Our 88 year old father is in an independent living facility in NH that costs under $4000/month for a one-bedroom. He pays an additional $400 for an independent caregiver who helps him shower 3x/week, changes his sheets and does his laundry. He has mobility issues and uses a walker. Cognitively he is really good.
One of the downsides to his current place is the distance from his unit to the only elevator to get to dining, exiting the building, etc. which is tiring for him. Overall, he is okay; he doesn't love the food or residents but has made a few friends but doesn't participate in other social activities, (partially related to the distance to the elevator).
We'd like to explore assisted living facilitiies nearby because he has had a few falls (requiring the fire department, since they don't have a nurse on staff) to take him to the hospital. One fall was pretty bad when he hit his head and possibly fractured a bone in his neck (sorry, light on the details) and needed a neck brace for 8 weeks.
He has other medical issues (diabetes, heart) but is managing with care.
The brother who lives nearby and sees him the most is extremely worried about another fall, relaed to the mobility.
I found a few places nearby to consider when it's time for AL, but the cost for a one bedroom that offers 45 mins. of personal care and an on-staff nurse, etc. is about $10,000. He can afford the expenditure after we sold his house so there is plenty of money, but it appears he wants to save the money for.... family? I don't know how to convince him to consider visiting other places to move or have on the option when we might need it.
The incremental cost, which is manageable, will mean he has to withdraw money from the now significant account he has due selling the family house, He seems focused on preserving this for his "heirs", three independent adults. I would like advice on how to approach this, that our primary concern is his well-being, regardless of the cost, especially since he has the funds available.
I read up above "I'm sure he wants to feel like a respected Father and leave his kids some money." That is so personal, distant, shows your character, looks like you'll be glad when he's dead/ nasty person you are! My feelings are hurt. One should respect another for the smiles he gives you, the advice he gives you, the conversation he gives you, the intelligence and kindness he gives you Present tense or Past Tense, etc. NOT his money.
Better to use it and continue to be the respected you were during your strong life!
1. GET ON A LIST TO MOVE HIS ROOM TO CLOSER TO THE ELEVATOR WHEN AN OPENING COMES UP. Seniors move around at our local IL and AL all of the time. When you move in you get the parking lot view. You get on a list and when an opening comes up you move to the unit with the wooded fountain view. Moving within the compound is common place in these facilities.
2. The bit of walking that he does not like is keeping him alive.
3. Those sitting in wheel chairs all day are at risk of developing bedsores. Those that are walking some are protected from bedsores.
4. Hire additional CNA's to help him at his current place. I see residents in IL and AL with private duty paid CNA's all of the time. They can drive him around. Take him to appointments and cook him some meals in his apartment.
5. He will still be a fall risk in A/L.
6. CNA staff ratio to resident can be 1:8 residents or more particularly with callouts.
Understand concern about money. There is the double loss per month- rent plus what is lost in interest income. Now there is that earning so that principal not being reduced as much.
Suggest keep looking for a place. Very stressful to live with thought that blowing thru $ 120,000 year.
Many great suggestions here. By the way, appt with elder car attorney is very informative. They are taking in all aspects and can give you good advice on how to handle this. Our attorney also provided a suggestiin of facilties. ID AL MC that there clients lived and felt positive about and that their office dealt with. His doctor can offer suggestions also.
Of course, each place is different. There are also differing levels of AL, so that is worth investigating.
Here is an example: https://allendaleseniorliving.com/assisted-living-levels-of-care/
All the previous replies are good, but his current IL is not one that I would like to live in either. He doesn't like the food or the residents and the location of his room, for him, is poor. If he moves to another IL, and you arranged for a caregiver, he would need a 2 bedroom. You would want a 24/7 aide or at least one that would be there through the night. Many problems arise during the night. The total cost would probably be close to the $10000 or more that an ALF would cost, but an ILF is more pleasant to live in than a ALF and having a personal caregiver is also safer.
Getting him to look around, obviously, is the first step. In Florida all the ILs offer free meals and a tour. Who doesn't like a free meal? I am sure he would also enjoy a day out with you or one of your siblings.
If he likes one of the alternative choices you can set up a meeting with his accountant and separate his assets into a self care fund and inheritance. Psychologically that may be more palatable than having his total asset base depleted. One step at a time.
He does not care about leaving anything for his heirs……but i do because that includes me …and i am not that for from needing care myself.
The government, be it’s state, county or federal will assist depending on your assets etc.
You have to spend down much of the funds you got from the sale of the house ……because they will look back at your last couple of years of his financial assets and will not accept him if he exceeds the minimum level.
Talk to a lawyer that handles estate etc. because they can help you to put some of the funds into accounts that cannot be considered his current assets
personally, for me, we just realized my husband was eligible for veterans compensation because of his disease and the fact that he was in Vietnam and was in the areas where Agent Orange was sprayed. So that will help us get some compensation that can go towards his monthly assisted living cost.
There are programs such as ALW, Assisted Living Waiver , which is something to look into.
Make sure and check with them now, they can help with things like property tax and insurance.
Thank you to both you and your husband for his service to our country. As bad as it seems, we still live in the best nation on the planet because men and women stood up for our freedoms.
An ALF can't stop falls. There is not one-on-one care or someone having an eye on residents 24/7. And you and your father will lose the ability to manage his care unless you continue to hire a private caregiver (and even that caregiver may be limited by the ALF management).
When I was caring for my mom in a "high end" NH (also no one-on-one care, though by law my mother should have received significantly more attention than she was provided*; I was the one who provided her an semblance of quality of life --- I was on the way through the ALF portion and heard someone yelling "help, help." Not a nurse or aide was in sight. I found the resident had fallen, and then found a staff member to get the situation handled. I subsequently discovered the resident had broken her neck. She end up in the NH portion of the facility in a semi-private room and never returned to assisted living.
* § 483.24 Quality of life.
Quality of life is a fundamental principle that applies to all care and services provided to facility residents. Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, consistent with the resident's comprehensive assessment and plan of care.
As far as the scooter , make sure Dad can get in and out of one safely. I’ve seen many elders struggle with that . I would rather a lightweight wheelchair that he can self propel using his feet . A scooter may not be permitted if he was to transfer to AL for other reasons later on . A wheelchair can be used anywhere .
My FIL complained about the cost as well . We told him that his money is to be used to take care of him .
Best wishes.
10k is just ridiculous for the amount of "help" AL actually provides, which won't be much more, if any more than he is already getting.
Spend that 6k getting him some actual help where he wants to stay..
What exactly does this AL place provide for twice the price? It should be twice what he gets now, with much better food and elevator system, for starters. He still may fall, so don't think an AL will prevent him falling. At 88, he is winding down his long life as it is. You won't be running around much at 88 either.
I'm sure he wants to feel like a respected Father and leave his kids some money.