How much help do we hire for Dad in assisted living?
He is now legally blind, almost deaf, and was newly diagnosed with Vascular Dementia. We just moved Dad, 96 years old, to Summerwood in CT. My bro is POA who is caregiver. Bro is fried like we are now and hopes to wean dependency out of father by leaving him in AL for 2 weeks and see what happens This is upsetting sister and I. She's in Fl and I live an hour and a half away. I see Dad once a month, noticing memory in steady decline. Although Dad is in a palace with a caring AL staff, they can't be with him like an aide. My rich bro and Dad has funds too. refuses to give Dad an aide even a day a week because Dad will keep asking him, when she is coming. Bro did a pretty good job till now. Can Dad possibly improve his emotional dependency when he has so many obstacles? Will the AL insist Dad get more help?
I appreciate your suggestions. Thanking you in advance.
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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.
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.
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.
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.
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.
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.
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