Need to move from Assisted Living to Nursing home for more care. Any advice?

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Mom is 90 yrs. old with dementia and failing health; CHF and Kidney failure. The assisted living facility is not providing enough care and wants to up charge us for highest level yet when my sister is there all day - there is no CNA or care given to warrant the level of care. They have asked us to hire private pay CNA care on top of paying the AL. This is outrageous! We are looking to move her to a Nursing Home in Delaware. We wish we could move her into one of our homes but that is not possible. Any advice would be greatly appreciated ~ Sharon

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margaret916 thank you so much for your response. Yes, I forgot to mention she is receiving palliative care through Delaware hospice. They have been great.
However, the battle is with the AL and their assessment of my mother now has placed her at a Level 2 care however we still have to hire outside CNA services because they are not staffed enough to give her the care she needs.
I'm not sure what advice I'm looking for or if I'm just venting because its all so stressful and emotional. :(
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Hi, again Sharon,
You do not need to know when the end of life will be in order to request an eval for Hospice care also, with her medical issues and advanced age, she is definitely appropriate for palliative care.
Best of luck
Margaret
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No she will be staying in state.
Care is being paid privately. Not indefinite, has about 2 years of funding left.
Family visits will be more frequent as we are very frequent now in AL
She's nearing end of life but no real idea of when that may be.
She's still eating although that has diminished to about 1/3 of the meal.
Her edema is bad and lasik is not taking the fluid off.
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Hi Sharon,
I am sorry that this stressful situation is happening. Your mother has some daunting health issues that will not improve as time goes by. I am not sure what advice you are looking for, but here are my thoughts:
-Does your mother receive palliative care? WIth CHF, dementia and Kidney Failure she qualifies. Indeed, she should easily qualify for hospice services. Hospice is a form of palliative care for people with a reasonable life expectancy of 6-12 months. Palliative care provides health care services for people with serious chronic illness regardless of life expectancy.
I would encourage you to get her a hospice eval asap, it can make her eligible for more services that it sounds like she could use.
I am a Nurse Anesthetist and I was a hospice RN at the start of my career. In my opinion, hospice and palliative care can be the most loving option for someone with such serious illness, especially at her advanced age. It is a way for her to get relief from any distressing symptoms her illnesses cause, and access to experts.
Best of luck
Margaret
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Will she be changing states to move to Delaware?

How is her care being paid for? Can she be private pay indefinitely?

How does she feel about the move? Will this mean more frequent visits from family?

I don't know that there would be any barriers to changing her care facility. Please provide more details so responses can be more specific.
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