My mom is in AL and pays over 5,000 a month because of her care level. She currently is experiencing some delirium as a result of yet another UTI and had fallen three times in 24 hrs. The AL said she needed one on one care and recommended a private caregiver company to me. I hired them at 24 bucks an hour to take care of Mom, hoping that the delirium is temporary and that she will snap out of it as she has in the past. The AL facility is refusing to adjust the billing even though they are not currently bathing, transporting her to meals, dressing her,or putting her to bed. Their response is that we are paying for additional service that they do not provide, when the reality is their service is temporarily suspended, and I feel the billing should be adjusted as they do during times she is hospitalized. I also want families to realize that "Assisted Living" implies a level of independence. They do not provide companionship and many of the amenities they brag about in their advertising are actually available for an extra charge, like that transportation to the doctor or grocery shopping. And if they require a caregiver to come with them, that's an even bigger charge. So done with these ripoff AL facilities. We are going to move her to a residential board and care.

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kwyattearp, I've had excellent luck with an Independent/Assisted Living facility that is nationwide. But I do realize they are not all created equally.

One time my Dad needed 3 shifts of private caregivers after coming home from the hospital after he had a bad fall. Dad had a set monthly cost for the apartment, with options for more help needs. Those options that Dad used were suspected until Dad was back to normal, then the options resumed once most of the private caregivers had left.

The facility still did their weekly housekeeping, weekly linen service, and the meals. Plus there still was the 24 hour a day nurse available, etc. The private caregivers worked hand-in-hand with the Staff. The employees would still stop by to see how Dad was doing, and if there was anything he or the caregivers needed.

Regarding transportation to the doctor, that requires two employees. One to drive the bus, another to be with the resident, taking him/her into the doctors, waiting, etc. Where my Dad lived it was $25 round trip within a 10 mile radius. Now, if I had to take Dad to a doctor appointment the old "time is money" would be a lot more than $25, plus the added stress.

Trips to the grocery store, the Dollar Store, to Wal-Mart were all free, as that was an "activity" that was well used by the residences. Of course, I couldn't imagine trying to round up all the residents at Wal-Mart, it would be like herding cats !!

Although I don't have any experience with AL, I've come to realize that the health care market for elder (so-called) options or solutions is a potentially massive market, attracting people through franchised operations, and drawing in others with the desire to exploit the market but not really understanding (or caring) about legitimate care. Just my opinion though.

Some of these people have little experience in elder care. I had to restrain my laughter, yet shocked response when one franchise owner told me he could train a home care worker in 4 hours. Another said he had "12 girls available". Sounded more like a harem or house of ill repute than a care agency.

Another company planned to send an "account exec" out to do the initial assessment. He was formerly a financial person, not a medical professional. But he thought he was qualified to make a medical and ADL assessment.

As I've told a friend, I've just discovered that one private duty company has altered its privacy policies to allow use of HIPAA protected information for "marketing purposes" and "fundraising purposes." To me this is very, very offensive.

Health care and older people are I think (if they're not already) a big market and that's not going to result in better care for older folks (including me).

A friend has also clued me in to the possibility of CVS acquiring Aetna. I can guess a few things that will probably happen, besides the issue of non health care retailers venturing into a market that's highly specialized: decision makers meddling into health care decisions, and doctors participating being required to use CVS Pharmacy to fill scripts.

I'd love to see those acquisition documents; it would be fascinating reading.

If you want to read more about this, search on "CVS bid for Aetna", and check out the WSJ article, which provides background on the efforts by health-care companies searching for growth opportunities by combining
diverse business lines.

(Friends: thank you for sharing this information; I don't mention your names out of respect for your privacy.)

I feel for your frustration - and the indignation too. They really do seem to have families over a barrel, sometimes, don't they? Hope you're able to find a place that suits her needs better very soon.

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