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The owner hires the live-in caregivers from an agency in New York, but we are in Texas. This is our second attempt at a residential care home. The last one was unlicensed and also hired the caregivers from an out-of-state agency. It was a disaster.


From what I see, these caregivers are unqualified and untrained. I see them as babysitters for the elderly. It does not appear they care nor know anything about dementia. The caregiver at my mother’s care home is cold and unfriendly. My mother says she is “mean” and “rough” with her. I am there every day and agree.


My mother wants to move. She is very dependent, in a wheelchair and has dementia. My problem is, I’m concerned about how another move will affect her. Also, she needs a lot of individual care. Any suggestions on how I should proceed?

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I moved my husband from a bad memory care home to a wonderful one. I hesitated only because I thought the move would be difficult for him because of his dementia. It was the best thing ever, and I wish I had done it sooner.
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Reply to WearyJean
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Sc2025 Jun 22, 2025
I hope heart agree with you. Move and go as often as you can the first couple weeks, if the person does well around others, have them keep them involved in activities. I have had to move Mom two times and wish I had left her at first. But had an issue with her meds, and was ask to move her. She hit a resident.
Now the rates have increased where it would cost 2k more a month.
SNF for dementia is so expense. I feel medicare/insurance should cover some of the cost.
But differently move to licenced facility. ASAP

I would be in jail if I saw anyone be mean to my Mom.
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Kthsho, in reading your past posts, your mom is now in her 3rd facilty in slightly over a year, is that right? So your parents interfaced with APS and for various reasons were required by APS to move out of their home; then they moved from their home to board & care/ personal home #1 in Spring of 2024; then they moved together to a MC where he had a fall and passed away; and then she moved from the MC to another board & care home #2. Correct?

Is that the backstory? Three moves & death of a spouse in a bit more than a year for your mom. Whew, that’s a lot to deal with.

Has she gotten an assessment done recently? They usually are done by a duo of a Social Worker & RN. Personally I think she should have an assessment done and she then gets placed at whatever level of care the assessment determines. The Area Agency on Aging for Tarrant county should have contact names for an assessment team. NH & perhaps AL also might can do an assessment for an incoming new resident as part of the admissions process.

On the “unlicensed” aspect….. TX allows for “personal care” homes if it’s 3 or less unrelated persons living there - other than property owner & any staff they may hire- to be unlicensed. It’s “hosting” done in a private home. If that is what this place is, they totally do not have to be licensed. They are registered with the State but unlicensed so do not need to have the stricter staffing & safety regulations of a larger size personal care home or a Type A or Type B AL, or a SNF/NH. The residents in a personal care home are expected to understand how to deal with an emergency.

If your mom cannot manage to transfer from her wheelchair, then she realistically should not be in a small care home. If she - due to her dementia - cannot understand what to start to do of there was an emergency, she realistically should not be in a place without sufficient staff and resources. Really get an assessment done so you can use it to get her proper placement. As you have been a SW in the past, call your old coworkers to find out what might be a good facility for your mom.
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Reply to igloo572
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AlvaDeer Jun 21, 2025
Thanks for this backstory fill-in, Igloo. Without it we are lost in this world of questions that don't, on the face of them, make much sense at all.
I find myself increasingly stuck in the realm of CALL SOMEONE. APS or doctor or social worker or police.
I seldom take the time to research back. Too busy talking, I guess!
Thanks for taking the time.
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Kthsho

Of course moves are hard on the elderly, more so with dementia, but if the care is troubling then you have to weigh her options. You are there daily so she has that going for her.
I have seen care homes who take disabled people’s disability checks and give then a bed and meals. They make no pretense about what they provide. They are not nurses or personal care aides. I doubt anyone is ” trained” except the owner/manager who gives meds and knows what she has to do to collect their checks. They are licensed by the fire department etc. County and State license. So many feet per person, so many to a bathroom etc. They send them to adult day care during the day.
Then there are other ones for the developmentally disabled who have a similar set up.
They are not for sissy’s I can tell you that, much less elderly with dementia in a wheelchair. Those go to a NH when they reach a certain age.

I’m sure you have your reasons for not putting your mom on Medicaid and in a licensed SNf/NH. I can tell you a good number of those are not trained either. It seems to be learning on the job. Would your mom qualify for hospice? She would get a little more help that way.

You might try bringing treats to the aides and try getting to know them. It must be hard to come to another state for low pay. I wish you and your mom success in finding the right place for her.
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Reply to 97yroldmom
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First...If mom wants to move there is less to worry about how the move will effect her.
I would be concerned about her safety.
I find it interesting that 2 of the Care Homes you have found have been unlicensed.
Both of these homes should be reported. there is no telling how many Local, County, State codes have been violated. This makes me frightened for the residents who can do little to protect themselves.

Please find a licensed facility or home that can properly, legally, safely care for her.
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Reply to Grandma1954
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Needing a lot of individual care and being at the mercy of mean and rough people doesn't sound good. Even if you feel you're on top of things by being there everyday, you may not be. And if something goes south, it doesn't sound like you have any legal recourse since Mom's in an unlicensed facility.

The fact that Mom wants to move should be considered seriously. Hopefully there aren't things she's keeping from you, the things that happen when you're not there.
You're paying out of pocket anyways, right? Find a licensed place that you're comfortable with. Get help through this website under the Find Care tab or contact the nearest Texas Aging and Disability Resource Center (ADRC) at 855-937-2372 to find an affordable place with kinder and happier people.

Best wishes to you and Mom.
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Reply to ravensdottir
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If she is not comfortable and content, then please move her. We moved my parents (with dementia) from assisted living where they were content, to a five start nursing home because we knew that move was coming and a good spot opened up. It turned out to be a mistake, because neither of them felt seen or treated with dignity by the caregivers, despite their training. They were not unskilled or uncaring, but the lack of personal connection had a very bad effect on my parents' wellbeing. My father passed within 7 weeks of moving there. I was not able to arrange to get them both out fast enough, but as soon as my father passed, I brought my mother home again, and she's done SO much better. Do not hesitate any longer!
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Reply to Unity1
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"Essentially, if you are providing residential care services to four or more unrelated individuals, or assisting with medication, you will likely need to obtain a license from the Texas Health and Human Services Commission (HHSC)."

IMO, them being unlicenced may mean you have no one to complain to legal wise. If there are four or more residents, this place is illegal. IMO you have to be on top of everything. In my State, there has to be an RN over the aides. Maybe not present but on call. Aides, unless certified, should not be handing out medication.

This residence has no one they need to answer to. I think you need to place Mom in a legal residence.
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Reply to JoAnn29
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Do you know for a fact that this facility is unlicensed? Most personal care homes do hire from agencies. Most contractors are from different cities because let's face it, not every town has an abundance of nurses and nurse assistants. Unfortunately, your mom will never be happy wherever she is moved. You need to find a memory care facility or let your mom get use to the place. My dad didn't care where he was. On the other hand, my mom complained about everyone and everything whether it was a hospital, rehab or personal care home. Don't get too sucked in by your mom's drama unless you have seen horrendous reviews or witnessed abuse yourself.
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Reply to Onlychild2024
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Beethoven13 Jun 22, 2025
It’s in Houston, Texas. The 5th largest city in the country. There are plenty of people there. If they are hiring people from NJ and bringing them to care for the residents they are probably paying them very little and holding them hostage with low wages and a place to live. ? Human Trafficking?? The residents are just getting the bare minimum, if that. This is appalling. I’m in Texas.
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She deserves better care. She wants to move. Why are you hesitating?
I hope you are able to find a good residential care home, although most are really not equipped with the trained caregivers she will need. As you say, they are just babysitters.

Perhaps a nice memory care facility? If she is very dependent, she may require a skilled nursing facility. Some are nicer than others, and while a SNF will provide more competent, hands-on care, they won't spend a lot of one-on-one time with her.
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Reply to CaringWifeAZ
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You can still contact licensing they will go out and check if they are licensed. If they are not licensing will contact DOJ and residents will have to move. Licensing will stay at the unlicensed facility until they are all gone. Licensing will also request a legal provider to assist with their care until they are removed. It sounds like their maybe a money issue that mom can't afford a lic fac as they can be up to 6 or 7,000 a month based on her needs. Unfortunately staffing for licensed facility can also be untrained to care for dementia. They hire 18yrr olds and up to babysit as you called it. As there is not a huge requirement to assist these residents with their daily living skills. Residential care facilities are not medical care so don't let them fool you. If mom needs medical care then a skilled nursing facility maybe what she needs. However if she does not have medi-cal or medicaid your cost can be 10 to 12k a month. To have 24/7 medial care which from what you have stated this is not the case. Unfortunately either way you go please understand they all have their issues and just because they are a 5star does not make them perfect. If you are looking for one on one care it maybe cheaper and wiser to have her in her own home. With a live in. But again that can be just as expensive as one of the facilities you maybe looking for except the fact that being in one's home will always be better for mom.
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Reply to LoniG1
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igloo572 Jun 21, 2025
If it’s a small private personal care home in TX, they do not have to be licensed! Guideline is 3 or under unrelated individuals is ok without licensing. So you could have 3 married couples / 6 persons in an unlicensed care home. No set staffing or safety requirements either. Kinda scary!
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