Are there higher functioning dementia care facilities?

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Are there any care facilities (in California) for higher functioning vascular dementia patients who need considerable help with ADLs but a much higher level of intellectual and emotional interaction than is typical in memory care facilities? In-home care costs are so high here ($20K/month) that facilities are more affordable in the long term, but typical memory care facility residents are not her peers. I am aware of Belmont Village "Circle of Friends" level of care, also not a fit.

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Check out some of the Assisted Living facilities in your area. Some can be quite tolerant of people with early stages of dementia, as long as they don't wander.
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Cblolo, you might want to look at Independent Living facilities that offer "options" where a patient isn't quite ready for Memory Care but needs a bit a help during the day.

It would be best to find a facility that offers all three "steps"... Independent Living, Assisted Living, Nursing Home. That way the patient is familiar with the buildings, with the Staff, with the meals, etc.
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Check out home care AL facilities, my dad is in a 8 person max house. One of the other residents is paralyzed from the chest down, mentally very there but needs assistance with everything. My dad on the other hand can do everything except remember to take meds, cook, clean, do laundry lol, all of the residents are very verbal, all but my dad and one other guy go on day trips using the paratransit system. It is an age in place home.

Larger facilities do have some added benefits but I found the cost far to much for the benefits.

Best of luck finding a solution. Finding a place is such a challenge.
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I'm sorry i cant help you as i live in Australia but i wish you luck and hope you find what your looking for. A lady named Teepa Snow who is an excellant educator on dementia, shes an American, she may be able to direct you.
My mother had vascular dementia and my grandmother had Alzheimers...i found they were very different.
My mother was so aware of her situaton even towards the end. Our dementia care in Oz is PATHETIC and in my opinion its starts at the top...Geriatricians...i wont get started...we looked after my mother at home...not easy..but for me very rewarding...she was and still is the most wonderful person ever!
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The best place to start when looking for information is to call your local Area Agency on Aging- AAAs provide a service called Senior Information & Assistance or Aging & Disability Resources. Because they're a branch of government, they provide unbiased information (some other referral services might not be entirely unbiased, as they usually get a "kickback" for making referrals). AAAs are also local--covering every county in the US. So your local office will probably have information on places in your area or nearby which may be a good fit for your mother, such as someplace that has a "continuity of care," meaning they provide multiple levels of care. For example, there are some places that provide from independent living up to skilled nursing care, so someone does not have to move as their care needs change (though they may have to move rooms/floors/building etc within the same facility or campus).

You might also want to look at places that will accept Medicaid in the future, even if mom has enough to pay privately for a time. I've gotten countless calls from family members in a panic because their loved one has outlived their money, and they're in a private-pay only facility and have been asked to move...then they can't find another facility that will take their loved one straight on Medicaid. Very sad, but it happens every day.
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Thank you for your comments and suggestions, much appreciated. She needs close to 24 hour care with DLAs which is a very expensive add-on to IL. She has been in MC for almost 2 years after being rejected from AL application. She is miserable there and it is true the residents are not her peers. I'm wondering if any facility supports the vascular dementia subtleties in particular, we have visited a lot of facilities and most of the residents seem Alzheimers-affected and more advanced dementias more than vascular.
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cblolo, my sister has vascular dementia and lives in a memory care facility in California. They only have dementia patients, but understand dementia comes in many forms and appear to treat each resident accordingly. It is secure, which my sister needs, to prevent wandering. There are several activities daily, including supervised group outings, with about half geared toward higher functioning residents. At meals, my sister is seated with others who can carry on a conversation. There is plenty of staff on hand around the clock. I appreciate their philosophy toward all dementia patients; they keep them safe but allow them to be 'themselves.'
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As others suggested, some of the "home-based" facilities who have limited residents might be of interest - we did not explore these (was not aware of them, and do not know if there are any in our area.)

As for MC facilities - the best you can do is check out those in your area. There really is no way to determine what level residents might be at in any facility. The causes and progression rates vary from person to person, so even if you found a place with all higher-functioning residents, 6 months later that could change drastically!

The place we chose was recently rebuilt (includes IL, AL and MC) and mom was actually the first to move in to the MC unit. A woman who came in shortly after seemed to be about the same level at that time. Within months, the other woman has progressed to the point that she likes to talk to us, but it is all gibberish. Our mother on the other hand made a step down after about 9 months to remembering a previous residence (sold 23 years ago) and asking about visiting her mother or how she is doing (gone almost 40 years!)

There are no rules about how or when regression takes place. Our mom needs no real assistance with personal care or walking, but is not safe to be left alone or in a non-supervised place (AL.) Another woman there is 6 years older (just turned 100!!!) and is more "with it" than our mother. Now that the unit is filled up, there are so many levels of cognizance that can be observed.

There may be several reasons why the places you have looked into only have low functioning residents:
- others have not chosen to put loved ones there or keep them home
- once higher functioning residents have regressed
- remote possibility it is just a lousy place and maybe cheaper for those who need it

Do check out more facilities, even if it means moving further away from you.
Do check these places at different times
Do inquire about activities, etc

One other note: after some meals or specific activity, some residents go back to their room or for a walk around the loop - mom will note that it seems like everyone has "gone home." So, if residents have retired to their rooms or are joining in activity outside the main area (mom's place does take residents to other areas and even outside the facility, if they can manage it and want to go), you might only be seeing those who cannot join in those activities.
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FF took the words out of my mouth! An IL facility with an "add-on" caregiver for showers, etc. At my mom's IL, there were plenty of folks in that category.
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My dad has vascular dementia and was in regular AL. However, the facility's regulations says if they need more than 50% support with ADLs then they have to go to LTC. Sucks and he hates it.
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