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Stair lift
Old 04-30-2007, 12:39 PM   #1
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Stair lift

My elderly Mother in Law may be moving in with us, as she is getting too frail to live in her own home and we can't afford the minimum 50-60k per year for a nursing home in Texas where she lives. Incredibly, I've been told that's very cheap compared with nursing homes in the DC area where we live, which can be >100k fricking bucks (that's US dollars, not pesos).

She can walk with a walker but has a hard time with stairs and baths, can't cook for herself, and needs help with meds. So we're thinking of making our home handicap accessible, and my wife and I would care for her as much as we can, and call in a nurse when we can't.

In case anyone else is in the same situation, or has better ideas, here is what I've found out so far. The biggest hurdles to handicap access are stairs and bathrooms. Bathrooms are easy compared to stairs. All it takes for the bathroom are some hand grips, a special toilet seat, and a fitted cutout to make the tub into a shower only.

Today I priced a stair lift, one of those chairs that rides an installed rail. There are many on the market for straight stairs but only a couple for curved stairs. Unfortunately, my home has curved staris, and those have to be custom made and cost 11,700 installed for my home. Alternatively I can get two straight lifts for 5,600 and have her manage two steps between the curve, which I think is doable. I don't understand why a curved rail, with one motor versus two, should cost twice as much but I'm not in a position to argue. I've seen some resales on ebay but am nervous about doing my own installation.

So it looks like two straight chair lifts, some mods to the bathroom, and a ramp or two on the outside steps and we will be in the nursing home business.
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Re: Stair lift
Old 04-30-2007, 01:17 PM   #2
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Re: Stair lift

If you haven't already, you might want to look at retrofit elevators. I understand that the cost has dropped quit a bit, depending on your home's design.
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Re: Stair lift
Old 04-30-2007, 05:03 PM   #3
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Re: Stair lift

Quote:
Originally Posted by Martha
If you haven't already, you might want to look at retrofit elevators. I understand that the cost has dropped quit a bit, depending on your home's design.


I have an elevator and it's great but I'm afraid if it breaks down I'll never get my Mother up the two steep flights into my house so I'm looking at a one story house.
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Re: Stair lift
Old 04-30-2007, 05:43 PM   #4
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Re: Stair lift

SoonToRetire, is there no way to make room for her downstairs?
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Re: Stair lift
Old 04-30-2007, 05:53 PM   #5
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Re: Stair lift

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Originally Posted by Outtahere
SoonToRetire, is there no way to make room for her downstairs?
I initially thought about that but don't think it would be a good idea. We have a 3 level house with the main level having the kitchen, LR, and half bath with no shower. There is a small room that could be converted to a sleeping area, and when we've had here here temprorarily we set up a bed there. The big problem is the lack of a bath, and there is no room to install one. And the area is pretty small, so she would not be as comfortable using that full time. So it is up or down.

Upstairs are 2BRs with full bath, downstairs is 1 BR with full bath. If she had mobility either up or downstairs, she would have her own full size BR with bath. During the day, she could come to the main level and be here most of the day, then in the evening retire to her BR upstairs.

The alternative is to sell and move to a ranch style which we were going to do, since we live in an overpriced aea, then the housing market ran into a brick wall. I refuse to sell at a big loss if I can find alternatives for my MIL, and would rather spend 5k for her mobility, then when the market recovers look for another home in a cheaper market. I can wait out 10 years if I have to.
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Re: Stair lift
Old 04-30-2007, 06:41 PM   #6
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Re: Stair lift

The elevator idea won't work? It's easiest if you have closets stacked above each other or another "natural" shaft location. Do you have a coat closet near the entry way? Anything above it or below it that might be a good locaton for the elevator shaft? What's above and below the bedroom closets in the BRs she might inhabit?



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Re: Stair lift
Old 04-30-2007, 06:47 PM   #7
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Re: Stair lift

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Originally Posted by samclem
What's above and below the bedroom closets in the BRs she might inhabit?
Mmm.. had not thought about the closets, just checked and I do indeed have some stacked closets where a shaft could fit. Any idea what an elevator would cost? My guess is a lot more than a stair lift, and it becomes permanent, right? I will make some calls.
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Re: Stair lift
Old 04-30-2007, 08:08 PM   #8
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Re: Stair lift

Also, perhaps some of our CPA types can chime in here, that may be fully deductible for a medical accomodation if it meets the % of expense items.
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Re: Stair lift
Old 05-01-2007, 03:08 AM   #9
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Re: Stair lift

My brother had the same problem. He installed a stair lift chair... but he has a straight staircase.

You could build an addition on the house. It is a little more expensive, but when you sell down the road, you could probably recoup the expense.

One problem you will encounter is that if you do not have her room close to yours, you will be running up and down that stairs yourself at odd times in the night.

I would suggest that you try to understand your limits in caring for her. What can (or are you willing to do) and what you cannot do. And use her current rate of decline to attempt to project when you might consider putting her in a nursing home. This will help you to plan more appropriately.

You did not describe her diagnosis (cause). You will most likely have to put her in a nursing home eventually if she continues the decline. Her needs will likely outpace your ability. You probably do not realize the medical complications that she will begin to encounter over time. People with mobility problems are difficult to care for. Many of the underlying illnesses cause the person to decline. You should talk to her nuerologist to understand her problem and what to expect.

My strong advice. Do not use 2 stairlifts. The transfer from chair to chair will be difficult on you. Buy the custom one that curves and take her all the way up and down. You can consider buying a used system. The curved part will probably need to be custom built. Do not scrimp on the tools. They will make your life more manageable.


Again... understand your limits and get her on the list of the best nursing homes you can find in your area once you relocate her.

Good luck! We are in the late stages of doing what you are beginning to do.
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Re: Stair lift
Old 05-01-2007, 07:59 AM   #10
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Re: Stair lift

Quote:
Originally Posted by chinaco
Again... understand your limits and get her on the list of the best nursing homes you can find in your area once you relocate her.

Good luck! We are in the late stages of doing what you are beginning to do.
Thanks for the advice, chinaco, especially since you've been there and this is new territory for us. It will be a definite change to our lifestyle, but there is another sibling who will switch off with us so it will just be six months out of the year. The other six months we can keep our normal lifestyle which includes a lot of travel. When we care for her we can still do our local boating and other day activities, since she is OK on her own for a few hours and has an emergency call device.

As far as her condition, She's 89 and right now her only problems are diabetes and an inability to walk very far without a walker -- she loses balance and can fall. But with help she can climb stairs. Her doctor had been putting off a wheel chair because he wanted her to keep using her muscles but finally said we should get her one. Her mind is sharp, and she can shower and clothe herself with a little assistance from my wife. So I think she is manageable for home care at this point but you bring up a good point that I hate to think about.

What if she declines, which she will, to the point that we can no longer care for her. I really don't know what to do at that point. She gets about 23k per year in SS and pensions, which is 1,000 per year more than is allowed by medicaid but about 80,000 per year less than the cost of NH in our area. Not many retirees, or even full time workers, can afford that year after year -- I know I can't.

I guess I'm hoping we can care for her until she is so feeble that she needs hospital care, a few months NH, then hospice care in the home. Medicare does cover that, I understand. My parents cared for three elderly and sick family members in their home for years until they passed away, and it was tough but they did it, so that set a good example for me. Our life will definitely be different, though.

On the lift, my gut tells me you are right and I should bite the bullet and get a curved lift. I've been focused on the lift right now because that's something I can control and there is so much that I can't. I found a support forum for caretakers and started reading it but what I found was a lot of anger and hostility, I hope to God I never get that way but I'm not going to judge someone else who is in that situation, venting is probably the only way to get through the situation. Well, wish us luck, and good luck to you. And to anyone who doesn't have LTC insurance, get it when you're young enough to be affordable. We got ours in our 40s for 117 per month each. I'm sure we could not afford it now.
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Re: Stair lift
Old 05-01-2007, 05:45 PM   #11
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Re: Stair lift

Quote:
Originally Posted by SoonToRetire

What if she declines, which she will, to the point that we can no longer care for her. I really don't know what to do at that point. She gets about 23k per year in SS and pensions, which is 1,000 per year more than is allowed by medicaid but about 80,000 per year less than the cost of NH in our area. Not many retirees, or even full time workers, can afford that year after year -- I know I can't.

On the lift, my gut tells me you are right and I should bite the bullet and get a curved lift.
Sharing the load with another family member will make it eaiser... That is what we have done.

Medicaid will pay foryour MIL once a doctor indicates she need that type of assistance. They will expect her to use her money Once she exhaust any assets, Medicaid will pay. I think she will have to pay some of the 23k income toward the NH bill... but she will probably get to keep some of that for certain living expenses. Call your state medicaid ombudsman and they will share the details.

On the Stairlift. You will have to do lifting eventually. Not to mention the possibility of an accident. Even if the curved one costs a couple thousand extra it will be worth it. Trust me.

If the money is a stretch, buy a used one. Many of the companies that install these things buy them back ans resell. You will need to talk to several local dealers. I will bet you can get a used one and save some money.

One other thought, use your MIL money to pay for the lift. She can afford it. Medicaid will not hold it against you. Any money used to help keep her out of a NH saves the state money. Again, call the state Ombudsman.

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Re: Stair lift
Old 05-02-2007, 07:01 AM   #12
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Re: Stair lift

Boy do I feel you on this one. We moved my MIL from California the Pa at the age of 89 and cared for her until her death at 91. She also had severe mobility issues and could not climb stairs of walk without assistive devices. We kept her in an apartment (elevator access and one level) near our home for most of that time. Our home is a three story and we did not have the means to make a modification at that time and she did not want to move in with us (did not what to be a burden) She was able to afford nursing care ( home health aids) in the apartment and this turned out to be much more cost effective than assisted living option we researched. Those places are expensive for what you get. That said taking care of an Elder is not for the faint of heart so do not try to go it alone, it is not worth it.

If I can offer a few suggestions. Talk to her doctor and see if he can get you in touch with any Elder care case management services in her area. These are Social workers who can help you negotiate the in and out of Eldercare and can help make her relocation go smoother. If she needs to go in the hospital you can access this through the discharge planning department who will get you in touch with home care services. Use them. They have a wealth of knowledge and will be of great deal of assistance for you. She will need a new Doctor when she moves in with you. A Geriatrician, a doctor who specializes in the care of the elderly, is the way to go. You can find them when you do a physicians search. Your in the DC area, see what Elder Care services are near you, they should be in the phone book.

AARP has a lot of information on line. They also have one of the best books out there for care givers. Check out their website. They also have links for universal design ideas to modify the home for a disabled person. Some of this can be covered by Medicare. ( you need a three day stay in the hospital prior.)

The CMS website (Medicare) has a lot of information also but I cannot stress getting the pros involved ASAP. You will go nuts trying to coordinate services your self. These people do this for a living and keep up with all of the changes in rules, regs and the like.

As far as online forums we did not find them to helpful. What worked for us was friends and family and if anyone offered to help we let them.
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Re: Stair lift
Old 05-02-2007, 08:09 AM   #13
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Re: Stair lift

Trebuchets are fairly inexpensive, but you'll need a lot of room in the entryway for one.
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Re: Stair lift
Old 05-03-2007, 03:25 PM   #14
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Re: Stair lift

Thanks for the suggestions, appreciate them.
Surreal, excellent suggestion about elder care specialists. Today I inquired at my regular doctor's office and they were pretty clueless, said I should call social security. I'm going to look for a doctor or social worker who specializes in elder care issues.
Chinaco, I may not have understood properly but I thought medicaid only applied if your income was below a certain level and it depends on the state. When I did the calculation some time back she missed by a thousand a year or so, and I thought that meant she was SOL even if she used every penny of her own money. One thing is clear, I need to talk to a professional about this and get the facts.
CFB I had to look up what a trebuchet is and if I got it right I could get her upstairs but would not get her back down gracefully.
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Re: Stair lift
Old 05-03-2007, 04:00 PM   #15
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Re: Stair lift

An attorney who specializes in elder law would be a smart consultation. S/he could also make sure she has all the paper work you might need as her life progresses.
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Re: Stair lift
Old 05-03-2007, 04:55 PM   #16
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Re: Stair lift

I can't help but think that there's a better solution than a $12,000 device that you'll use for a few years, then throw away.

I Googled "used stair lift" and got things like this:

http://www.tkaccess.com/used-stair-lift/

I'd do a lot of brainstorming on this.
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Re: Stair lift
Old 05-04-2007, 10:23 AM   #17
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Re: Stair lift

Quote:
Originally Posted by SoonToRetire
CFB I had to look up what a trebuchet is and if I got it right I could get her upstairs but would not get her back down gracefully.
You just need a second trubuchet, or a couple of thick mattresses.

I figured a lot of people would find helping their in laws upstairs on a trubuchet to be a pleasing thought.
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