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My mom and stepdad live in southern California. They currently reside in their own apartment with the assistance of my sister, who has to return to her own home out-of-state in January. Mom and Stepdad have paid a deposit for an apt. at an AL community and expect to move in Jan. or Feb. 2020. Stepdad has serious mobility issues (knee and hip) and Mom has Parkinsonism. Mom is afraid that the AL facility will kick them out soon after moving in (and paying a hefty non-refundable community fee) due to their poor health, saying they need nursing home care instead. I know that AL facilities make a lot of money by providing extra medical services to their residents. But at what point are the residents required to leave?

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The AL home will do an assessment and rank what level of care that they need. Each level comes at a higher price, one can be ranked at a 1 and another at a 3.

My step father is on dialysis (out patient) in a wheel chair, has bladder cancer, clogged arteries and more, he is ranked in AL at a 2 right now, as his wife who has dementia takes care of his messy diapers.

I wouldn't concern myself with this, they want to keep their residents as long as possible...this is a big money maker for them.
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Haave mom and dad been assessed by the AL as to their suitability for the supports available in that community?

Before my mom went to an AL, she was assessed by an RN as to what her care needs were. We were apprised of the extra charges for what she needed up front. These were adjusted after a week or so when it was clear mom needed more.
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My mom had to move from AL to SNF (same facility) after being recommended for PT, she became a two person assist and she didn’t want to do PT. They told her if she wanted to move back to her AL apartment she would have to do PT and get stronger.. she told them she was “over” the AL, so she was moved to SNF and she thrived there, being involved in all activities and the hair salon was on her floor.
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The answer may be different for different facilities. Can you call that place and ask? Also, is it not a place that has a continuum of care on its own campus? I suggest you have a bigger conversation with them regarding being so far from you. Do they know how much a plane ticket to CA costs? Are you still working? Would you have to use vacation time to tend to them? These are your realities and they need to understand what it means for them to live so far away if they expect/need you to help manage their care.

Wherever they end up, please make sure the facility accepts Medicaid and that it has a continuum of care. Good luck!
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DePopa Dec 2019
Oh, Geaton, I have urged Mom and Stepdad to move into a beautiful AL community in Arkansas to be near me. I have also located a very nice nursing home that accepts Medicaid, should it come to that. But Stepdad, who has severe COPD as well as mobility issues, will not leave the beautiful weather of southern California and his doctors. Mom won't come without Stepdad. All they have in Ventura are each other--no family or friends. When one dies, the other will have only the AL or NH community, should they ever make that move from their apartment. Once they pay the hefty AL community fee, they will not likely be able to afford to change locations. I told them I do not have the means to travel to California, and they understand. It's out of my hands and I have to accept it. :-(
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