Live-in care versus facility: How do I figure out what to do?

I'm taking care of my 68 Y.O. husband at home with live-in help. He has young onset Alzheimer's disease and is under hospice care, 9-1/2 years after diagnosis. He was in a NH for 3 weeks following 4 weeks in the hospital getting his meds adjusted. The NH was recommended to us and -- not faulting the NH but due to his agitation -- we were required to have a 24 hour a day sitter. The cost for the NH and the sitter combined would have been prohibitive. I hated having him in the NH. The kind social worker at the NH suggested hospice care, and the hospice recommended a licensed agency to provide caregivers 24/7. I've been extremely happy with the in-home caregivers I've had, and after a certain number of hours, live-in is less expensive than come and go. It's expensive but I'm happy that my husband gets one on one (& often two on one when I assist) care and showers as needed. We keep him very clean, as well fed as possible, and comfortable. In a NH environment, there are usually about 6 patients to each caregiver and 1-2 showers a week. The hospice people maintain that quality in-home care is far superior to NH care when it's possible. I couldn't agree more!

Hiring help at home is a good solution but placing a loved one in a facility can offer many benefits to you and your father. Being in the right environment with stimulation and support is essential for someone who is suffering from dementia. Reminiscent activities, socialization and structure have been proven to delay the progression of the disease. Moving into a facility that offers specific memory care provide all of these things to your father. It not only provides the safest environment, it will also allow you to become the 'daughter' again. The staff takes over the tasks of caregiving, cleaning etc. and you will be able to spend quality time with him again. He may have said that he never wants to go into a facility but once you see what they can offer and that the environment can be very homelike and comfortable, the decision can become much easier. It can't hurt to explore all of your options.

I posted that I have live-in care. We went the day care route, and I'm grateful to the staff for their help for 1-1/2 years. My husband progressed to the point where he couldn't be in daycare. It worked for us, but daycare beginning/ending hours can make it difficult to drop off or pick up if they overlap with job hours. Even with bus pickup, if lgregg's father is unable to get himself out of and back into the house, that can be difficult w/o assistance. PBS Frontline had a show on 7/30 about assisted living: http://www.pbs.org/wgbh/pages/frontline/life-and-death-in-assisted-living/
Although there are undeniably excellent AL facilities, at this point they are regulated very lightly, unlike NHs. If a person can participate in actitivies in an AL or NH, that's great. But some dementia patients are so far gone that those activities are of very little benefit to them. My husband is safer at home, whereas in the NH he fell, hit his head and had to go to the hospital for stitches, Xrays, etc. He wanted to walk, and the NH wanted to keep him in a wheelchair. That's one reason that they required a 24/7 sitter after he fell. I'm glad to be able to do this at home.

the nursing homes sedate agitated patients like my father who has dementia. each staff member has lots of paitents and other duties. the care is not great and pretty expensive. we have 24/7 in home care with my mother at home also. even more expensive but the care is expceptional. what you can afford will determine course of action.

I would advise hiring help whether it be live-in or 9-5pm. Only you can decide which is best for your situation. From experience with mom for 10 years and 2 years home hospice, help is invaluable!

Your dad can't KNOW that he won't like living in and AL or SNF.
Let him try it.
Tour a few in your area, pick one and insist that he go for a respite stay of a few weeks (if necessary, you can tell a little white lie about needing to work 10-12 hours a day on a special project or something). You'll get a much-needed break and he'll see that life can be more interesting if he's not just sitting with a caregiver all day.

Depending on what state you live in, adult foster care is another option. It pays the caregiver of an elder who needs care. Its tax free and nonreportable income. This allows you to earn money at home and helps defray the cost. I know there are programs in Mass. RI IN and OH. there will soon be in other states as well. You also get free services of a nurse and case manager to help you manage your loved one at home. Caregiver Homes is one company that does a great job. You may also want to try a day program while you are at work. Most insurances cover most/all the cost and he will be supervised with the ability to have activities and meals. This would help you conserve cash for in home care on weekends or early mornings to get him up and dressed for the day.

Let me add a third option, adult day care. This would provide activities and company beyond the caregiver. The ones by me pick the person up and return them to home, though I am sure each area differs. I had live in help for my Mom for several months and then moved her to a specialized AL (memory care). The AL costs vs the cost of her staying at home + live in help + food for both --- actually had the AL cost less!!! I chose one that was near me and visited every day. They were busy all the time. And even though my Mom wasn't always participating, at least there were others around and the sound of humans. If you go the AL route, choose carefully. Some centers actually have well trained aides for dementia care, others it's a side line. Good luck

I have 24 hour in-home care for my dad in an apartment. This equals to the cost of a nursing home. Much better care in my opinion. I have a nursery cam and can view all happenings. I am in control this way. I visited nursing homes and couldn't get out of there fast enough. Again, this is just my opinion and what works for us.

I think AL and memory care facilities are a much better option because of the security and balance they can offer. In most cases much more economical than 24/7 in home care. Consider finances and long term prognosis and therefore skilled care needs that may be required in the future.

This would take the day to day burden off of you.

Maybe consider visiting a couple places and having him stay in one place for 2 weeks as respite care. You can see how he does and he might just like the dining, social and activities offered.