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My father in law was diagnosed with Late Stage Alzheimer's five years ago. He and his wife have been living in independent living for the past 2-3 years.
For the most part, my FIL has been doing pretty well since his diagnosis. Definitely a decline and therefore no driving and no longer manages the money. Over the past couple of years he certainly has gotten more confused. However, in the past month, his symptoms have grown much worse. He is now very agitated and has taken to wandering in the middle of the night. Recently, he entered some other residents' apartments in the middle of the night. The facility managers don't seem overly concerned about it; however, the family is concerned that it may be time for more care.
All the family members are engaged and involved in some aspect of their care, so that is not an issue. We are just trying to figure out what would be best for him.
Does it make sense to move him to memory care now? Is there such thing as in-home memory care? Who is the right person or agency to ask him/them to be evaluated? What are the right questions to ask?


They are located in Massachusetts and we are trying to get some advice from an elder care attorney regarding their finances. One initial comment was that memory care facilities are not paid for by Medicare - that they are primarily self-pay. Is this true?


Any and all advice is welcome and appreciated. Happy to answer any questions, as well. Thank you.

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Because of the responsibility involved in caring for an elder with Alzheimer’s who wanders, paying for 24/7 nursing or home health care would be cost prohibitive. The caregivers would have to be absolutely top caliber. And, you would have to be ultra vigilant to choose someone up to the task. My mother was on Medicare and Medicaid and her Memory Care was paid for. But seeing a Elder Law Attorney is a great idea.
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Medicare doesn’t pay memory care, assisted living, or nursing homes. They’ll pay for short term care in a rehab/nursing home but to answer your question, yes it’s true Medicare doesn’t pay for memory care. If your dad needs to go to assisted living then Massachusetts Medicaid will pay for SOME of the cost but not all of it.
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Isthisrealyreal Oct 2019
Medicaid will only help pay if you qualify.

Ask the certified elder law attorney about that aspect of receiving Medicaid. They will know if he qualifies and be able to assist with the application and be able to keep mom from becoming destitute.
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Has he been checked for an infection, urinary tract infections are reasons for behavioral changes that appear suddenly.

Well worth checking it out.
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For someone who wanders, they need to be in memory care at minimum. If they are also violent, then a SNF, Usually, if they can walk, then they are usually not violent.
Hugs 🤗
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In home care would be outrageous, unless they are loaded, they will run through their money very quickly.

Also, safety would be an issue, much better to be in a memory care facility in lock down.
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I don't know what kind of care you are thinking about but, there are things that can be done to help keep him in the house, within hiring 24/7 caregivers.

I would definitely get a medication that is proven to help agitation in Alzheimer's patients.

You can put a black or dark rug in front of the door. This is supposed to look like a hole and the patient will not step on it.

You can put the child grips on the door handle. They just turn if they are not gripped properly.

What kind of activities is he involved in during the day. He should be doing things that make him tired so he will hopefully sleep through the night.

The facility has probably seen everything and that they are not concerned is a good thing. It means that he is not putting himself or others in danger.

Have you asked them what they would recommend to keep him from wandering?

How is your MIL dealing with this? Her wellbeing should be considered in what should be done with FIL. Is she wearing herself out being his caregiver? Would she do better in an environment that provides care for FIL and her by providing meals, doing laundry, housekeeping. Someone to follow him around at night and keep him busy during the day.

I commented previously about an infection, has that been eliminated as a problem?
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