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ibeenscammed

Thank you. She's in a better place probably "having a ball" with her loving brother :}
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Very sorry to hear about your mom.
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Helpermom

Thank you. Mom has passed, 99% of the AL/NH are Medicare rated 3 stars and lower. There is only one 5 star rated one. Ironically, or not, the last AL she was at, bragged about being 5 star rated when it came to Quality measures. Guess, what? They've lost a star and have taken down all the signs that bragged about their 5 star rating. You were fortunate and lucked out. I wish you well as well.
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Z, I can empathize with what you're staying, and I don't doubt that this has been your experience, however, it's not been mine. We had to choose between two different buildings with high quality care that had vacancies when our parents needed an ALF. Maybe it's a question of where you live? Or just timing. When we recently had to move them to a smaller apartment there were only very small units available. Luck of the draw, I suppose. Wishing you well.
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I'm only saying that things were not better in Medieval times. Which is what Z made reference to.
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The problem with the public welfare system is that the System is designed to keep the poor poor, the incarcerated incarcerated, homeless people chonically homeless, and the mental patients turned into Revolving Door Syndromes. The System will not function without its loyal customers returning again and again. So therefore, it is made to please, made to satisfy, not cure. God forbid not cure! Or else it'll lose its customer base. So we have waiting rooms full of dependent patients who worship their "expert" doctors who know better, the State who knows better, the government who knows better, and suddenly, we are sick and in pain and wonder why on earth we've lost touch with our own bodies, our own selves, and we have forgotten what makes us tick. I often tell people (if they are willing to listen) to take back their minds, bodies, and souls from the medical/governmental establishment and take back ownership of them. Your doctor doesn't know best. That's the biggest myth going. You know yourself better. Take your body back before they steal your rights to it.
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Z, I'd really like to know where your information about Medieval times comes from. I'd be happy to learn from some primary source material that shows that ALL folks with disabilities/ old age/poverty were better off relying upon private, individual charity than those populations are now with Governmental assistance programs that are administered without regard to color, morals or diability.

Please, educate me.
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Issues? In the Middle Ages? No, really? When folks with epilepsy were thought to be possessed and burnt at the stake? Do you really want a short history of how the poor, indigent, insane and elderly were treated in the Middle Ages in Great Britain and Europe?
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Oh right. The Good Old Days. When you had tk be among the "deserving poor" to be helped by Lady Bountiful characters. Read Angela's Ashes, or A Square Meal, recently published, about relief efforts during the Great Depression.

The whole idea of "people taking care of each other" is posited on the assumption that half the population ( women) are not engaged in paid employment. We're not going back there, folks. Nor should we.
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Well, yes, they did. Except when they ostracised each other, excommunicated each other, knifed/hanged/burned/drowned/branded each other...

My neighbours' house has a special kitchen window, larger than usual, which opens inwards. This was originally designed to be the alms window, from where bread was distributed to people who had no other recourse (17th century, long before workhouses). That way a) you didn't have to let them into the building and b) you didn't have to come into physical contact with them. But bubonic plague was popular in those days, so you can't blame the charity workers of the time for being a bit jumpy.

Walt Whitman said "what we call progress is merely the exchange of one nuisance for another nuisance." The reverse - that the virtues we hark back to were in a context that we definitely don't - is also true.
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zytrhr: Yep!
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I kinda wish society was more oriented toward Helping Communities. I don't mean "services" via The State. That, I believe, is turning The State into The Parent Who Knows Better. As far as I am concerned, as soon as The State via Your Doctor Knows Better, we are all in very serious trouble as a society. Sadly, it's headed straight in that direction. I personally am hoping we can return to Communties that really care for each other, neighborhoods where neighbors aren't at each other's throats, nor hostile, but inclusive, loving, and helpful. Why should the care of elders be on the shoulders of one or two family members when there is a whole block, or whole building, or church group, or town that can help out so we wont need to put old people away in Old People Ghettoes anymore. Just a thought. Can this become reality?
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Helpermom- Problem is there are many more bad, than good, and the good either have no space available, and/or have a waiting list. So a concerned caregiver has very little choice, especially if the loved one can't wait, to go with a lower rated facility.
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justbereal

It's all about the money, and how much these places can make on these patients. One thing to add to your assessment, when the loved one dies, the AL/NH will "forget" not only the family of the loved one, but the loved one, themselves, unless there is still money owed.
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Llamalover47

Oh well, then it's a different ball game.
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For anyone else who is reading this and worried about ALF's, or is feeling put down or distressed by these remarks, please know that while some places are not good at taking care of frail elderly people, and may indeed ignore bedsores or even be abusive to the residents, they are not all like that. The one my parents live in does not have 24/7 nurses, but the caregiving staff is excellent, and they don't let my folks suffer wth even a diaper rash, let alone bedsores. The only thing you can do as a family member is investigate the place thoroughly, visit as often as you possibly can, and build enough rapport with the caregivers that they'll tell you when something is going on. An ALF isn't automatically good or bad, but like a lot of places, it's what you make of it.
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Freqflyer- I said if the word ASSISTED is in the name of the MC facility...as a MC Resident declines to bed bound, unable to feed themselves, or act in a way such as uncontrollable screaming (which by the way, makes life hell for other residents and staff) they need to be moved to a full scale nursing facility. They need an RN on staff that can medicate them to control their hours of screaming. ASSISTED anything is not required, and DO NOT IMPLEMENT PROCEDURES to do range of motion movements to all limbs of bedbound residents; thereby rendering these poor people stiff as a board and contorted into ungodly positions, which in case you didn't know is EXTREMELY PAINFUL. Hospice does NOTHING for that EITHER. Hospice comes and packs u.healable bedsores that go bone deep, they disimpact the poor contorted, basically abused individuals because they become impacted from no movement whatsoever. The ASSISTED facility will gladly take your check every month but no human being deserves the treatment they will endure until they finally die. Harsh but real talk. If your loved one is in a facility with RNs on staff 24/7 then BRAVO for you, you picked a great facility. If they do not have RNs on staff 24/7 and your loved one becomes bed bound, then you, just like all the other people in denial, are free to think whatever it is that helps you sleep at night, and pray that God forgives you when your time is up.
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zytrhr: Good if living with the family works for the elder, but what happens if the elder gives you a big "NO?"
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HelperMom

I see. Some older people would go "stir crazy" if they had to be indoors all the time.
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Thank you so very much in providing/sharing these questions and answers. They are so so helpful to me. I'm sure I'm not the only person wanting to know those questions. I truly appreciate it very much!
Teresa S.
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zytrhr: Yea, until the elderly parent says "uh uh, can't make me, not going to it, stomp, stomp!!!!" said my late mother!
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justbereal, one shouldn't paint all Memory Care facilities with such a broad brush. The Memory Care that my Dad is in is like a 4-star hotel [I realize not all places are like that, but many are in my area].

As for "dumping" my Dad there, it was his idea to go from Independent Living to Memory Care [Admin also agreed it was time] because he still had math ability to know it would save him a lot of money as he wouldn't need his 24-7 outside caregivers. His budget did allow for him to keep his very favorite caregiver for 4 hours per day to give him a routine.

I only visit Dad once a week for an hour, mainly because I am trying to catch up with all the doctor appointments I had put off for years as my Dad and my late Mom were keeping me busy running them here and there, getting their groceries, all of their own doctor appointments, minor repairs around their house, etc. My own house/yard had been terribly neglected over the years. Oh, did I mention I am 70 years old? I have my own age related declines and medical issues. Like who would pick ME up if I fell? I thank my lucky stars for such places like Memory Care and thank my parents for being frugal to save the money for this huge "rainy day" situation.
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The progressive living arrangements are unbelievably helpful but also so expensive most can not afford them. This that can usually have enough money to stay home and pay for the necessary help.
I think ALs could do a lot more about getting their residents moved on to more suitable facilities when they become too disabled for the staff.

COLady you are one smart cookie. But you are not disabled with dementia which is the big difference between you and the families who place their loved one or not so loved ones in facilities.

My ILs were a good case in point. They downsized when appropriate but clearly problems started but were coped when FIL's health began to break down but his mind remained clear. ML's mental abilities began to decline but the family did not realize because FIL could watch and make sure she did not do anything stupid like leave the cooker on, plus he had always handled the finances and when that became difficult handed it over to his other son. Being in the UK they also seemed to get a lot more help than most people do in the US from Govt paid caregivers. FL died first and MLs deficits immediately became apparent so she had to be placed after a few weeks. After that ML declined very quickly but I think she would have anyway because she had vascular dementia and had frequent TIAs.
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Does the person NEED assisted living?
There are independent "Retirement Communities" and may have all stags from retirement, assisted to memory care and some to full nursing care. The cost will depend upon the level of care needed.
Advantages...
No Mortgage..but chances are the current house is probably paid for unless there are second, third or more mortgages.
No heating costs
No lighting costs
No water bill or sewer
No garbage pick up bill
Minimal food costs
Some transportation provided
Arranged outings.
Being able to pick up and go without having to worry about a vacant looking house
Disadvantages
You have to let someone know where you are going, signing in and out
You are living close to people that you may not like
These are just 2 that I can think of now..It would be like me moving back into an apartment not something I want to do..ever again.

So there are advantages and disadvantages
Much depend upon what the person needs and wants.

At some point though Assisted or Memory Care might be necessary for the sake of safety. And Assisted Living or Memory Care is probably less expensive in the long run compared to having a live in caregiver or multiple caregivers 24/7
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Often family who just drop in and visit briefly have no clear idea of how much their parents have declined and their real care needs, this is true whether they live independently or in a facility. In my opinion it is up to the facility management to re evaluated their residents periodically and to set firm boundaries about the care they can offer. Unfortunately some companies focus too much on keeping every space occupied, even offering large bonuses to management based on occupancy. Here there has also been a boom in the building of new, high end ALs so that many older facilities are having difficulty attracting residents, so there is an incentive to hold on to clients who really do need a greater level of care. Add in the fact that there are also long waiting lists for long term care and you end up with a lot of people living, and unfortunately dying, with sub standard care.
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I see both sides of it, Glad - the "dumping" has been going on for decades and still does. Sometimes it's because families or others taking responsibility will just grab the first place they can get, out of desperation, whether it's really suitable or not, and then after that they'd rather not dwell on what might be happening; sometimes it's because people feel happier, irrationally but still, if they're placing their LO in a specialist unit rather than a nursing home which they see starkly as being the end of the line; and in any case there is considerable variability in the quality and competencies of facilities, whatever they're called.

But yes there are souls whose minds have disintegrated inside otherwise healthy bodies, and they do not belong in the highly regimented environment of most Nursing Homes, I agree.

The best facilities I have seen follow care through from simple older age support to full-on nursing for the "elderly, frail and mentally frail" as they used to put it in the olden days (1990s!), providing client-centred care in the truest meaning of the phrase. I'd be happy to name names but I don't think it would go down well, and besides they're UK organisations and no help to AC members - though I'm sure there are US groups which are at least as good. I just wish there were more of them.
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Memory care is often necessary when their care needs exceed the skills or patience for family or other caregivers. Care in the home is not always ideal, though it would be nice if everybody with dementia had a family member that could provide for the ever increasing care needs. Home care is not feasible many times due to cost. Facilities are often the most cost effective option and the best option. Dementia is a progressive disease and yes the move from home will often cause a decline. Nursing homes for memory care are not warranted until the physical needs align with the dementia symptoms.

Moving a loved one to memory care is not "dumping". Many times it is the ONLY feasible option. When the become uncommunicative, not able to eat or get out of bed is many times when hospice is brought in.
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I work at an AL which also has a memory care unit. Our residents in the AL side are very happy, they have many activity options daily. They are like family to one another and even the staff. We love them like our own grandparents. This is because they truly only need assistance. We do their laundry, provide all meals and two snacks per day. We give their meds or if they prefer, they do their own.
Now, Memory Care is totally different. It is pitiful that families dump their memory impaired loved ones, who are always incontinent, if not when they arrive, definitely soon after, off at an assisted living and literally leave them there until they die. As a person declines they should be moved to a full scale nursing home with RNs on staff and machines to lift these people who eventually become bed bound, develop bed sores that never heal, and break the backs of the caregivers. But families NEVER do that. NEVER. It is tragic. It is illegal, but goes on all the time. If your loved one needs full care, take them where they can get it for God's sake. Don't be in denial, no facility with the word ASSISTED in the name is for people who cannot get out of bed, or feed themselves, or stop themselves from screaming uncontrollably for hours on end. And I say all of those hard to hear things out of LOVE for human beings who have worked hard their whole lives and DESERVE better than to be dumped off at a facility who cannot possibly give them the care they NEED and DESERVE.
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I am a very healthy 85year old woman and live in a house of my own (paid for). I am just going into a phase of my life where I will finally be living alone. I am still able to drive and I have help running my house consisting of a gardening person and a house cleaner. I am going to try it out and see how I do. If it is a struggle in any way, I plan on looking into what alternatives are available and moving if anything else seems to be a better choice for me. Perhaps a housekeeper who would also cook my dinner would be a solution. I am sure there are other options. I am very independent, but sensible, and want my family to help me make the right choice when the time comes. Thinking and talking about the choices ahead make it easier for both my family and me. There won't be any family meetings about 'What do we do about Mom".
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Oh I should add, many are also still licensed to drive and perfectly capable of taking themselves wherever they want to go! It all depends on the individual.
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