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you may have tried this, but if you dad answers the phone, could you tip the driver a bit to telephone him as she arrives. I assume someone helps him onto the bus. Maybe the driver could telephone him/her. I wouldn't be thrilled at having to pay on top...
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24 hr oxygen qualifies him to be homebound - only able to leave the house with help, which might make him more eligible for more assistance. If you haven't yet, check into what community medicaid might be able to help with. I don't think it would pay for the AL, but could pay for additional aides to help him stay at the AL, rather than NH. If you're in NYS, this would mean going through a Managed Long Term Care Plan, but that means there would be someone to assess the situation and coordinate needs. You may be able to get some info from a plan like Hammaspik care, as to what the process might be. I'm not suggesting it, but if you think about moving him back to his home, or moving in with you, this could help pay for aides, so that you wouldn't need to be up with him at night. If the oxygen is critical, and he takes it out at night (like my mom did), that might count for having someone monitor him at night, and maybe get it covered by medicaid.
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... and I looked into the option of a Veteran or volunteer to drive Dad instead, but the 24 hour oxygen is creating a bit of a hiccup. I guess it's an additional liability with the oxygen.

CURSES to cigarettes!!!!!! How is it that HE decided to smoke the majority of his life and I'm suffering for it? How is that fair??? YIKES I'm crabby today!!!
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katiekay, the AL has plenty of activities available for Dad, but he refuses to go to them. He is quite stubborn. Since the VA provides the Adult Day Services and the driver at no cost, I use that option. Before moving him to AL, I paid $70/day for it.

If it weren't for the Adult Day Center, Dad would sit in his room and complain all day. On the days that he doesn't go, I have to keep my phone on silent because he calls me constantly to say he's lonely. I suggest that he attend the activities, but he says that he's not interested in the activities. I honestly am not getting my $5K a month worth of service. Dad hardly uses any of it.

If there was a way for me to reconcile my need for my own space and sleep at night (Dad is up and down all night), I would just get a larger house and move Dad in with me to save money.

I keep toying with the idea, but remember how miserable Dad and I both were when we tried a similar option a while back. He wasn't on 24 hour oxygen then...
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I think cm has a point that if he did not go to the senior centre he might join in more activities in the ALF, BUT, the staff would have to encourage him, make it his job or whatever works. It is assisted living and I suspect your dad's needs are exceeding their mandate and his needs will only increase. The staff are unwilling or unable to put in extra effort to see that he is where he needs to be, and the testy driver wants him to come to the vehicle on his own which he can't do. That is the reality of the situation. We all have our "druther's" - druther have this or druther have that, but no one can have all they want.
Tiny, it may be time for you to be looking for another facility. There are acceptable medicaid facilities. Your dad won't be able to stay in an ALF forever, Since he is between memory care and assisted living he will be straining their resources. I am sure the ALF breathed a sigh of relief when mother was transferred to the NH. She was straining their resources. At the NH she was welcomed with open arms and many more resources. I breathed a sigh of relief too.
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Its sad that you have to send your Dad to day care when he is in Assisted Living. Would be nice if they provided activities for him there in the facility to make things so much easier on you. The least they can do is assist him to get to day care since it sounds like they provide no activities for him. (My opinion)

Do they not have any entertainment or activities to keep your Dad busy?
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I grimace with disgust for you, Tiny.

They are paid to do the job. The job has to be done. They might just as well do it well as badly; and although I'm the first to sympathise with and protest about the contemptuous pay prevalent in the care sector I'm also totally exasperated with the attitude that says "you only pay me enough to do this half-assed."

I think all you can do is keep your temper and keep smiling and hope to win them all round with charm. But you are paying for this! They are taking your money (both sides)! If they think it's not enough that's an argument they should be having with their employers, not taking it out on your poor Dad.
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Countrymouse, I can always count on you to give me the slap of reality (smile)!

So... the "pickup point" is in the downstairs lobby area. Ideally, the driver would like to be able to honk the horn and have Dad come out, but dad is legally blind and he can't see her van when it pulls up, so he will often sit in the sunroom which isn't the warmest during this time of year (an issue in itself), in addition, his hearing isn't the best, so sometimes he doesn't hear the horn. According to the AL staff, the driver will "storm in" and make it known that she is unhappy with this inconvenience.

...and she's not a volunteer exactly. The Adult Day Center is part of a Veteran's program which covers Dad's three days and transportation. The issue, however, is that the rate that the VA pays is considerably less than what this driver could command if she did it on her own. As a result, the Adult Day Center struggles to find decent drivers. In fact, they've all been pretty awful.

I really would like the AL staff to help with this, but it is like pulling teeth, and I get the eye roll every time I go to the desk. I don't think it is unreasonable to ask someone to head to Dad's room and help him down to the waiting area or assure him that his ride is coming, but that would be too much like work. They literally switch on his portable oxygen machine and leave him. Assisted Living is a ridiculously expensive joke. In fact, "senior care" is nothing but a capitalist plot to make the doctors and facilities richer and the patient and caregivers poor and miserable... yet I digress.

It's times like these that I wish I had the resources to add private care service to what Dad is currently using, but I just can't afford it. This shouldn't be THAT big of a deal, but for some reason, it seems like more people are against me than with me.
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Hang on, I must have missed things.

So. The driver is arriving at the ALF to collect your father and take him to the day centre where he enjoys all the activities. But when she arrives at the designated pick up spot (which is where, exactly?) he isn't there waiting for her, she has to go in to the ALF to ask for him, she shouldn't need to do that so her manner is impatient and brusque, then there is a kerfuffle tracking him down and getting him out of the building, so everybody is having a rotten start to the day?

Hm. Well. You should stop trying to make everyone happy, is number one point.

The driver's job description may only cover driving, collecting and dropping off; but it really won't kill her to look past her job description and consider what is actually required. The job to be done is to get an elderly and unwell man from A to B. So if to do that she has to park up, walk a few paces indoors, enquire for him and then sit tight for a minute or two is that really the end of the world?

Are you paying for this service or is she a volunteer?

Can anything be done to make the pick up point easier and more comfortable for your father to wait at? Can he sit down in the warm while he's waiting, or does he have to go out of doors?

Look at it as a logistical problem and not an emotional one. Consider your father as a package marked Fragile and see if there is a practical way to get him from A to B that does not ask anything unreasonable from anyone concerned. And by anything unreasonable, I don't mean "anything at all." This is, after all, supposed to be Assisted Living. No they don't have 30 minutes to dress, escort and wait with him, but they can remind him to get ready, they can reassure him that the driver will be there in a second - they can do what anyone would do if they wanted to help him get to his activities.

And if it really does prove to be an insuperable problem, that isn't the end of the world either. Could be that if the day centre option just isn't possible any more your father will be driven to join in more of the on-site activities.

You can do your best to jolly everyone along. But you are paying handsomely for all of this, and it shouldn't be creating work for you. How about you get a tiny bit testy from time to time, too?!
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Dear Tinyblu,

Sending you hugs, my friend. I know you are doing everything you can for your dad. Please try and be kind to yourself. Us, women want to do it all. It is admirable but misguided. Please do not be afraid to ask for help. I wish I did it more for my dad. Otherwise the anger and resentment just swallow us up.
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Even if it feels like you don't have the time to investigate other places now, you might come out ahead in the long run, if his services aren't meeting his needs, as you say. Is there any way you can take at least some days off from work, or some part time days, or possibly talking with the Office of Aging or a good geriatric care manager to help you look at what is available and affordable. That way, once you get dad in a good situation, the calls will be less. He might need more care than AL can give. Is it possible that you can move any resources so that he can qualify for community medicaid? Perhaps that would help pay for more aide services that could help him prepare for the ride to day care? I know that I was overseeing a lot of the care for my mom, and filling in whatever gaps there were, but once I found people to help with those gaps I was able to step away a bit and see more clearly what needed to be done, and how to do it. I wish i had done this long ago, as I spent lots of time stressing over what was a good situation and how to manage it, but not getting aides set up that could be there full time.

The Adult Day Center sounds great if your dad will socialize there - socialization is so important. So in reading your post again, it's really just the transportation that is currently an issue, unless his care is getting to be too much for AL. You should find out from AL what all the current issues are, because if he can't stay there, you need to know options. Then talk to the day center and see about other transportation, and the office aging for other solutions you might not be aware of now. If your dad is a veteran, there is also aid and attendance that could help pay for some memory care locations.

Sorry if that rambles, hopefully it helps some. It really is so hard to be the caretaker when you are the child and you are working.
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Wondering if the AL facility could find a 'job' for your dad, so that he can't stay put and not deal with transportation. My dad's Memory Care facility finds 'jobs' for one of the dearest ladies there that just can't sit still.
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I feel caught between the rock and the hard place AGAIN!!!!! Sometimes I wish there was a SHUT OFF button where I could just NOT have to be involved in the caregiving thing for just a day.

The saga continues with the transportation driver, Adult Day Center and AL facility. Once again, I've somehow back in the middle of a mess that I'd rather NOT think about at all.

The Social Worker from Hospice was just trying to help, but stated that the issue with the Adult Day Center Driver and the AL has nothing to do with Dad's care and she's right.

I honestly believe the AL staff when they say that the driver is rude because I have talked to her and her tone is rather testy. Nevertheless, I understand that she's simply a taxi driver. Her role really is to pick up and drop off.

It's becoming clear that Dad's needs and her services don't match. To make matters worse, the AL staff says that the driver is often late and Dad will leave if she doesn't come "on time" or what he perceives is "on time". In her defense, Dad can be quite impatient.

The AL staff is understaffed and doesn't really seem to want to provide assistance in this area which I can partially understand. They don't have 30 minutes to carve out to make sure Dad is where he's supposed to be for a service they don't provide.

So, what do I do? I've tried to intervene but feel like a total B**** by asking for help from anyone. I really think people see me as a drama queen. Maybe I am, but I'm sick of all the back and forth.

My only other option would be to pull Daddy out of the Adult Day Center. This would be completely crippling to my Dad. He loves going to "work" as he calls it, and that's the only time he actually interacts with people. On the days he's at the AL, he just holes up in his room and doesn't go out much.

On the other hand, it's getting harder for Dad to get to the pickup location as his COPD progresses. I think some cognition issues are getting in the way of him being ready when he's supposed to, and quite frankly, I'm sick of the whole thing.

I think it would be selfish to pull Dad out because I'm inconvenienced, but the only other option would be to spend time I don't have trying to find another FREE alternative or pay someone for more specialized service. We just can't afford anything else.

It's really a catch 22. Dad isn't quite at Nursing Home or Memory Care status (and we really can't afford a private pay -- and he's too "rich" for a depressing Medicare facility), but still wants to participate in activities that are beyond his abilities. I could say SO many mean things right now about this whole mess, but I'm just going to shut up...
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