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Father (86) is in an expensive AL and has dementia, mostly alcohol induced.. The AL said he needs a sitter or must leave. Sitters are $25/hr. So sitter and AL is over $300K/year. I have tried other places, but they do not want him if he falls. He was warned he would become wheelchair bound if he would not exercise or do his PT. Hospice (care, not EOL) has told me homes are rated lower if they have a record of falls, that is probably why they will not take him now. At this rate my mother will have no money left for her life and eventual care in less than 2 years.
Does anyone have any ideas? I am at a loss, and mother (84) is a wreck. I hate to do it since he will feel bad, but I am going to speak to him today and let him know how he is ruining his wife's life with his insistence on getting up. Maybe if he has no falls for a month or two we will have a chance of placing him, but this is probably grasping at straws, especially if he does not comprehend totally.

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Ender, he has dementia unlearning behavior and learning new ones most likely will not be possible. We would all like to be able to change our behaviors to make life easier, I do not think this is realistic in those with dementia, probably will cause more frustration and stress especially for the caregivers whether they are family or those working in the facility. I am sorry you are going through this.
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Country - Just noticed your reply. He is in a memory care unit, and has been for a while. Their solution is for us to hire 24 hour sitters. Mom cannot afford it. We are trying other places, but have been turned down because of his fall record (although he has not fallen in a month and a half).
I wanted to keep him in a nicer place, but it looks like we may need to move him to more of an institutional hospital atmosphere (Skilled NH).
I was not going to talk with him, but I really feel he should at least have a chance to change his behaviour for a fighting chance at a nicer place (AL). It is possible he won't understand, but we really think he would want the chance. I know I would if I were him.
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glad - great idea. I had not suggested that one. freq - It is all very confusing to us too. He has always been a fall risk. When he was first admitted they put that on his room. The frequency went up when he had an infection. I still do not understand this. His other needs are really not a lot for a home resident. We always pay the bill and even launder his clothes. We called the state, but they were no help at all.
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Agreed FF. What are we supposed to do if nursing homes start to refuse residents because of falls?! I know, we will have them all held up by marionette strings, install a track type system? LOL!
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This is confusing, I never heard of a nursing home not taking a patient because they are a fall risk. If that was the case all nursing homes would be empty because the elderly do tend to fall. Is this something new?
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Countrymouse - I agree, he should be in a memory care unit. In fact, he is in one now. But they will not let him stay because of the falls. And other units do not want him because of the falls. They do not want to deal with it and risk losing their facility rating. The hospice folks who first told me this are trying to help us place him now.
We are starting to wonder what they will do if we just stop the sitters.
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Under Medicaid Law, your Father's the money is split evenly between both parents if the money is help in joint accounts. He has to spend his half before he is eligible for assistance from Medicaid. He does not have to spend her half to qualify. You must get your Mom to a Medicaid Planning Attorney to make sure that her half of the assets are protected for her own care as she ages.
They will also make sure that when he does go on Medicaid she will have adequate income to maintain her home and other expenses.
Perhaps your Dad should be in a Memory Care Facility rather than an Assisted Living. They will better know how to deal with his Dementia issues.
My Dad had Dementia and also fell frequently because he "forgot" that he couldn't get up and go to the bathroom by himself. They tried a variety of strategies to keep him seated.
Good Luck to you.
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Your father cannot be made to understand that he must not get up, so stop trying: it is frustrating for you and in the end becomes abusive to him because you are requiring him to grasp a concept that he is incapable of grasping. I hope I don't sound snotty - I know this from painful experience with my own mother, and I truly sympathise.

He needs to be in a memory care unit, where the staff will have experience and expertise in managing dementia patients at risk of falling.
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glad- Hard to believe they do not want to take him in the nursing homes either so far. There is a large focus on falls now, so a nursing home or AL has their rating affected by the number of falls. As cliche as it sounds, most of the homes are owned by larger companies which are very concerned with how the ratings affect profits. So the decision to not take him is business related. So yes, where else can he go?

Jeanne - thanks. We are concentrating on those two search options. There is a real shortage of beds, but we will keep trying. You are the second person to mention the lawyer, I will set that up this week. I did not know about that one.
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1. Consult a lawyer specializing in Elder Law to help avoid impoverishing your mother.

2. Restrict your search to Nursing Homes and Dementia Care places. Dad is no longer a suitable candidate for Assisted Living.

My mother's dementia keeps her from remembering she can't stand up, so she is a fall risk. Her nursing home has put a number of practices in place to help prevent that. No one has asked for "baby sitting" or talked about discharging her. You will find a place that will take Dad. Keep looking.
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Nursing homes won't take him because of history of falls? That seems strange, many of them fall. Does that mean a nursing home will only take them if they are bedbound? Assisted living would send him to a nursing home if his care became too much. So, I guess my question is the same, where else is there for him to go?
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freq - You are right that it probably will not help to talk to him about it. That is really why I haven't. There probably is no use in making him feel worse, although sometimes I think it would actually make my mother feel better. She has a lot of anger about it for a number of reasons.
A trust for his grandchildren means for inheritance, not while he is alive. Again, this is not the issue and I should not have mentioned it.
My question was whether there were options anyone could think of to a nursing home and a sitter. They can afford the home, but sitters triple the cost. It is devastating them financially and there will not be anything left for my mother's care. Because of the history of falls, nursing homes do not want to take him.
I have followed this site for a long time and have seen some great help and ideas from some great people. I was really just asking for suggestions for his care.
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enderby, please remember your Dad has dementia, he's not going to remember from one day to the next that someone has told him not to get up. He can no longer reason. Therefore, he won't remember you talking to him about how he is ruining your Mom's life, so don't even bother, all it will accomplish is getting you and your Mom more upset.

Case in point is my Dad, even though he seems clear minded I believe he has the start of dementia.... for the past year I have been repeatingly telling my Dad that I get panic attacks when driving so I won't be able to drive him or Mom on a regular basis like I use to.... so what happens the next day, I get a call from Dad asking to be driving somewhere :P

Oh, please clarify as you had written "We have his assets in a small trust for his grandchildren".... are those assets available to take care of your father and mother if need be, or are the assets somehow locked and only to be used by the grandchildren?
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I don't quite understand what you mean by "their care first." Their money in its entirety is used for their care. That has nothing to do with the trust. I probably should have not brought it up except to show that my mother's care is the real issue, not protecting an inheritance. I do not expect there to be anything left after they are gone. That is not the point. I think they should both be in the best places they can afford while alive. I can help a little, but it seems like nothing against this huge cost.
What we need is a reasonable living arrangement for my father that does not devastate my mother financially. She is ultimately the one I am trying to look out for. She has even taken to staying all night with him sometimes to save the sitter fees, then telling me afterwards so I do not stop her. I only have dealt with nursing homes and AL, and really do not know of any other options. I've talked with agencies and some professionals, but his behaviour must be more uncommon than I thought. He has been in AL for a year and a half, but this getting up and falling just started a month ago. He had an infection, and after treatment he seems a lot better, but we cannot erase the record. So far that has stopped us from getting him in a skilled nursing facility.
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I'm sure the trust is worded that it is for your parents care first? In fact, trusts are not safe from Medicaid recovery, it would have to be used for your parents first. If your parents names are on it, it is their money. If the trust was setup in the last five years, Medicaid would more than likely consider this fraud, an effort to hide assets.
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Yes, he needs a nursing home. He needs meds and help with all aspects of living. All of them except eating. He is not a danger to other residents, just to the rating of the facility, according to some of the health care workers.
Yes, contacting the lawyer is a good idea. We have his assets in a small trust for his grandchildren, but the only concern now is that there will be enough left for my mother.
We really just need to place him somewhere where he can be cared for without both of them becoming destitute in two years.
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See an attorney now to protect your mother. Elder law that is well versed in Medicaid planning! There are procedures in place that will protect your mother. Ask specifically about Medicaid impoverishment?

You father needs a nursing home and meds to keep him comfortable and safe? Safety of other residents is a major concern in assisted luving?
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