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What do I look for besides doing a site visit, and asking about visiting hours, do they take Medicaid, visits off site, pets coming with me for a visit, activities, meals, bathing schedule? I have kept my wife home for several years, but she is getting beyond my ability to manage.

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I know that I am late in giving you some insight, but I do want to add that you should keep an eye on the laundry situation, and the medication dispensing.

My mom has been in a memory care unit (the best in this city) and she has already lost a throw blanket and had other people's clothes in her closet. I reported this and I check every day to see that her clothes are there and no one else's. As for the medications, I noticed last night that mom did no get her eye vitamins. By the time I realized it, the nurse had already gone to a different area. I will have to call mom's case manager to find out if they are just not giving it to her, or they are out of it. If they are out of the vitamins, I never received a notice.
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This is the OP. We looked at three places that take Medicaid Pending. One smelled like antiseptic, one didn't have room but we toured just in case. We like the first one, and hope they will have an opening withing a couple of weeks. The best parts are that I bring our two small dogs to visit her in her room, and she is excited about going. Thanks for all your comments.
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Isn't information about a resident's medication protected by HIPAA? Also, if a resident is in need of medication, why would that be a bad thing?

When I toured MC facilities, I was impressed that the one I selected had mostly long time staff in the MC unit. Most had been there for over 6 years. These employees had a lot of experience and even a calling for working with that type of resident. I grew to see how committed they were to the residents in the MC unit and I was able to trust them.

I was pleased that I have never smelled any odor at all in the entire AL facility. I'm not sure how they do it, because a fair amount of the residents in the MC unit must be incontinent. They really stay on top of things.

ALSO, I know that in my state, you can go online to the website for the State agency that regulates long term care facilities and they list all licensed care facilities, along with their star rating. It list how many violations each facility has, along with the details of what was done wrong, how it was corrected and the fines, if any that the facility paid. I found this very amusing. Some of the fancy facilities sure do have their share of problems. I'd try to find this, as it gives you some idea of how the place corrects problems when cited by the state.
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Make sure you see the staff interacting with the residents. My dad almost always had someone near him, doing thing with him and keeping him company.. and we were there almost daily at different time. Sometimes he was in front of the TV, and sleeping,, but normally not. My MIL almost always seems to be parked in her wheelchair,, alone or sleeping over her "activity". But we are not there as often.. and her nails are always painted (she likes that) an FiL says they do include her in things. IT's a bit of a crap shoot I feel
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I just wanted to add that I really appreciate the latest responses. We had checked most of these before dad moved in, and I used the rest of the suggestions to measure his facility now that he's been there a few months. Luckily, it came out very well. The note about antipsychotics is really good. Dad's facility uses them only as a last resort and as sparingly as possible. These are all really great suggestions and should help andrewr make what is a very difficult decision.
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I'll add these:
- Can they offer special diets as needed; i.e., dysphagia, mechanical soft, or diabetic?
- Can you bring in treats or favorite foods? (I keep Dad's favorite oatmeal there, & they prepare it for him.)
-Can you bring entire meals in & eat with her for special occasions?
-Do they have an area for you to come in with family or friends to visit with her privately besides her room?
-Can they provide transportation to outside doctors?
-Can you use your own pharmacy? Is there an extra fee for allowing that?
-What are their programs for stimulation, both physical & mental)?
-Do they have an activities director?
-If hospice, palliative care or therapy is needed, can you bring in your own or do you have to use someone they've contracted with?
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Most memory care facilities are considered assisted living and are private pay
You may want to enlist your county agency on aging to help determine your wife's needs and suggest placement

If you do go the memory care route - mom has been in one 20 months - here's a short list
What is the ratio of caregivers (not staff) to residents
Are nurses on site 24/7
How many residents are on antipsychotic meds
How are disturbing and aggressive behaviors handled
Do they have a hospice waiver for end of life
Who are their visiting physicians, psychiatrists or do you have to take her out to her own doctors 
May you visit any time day or night 

Don't be taken in by the tour and the sales pitch - staff is advised that a tour is coming and they put on a show for it
If you find a place, ask to come back a second or third time at different times to just sit and observe - I suggest about 2 pm and after dinner
Times when caregivers generally are not visible
Are folks left in the dining room
Are they herded and left for hours waiting to be put to bed at night

Smaller residential board and care facilities may be a good alternative

I'm sorry for your struggles, dementia is a long tiring journey for everyone
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My parents both moved into memory care and I spent several months doing tours. I looked for the basics.. as you have mentioned, looked at the residents to see how well cared for they looked.. were they clean, didn't smell like urine. I ate a meal at the places I looked at and also took note of how residents were treated and the quality of the food. Is it clean? Does it have a good staff to resident ratio? If there is one you are interested in ..go several times at different hours and make an unplanned visit.

Beyond that, I tried to find a place that offered some things that I knew my parents would enjoy and that they might fit into. The place I settled on had a large backyard and my parents have really enjoyed this as they prefer to be outside on warm days. It also had some residents that are higher function (now anyway) that match where may parents are currently at. They also allow pets to visit and have a house dog which they enjoy.

All of the memory cares I looked at (I live in Texas) are self pay and do not take Medicaid.. unfortunately.
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My dad moved into a memory care facility five months ago. In our area, there was really only one choice, and it turned out to be a great one. I suggest multiple site visits at different times of the day to get a feel for activities, staff, etc. Pay attention to how staff out on the floor (not just the person conducting the site visit) greet you. Pay attention to how they are treating/interacting with other residents. Do they call them by name? Go into the common areas and see what's going on there. Your visit should take at least an hour so you can really get a feel for the place. Your list is about the technical aspects. You really need to get a feel for what it's going to be like for your wife to live there.
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