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Just beginning to look around for assisted living for MIL. What does it cost? She has some assets that she has failed to protect from long term care expense.
She will probably need a memory unit. Please share your experiences with me. Will they take her if she is uncooperative about being there?

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Skinonna, I remembered one other detail: you might find yourself making an appointment at a nice ALF, have lunch, hear the Sales pitch, and be thinking you have found the right place....only to learn that they have a 2 year waiting list (this happened to me). They will then offer you to be put on the wait list for a few thousand dollars; of course, this could be an option you might choose (simply pay for in-home care until a bed opens up). However, think about these wait lists: what good does being on a wait list do, for your mom? You need care now. Or, you might not need it exactly yet, but, it is up to the individual person to decide if and when they move to a facility--not the facility. My point is, everyone in my family was like, "get dad on the wait list there--you gotta get in line! these places fill up fast, you better jump on this opportunity (said of a brand-new place that was way too expensive)" But to me, Wait lists only serve the best interests of the facility--to keep them full and making money (they are for-profit after all). There is no sense in putting money down on 3 or 4 facility wait lists....they are not going to magically have a room for you, when **you** need it. And there is absolutely no RUSH to get into an impossibly expensive facility.
The other thing I remember is (I learned too late), there are Certified Senior Advisors, who specialize in helping people find ALF and SNF's. They are trained to assess your financial situation as well as being able to negotiate rates (at least the one I talked to, mentioned be able to do that). It is extremely helpful to have one of these CSA people guide you thru this process.
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Dear skinonna,
yes, you need to do your own research in your own area.
I did some research in 2013 for my parent: here's what I learned:
1. 90% of AL are private pay only; when the money is gone, they get evicted.
2. you will sign a "lease" similar to renting an apartment, and most of the ones I visited are month-to-month. While this could be beneficial in that you could leave if you don't like it, they can also ask you to leave, if they don't like you (I do have one high school friend who is currently moving her mom to a 3rd AL....).
3. AL costs rise about 5% per year on average.
4. It's not easy to compare apples-to-apples; in our state they have tried to force the AL's to fill out a "uniform AL costs" worksheet to alleviate this, but none of the facilities filled these state mandated forms out in the same manner.
One facility might include 14 dinners in their "rent", another, 30 lunches. You will probably find yourself narrowing down to 3 choices and making an immense spreadsheet (as I did) to compare what your individual parent might need.
5. You won't be able to find out their costs by calling. Expect to have to visit with their Salesperson, for several hours, and eat a meal. Expect to receive a huge glossy custom-designed folder with dozens of sub-folders describing how wonderful the place is. You will take it home and comb thru these various folders for price info, trying to make sense of it all, and might feel helpless to know, in advance, exactly how that facility will fit into your parent's budget (or not).
6. You will get accused by your siblings of not choosing the right place/choosing too cheap of a place; choosing too expensive a place/ etc. If you don't have the DPOA, already, get it or you're sunk.
7. It will take days or weeks to get answers from the nursing staff about specifics for medication management fees (they try to describe it in their dozens of pages of fee schedule, but for your parent, you want to know how it adds up in advance, it's like buying a custom decorating scheme).
8. The ALF might try to sell you on the possibility of continuum of care; However, what they don't tell you is that if your mom needed SNF but they don't have an available bed--at the time your mom NEEDS it--you might end up moving your mom to a SNF (at $8,000/month), and STILL paying RENT at the ALF (at $4,000/month). The ALF is NOT going to hold your room for you, rent-free!!!
9. Don't forget, when working on your spreadsheet, your mom will still need many many items that are not included at ALF: in other words, the ALF does not pay for: Medicare part B & D premiums; other insurances; income taxes; funeral pre-pay costs; meals beyond the included number/type; snacks; bottled water or beverages (my parent has a particular type she likes); eyeglasses; prescriptions; orthopedic shoes and devices; doctor visits; dental visits; Depends; daily laundry (if they are incontinent once a week isn't enough); transportation to events that your parent wants to do on their own--a special concert at their granddaughter's school for example; etc etc.
In my parent's case, there were easily $10,000 per year of costs beyond the $48,000 per year of just RENT at the ALF that my siblings liked....a major family battle ensued, and for the time being, my parent has not moved to ALF, because it is simply too expensive.
I encourage you to count the cost, before signing on the dotted line. Prepare yourselves that your parent may well outlive their assets and have to go on Medicaid (hopefully their mind will be totally gone by the time that happens). Just like everything else in life, an ALF often costs a lot more than you ever imagined, and once you've moved your parent to an ALF that is of a certain level of luxury, they (or your siblings) aren't going to like going to a Medicaid facility.
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Skinonna, you should really start to call & visit some of the ALs in YOUR area. Costs are based upon regional issues (cost of labor, real estate, taxes, etc) as well as the services provided. Also, I disagree with pstegman's response as to the depth of services provided in memory care. In my area (No. NJ) Assisted Living Memory Care does cover residents with incontinence, behavior and wandering issues. EVERY place I visited and interviewed (9 ALs & 3 SNFs) offered different levels of services; had different cost structures and left me with different impressions. And one AL Memory care actually would accept Medicaid after 2 full years of private pay.

Visits take time to set up and do. Keep great notes (it get consfusing after you have seen a few). Trust me, you will know it when you see the right place for YOUR Mom. Good luck.
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Hi skinonna,

Please click on the link below to go to our senior living page on AgingCare.com. Here you will find a page that will allow you to search for Assisted Living in any area you choose. It will also give you information about all the details in searching for Assisted Living care.

https://www.agingcare.com/Assisted-Living

Hope this helps.

Best Regards,

Ashley T.
The AgingCare.com Team
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I live in Georgia and my mother-in-law is in assisted living. The original cost was $2,500. They charge $450 for each additional level of care she requires. She is up to $3,200 because she doesn't want to do anything for herself and is a very difficult, mean spirited woman (has been all of her life). Luckily she has the money to pay for it for the time being. Medicare and Medicaid do not pay for Assisted Living. It is strictly out of pocket. The pharmacy puts her meds in blister packs so they just have to give them to her at the required times at no extra charge. She gets her laundry done and her meals and shares a room with another lady (using her own furniture, linens, etc.). Assisted living means just that; they will assist her in bathing and dressing but she must be able to do some things on her own. The facility where she lives also has a memory care unit which
costs more and in extreme cases may require 24/7 observation which the patient/family has to pay for additionally. I have a friend whose parents are both in the memory care unit and it is costing $20,00 a month for around the clock care. Nursing homes in my area are around $5,000+ and in order to get on Medicaid almost all assets must be depleted depending on the state where you live. In your case, skinonna, memory care is a whole different ball game and will probably cost much more than assisted living.
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A facility near me offers Assisted living program called "Tapestry" for patients who still have pretty good ADL's but have memory and cognitive issues. MIL cares for self, has not wandered, but is terribly confused. Dr. had suggested assisted living, living with family or having care giver. Said she does not yet need 24/7 care. Has few medications and supplements, which she takes herself when put in her pill box with occasional reminder. But will call her 92 year old sister 3 times at 3 am to 4 am with questions. And then call one of her friends repeatedly after that. they are begging we "do something" with her. So she needs to be where she can be watched. She is a self admitted "wild woman"
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Whoa! Assisted Living is not the same as a memory care unit. I live in Western NY and AL is about 3000-4000 a month. They do the housekeeping, provide meals in a dining room. All facilities have rules of behavior. The patient will get assistance with bathing and dressing but they must be cooperative. Medication management is an additional charge, so is OT PT.
If the patient can't find their own room, if they can't hold a bowel, if they curse and swat at others, refuse meds, refuse showers, or make inappropriate advances, they need a higher level of care. The place to start is by talking with her MD about what options are appropriate.
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