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You might want to consider another option - a board and care facility that specializes in memory care. They only house 6 people per house, but provide 24 hour care at around $5-6,000. per month. It more residential and home like than assisted living. We have a local group with 12 homes in their company - each has different levels of dementia. As much as my father wanted to stay at home, he told us while he was still alert that he didn't want his money spent that way - $17K per month here in California. Its worked out well for us so far.
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Reply to cdeh61
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We are doing in home care for dad right now because he is only getting 6 hours per day. He's really needing 8 hours or more. He pays about $5000 per month for what he has which is still under the threshold of memory care at about $6500 plus if we moved him to memory care, I will have to hire caregivers to take him to church and the doctor appointments. For now, this is the lesser of two options but I am told assisted living is no longer an option for him. If he leaves his house, he will have to go to memory care but then, he still has 'it' upstairs a bit so he would be very, very bored in memory care (his caregivers get him out of the house almost the entire 6 hour shift because he hates being inside).
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Reply to Babs75
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harryhel, to compare both in-home care with that of assisted living, one major decision is price.

My Dad, a major fall risk, needed around the clock caregivers and the cost was $20k per month in my area. Yes, $20k per month. Then Dad wondered about the cost of being in an Independent Living facility and later Assisted Living [sundowning]. The monthly cost was $5k, then $7k for Memory Care. The cost depends on what options are included in the price, and what options are extra.

If those prices aren't within your budget, then see if your wife could be accepted by Medicaid [which is different from Medicare]. Each State has their own programs. Some States offer a waiver to help pay part of Assisted Living, while other States will only offer nursing home care. Tough decisions.

Let us what what your decide, and if you have any others question feel free to ask.
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Reply to freqflyer
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Your profile indicates your wife has dementia so at some point she is going to need 24/7 supervision and care. At that point a LTC facility is probably going to be needed unless you have a lot of financial resources to pay for 24/7 in home care. In the early and middle dementia stages, in home care can probably provide adequately, particularly if you have even limited outside support from friends or family. Medicare will provide some in home support, such as help with bathing, but it's not much. If your wife qualifies for Medicaid, there is some additional in home support services available. If you can find an adult day care program she can attend 3-5 days a week, it will significantly extend the time you will be able to support her at home. The time to take care of your own appointments, shopping, etc. or just rest without worrying about your wife significantly reduces your stress. Remember that in order to take care of her, you must take care of yourself too. When you get to the point that you cannot physically perform her care needs or you fear for her safety when you're not actively watching her, it's time to move to LTC. Please contact your Area Agency on Aging and ask what programs are available in your community to help.
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Reply to TNtechie
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It depends on a lot of things. How much care is your wife in need of? Insurance will help some, but if she needs care 24/7, paying for it will mostly be up to you. Home Health Aides can cost $15 -$20 an hour. If all she needs is an hour or so a day to help with activities of daily living, having someone come in may be the way to go.

Bear in mind that in a facility, she will have the benefit of 3 shifts of caregivers 24/7 if she needs that. If you are unable to pay for AL out of pocket, private insurance, Medicare and Medicaid may help, but don’t pay for everything.
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Reply to Ahmijoy
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