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My mom with schziophrenia and knee arthritis is in the process of moving into an assisted living home. I'm a long distance caregiver in my 20's and trying to setup a system that would allow me travel for work or school if need be. At the moment the assisted living she'll be moving into is less than 2 hours away from where I currently live and work. She is transitioning from one on one homecare to assisted living for the first time. On one hand this transition seems great because we can always expect her to get her meds and do not have to deal with coordinating caregivers, however there still seems to be confusion with the health care part of the equation. Because my Mom has a mental illness its hard for her to setup dr. appointments and advocate for herself in the drs. room. Does assisted living do this for you? For ex, if they notice something wrong with her foot do they set an appointment with her foot doctor and go with her there to address it? They have a nurse on staff but in what way are they usually involved in these facilities? Do I have to hire someone else to do this And if so, how do I coordinate this? Geriatric care manager? Home health aide? It would difficult for me to just be down there at a moments notice for a drs. app.

My mom's AL has a nurse practitioner who visits every other Tuesday. She writes prescriptions, orders tests and lab work, performs physicals and placement assessments. The resident is billed by the company that contracts with the AL. If you want to use your own doctor, transportation is on you. The AL also uses a central pharmacy for medications. If you want to use your pharmacy the meds have to be packaged exactly the same way. The pharmacy bills the resident directly. There is little to no coordination of care if the resident uses an outside provider. All ADL assistance is included in room rent (except toileting assistance, feeding assistance and mobility assistance) BUT the family or resident has to actually ask for the help needed. If you don't ask for the help, they won't offer help. So residents can wear the same clothes day after day, not comb their hair or brush their teeth. If you want to bring in a care provider so your loved one has individual attention, the facility strongly discourages you.
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Reply to Longears
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I wonder also what would happen if my mother moved into AL. There is a van service for medical/dental appointments and shopping. I don't see my mother as capable in scheduling and remembering appointments. I don't want to have to be her taxi service. That van service is part of the monthly fee, so why should I be responsible for transportation? Plus, I'm not allowed back into the examining room.

I also don't want to be the one to be called when there are issues. And I've told my brothers (all out of state) as much. I feel like I've done my time, and it's time for someone ELSE to step up and take care of this domineering, controlling and obsessive 92-year-old whose memory and reasoning is going.
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Reply to CTTN55
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So to put it into perspective.... They don't coordinate the care, they just essentially just execute it? And I or someone I hire has to make all the arrangements to make she gets the care she needs. And also make sure that the care she needs gets communicated to the AL through her doctors?
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Reply to boombop
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ALs are their homes. They are residents not patients. I used to ask that Mom be ready for me to pick up. One time I found her with food all down her another she was sleeping. Good thing I always gave myself a half hour. Was ready to ask the Nurse if I was asking too much when I had to transfer Mom. I know that the ALs activities director took residents to doctor visits. I would think that making appointments and taking the resident would mean an extra cost to Mom. If the AL doesn't offer this service, maybe you can set up appts and hire one of the facilities CNAs to accompany Mom. They would probably love the extra money.
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Reply to JoAnn29
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I forgot to mention that nursing duties vary by state and the nurses are restricted to the state scope of practice. You may notice this when shopping
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Reply to MACinCT
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How many hours did your dad's caregiver come in for?

Thats a great idea. We could budget to have her come in once or twice a week. It wouldn't exactly be ideal money wise, but I'm not sure we have any other options at this point. I've thought about board and care facility's, but my mom is fairly high functioning, in her early 60s. Would hate for her to give up her cats, privacy, and be around people who need a higher level of care than her.

Her caregiver is currently coordinating and ordering all the medications and taking her to the dr. apps. I'll have to compare the costs between that and a geriatric care manger.
She's already setup on a payroll so I don't think it will be too difficult of a transition.
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Reply to boombop
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boombop, could your Mom budget to have the caregiver she had when living at home come to help her out during the day?

My Dad did that, he was able to bring along his favorite caregiver who came for only half days when he moved to Independent Living, then later to Assisted Living/Memory Care. And this caregiver would take Dad to his doctor/dentist appointments and would go right into the exam room with him.

As for what will Assisted Living do for your Mom, you need to check with facility before signing on the dotted lines, seems like each facility does things a bit differently depending on the cost. The less expensive ones may have an option list of extras that your Mom would need to pay for, like transportation, pill management, laundry, etc. While others that charge a higher monthly rate, those items are included.
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Reply to freqflyer
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Wow. It sounds like so much more work than having her at home. I'm upset my family has lamented this as the golden ticket to everything. I was under the impression they did most of the work and coordinating. Including ordering her medication. At this point they seem like glorified apartments. What is the purpose of having a nurse on staff and suggest as though everything will be taken care of? Sounds like I need to hire a geriatric care manager asap. Or at least continue to have home health aide come in.

Do you know of any alternatives? Is there an in between of nh and assisted living. No one in my family (myself included) have the time available to make that kind of commitment. Didn't realize how all encompassing home care was in comparison.
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You will have to ask or review the contract. When mom gets sick they call me for ambulance approval or ask if I will pick her up. They draw labs when I request after I call the doctor to fax orders. They DO NOT order meds, or have anyone to be with her at the doctors. The only assist on time to hand her pre filled pill boxes as long if they are not complex. Assisted only gives assistance with daily living skill up to 2 hours each day. It could include bathing, dressing, meals, meds and once a week laundry. Van transportation is available on certain days to certain regions but someone has to make the appointments and coordinate the times. You would have to hire someone if she is not capable.  The problem is HIPPA. The doctor will not give instructions to a stranger and mom has to give consent to pass on info. Would she be capable or compliant to notify you on her condition or if there are medication prescriptions.I take mom to her doctors as her POA and Medical POA. I am the only one who manages the medical side is assisted living.
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Reply to MACinCT
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Here are 3 articles on this website that I think you will find helpful. You can also do a "Search" for Assisted Living articles and posts. Did you read the Assisted Living (AL) contract and see exactly what the staff WILL DO for FREE and what the staff will DO for A FEE? It might surprise you.

https://www.agingcare.com/articles/difference-between-independent-living-and-assisted-living-168142.htm

https://www.agingcare.com/articles/assisted-living-questions-137146.htm

https://www.agingcare.com/articles/hidden-costs-assisted-living-154725.htm
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