I live in Mass..want to move back to Florida..husband is in nh with vascular dementia w uncontrolled diabetes. I don't want him in a nh in a bed w his watching tv all day..isn't there a six or so intermediate housing situation for the early onset dementia pt where there are activities for them anywhere or F2f l?

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Because of the large senior population, Florida has a LOT of options. The small homes I am aware of are all licensed as "assisted living" or "adult family care", which may or may not be able to meet your husband's needs. Do you know where in Florida you want to be? I'd start with the Area Agency on Aging for your preferred region, which should know what's available. If you're not set on a locale, I suggest starting with The Villages in central FL, which is a whole city built for seniors and therefore has a high density of related services. If you're interested in west Orlando, PM me and I'll put you in touch with friends who have a small AFC home.
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TV is not a healthy choice whether he's in bed or in a group room. If you bring him home, you can cure the diabetes. A raw food diet (see the work of Dr. Gabriel Cousins) has cured hundreds.
Can you afford to pay a caregiver out of pocket? Is your dad a veteran? If he's a veteran, he can qualify for a monthly check. My mother gets $1100+ from my father's VA benefits. First thing is to get him out of the NH and into an environment where there is no TV and where there is someone monitoring his diet. TV kills the brain.
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I'm not sure what the options are in Florida, but I have an agency in California, and if your Dad needs injections for his diabetes, he has to be able to self-inject in order to live in a licensed assisted living residential care home (6 bed). It's against the law for them to do any injections; which means that he either has to live in a very expensive larger dementia care community that does injections because they have chosen to have 24 hour nursing (most do not), or he moves to a medical community such as a nursing home. I would contact a seasoned referral agency to let them do the work for you (it's free) and they will give you qualified options based on level of care and budget. Good luck.
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I don't know this for sure, but I would imagine you could find nursing homes with small number of beds and a large number of staff, but this type of care would be very costly. One of the problems with nursing homes is the extremely high cost of operation. And this high cost is with a caregiver to resident ratio of about 1:10. Imagine what it would cost if they had a 1:4 ratio or 1:1 ratio?

Some Suggestions:
1) Does he really need SNF care? Will an AL Memory Care facility work better? Its better equipped to handle the dementia and its half the price of a SNF.

2) Why is his diabetes uncontrolled? I can see this in a AL or IL, but in a SNF there is much better control of what he eats. They actually *can* tell him what to eat in a SNF, where as in a AL or IL they can't really dictate what he eats.

2) Can you hire a Home Care Agency to provide 1:1 companion services for part of the day? (This is what we did with my mother... but then again, I own a home care agency so this is what we do)

3) He should be in a wheel chair or medical chair watching a group TV in a common room. I know this is not much different than in bed alone in his room. But its different enough to get him a little socialization, and out of this bed, also helps reduce bedsores.
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I feel your pain. My dad died fearing death less than a nursing home. Life is not life, in bed with uncontrolled diabetes (which exacerbates and brings on early onset dementia in many cases - so much that dementia is now called Diabetes type 3)
There are many small homes in south FL. Our Angel House is in Pembroke Pines, SW Broward county, FL. People are treated with dignity and get personal care and attention. The reason many people end up in nursing homes, is the cost, though. It's not that expensive in a nice ALF for what you get.

But in the NH, To the family and individual, the cost is less, because the state (Medicare, Medicaid) and federal government absorb much more of the HUGE cost of nursing home care, where they pay less of Assisted Living care, which helps Avoid Waste and corruption.
Well, I am not sure what the Real goal is there, but it's not working as they seem to say it's Intended to work. I wish Medicare would pay even $700 a MONTH toward ALF care, where they pay $700 a DAY for nursing/rehab care.
Also, there is a Waiting list (here) and when a person moves from one state to another, they go through Medicaid qualification & signup all over again.
My mom moved into Angel House from TX at my sister's home.
She was on the waiting list nearly 7 months. A day or two before she died, I got a letter saying she was approved. Then another letter a week later, saying, "Benefits Denied. Reason: Deceased".
Yeah, really good with people skills, the state of FL.
What if I were out of state and they got the wrong person? Way to give me a heart attack.

Doreen C.
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