors, they take home enough for another meal. They can share a meal, because of how large the portion is...
I am not going to say you aren't worried, but right now it is their life until, they cannot manage anymore...and it sounds like they are coping and have a plan in place...some seniors do drive and maybe there will be something with that, they still have to take tests, eye exam, etc, there is something in place to try and catch them if they are too old...
Also if your seniors have an ethnic issue like they eat old European food, going into a facility that only offers American food is also a problem.
In our case, the POA's were quick to make decisions that affected their mother and I the unofficial caregiver (the mother's choice of caregiver, not theirs), she wanted in her own words to be carried out, like my husband and we had every intention of helping her to the ed in her own home, a two flat where one youngest sibling was the caregiver along with his mother to the father and then now the son alone with his mother. They couldn't wait to exude their power, it was biting at them, in a vengeful act, they removed their mother from her home and tried to do what I was already doing, they could not within four months they had her in a very prestigious, nursing home in a small maybe 8X12 room, where they promptly spent her life savings, to the tune of $6,500.00 per month she was in AL but needed more and this facility handled changing circumstances, the other siblings were older and still working (god bless them they take after her, 82 when she retired with ALZ) they didn't want to be stuck, so they tried to do it "their way" and their way was removing her from her home she lost 15-20 lbs in 11 weeks, we were lucky we got her out, but no one got her stuff out... fast forward they paid for three more months forcing the sale of her home by the Guardian at litem and the judge to pay the attorney fees for their lawyers to oppose us who wanted her to live in tht very home. The sale of her home has provided us a rental home and her living expense but no compensation for care-giving, living with the people she felt very comfortable with, able to have her old friends of 50+ years still see her, doing everything in her power to live life on her terms for as long as she can...that is what she wants isn't that what we all want...
Another question is involving private pay: how much income and assets do they have to sustain the 'assisted living'?
another consideration is that they likely (if they decide to move to an assisted facility), they would not be happy in a 1 room arrangement. It may require a 2 bedroom suite, with a living area.. again cost....
In the end, many people simply can't manage at home and in-home care isn't enough. In-home care can often put off the move, so it can be worth a try.
Your advice to choose the home carefully is wonderful. Even if in-home care works for awhile, it's good to start the search for AL early and put the couple on a list. They can always be moved lower on the list or taken off if in-home care is effective.
I have known people who simply wither when they are forced to move from their homes. I've also known many who thrive once they've adjusted to AL or even a nursing home.
Often we have no choice but to go with what works at the time and hope that time will help with the rest.
As you say, stay strong. Something needs to be done.
Carol
You could call your local Alzheimer's organization as see if a social worker can come to your home to evaluate the situation. They can be very helpful and there's no agenda to sell you services. This person may be able to suggest in-home services available in your community, as well.
Take care of yourselves and please let us know how this progresses.
Carol
They probably can be happier at home with support. If driving is not advisable, then they need to be driven to appointments, social outings, church. If they need someone to shop for them or have their food delivered (consider paying for meals on wheels for them).
If they are not able to manage cleaning, hire a cleaning lady for them. Do their laundry weekly or pay a friend to do it for them.
Get the mother in a daycare program for people in the early stages of her disease. This will give the older father a chance to rest while she is being looked over.
If Dad can still do the check writing fine, if not get the POA and write the checks for them so their running bills are paid. I would get a home health aide there daily to help get them bathed etc. If not done already, get the home set up for handicapped especially in the bathroom to reduce the likelihood of a fall.
Bottom line assisted living isn't for people who can be cared for better in their own homes with help. The last 2 or 3 years of life should involve nursing homes and assisted living ---not decades of it. We are living longer, and we can support elders in their home.
If you get a POA remember, you need to assist them to do what they want for their care. I think their cancelling out on the assisted living tells you they know they are not ready for that type of placement yet. When I had the POA I did what my father wanted and we reached "agreement" on the home supports he would receive. Forcing the elder (like forcing a teenager) generally leads to rebellion--you want their last years to be cheerful and you having their respect and love. It can be done. Yes it is more difficult then a transfer to assisted living where the elder is left to deal with strangers meeting or failing to meet their needs. Many assisted living facilities do not offer much support and are ill prepared to deal with your mother's illness or any mental health issue. Don't
listen to the sales job when they say they do it all---investigate.
Good luck---this is aging, it is a normal part of life not a crisis.
Good Luck!