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Mom (93) has dementia with sundowning, but is ambulatory and doesn't have any other health issues. She lives in an apartment in the ALF unit where they give her assistance with getting up in the morning, personal care, etc. They also get her to a number of activities daily. I do not fault the ALF, they have taken wonderful care of her.


The ALF says she has most trouble in the afternoon, and it's beyond the capacity of their staff to provide the help she needs, especially with dinner. Her nutrition is not great.


I agree that an in home care person is a great idea, 3-4 hours/day to help her in the sundowning hours. They helped me find a provider at a reasonable cost.


The problem that I see no solution to is that she will burn through the bit of savings I've built for her (I manage her money as POA) in about 3 months. Then what?


(There is no question of my paying for this for her.)


The ALF folks have no answer or ideas about what to do after the money's gone. Does anyone here have ideas? Much appreciated in advance!

Is there a Memory Care unit within the same building? If so mom might do better in Memory Care and MC will provide more supervision and she can not wander out of the unit.
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Reply to Grandma1954
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You need to find that Contract Mom signed. Read it carefully and definitely have a lawyer review it. I don't totally understand these "buy ins" but I do understand that they are to take you thru Independent living, then Assisted living and then Long term care.

I knew a woman who was POA for her SIL who was in one of these "Communities". Lets say her buy in was 150 to 200K. But she paid 1400 additional a month for her IL apartment which included her meals. She had a stroke and ended up in LTC for a very short time before she passed. The Contract read that either 90k or 90% of her buy in would go towards her care in LTC. They billed the estate for her time in the LTC. Her POA now Executor told them that her 90k/90% was to cover that. TG the POA/Executor was there when her SIL signed the Contract and the SIL probably had it reviewed by a lawyer.

Your Moms buy in was done 30yrs ago. Cost of living has increased way beyond what this Community thought it would 30 yrs ago. Interest rates and investments weren't as good as they probably speculated. Your Mom lived to be 93. I bet what Mom paid is lots less than what is charged today to buy in. You are talking to people that probably were not there 30 yrs ago. Don't put it passed them to try everything not to honor that Contract. They didn't expect Mom to live that long. Meaning that she has outlived that buy in. But, they will probably have to honor that contract so its money out of their pockets. They are probably hoping you take her to another facility with Medicaid paying for her care.

Find that Contract and get a lawyer to review it.
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Reply to JoAnn29
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I would send the administrator an email that addresses the questions that you have and request that she only respond in writing.

This is how you get around the avoidance of questions and he said/she said issues later on.
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Reply to Isthisrealyreal
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After the money is gone she will go on Medicaid. The ALF folks would prefer you or other family will cough up the extra money once mom's has run out, that is why they are not giving you any answers. Meet with the person in charge of finance and tell her/him that your mother will need to transition to Medicaid in 3 months as she will be out of money.
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Reply to mstrbill
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"The coordinator said the nursing wing "is not a possibility at this time"...

Probably shouldn't speculate... could be full? Could be full of residents with high physical needs rather than memory/behavioural needs??

My relative with quite high physical needs was moved from lower care to a higher care section in two parts. Part 1, I called 6s & 7s. Only 2 were moderately frail (6) & could walk. The majority were fully dependant(7). A small number of whom could hold an OK conversation.

Part 2, I called 8s - approaching the end of life. In recliners, gazing at the window or ceiling. They looked at peace, comfortable, snug with their knee blankets.

But your Mother has too much life for this!

Ask about Memory Care options. Somewhere with mobile people like her, lots of engaging activities, singing etc.

PS shared rooms don't always have to be the end of the world if you can spend most of your day in a nice lounge, enjoy activities & have a garden & staff to escort you outside.
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Reply to Beatty
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Adding to what has already been suggested to you: Medicaid will pay for AL in only a handful of states. If yours is not one of them, then she will need to be assessed and qualify for MC and then it can be covered by Medicaid. This can be a discussion with the admin of the facility as to whether she qualifies. FYI a Medicaid recipient usually is in a shared room, but not always.
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Reply to Geaton777
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Kittybee Mar 10, 2021
Thank you, this is something I wondered about.
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Exactly as stated above by Alva.

I'm surprised that the ALF doesn't tell you that this is the situation - if she's out of money she will have to go to a nursing home and go on medicaid that will pay for her stay there. I suggest you start looking around now.

This happened to my husband's aunt. Having paid care at the ALF is just a way that they can keep them at the ALF because they do not have the staffing to deal with patients that need too much care. They found a memory care facility for auntie and she was very happy there for the next couple of years of her life.

Moving her to a SNF sooner than rather than later might not be a bad idea since it is inevitable. The ALF does have a vested interest in keeping your mom there as long as possible. $$$. There is also a good word to be said for keeping someone in a place they are used to and comfortable with.
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Reply to againx100
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Kittybee Mar 10, 2021
Thanks, yes she's been in that room for a long time and its familiarity is very helpful for her. I know a move to the nursing wing is inevitable and she will likely have to share a room. I think that will really be rough on her because of her dementia. But what are ya gonna do, you know? The whole thing sucks, but I can't help still being thankful that she has shelter and care in a pretty well run place where people know her and are kind to her.

The coordinator said the nursing wing "is not a possibility at this time" and when I tried to ask why, she just repeated herself. I wondered what that was about, it felt like she wanted to avoid the topic for some reason.
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I am glad there is no consideration of your sinking in money you will need in your own future. That is always unwise.
Hopefully the ALF will recommend to you best how to make money last there. Mom is going to have to move to Nursing Home on Medicaid when her funds are gone. There really aren't any other options I can imagine.
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Reply to AlvaDeer
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Kittybee Mar 10, 2021
Thanks Alvadeer. Something I totally forgot to include in the story is she's in a place where she gave them a big upfront buy-in years ago and the contract is such that they can't "kick her out if she runs out of money." That's how she explained it to me 30 years ago (!) but I haven't looked at the file. She does pay about 1/3 of her SS on room and board, then there's some RX and incidentals - there normally is some leftover. Not enough for daily care, but some.
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