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Where can they live if he needs assistance but she cannot provide it because it's too much for her? Needs affordable housing with assistance for him but not for her.They do not have a home to sell to BUY-IN to a luxury place. They are renters.

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Thanks joannes and ed123456. You put it in better order than I did. So right on the RN part too. Another thing, before I had to move my parents, they were already in independent living and some residence had part time caregivings around that did other things usually but had enough skills for basics that they needed in beginning...like making my mom lunch so she would remember to eat, driving to grocery store or longer distance to visit someone, bathing my dad etcc..they did not work through an agency so were cheaper, much cheaper. $12 an hour compared to $22 or more with agency and caregiver still got 10 or 12an hour.
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See if they can LIVE IN PLACE with home health aides coming in for the one who needs it.
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I agree with everything Lizzy48 said! I have my Mom now in A.L.....and it's a very nice place, but having been through the placement for Dad into Memory Care...AND having an attorney and elder care manager through the firm....it was still one of the worst experiences of my life thus far!! If home care will work for them, do that first. You can find screened private caregivers on Care.com. If you decide on assisted living or placement in a smaller group home, be sure that you only look at those places that will accept Medicaid down the road, when they start running out of money. This will prevent one or both of them having to move somewhere else....and then being separated in the end. Also, with one having dementia, look for a full service place, so when it's time, one can move into Memory Care status and stay at the same place. The facilities that Dad was in, and that Mom is now in, will permit the spouse to move into Memory Care with the one who needs it, if they want to do that. Otherwise, the cost increases with two different living situations instead of one shared. We never could get Mom to agree to leave her home, after Dad was placed, so as needed, we hired caregivers in home with her, especially when she was officially diagnosed with Alzheimer's herself. But when Dad passed, we were at the point where the cost of her home, insurance, utilities, property taxes and all, along with caregiver fees were about the same as A.L. and there was no family in her town at all. I was having to travel 200 miles ea way, and stay for about 4 days every two weeks to keep tabs on everything. That was nearly half time away from home, and I have a husband with early Parkinson's disease, who didn't like me traveling so much at 70 years old. So after a couple months of grieving time, the lawyer told her she was running out of money and we had to sell the house and get her to choose an A.L. place to live in. We've started applications for both Medicaid and VA Aid and Attendance, last February but still waiting for approvals. Medicaid will ding her for 5 years because she sold the house, and Dad had been on Medicaid for over a year when he passed...so they felt they needed to get back all the money they paid for Dad out of the house sale. Lawyer helped us with a work around, because in order for Mom to be in A.L., there was a 3 year timeframe of private pay before they would approve for Medicaid for her, so we needed all of the house sale money to be held for her, in case Aid and Attendance didn't come through and she lived that long...very complicated stuff. Through out all this....my parents had the choice to move to WA state with a granddaughter and family for the rest of their lives, but they consistently refused....and once Dad was on Medicaid, they would have had to live separated, because Medicaid requires state residency even though it's a federal program. So he would have had to quit Arizona Medicaid, then move to WA and apply for WA Medicaid after achieving state residency. That was too scary as his dementia for sure required 24/7 care at that time. As it is now, Mom could elect to leave A.L. anytime and move up there but she doesn't want to be away from me..... As she gets worse with Alzheimer's it may become too late for her to move there too.. It's very difficult to try to plan for and anticipate all things. Right now, she cannot even get there, because she is on 24/7 oxygen, and we do not have Medicare approve for a portable concentrator, so she cannot fly. I cannot drive her alone, and deal with stopping to replace oxygen tanks every couple hours, and be sure she stops to take multiple nebulizer treatments a day for her COPD....so some medical stuff has gotten worse and that affects choices too. This is why I would say IF you looked for advice from a geriatric case manager, find one who is an RN. I am a retired RN, and my daughter in WA state is a non working RN, so we know how to assess and deal and what questions to ask. Some case managers are social workers only, and some really have no professional education other than they have direct caregiving experience.
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My father and Mother are in the same situation. They were able to get into a place through an in home care place. You can get help in paying for it through insurance and various places. Ask your in home care provider for information.If one of you served in the armed forces, you can ask the VA for help. You can get both in to a place and it may be cheaper to get both in now. My father needed the place, but my Mother does not and the place where they live explained to us that it is cheaper to get them both in now . Your in home care provider should be able to explain it better than I can why it is cheaper in the long run.
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I agree with the comment about "a place for mom", I sent them an email asking for information when my folks first moved in, asked them NOT to call because the folks have big ears... my phone started ringing 15 MINUTES later.. no lie.
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Sorry to everyone but I am still not over it. Its a new world out there for seniors. The medical world has them living longer but with no quality of life and everyones lining up to get a piece if the $$$. Go online or call your states senior services for lots of info and educate yourself as much as you can.
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I wasnt very helpful but also think about place that has SNF or Memory care within premises also. You could possibly get part time care for Dad during hours when he needs the most or every other day, we did that for as long as we could and made Mom lists and I wrote her notes or even had people write for me telling her where I was etc..if I was gone at all. And will repeat, be vigilant with checking on them. Sadly, my mother fell and went to rehab. She ended up on hospice and the first day of it a nurse OD'd her on morphine. Tripled the dose. Even though I has DPOA NO ONE called me or let me know anything. I left her OK night before came back next AM and she was on oxygen and having seizures and i had to ask why. She never spoke or came out if it again.
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The more rooms they fill the better profit. I hired an senior moving service that was incredible. My parents actually used them before when they moved from home to indpendent living. They pack up everything and than set up there new apartment as close as they can to layout of old one, even making beds and hanging clothes before they move in. Very reasonable rates for such an awesome service. This sight has saved my sanity over the last 3 years so keep coming. Dont go on A Place for Mom. They will bug you nonstop. I am in WA state and if you were I could give you a wealth of info that I learned. My heart is with you
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My mother did not want to mive all her routines, and friends were there but father did. They had long term care insurance but we did the math with in home care and very expensive and they would of run out of money quickly. You dont know if they will live 5 more years or next month. We also hired geriatric care consultant who was also nurse. She was very helpful in that she knew what places would work with our complicated issues and did alot of legwork. But she charged by the minute for emails and phone calls so cut back as soon as was able. So, I moved them both into a assisted living facility. My dad did well and thrived for awhile with all the helpers and physical therapy but it sent my mom downward fast. Her new apartment, no friends or routine she was lost. My dad passed 6 months after i had moved them there and now here was my mother in new surroundings all alone and confused. I than stayed with her for 2 months and moved her to Western Washington with me. She passed 11 months after my Dad. Sorry going on and on but it was such a difficult and hard time and its not like we all know what to do and you dont get a do over. I dont want to see anyone go through the hurt i went through. My main advice, get the lawyer, find and educate yourself on any insurance they have and find people that you trust or can update you near them also. Be vigilante with there healthcare and medicines and demand to know everything that is being given or done to them. Dont let anyone tell you the need all kinds of services that add to cost if you can get creative with less important things. Dont let healthcare providers tell you they need mire and more meds. The elderly need less. And listen to your parents of how they feel, about different scenarios. Hopefully you wont get the massive guilt and regret I did. Also, most of the large asst. Living facilities are for profit corporations who do not care about your parents at all. They have there own term, its called "heads on the bed" to make $$. The mire heads
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This exact situation happened to my parents 3 years ago in California but mother beginning dementia and father physically needing help. I learned alot the hard way having to make these decisions by myself. First and foremost, make sure you have DPOA for healthcare etc ..because of dementia. I also had my parents put me on there bank accounts. We had a lawyer help my mother resigned off of there trust, (she was starting dementia) and my brother and I were added along with my dad. After my dad passed so glad we did this because you cant do it after when they are really mentally incapacitated. They already lived in independent living but dad falling all the time and having my mother pick him up at hospital when she hadnt driven or had license in 4 years and I lived in another state.
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I hadn't heard of "An Aging Life Care Professional" before. These rates ($120-160/hr) seem awfully high to be recommending senior care options. What type of qualifications do they have? I have heard of (but not yet used) a 'geriatric case manager' -- are they also this expensive? So many difficult decisions involved.
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My sister personally numerous assisted living facilities for our parents but was so confused and frustrated that we hired a geriatric case manager. She was an answer to our prayers in that she led us to the perfect place for our parents to live our their lives with grace and dignity, and as if they were in their own home. Our dad had a severe stroke while living in this place and they found him right away. After being in SNF, they took him back without any issues. A 6-12 person board and care is the way to go. The assisted living places were too big, impersonal and way too much money. I hope that you find what you are looking for and that it will give you piece of mind.
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A private adult care home is perfect gor your parents: small, great care, less costly, family living. In Hampton Roads area of Virginia,
Try googling adult care homes.and check with soc workers in your are
Best to you!
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Don't forget to consider proper assistive products to keep the person and caregiver spouse safe. In the case of elderly spouses a caregiver injury may mean "game over" for both people. Paid caregivers is usually a requirement at some point but assistive products may also be critical . Even when 24/7 care may be in order sometimes a person can skip the entire night time paid shift with the proper assistive products- making someone's budget go much further.
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Sometimes because of different care needs they need to luve separate. Happened with my mom and her husband. They are living in the same building, different areas, but they have lunch together each day. It was really the only choice. See an elder law attorney that specializes in Medicaid Planning for help. It will be money well spent.
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It's awesome that they are being proactive! So many people age in place without a plan. I would start with a Certified Elder Law Attorney to navigate the legal and financial. Look for an attorney with CELA after their name. The will get the the documents needed a will and POA and walk them through Estate Planning. Their choices will be based on their assets. The buy-in places are very nice but expensive they are called CCRC's. There are places you don't need to buy into. It sounds like they need assisted living at the moment. There are many Assisted Living places that do not require a buy-in that are very nice. Five Star Senior Communities operate all over the US they have very nice communities without a buy-in. There will be many other regional and local assisted living places. An Aging Life Care Professional or a care placement agent can help you navigate the system. A care placement agent is free for your parents but works on commission so they are going to encourage places that pay them the best. An Aging Life Care Professional will be paid out of pocket and charge &120-$160 an hour depending on where you live and will act as an advocate for your parents to help them find the most ideal placement after the attorney determines the financial areas. You could also move them into an Independent Living facility that provides meals and other support services and hire a caregiver. It's a complicated situation. If they can afford it the Aging Life Care professional this might be the best route if the goal is for them to stay together for the long run.
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I have a similar situation with my Mom, mind ok but mobility and health not good, and Dad, physically ok but with dementia. I'm just waiting to see which begins to fail first. Neither could live alone.

The progression I predict for us is in home assistance for a short while, which I have arranged when needed, then to a single facility that offers assited living for mom and eventually memory care for dad. But a fall or dementia crisis could expedite things quickly.

I assume your looking at money issues. Is it time to apply for Medicaid?
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Moving anywhere is going to cost money. Your parents will probably not be able to pack up and move themselves. Can you hire in home help? My MIL has an aide who helps her with activities of daily living because it was becoming much too much work for my FIL. Help your parents work out a budget for themselves. Once you have numbers down on paper, you can help them figure out how much help they can afford.
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