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So I've come a long way since last I posted: 1) hired an elder law attorney to handle dad's finances and options for moving out of his apartment to AL, and 2) started the process of looking at Assisted Living Facilities. The law firm recommended 3 that would be in line with dad's finances of SSA/VA benefits. The problem is I've visited 2 of them and find them so darn depressing that I cannot even picture my father living there. They were both clean but both reminded me of an institution. The second one I visitied I noticed all the residents seemed "out of it" or grumpy. I have one more to go but I am already disheartened that my dad will absolutely hate being in one of these places.


And what is with the infantilizing residents with all the childish games/activities? My dad is a total introvert so forget about engaging in any of that stuff - but can't say I would blame him. Also, he is of completely sound mind which really makes me wonder how he would do in an ALF.


Just venting and wondering if anybody thought the same about these places? It just seems to me that these places are god's (or whatever) waiting room. Thanks for the mini-rant.

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"These places" are often depressing enough, but there's also the problem that we tend to be in pretty low spirits when we look at them. Nobody is full of the "oh be joyfuls" when we already partly feel that we're trying to find somewhere to park our parent, so we're not tuning in to the positives to start with.

What's frustrating is that we know they don't have to be. I personally have come across three facilities, all offering continuing care, that I'd be happy to move into tomorrow except they wouldn't have me. Two, admittedly, were high-ish end (although they also ran charitable funding schemes for less wealthy members of their respective communities); but one of them, rooted in the Methodist movement, was far from expensive and exceptionally well-led.

And again, if you look at dementia village schemes and tv documentaries like "Old People's Home for 4 Year Olds," there is astonishingly good work being done in older people's care, and really progressive research into promoting quality of life throughout older age.

I hear you on the fun and games aspect, but that too is not universal. The very first question the assessor asked my mother at what would have been my facility of choice for her was "would you say you are a people-person?" To which she answered a firm "no, I wouldn't" - possibly the most honest answer she ever gave to any question in this context.

So, there aren't really any excuses for it. We know it can be done and it doesn't have to cost the earth. It takes imagination, leadership and genuine empathy.

Apart from the recommended three, have you looked around yourself at what's available in your area?
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SZHNJ1023 Sep 2019
Thanks. Yes but some are way out of budget. $135K entrance fee; $8K/month, etc. It always comes down to money.
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Being of completely sound mind makes it very difficult to be in assisted living situation.My brother is there. He is 85 and he has a benign brain tumor that sits on his medulla and makes his balance quite poor. He has a probably early Lewy's Dementia diagnosed more by symptoms than anything else and he has some problems with memory,though often is more sharp than I am in that regard. He is easily made anxious, can no longer drive and lives in a hot place with poor transit. He has no support system there and I am at the other end of our state. So assisted living was the choice he and I thought best together.
Now however he is thinking of moving home, which is only a few long blocks from where he is, of using something like Visiting Angels for shopping and so on and giving this at least a try for whatever amount of time he might be able to do it. There will never again be the ability to drive and he knows that.
The games, yes, are for those who honestly are more impaired than your dad will be, and he will find it difficult to find those he can communicate with in a meaningful way more than likely. There are only a few where my brother is and he at times feel like he is more a caregiver than a resident.
You are correct. There is no ideal. The people in Assisted Living facilities are for the most part not happy. Indeed, why would they be? If you think about it a whole lot? Why. A few have their small dogs; I think it is better perhaps for them.
Wishing you good luck. There is no good answer really to any of this; only the best answer you can come up with given the circumstances.
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I agree. They’re all depressing as hell. My mom was still a little “With It” when she went into assisted living. She was appalled at first but the staff did a good job of placing some ladies at her dinner table that were similar in abilities to mom. Mom was kinda the queen bee. She still hated it but it was the first time she had socialised regularly with people other than my dad, with dementia, in years.

In eldercare there’s not much good stuff happening any longer. The menu we have to chose from runs from Not very good, to really awful. I had to do lots of not very good stuff for my folks.
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My mother lives in an ALF which is beautiful and not depressing at all. The games and crafts are not designed to be intellectual, for obvious reasons, but to be doable by elders who have lost some cognizance. Mom's ALF has lots of parties and entertainment and a very large garden for strolling. She's in the Memory Care annex now, but it's still nice and not depressing, but many residents are pretty far down the dementia road.
Keep looking until you find a NICE community for your dad. They DO exist
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My moms facility was not fancy. She first went into AL. They have IL, AL, MC, SNF.. when I first went to look at the facility and I went to to the AL floor, I got off the elevator and it looked almost like my sons college dorm.
I spoke to Residents, one man had lived in in IL for almost 15 years and downsized to AL when his wife passed away. The facility had started out as a retirement home only decades ago.

She was in AL for almost a year and she went to SNF in May of 2016.
She actually thrived in SNF, she got involved in all the activities made friends, went to church services. The hair salon was on her floor and she still got her perms, and the hairdresser even got my mom to fold towels, mom loved doing that. She was never in her room.

At the Remembrance Service in July, my mom passed in June at age 92 , two other women who passed also, lived there for 15 years. Another woman who passed at age 107 moved in there years ago when it was a Retirement Home. I worked in two SNF facilities and they were not depressing.
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The assisted living facilities in my area are nice. It’s the nursing homes that are depressing. People are very active in the assisted living facilities here. There are tons of activities to participate in.

There is one place I visited that was only memory care and I wasn’t crazy about it.

You know what’s interesting to do. Just to snoop, look at help wanted in that field.

The place that I picked up the funny vibe from was hiring in all fields. They had reviews posted from current and past employees, none were positive. This place was one of the most expensive so don’t always go by price.

All of the others had good reviews. Hardly any nursing homes have good reviews here.

One place I found that was interesting was a ‘group home’ that was owned and run by nurses. They had good reviews. Smaller places that are ‘home like’ because they are individually owned homes. Some said their loved one did better in the smaller ‘less institutional’ type atmosphere. I don’t find the assisted living facilities to be like an institution, more like an apartment or hotel.
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I was gonna day what Needhelp said. The assisted living facilities here are beautiful, on the outside they look more like hotels and nice apartment buildings. They have beautiful common areas & dining rooms (like a restaurant setting). The front lawns are well manicured. It’s the nursing homes that are downright depressing. The halls are dark, the rooms are all white, there is the tell tale smell of old urine. They LOOK like a nursing care facility and a not a home. They are long single story building, sometimes in an L shape, with a low ceiling. They don’t have front yards or beautiful grounds like an AL.
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That’s how I feel, Cali. I could easily live in one of our assisted living facilities. They are welcoming.
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worriedinCali Sep 2019
Yep! I actually had no idea that a nice residential building behind my old job was an assisted living!y employer was a county office but it was in a small shopping center and I used to take a 15 minute walk through the residential neighborhood behind the building on my afternoon break. I knew by the people I saw around, it was some sort of senior housing. Out of curiosity, I googled it and found it it’s an assisted living and it is beautiful inside! I could live there. It is nicer than any apt complex in town. If I could get my mom to move down here and she wanted to go into AL (she would never be opposed to it), she would like it there! It’s close enough that the residents can go to the 2 restaurants and grocery store in the little shopping center. And the liquor store to buy a bottle of wine if they so desire ;)
And actually 90% of the street the facility is on, is all assisted livings. There’s 3 there, one I believe has a memory care unit but I think the other 2 facilities are just IL and AL.
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SZHNJ, in my area there is a large difference between Assisted Living, and that of a Nursing Home.

My Dad was in Assisted Living and it resembled more of being a hotel with a beautiful lobby, and the dining area was more like a restaurant with a menu and white table cloths. Same when Dad moved over to the Memory Care section of the same complex.

Now, my Mom was in a Nursing Home, and even though the building was brand new, it was depressing. A whole different concept. But then again, my Mom needed more physical care then my Dad.
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It's good that you are checking things out to find your dad the best place to meet his needs. I've spent a lot of time in various ALs and MCs over the last 5 years, (since becoming caregiver for my cousin), and I always observe the place with an idea in my mine that I COULD END UP HERE. I know it's true, because, we can't know what the future holds. I've learned some things along the way so far, that include: Be sure to check out the STAFF and how they operate more so than the fancy chandelier or water fountains. I've visited those with the spa light facilities, lovely courtyard, designer decor, etc. But, if the staff is not top notch, it means little. You can ask questions from resident's family members to get an idea too. No place is perfect, but, some are pretty good.

I'd keep in mind that some of the residents are dealing with various losses, like loss of spouse, health, mobility, etc. That can be a sad time for them.

I'd keep in mind that the activities vary and are designed to meet all levels. Not all residents are able to function 100%, so, they need games, activities that can appeal to most all residents. Playing dodge ball sitting in chairs may sound silly, but, it's a lot of fun and seems to entertain all that play. I used to go to regular AL and just sit in the evenings and chat with the residents. My LO was a resident, but, not able to engage in conversation due to her dementia, but, the other residents really would talk about their day, experiences. They let me know the food was awesome! I even ate there a few times. I thought it was high spirited and positive, especially, when the live singers came to perform in the dining room. You can meet with the activities director and get more information about what they offer.

You can also explore other options. There are some home care facilities that are in an actual house, where there are only 3-6 residents. Some people prefer that kind of environment.
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Most in nursing homes need 24 hr care and a lot are heavily medicated. My dad was just in a nursing home almost 3 years.. until he passed away in there. He had Parkinson’s and dementia. The home where he was was understaffed in my opinion.. however they did a pretty good job of caring for him. It is hard. My mother is currently living with us at 87 with end stage COPD. I’m trying to keep her with us until the end if possible but we (hubby and I) are still working full time. It’s so challenging the hardest thing I have done in my life. My mother is not the sweet elderly grandmother type.. she’s always cranky and never says thank you.
My advice is depending on the parent personality and your relationship you might try the co-living if you have room and they can manage some one their own. But don’t make yourself sick over it just do your best to do the right thing💗
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NeedHelpWithMom Sep 2019
It’s so hard. My mom is home. Cranky? Sometimes. But it’s the non stop worrying that gets to me. I absolutely hate it. I swear after she’s gone I am never going to be near a worry wart again. Ever!
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WHEN MY SON WAS 47 HE DEVELOPED END-STAGE RENAL FAILURE. THE FIRST CARE FACILITY HE WAS ADMITTED TO WAS DREARY AND IN NEED OF SPRUCING UP. THE CARE WAS EXCEPTIONAL. HE HAD WOUNDS ON HIS LEGS THAT WERE HEALED BY THE AMAZING WOUND CARE NURSES. PREVIOUS TREATMENTS IN A HOSPITAL HAD ONLY AGGRAVATED THEM. THE LATE NIGHT HE WAS ADMITTED A NURSE HAD SAVED US SOME SANDWICHES IN CASE WE HAD NOT HAD DINNER. NO ONE MINDED THAT I DECORATED HIS ROOM WITH PICTURES, A SMALL FRIDGE AND TV. IT BECAME VERY HOME-LIKE.
SEVERAL HOSPITAL VISITS LATER HE WAS ADMITTED TO THE "BEST" REHAB IN TOWN.FAIRLY NEW BUILDING, NICE FURNITURE IN THE LOBBY, ART ON THE WALLS.
HE HAD TO BE TRANSPORTED TO THE LOCAL DIALYSIS CLINIC. ONE NIGHT THE TRANSPORTATION WAS DELAYED. BY THE TIME HE CAME BACK TO RE-HAB HE WAS EXHAUSTED AND HAD A SEIZURE. THE NURSE ON DUTY DID
NOT KNOW WHAT WAS WRONG WITH HIM.
CRYSTAL CHANDELIERS AND BEAUTIFUL SOFAS DO NOT MEAN ANYTHING. STAFF IS THE KEY. THEY WORK VERY HARD WITH LITTLE PRAISE.
IF YOU KNOW ANYONE WHO HAS A FAMILY MEMBER IN ANY FACILITY CONVENIENT TO YOU ASK TO VISIT. STICK AROUND, OBSERVE AND WHEN POSSIBLE HAVE A SHORT CHAT. MEET WITH MANAGEMENT. DO THEY LIKE WHAT THEY ARE DOING OR IS IT "JUST A JOB".
THINGS I WOULD LOOK FOR ARE AN OUT DOOR PATIO WITH SOME SMALL GARDEN FLOWERS, A GAME ROOM WITH PUZZLES AND A LIVING ROOM AREA WITH A SMALL PHONEY FIRE IN A FIREPLACE.
THERE ARE ALWAYS GOING TO BE RESIDENTS DOZING IN WHEEL CHAIRS IN THE HALL WAYS AND A PATIENT CRYING FOR HELP. IT IS IMPERATIVE TO MENTALLY AND EMOTIONALLY MOVE IN TO THIS WORLD. IT TAKES COURAGE AND UNDERSTANDING.
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Harpcat Sep 2019
Please don’t type in all caps..it’s akin to yelling. And difficult to read. Thank you.
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Keep looking. My Mom was in a NH so she was down the path a little farther than your dad, but her care was exceptional. And she was on Medicaid. No smells, nobody sitting around the halls, residents living up to their potential, cheerful aids and nurses that cared. After my Mom passed in April I still go back every couple of weeks to visit her roommate. I was explaining to someone today how I can go back there and not feel bad or sad, and it really doesn’t bother me, and it’s because it was/is a happy place. Hard to describe. Anyway they are out there.
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Yes absolutely keep looking. The "infantile" activities it is for them to keep moving as they have to cater to multiple levels of the disease and I am sure they have multiple different activities for all levels. I just moved my dad 3 months ago now into and AL Memory and as you describe your my dad is an introverted country man now in a big city. He is adapting slowly, found different things to do on his own in the facility. He now is starting to chat with others although the activities not so much.
as far as AL places keep looking you will find the best place which will make you feel comfortable that he is safe and that he will be taken care. I visited 7 ALs prior to deciding on one. One thing that I felt most important was ratio CNA/patient, nurse/patient and make sure there are multiple activities for example activities for all levels, options like library, fitness center, outings, TV room if the rooms are looked during the day, patio area. Are there any patients on wheelchairs setting at nursing stations? Visit the AL at different times of day so you can get a better feel for the place. If your dad is a fall risk what methods they take to prevent, alert in case of falls?

Best wishes to you and your dad and trust me you are not alone.
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It may depend on the area you are in. I toured 6-7 of them and we ended up with 2 solid choices. We used one at the independent living. They were nice apartments with a clubhouse centrally located with dining for all meals. It was like a restaurant where you ordered off the menu. When Independent living became too much we moved them to an AL facility with memory care as we knew that would be next. This place is set up as Houses-central living room and dining room and about 12 rooms per house. They are super nice and clean and the food is good home cooking. After only 30 days it became obvious that my MIL needed memory care. It was dragging my FIL down and he wasn’t sleeping well for watching her. They were fighting constantly. Now she is 2 doors down in her house and he visits with her 2-3 times a day, but they both sleep better and therefore cope better in separate houses.
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In my experience. Yes, they are all depressing. How can they be otherwise? They are filled with people not in the best shape either physically, mentally and changes are both. They are filled with people who rather be anywhere else. They aren't resorts.
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DILKimba Sep 2019
The independent living place, that also had AL, and the one my Aunt/Uncle are so nice that I would have no problem living there!
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You know what? I don’t think I want to live so long that I have to go into a facility. It’s almost like an animal living in a zoo rather than in nature.

That being said, the assisted living facilities near me are not at all depressing. The food is good. The facilities are actually very pretty like a fancy hotel or an upscale apartment complex. I’d live in assisted living.

The people who are in reasonable health have lots to do. It isn’t just bingo. They even do field trips. They have card tables, bridge games, poker games, pool tables, library with books, holiday parties, banquet rooms available to rent to host parties and so forth. Musicians playing, dances, luaus, all kinds of themed events. This is New Orleans. We party here! Only people who are not as healthy don’t participate.

There are religious services, Protestant and Catholic. They have beautiful chapels. They have hair salons. Some have swimming pools, gyms, exercise groups, walking paths through beautiful landscaped areas and so on.

The nursing homes are a different story. They are truly depressing with people screaming, “Help me!” Or, “Don’t leave me! I want to go home!” Horrible.

When my mom was at a nursing home for skilled nursing rehab I detested the place. The OT and PT was good but that is all that was good about it. I had to file a complaint about mom being given a double dose of meds due to an LPN being lazy.

The LPN admitted to saying to my mom that she wanted to save another trip back to mom’s room later so gave her a double dose. My mom asked if a double dose of her Parkinson’s meds would hurt her, of course the lazy LPN told her that it wouldn’t hurt her.

I was so upset when mom told me that I called the pharmacist and she said if she was doing that to mom, she was doing it to others and it was my responsibility to report her, which I did. That’s sad and dangerous to alter meds dosages like that.
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SZHNJ1023 Sep 2019
I agree with you on not wanting to be in one of these places should I need that level of care. The whole time I was touring these places I was in my mind thinking, should I ever get to this stage, “what would be faster: slitting my wrists or overdosing? Or doing both simultaneously so that at least one takes hold?” One things for sure, it has brought to light the importance of living every day to your fullest.
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I really hated the assisted living my parents were in. They didn't last long there. There was not enough help. And at 8k a month each (we're in NY), what a waste. My dad had to wait like an hour for someone to bring him up from the dining room to his room. I also hated the dumb activities. I felt like they were an insult to these people's dignity. My parents never participated. It makes me really sad when I think of their time there. We were doing the best we could, but it was a sad chapter in our lives.
My dad unfortunately passed while he was in AL. My mom after that went into the nursing home where my sister works. The nursing home is fantastic. Bright, clean, excellent care and mom actually has a smile on her face when I see her.
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NeedHelpWithMom Sep 2019
Different areas of the country have different facilities. That’s horrible for your dad to wait an hour to go back to his room. Glad the NH is good in your area.
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My mom was in a great assisted living facility - one which I wouldn't mind being in myself. It was beautifully decorated, clean, quiet, great food, lots of outings, beauty shop and rehab services, if needed. She was very happy there and we were happy for her.
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The facilities here have bars! I’m not kidding. I’m in New Orleans. They have wine and cheese events. They have cocktails, snacks, etc.
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SZHNJ1023 Sep 2019
Sign ME up!! LOL Seriously, I love that.
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Pam,

The AL facility that I visited when happy hour was going on had a lot of smiling faces!

I have to ask, was that a fun job? I bet it was.
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pamzimmrrt Sep 2019
Well, I was in the LTC area.. but the others I saw were happy as clams! And my FIL was there for rehab for 3 weeks, he had no complaints! They did feed the staff.. but we didn't get the wine.. LOL I have thought about going back to work there PT again as retirement looms,, and mom may need placement.. you got a hefty discount for family members! Maybe I can get hubs a job as the bartender?
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Pam,

Not a bad gig! Hahaha
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I do not have much knowledge of the inner workings of Assisted Living facilities in my area, but the ones I have been to (as part of the entertainment at Christmas) were very attractive and resort-like. One of them has bay views.

Having toured almost every LTC within 50 miles, I can speak with more knowledge. There were a few LTC facilities that I toured that I found depressing due to the age or layout of the building. As one of the posters mentioned, you can’t always tell the quality of care by the surroundings. There were several much more attractive than the one my parents reside in, but my brother chose that one for my mother’s rehab and she then transferred to the LTC section followed by my father.

Of course, it is not exactly cheering to see so many people with such infirmities and disabilities, but I think it is more difficult for the able-bodied visitors than for the people who actually reside there. My parents don’t seem to see the other residents as depressing and pathetic. With mild to moderate dementia, they are mostly oblivious to what I guess what the outside world would call depressing. My father recently was hospitalized and when he returned, he couldn’t get over how many people asked after him, from residents to staff.

The facility itself is clean, and great effort is taken to decorate for the seasons. The activities that have been described about assisted living facilities by other posters are all included in this nursing home. Last year, my father and others were taken to fish off a pier on the beach. Once a month they go out to a restaurant and every Friday, they can order take-out. I know for a fact that the food is excellent and varied. There are daily activities, and weekly volunteer entertainers. Last month, they added an Elvis impersonator who sang old Gospel hymns. The residents loved him! There is a priest who offers daily communion, and several retired preachers who lead the residents in song during the week and preach on Sunday.

We have not always been pleased with the care they receive at the facility, but they are very open to suggestions and willing to make corrections. I am saddened that so many of the posters don’t have access to excellent facilities like the ones that are so numerous where I live. It’s curious, because I live in one of the poorest states in the country. Maybe it’s because it is a high retirement location.
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I worked in a assisted living as a CNA once... I honestly thought it was worse then the nursing home. When it came to care. The place was brand new, so they were desperate to fill up the beds asap! They accepted anyone in the facility, people that were independent, to people that needed assistance, to people that needed to be in a hospital or a nursing home. I'm not joking . I only stayed there 6 months. I couldn't stand it, seeing how some of the patients, needed way more help then they were getting. The facility lied to the family members to get there loved ones in there, some family members were in denial with how much care, there loved one really needed. Some were fine... but some others were not. The place was only open for 6 months, when I left, and already they had 4-5 people passing away . I could go on. But ya, that was my experience .
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NeedHelpWithMom Sep 2019
That’s just so sad. Were you a nurse there? What did you do there? That would make me depressed. I think I would have left too.
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They are depressing because you are surrounded by old and frail strangers. I would not want to live among a bunch of strangers and see them day in, day out.

And then the cost, which is a turn-off itself. If these places were affordable, we might force ourselves to turn the other way.

If I reach an age when I must go to a facility, I would end my life. Why prolong the inevitable at that stage?
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I had aides for my mom, in her house until she died. She had dementia, and could not dress, feed herself or walk near the end. Maybe you can look into that as an alternative? The Agency for the aides told me there is no state of deterioration that a person can be in that they would refuse to supply the aides in the home. Medicaid paid for them.
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The one where my dad lived was lovely and reminded me of a nice hotel. You May think bingo and dominoes sounds childish but the residents loved it. They had movie day and various programs with speakers and an occasional outing. So perhaps widen your circle of where you tour. The food is always the biggest complaint because face it...it’s not home cooking!
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There are so many stories of the elderly who live at home in detoriating conditions. The elderly are just that. Al facilities meet many needs. They are provided with regular meals and generally there is thought to those meals. Mealtime also provides an outlet for socialization as many residents eat at the same table. More so than not a sense of concern develops amongst these residents for each other. My mother has outlived all her friends. Residents at her AL have become her friends. You choose the words "Gods waiting room". They are elderly and closer to the end of life. No they don't reside there and find a fountain of youth. If they participate in games you find purposeless you are seeing it from the perspective of your age. There is a structure to these activities. I have been told by the resident director of the facility where my mother is that mostly that is what the elderly need meaning a structure to the days. If she has an ailment it is addressed quickly and I am given a report regarding that. It gives their life a sense of purpose. Obviously there can be a difference amongst facilities but for the most part they work for the common good. Prior to entering one my mother could not regulate her medications. She could not bathe well or really do her laundry. She ate poorly. I think you should try to understand what these facilities provide for the elderly with diminishing capabilities. Visiting them should not mean your perception of yourself in that environment. You are younger and don't likely have the needs provided there. It might help your outlook if you would change your perspective and understand that many who reside there have needs met that very likely would not happen if they resided at home. If certain individuals can remain home and continue to live there positively than all power to them but that is frequently not the reality. I may seem blunt but i found your post lacking of truly understanding the aging process. I have admiration for those who can remain at home and not detoriate but that frequently is not the reality of many situations. I hope you might find aspects in visiting AL facilities that show positive factors. It would truly be in the best interests for you and for who you might have to place.
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MaryKathleen Sep 2019
You said it correctly. 🙂
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My mom is in a very nice one close to my home. She had a stroke last spring and although she recovered well from it she realized she could no longer keep her condo. I looked around for an AL facility and got lucky that this one is so nice and close to me. She has a studio apt and many of her things from home to make it more familiar. At first she was reluctant to meet people but now when I go over she tells me about one or the other of the residents that she has met on her walks. She will worry if she hasn't seen someone for awhile and will ask one of the aides if that person is okay, she likes keeping tabs on people, it helps her to feel involved. This facility is not cheap ($2,000 per month one meal included)but it was the least expensive one available in my general area. She has a little kitchenette and makes snacks for herself when she wants. She goes to the "Coffee Club" in the morning for free coffee and donuts. Everything is ala carte so if she doesn't need any assistance, which is most days then she is not paying for someone like she would with shift helpers. It takes some work but there are places out there.
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I am sorry for what you are going through. You are lucky he is of sound mind because it’s much worse in memory care unfortunately.
I do agree with you that it’s very depressing. I am starting to recognize the signs when someone is nearing the end. I would say if you can get get helpers at home that may be a better way to go until you cannot do that anymore.
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