My spouse has Parkinson’s disease. If the disease progresses to the point where I can no longer care for him, what will determine if he goes to assisted living vs. nursing home care? We have worked with an attorney to plan for nursing home care, but I am concerned that, if he is not eligible for nursing home care, then he will need to go to assisted living - and there is no coverage for assisted living.

Lets say that he is no longer ambulatory and I am not strong enough to lift him (like from bed to a wheelchair or shower or toilet), but he does not require a feeding tube, ventilator, or pic line, then what are my options?

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My mom could handle her ADL’s very well up until about 6 months before she passed. But she took a fast trip down the slippery slope of dementia and needed to go straight to a NH. She was a wander risk, delusional and hallucinatory. The NH was the best place for her broken brain.
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I think your vision of the NH home residents may be a little off. Most people are not as gravely ill as you may imagine, just need long term care, in other words they’re not leaving. My Mom is in a NH and not on feeding tube, ventilator, nor pic line. Just a few meds for pain, some dementia, but can’t walk due to arthritis. In my area of central NY the assisted living facilities do not take residents in wheelchairs. They must be able to walk with a walker to the dining room. That put Mom in a NH since she could only walk about 100 feet or so. So at the AL evaluations she was rejected. In hindsight she probably would not have been able to stay in AL very long anyway due to declining health and so it would have meant another disorienting move anyway. I would suggest you visit a few AL and NH to get an idea of the levels of care they provide. Remember that the AL are private pay and want your money, so they may exaggerate or at least stretch the amount of care they will provide, then tack on more charges quickly as it becomes more evident he needs more care.
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Nursing homes care for those who can not perform ADLs (feeding, toileting, selecting proper attire, grooming, maintaining continence, putting on clothes, bathing, walking and transferring). I think that a diagnosis of parkinson's and an inability to ambulate are probably enough to make him eligible for a nursing home.
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