Are you figuring in the cost of taking care of an aging parent or spouse?

[athena53]

If the loved one needs to be on Medicaid immediately or after just a few months, it's hard to be fussy. In our area, NH's that take Medicaid clients from the get-go often have a bad reputation and perform only to the extent necessary to avoid litigation.

That's my nightmare- similar to the type of place Blue Collar Guy described. As the number of elderly who can't live at home anymore and whose LTC plan was "Medicaid will pay for my nursing home" increases, it will be reality for more and more people.

 

[Clone]

There is something else that we need to be cognizant f when we are discussing nursing homes. Especially the scene of people sitting in wheelchairs crying for someone to take them away from this place.

There are several possibilities in that scene:

The place may be a terrible place, or it may be a very nice place.

The person may have complete cognitive skills, or they may have minimal cognitive skills.

DW's parents were in a place where they were quite happy once they settled in. They did not move to the total nursing care phase of the facility. Some of the folks in that wing were not in good mental shape, but I feel the staff did a respectful and compassionate job taking care of them. I could not do that kind of work. And I hope that my brain does not fade away and go that route.

But some things are beyond our control. If I were to develop diminished capacities, I would hope that my kids do not try to take me in thinking that they are providing a better place for me. I have seen elderly couples try to take care of each other, and it often does not turn out well. At some point, we may need 24/7 help, and most families cannot provide that.

 

[Walt34]

The place may be a terrible place, or it may be a very nice place.

One thing I noticed when reading up on CCRCs and nursing homes is that almost every article mentioned being aware in smells while inside. In good ones you will not smell stale urine. Ever.

So when we were looking for a place for FIL that was one issue we were aware of. FIL was in a rehabilitation place for a week or so that we were not impressed with since we did occasionally smell that but since it was going to be temporary we let it ride. At the time he was ambulatory and his mind was fine so it wasn't really a concern then.

 

[Fedup]

My dad was in a Medicaid type of nursing home. While it was not my ideal final place, but there was no abuse. He liked it well enough to suggest my mother to move be there. I think for a brief moment he forgot my mother was already dead. He did not have Alzheimer's.
But our family came and visit him often enough, maybe that's the difference. They did steal his money that he hired in his dresser but that's thief and not abuse. He asked us to buy gifts for all his caregivers around Xmas. So I didn't think it was abusive. In general he liked them all.

 

[youbet]

But our family came and visit him often enough, maybe that's the difference.

Being there means a lot. We have someone visiting MIL 5 - 6 days a week. I go most Friday afternoons. At 3 PM, it's happy hour! They convert the ice cream parlor into a pub and serve those who can have it real, live booze! (Remember, this is a skilled nursing facility, not assisted living.) Here come a couple dozen mostly wheel chair bound geezers down the hall looking for a Friday afternoon cocktail. It's a hoot!

My wife, her brother and a lady from church share the other days with my wife taking care of chores like picking up articles of clothing she doesn't want the NH laundry to launder, dropping off and picking up library books, etc.

We all try to get to know the staff on a friendly, first name basis. We give gifts at holidays. I send in a pizza to the night shift staff from time to time. I tip the valet once in a while and he's off his stool and outside waiting for me when he sees me pull into the lot. It all helps.........

We feel fortunate we have MIL in a relatively high tier facility but on Medicaid. But we want the staff to understand they're going to receive all the attention (positive and negative) from us that they would receive if MIL were a private pay customer, which most of their clients are and MIL was for almost two years.

 

[TrophyWife]

Here the article that scared me into thinking about this. Coupled with my MIL's husband passing away. There are already laws in place in several states.

Broke Parents, When Their Medical debt Could be Yours

 

[athena53]

Here the article that scared me into thinking about this. Coupled with my MIL's husband passing away. There are already laws in place in several states.

Broke Parents, When Their Medical debt Could be Yours

Yes, that IS scary. DS and DDIL live in Iowa (a state with filial responsibility laws) and so do her parents. My assets are in a revocable trust that would pass to DS on my death so they may be protected from claims by the state for DDIL's parents' LTC expenses. I need to get to the lawyer who put the trust together one of these days, anyway. The trust had reasonable provisions for what would happen if I survived DH (we knew it was the likely scenario) but it may need some tweaking.

 

[Fedup]

Being there means a lot. We have someone visiting MIL 5 - 6 days a week. I go most Friday afternoons. At 3 PM, it's happy hour! They convert the ice cream parlor into a pub and serve those who can have it real, live booze! (Remember, this is a skilled nursing facility, not assisted living.) Here come a couple dozen mostly wheel chair bound geezers down the hall looking for a Friday afternoon cocktail. It's a hoot!

My wife, her brother and a lady from church share the other days with my wife taking care of chores like picking up articles of clothing she doesn't want the NH laundry to launder, dropping off and picking up library books, etc.

We all try to get to know the staff on a friendly, first name basis. We give gifts at holidays. I send in a pizza to the night shift staff from time to time. I tip the valet once in a while and he's off his stool and outside waiting for me when he sees me pull into the lot. It all helps.........

We feel fortunate we have MIL in a relatively high tier facility but on Medicaid. But we want the staff to understand they're going to receive all the attention (positive and negative) from us that they would receive if MIL were a private pay customer, which most of their clients are and MIL was for almost two years.

I think it doesn't have to be that frequent, every day or every week. But at least has visitors come in on a regular basis, may 2-3 weeks for us, and other family members, plus his church group and friends, his in laws and friends, then it does seem like more regular and frequent. If there is some abuse, there are people to verbally communicate such issue.
I think abuse might happen to elders who are neglected, nobody visits them, that kind of thing.

 

[Teacher Terry]

For the first year we went every week to see my friend but it is an hour drive each way. Now we go every 2-3 weeks but hospice goes 2-3x's/week and I talk to them weekly. Unfortunately when someone gets sick most friends drop off and all her relatives are dead.

 

[Sunset]

It's one thing to help someone out if they have put some effort into planning and tried to be responsible and just fell on hard times...it's harder when you have watched someone make bad decisions their whole life and then they expect you to take care of them. That's just so much harder for me to reconcile.

So true, I have a relative like this.
I'll help out to the tune of $4K /yr. but that is my limit, as I'm not going to make myself a burden on anyone else by making up for all the miss-spent money this relative wasted.

 

[imoldernu]

While any information is better than none, when it comes time to actually make a decision, I believe that nothing takes the place of an extended term of visiting, observing, and then talking to the relatives who have a family member living there. No amount of study or review can take the place of actually being there.

DW was an activities director of a mid size nursing home, and was there tho see everything, every day. The most feared visit was that of a state employee, who would review the home for deficiencies. The list of checks is almost endless, but in the end the report is based on observed violations. Fair enough... but... not the final word.

After going to one of the sites linked here, I was surprised to find that the nursing home in my CCRC, while rated five star overall, had one low mark, re patient safety. Curious, I went to the actual written complaint to see what the problem might have been. It was a five page, single spaced report of a single incident that the "rater" had seen. It happened at lunch when one resident was observed "pinching " another. The review listed in detail who pinched who, and detailed the back and forth between R21 and R21, and the aide who resolved the problem. Yes... 5 pages. The complaint came from the fact that the aide did not file a detailed report of the incident... which resulted in the low grade. That was the one and only observation re: patient safety, and the problem was not that the incident was allowed to occur, but that the proper report had not been filed.

I did not pick and choose this report... and there were no other indications of safety considerations. Mentioned to suggest that sometime bureaucracy can be blind.

One more thing to note... not all websites that purport to list the facilities in a given zip code are accurate. One of the most popular, that is advertised on TV, only lists those facilities who have paid to advertise on the site.

 

[1-31-18]

While any information is better than none, when it comes time to actually make a decision, I believe that nothing takes the place of an extended term of visiting, observing, and then talking to the relatives who have a family member living there. No amount of study or review can take the place of actually being there.

DW was an activities director of a mid size nursing home, and was there tho see everything, every day. The most feared visit was that of a state employee, who would review the home for deficiencies. The list of checks is almost endless, but in the end the report is based on observed violations. Fair enough... but... not the final word.

After going to one of the sites linked here, I was surprised to find that the nursing home in my CCRC, while rated five star overall, had one low mark, re patient safety. Curious, I went to the actual written complaint to see what the problem might have been. It was a five page, single spaced report of a single incident that the "rater" had seen. It happened at lunch when one resident was observed "pinching " another. The review listed in detail who pinched who, and detailed the back and forth between R21 and R21, and the aide who resolved the problem. Yes... 5 pages. The complaint came from the fact that the aide did not file a detailed report of the incident... which resulted in the low grade. That was the one and only observation re: patient safety, and the problem was not that the incident was allowed to occur, but that the proper report had not been filed.

I did not pick and choose this report... and there were no other indications of safety considerations. Mentioned to suggest that sometime bureaucracy can be blind.

One more thing to note... not all websites that purport to list the facilities in a given zip code are accurate. One of the most popular, that is advertised on TV, only lists those facilities who have paid to advertise on the site.

This is a characteristically thorough and thoughtful post from you, Mr. Mold. Have you considered, as I do, that your guidance on this forum is a calling for you in your older years? I feel grateful that you are among us and are willing to share your wisdom freely.

 

[pb4uski]

It is "I'm older than you", im-older-n-u...... get it? ..... not Mr. Mold!

But otherwise you are correct, and esteemed member of our community who has the experience of having been retired for a long time.

 

[Amethyst]

A lady who does videos on Alzheimer's and dementia, Teepa Snow, says the cry of "take me home" often means "make me like I used to be." The unfortunate s don't even know where home is anymore. But they know something is wrong with them. I would prefer death - the dead know not anything, as the Bible says.

 

[audreyh1]

A lady who does videos on Alzheimer's and dementia, Teepa Snow, says the cry of "take me home" often means "make me like I used to be." The unfortunate s don't even know where home is anymore. But they know something is wrong with them. I would prefer death - the dead know not anything, as the Bible says.

A longtime friend of my Dads, who was at his assisted living place when he moved in, told us many times she wanted to go home. She doesn't recognize anybody, although she could tell that we knew her by our reactions - well, we did address her by name, and she made us explain how we knew her.

So thanks for this gold nugget, because all I could do was be friendly and sympathetic, knowing that no way could she go home.

This explains a lot.

It was hard for us to see her like this as we remember her well from 10 to 15 years ago when she still had her memory. She was one of my mom's best friends growing up.

I guess we all feel so thankful that Dad still has a clear mind in spite of his physical frailty. He's our only surviving parent between DH and me.

 

[Teacher Terry]

A good friend of mine has Alzheimer's and has been in a home since she was 64. I had to put her in one because her DH was dying from cancer and she had no other family that was still alive except nieces who could care less. She is too bad off now to ask to go home and is dying from cancer which is a blessing at this point. WE bring 2 of our dogs and it cheers everyone up.