My dad with dementia is being discharged from rehab. I'm concerned mom cannot care for him. Should the move to AL? - AgingCare.com

My dad with dementia is being discharged from rehab. I'm concerned mom cannot care for him. Should the move to AL?

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He has fully recovered from the hip injury but needs assistance w/ daily living, and is easily confused and i am concerned that mom cannot care for him upon return home. We will get some help, but am wondering if parents should move into an assisted living facility so that mom can get support as needed. What are costs? Anyone have any insight on best time to transition and if this is going to be very costly... thanks!

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Thanks, Blannie. That's expensive! But I know that's the going rate. Folks are spending around $2,500 per month currently.... and that will be burdensome, but we may need to do just that...
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PStiegman's link is a good measure of costs. My folks paid about $3,500 per month in the Chicago area for a 1-bedroom in independent living, which is within in the range on the link. It worked out well when my dad went downhill, he spent the last three months of his life over in the skilled nursing portion of the facility. So I had both folks in the same place, just different sections. It made it easier for my mom to visit my dad and for me to visit both.
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The discharge planner at the hospital let him go home after being reassured there was someone there to care for him. It's unfortunately common for the elderly to say whatever the discharge planner wants to hear, just so they can go home. If it is more than Mom can handle, she could look into the VNA. Search for "Visiting Nurses in (state)" where they live. She could also ask his MD for recommendations on OT, PT if he needs it.
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Thanks to CarolLynn and Jeanne for great feedback. Situation is my folks sold their house over 5 years ago. Wish we had the house to hold on to. Idea was for them to live off of the sale, which is what they've been doing. I think a consult w/ elder care attny is in order. From research I have done, my mom is minimally protected from spending down cash when dad needs assisted living. My mom is relatively healthy and will need my support after dad passes. I think that's the bottom line. On a larger note and one that has no forseeable solution, it is a real shame that families have to worry about going broke to care for their parents in old age. You are really on your own, sadly.
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that was supposed to read: if your folks own a house, and the WELL SPOUSE stays in the house...

And the reason I even brought that up is because it's probably VERY different if both parents leave the home for assisted living.
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If your folks own a house, and will spell stays in the house, it is generally exempt from the Medicaid claims. I don't know your situation but if YOU live in the house with them for 2 years, and doing so prevents the need to send one to a nursing home for that period of time, you can protect the home from attachment. It maybe more cost effective to do this and hire someone to come in their home and help both your mom and your dad.

The suggestion has been made to see an elder care attorney, an NAELA certified one would be best, as probate and estate attorneys don't always know the ins and outs of Medicaid. Do not pass go!
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The harsh reality is that chronic illnesses and catastrophic medical events are catastrophic financially as well. Whether Dad stays at home with in-home care or is placed in a care center, it is very likely to eat away at any estate Dad and Mom have built up.

(I am now in the situation you fear for your mother -- I cared for my husband with dementia for ten years and now I'm a widow with no savings, very little retirement funds left, no life insurance, etc. etc. -- and a big mortgage on the house.)

I suggest that you see an attorney who specializes in Elder Law and/or a certified financial planner well acquainted with Medicaid rules, and figure out the best way to proceed to protect as many assets as possible for your mother's future use.

A day health center is an excellent way to help avoid burn-out for Mom. Keep in mind that Dad could have fallen at home just as easily as at a center.
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Thanks, Jeanne! I do not think dad is eligible for Medicaid and will require a spend down prior to eligibility. I do think a continuous level of care model would be ideal, but I am worried about expense. My other concern is that my mom is going to burn out and I don't want her health to deteriorate. Prior to the recent rehab, dad was attending a day care center, but he fell there which required subsequent hospitalization and rehab. Am trying to weigh all options and the really good ones are going to require that my folks spend down all their hard earned savings to get the care they need, which will leave my mom with very little. She is quite healthy and I want her to have a reasonable quality of life after my dad passes. It's a tough situation that many face. Elderly care is very expensive and Medicare has many limitations to what they will pay.... the rest is out of pocket....
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How do Mom and Dad feel about moving?

A place that offer continuous levels of care might be ideal. I know a couple that moved into an independent living apartment on such a campus. When the husband's dementia became too much for her to handle, he moved into the memory care unit and she visited him daily, using their skyway system and never having to go outside to do it. These kinds of arrangements can be quite expensive.

Do you think that your dad might be eligible for Medicaid? In some states Medicaid can cover part of assisted living costs -- if you can find a facility that accepts Medicaid.

Medicaid will also provide some in-home care. They could start with that and consider moving if/when that is not sufficient.

I suggest contacting your parents' county Social Services department and asking for a needs evaluation. They can help you determine what services, if any, Dad might be eligible for, and how to qualify for those services.

Best wishes to you as you start this journey.
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