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Deborah13 Asked January 2017

I am unprepared to move my mom from her memory care to nursing care if she requires it. What do I do?

Mom was in memory care/short term memory loss. She caught respiratory infection going around the ALF and upon hospitalization, learned she also had UTI. She is now in rehab after 10 days in hospital, extremely weak and trying to walk again. I am unprepared to move be her to nursing care if she requires it, should her community not accept her back, What do I do?!

TooYoungForThis Jan 2017
How are you "unprepared"? Emotionally or financially? Who was paying for her in AL/memory care unit?

Llamalover47 Jan 2017
She will need to go into a SNF and paying for it by applying for Medicaid unless she plans to private pay, which is extremely costly.

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Ombudsman1 Jan 2017
If your mom is in "rehab", it is likely she is in a nursing home. Nursing homes like to call their facilities "Rehabilitation Centers" when in reality they are just licensed nursing homes. It just sounds better to be in a rehabilitation center than a nursing home. Sounds like she is in a nursing home for rehabilitation which is considered "skilled" care. The other option would be for her to be in a hospital for rehab.

As to whether your mom can return to the assisted living (AL), you probably want to start with your mother's contract with the assisted living home she was in. Then, depending on the state you live in, there may or may not be regulations governing when AL is appropriate. In my state we have regulations for AL and a person can stay a long time in AL if there are some outside nursing service provided. Depending on your mother's care needs, AL may or may not be the best for her. For example, there may or may not be 24 hour nursing care available in AL.

If you are willing and able to pay your mother's bill for the AL while you are waiting to see how well she recovers, then they should hold the room for her. Again, you probably want to look at the AL contract.

If your mother needs to be in a nursing home from here on out or even temporarily, please become an informed consumer. Medicare.gov has some information on what to look for in a nursing home and also the 5-star rating. You may also want to contact your local long-term care ombudsman for additional information about local nursing homes.

If your mom uses all her Medicare days for this rehab stay and cannot pay privately, and does not have long-term care insurance, you will want to apply for Medicaid. If that is the case, you may want to contact a certified elder-law attorney---depending on her assets. When it comes to Medicaid----please, please, please don't rely on information from the hospital, nursing home, rehab, friends, family or any non-attorney persons.

If your mom ends up staying in a nursing home, you will want to learn about the rights of residents. There are many rights, based on federal regulations, that are there to protect the residents and provide for quality of life and care. Information is power! Your mother is fortunate to have you in her life. Take care!

Lmaxwell Jan 2017
Well talk to the doctor they may need to extend her rehab for a couple more weeks. If not then you should plan on having extra hired assistance from an outside source such as a senior helpers agency so that your mother gets the individual care she needs while still recovering in her home/facility. Its a great option for all families to consider, yes its an added cost but this way your mother is receiving "individualized care" while recovering.
I am a RCFE owner and I welcome outside agencies to assist in rehabilitation when the resident returns to the facility from an illness or surgery. Try this alternative for her care short term.
Best wishes,

Sunnygirl1 Jan 2017
Deborah, is there some reason you believe that your mom needs skilled nursing care? I don't know what state you are located, but, I would check the rules on Memory Care facilities in your state. In my state, a resident can stay in Memory Care for so long as they live, assuming that they do not need skilled nursing care. Does your mom have an Advanced Directive about her wishes? Is there something about the UTI that needs continued treatment, other than antibiotics? Does she need physical therapy?

In my state, the resident can remain in MC and they will care for them even if they are bedridden, need hand feeding, incontinent, etc. Unless, you intend to have tube feeding, then, I'd discuss it with the MC director about their requirements. If it's just physical therapy that she needs, maybe she could return to MC after she gets her strength back in Rehab.

That is one reason that I felt comfortable with MC for my LO. It's a place that she will receive her care until the end.

yogagirl Jan 2017
Deborah, my mom broke her pelvis on Christmas day and was taken by ambulance to the hospital from Memory Care.
After a week she was transferred to a Rehab facility.
We have decided she will stay at the Rehab on private pay when her days are up.
We discussed it with the admissions office and social worker. There are other full time residents there and the care is excellent.

surprise Jan 2017
The hospital or rehab social worker will help you find appropriate placements. If she does not have the money for these, you will need to get her on medicare. If she does have the money, this is what she saved it for.

jeannegibbs Jan 2017
If she has declined to the point that her needs exceed what the ALF is set up to provide, then I don't see any alternative to placing her where a higher level of care is available, such as a skilled nursing facility.

It is going to take her a while to recover from both of those infections, and also time to recover from hospitalization which is hard on seniors with dementia. Does she seem to be making progress now? It is possible that she MAY return to her baseline (or close to it) over time. But unless she is at a level that matches the ALF's care level, when she is discharged, she will have to go somewhere else. It might be a good idea to start looking at SNFs incase that will be needed. Maybe you are worried for nothing -- maybe the ALF will be able to accept her back.

Hope for the best. Plan for the worst.

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