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Dad's been in the hospital for 16 days and they now want to move him to long term care with rehab 1 hour/day. He’s no longer on IV but isn’t eating much and it’s puréed food. Whenever I mention the memory care facility I had previously picked out, they tell me he needs long term care. I can understand needing rehab or some PT as he is very weak. I just don’t understand the difference. I guess I can always try what they have in mind and if it’s awful, just move him to memory care. He’s 93 and I don’t think he’s going to be able to rehab anyway. Maybe it’s because Medicare will pay for a few weeks of nursing home rehab “long term care”.

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You have to decide what you want to treat. My mother has edema, heart failure, is wheelchair bound, has macular degeneration, and has dementia. None of those can be cured, but after seven months in a skilled nursing facility (because I didn't know any better and my dad had been on their board of trustees), I was watching my mother get medical care but absolutely no mental stimulation. I decided that what I could still treat with some success was her dementia, and I moved her to memory care.

She was not coming straight out of the hospital, however, as your dad is, so perhaps he needs some of that rehab time until he gets a bit stronger. A memory care facility cannot give an IV if he needs that again, so until he needs less medical-focused care, I'd say let him be in the rehab place for a while, then move him to memory care once he's a bit stronger.

My mom was in the hospital in late December, including a week in rehab to finish off IV antibiotics. She's been back at memory care on hospice since January 2, and I will say she's received remarkable care. No, she's not going to get better, but they certainly treat her like a loved one rather than a patient, and I think that's priceless.
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Reply to MJ1929
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So they decided to put dad in the hospital's in-patient rehab unit. I think it's because they see he has very good insurance. Earlier in the day the doctor said he didn't think he had it in him to do the 3 hours of rehab a day but, surprisingly, now he's going there tonight.

Dad's dementia is so much worse now that I am not sure this will help him too much, but he's a fighter and has worked hard on exercising in the past so maybe....

Thanks for all the questions you gave me that I can now discuss with this memory care place for After rehab
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Reply to marydys
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NeedHelpWithMom Apr 13, 2021
It’s wait and see now, as to how much it will help.

Wishing you and your family all the best.
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I was reading reviews of places online while looking for AL for my mom, and saw one very irate review for a place that ended up moving the family member out within a month of arrival from rehab due to a new need for pureed food, and the family was on the hook for the 30 days of rent. In my state there are degrees of care the AL/MC’s can provide, so some could do pureed food or assisted feeding, and others could not. The major determinate was patient mobility, and even in that there was some variation between the levels of licensing. No matter what, if you end up searching for a different place double check with the facility’s nursing director about what they do or don’t cover..sometimes the community relations folks can paint a rosy picture, and with covid, places may not have full staff. I think you can go out on most state’s websites and see what the facilities are licensed for. In my state they posted the state inspection results, which was helpful.
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Reply to ElizabethY
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Memory care is self pay. Medicaid does not cover MC or AL. My State will after at least paying privately forv2 years.

I would talk to the Memory Care you like. Give them permission to get Dads records. Then they can evaluate and see if they will except him. Ask them about PT/OT being brought in at their facility.

Mom was in rehab for 18 days after a 4 day stay in a hospital. The stay was to get her strength back. With Dementia it was a waste of time and money. I was told she never would walk unassisted. She got back to her AL and was walking all over with her walker.
I was able to get her "in home" therapy at the AL, with Medicare paying, at another time.

The difference between a MC and a LTC/NH/SNF is the care. MCs, as too ALs, are not set up for skilled nursing. At Moms AL they had one RN, one LPN and the rest of the staff were CNAs (not medically trained) and Medtechs (CNAs trained to dispense medications). MCs are set up the same. Both are for assisting only. MC is just a step up from an AL which isn't really set up to care for those who have Dementia even though they have residents in the early stages, And as something like Dementia progress, those in MC may eventually need what a Long term nursing facility requires.
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Reply to JoAnn29
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If you want your dad to be in the memory care facility that you selected, I agree with countrymouse, specifically ask them how they can assist you in providing the proper help.

It looks like they are only starting him out with limited PT so I feel that you should be able to bring someone in to handle it.

Insurance may be an issue. Does that make a difference to you?
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Reply to NeedHelpWithMom
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If you know of a place that offers assisted and LTC levels of care, it is possible that he can be switched to MC after gaining strength. Your current description points to LTC. In MC, the patient needs to be either ambulatory or in a wheelchair and willing to participate in daily activities, including eating in the main dining room and self feeding.
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Reply to MACinCT
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marydys Apr 13, 2021
Thanks... and he isn't self feeding so that answers that question. He COULD but won't and does best if he his fed by someone else. I think he would like the activities and atmosphere of memory care versus a "hospital" like atmosphere of LTC, but maybe it's down the road
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My 94 year old dad went to skilled nursing last May from assisted living after too many days stuck in his room and not being allowed to be out and about because of covid. He became pretty immobile and his edema flared up in his legs, along with open wounds. His diabetes worsened and he is now on insulin. He initially consented to rehab, which Meducare paid for, but then we went on self pay after he was no longer cooperative (very expensive). After many, many months, I finally found a memory care that would accept him with his medical needs. It is managed by an RN. He has stabilized enough to where his medical needs can be managed by outside services coming to him and he does not need the full services of a SNF any longer. It could be skilled nursing might be needed for now but a move could happen to memory care at a later time like we did.
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Reply to Babs75
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Speak to the memory care facility and provide them with any information they ask for. If they're not able to meet your father's care needs, in addition to his ADL support needs, they will say so.

Speak again to the hospital discharge people and be specific. "I would like Dad to be discharged to Acme Memory Care and have his rehab there. Is this possible? If not, why not and can we solve it?" And don't close the conversation until they've given you sensible answers!
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Reply to Countrymouse
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Is there a memory care in your area that offers rehab? If so, ask about that one. Some assisted living facilities with memory care services in my area offer rehab.

Why are they suggesting long term care? Just for rehab or for a permanent residence?

Tell us a bit more please.

Best wishes to you and your father.

My mom did rehab in her 90’s too but she went much longer than an hour. Is that a starting point or they are sticking with that? Is it PT and OT?
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Reply to NeedHelpWithMom
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marydys Apr 13, 2021
Well there appear to be three kinds of rehab they are considering. 1) is at the hospital but they feel dad probably can’t do it because it’s 3 hrs a day. I assume OT and PT. 2) is a post acute rehab but they don’t think he needs that since he’s off IV feeding as of today. And 3) is long term care rehab which I think is just a nursing home that has 1 hr of rehab per day. I think basically they just want to park him someplace and I get that. He’s going to quickly get dehydrated and not eat enough. The memory care place I liked is not set up for true rehab but I could get PT to come in for awhile.
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