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Skilled nursing is for those that “require” 24/7 nursing care. Patients need a higher level of medical care. Many also have a devoted memory care section that is quieter and less stimulating to those with dementia.
AL’s provide multiple levels of care and one of their primary jobs is assisting with Activities of Daily Living (ADL’s); bathing, dressing, toileting, grooming, feeding, transferring.
In my experience, AL’s and Memory Care communities are happy to have the help of Hospice once the individual qualifies for this Medicare benefit. You can always request a Hospice Assessment for your loved one from a quality, local agency.
Home Health is another benefit ordered by a physician and paid for by Medicare. There are very specific rules for these benefits; medical necessity, etc.
Lots depends on the cognitive abilities of your mom and if she is making any decisions about her life. Discuss options (and guidelines/regulations/ governmental requirements at AL. Administrators/social workers there should be talking to you about options. I would be very surprised if you asked for their input if they did not advise you. Decisions may also depend on her advancing needs of care and who and how they can be managed. And, considering, if you know, how close the end of life is - it might not be advised to move her - if you are comfortable and trusting of the current situation/care provided-skilled nursing or other facilities aren't the same. The care your mom is getting now might be a better fit - for everyone. This is a determination you would need to make by doing research. I'd think calling the Alzh Association and getting support/counseling from them would be the first step. gena.
If I were you, I would talk to the facility about if and when she would be a candidate to go to skilled nursing. I would also inquire as to whether or not they would allow hospice to come in to assist with her care. It's possible, depending on the state and the licensing laws, that your mother may be able to stay where she is with the added help of a hospice/home health, and that would help to maintain continuity of care for her and disrupt her life less.
My my sister and I faced the same situation with our father. We were able to find an assisted living service in a home that also allowed Hospice in. Both my mother and father were able to be placed on hospice. They lived there until they passed away, only about 88 days apart. The hospice people and the staff in Assisted Living were great! I hope that I've helped. My thoughts and prayers are with you as you go through this.
I go on to explain SPECT here:
Single-photon emission computed tomography (SPECT, or less commonly, SPET) is a nuclear medicinetomographic imaging technique using gamma rays. It is very similar to conventional nuclear medicine planar imaging using a gamma camera (that is, scintigraphy). However, it is able to provide true 3D information. This information is typically presented as cross-sectional slices through the patient, but can be freely reformatted or manipulated as required.
Assisted Living assumes that the person still has a certain amount of independence and can dress themselves, bathe/shower themselves, feed themselves, and are oriented to time/place/person.
As others have said, you should put your name on the waiting list, as almost all facilities do not have open beds on short notice.
It's my experience that a certified Memory Care special unit in NC is better able to meet certain needs than a regular AL. But, if she's going to need skilled nursing care, then, a nursing home might be needed. I'd discuss it with the facility and her doctor to see what she's likely to need as she progresses. It's my understanding that the resident can stay in a Memory Care Specialized Unit, as long as they are not on tube feeding or IVs.
I think that Hospice can become involved, regardless of the facility.
I moved my LO from regular AL to Memory Care AL, with doctor's orders, because they were not able to provide her with all the care she needed, which was pretty much everything. She could still feed herself then, but, that was about it. I saw a big improvement. When the resident is getting their needs met, you can see how much better they do. It's amazing. If you are getting a lot of franic phone calls from the facility about how they are struggling with her care.....I'd have a meeting and figure out how to address it.