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My father is 93 with Alzheimer's. He's home now with me monitoring cameras and paying people to "visit" to keep dad safe. He's on an approximate 6-month waiting list for a facility we have chosen.



Should I have a "plan b" in case dad declines over the next few months where he's no longer safe at home or do I have to wait until he actually gets hurt before I can find temporary housing? We are going to apply at an AL nearby but it seems like he can make it a few more months and by then an AL would seem a waste of time/money for that short period of time.



I think he'll be ok over the next 6 months but if things "go south" could I get him into a NH for a month or two paying cash and if so should I be calling these places now? Any other ideas if he only needs a couple or few months?

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AL is very minimal care. If you're paying people to check on him now, in your own home, you'll probably have to do that for him to be in AL. Why not just pay what you would be expected to pay at AL (+some extra help) and keep him at your house by hiring more hours for him as needed. Move him once to avoid confusion for him.

If he does need NH care, it appears you would be self pay until his money (like savings) runs out. When income and savings exceed cost of care, it's self pay. When the savings runs out, would his income still exceed cost of NH care? If yes, he continues as a self pay. Should income be less than cost of NH care, he applies for Medicaid to get state to cover what his income won't. You just let NH know when he's getting close to not having enough money to pay and their social worker should help you complete the application. Start getting about 5 years of bank account records and other property info together - Medicaid looks back 5 yrs from date of application to make sure he hasn't given /property money away, sold a house below market, etc.
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kilkoyne: Perhaps he requires a memory care facility.
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Does your father might qualify for Hospice because of his age and his Alzheimer's. Call them and see what you need to do to get an assessment. He may need his doctor's referral.

My mother is under Hospice care and she is fairly robust these days. Hospice has been wonderful. They provide supplies, a weekly or bi-weekly nurse visit, they call and check in, they can provide a hospital bed, an aide to help with bathing, a free volunteer to sit with your father while you take a break and they have a place for respite.

Maybe they can help you.
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Respite care in a Memory Care facility. Call Adult Protective Services to help place him.
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Definitely do NOT wait until you're in a crisis because generally that's when all rational thinking goes on respite. A wise man once said, "The shrewd one sees the danger and conceals himself, but the inexperienced keep right on going and suffer the consequences."

Please plan for contingencies now, check out facilities now, know what services are offered in your state/county now. A few suggestions:

1. Plan B should include a nursing home in case Dad has a STEEP decline. You could also ask there about respite care.

2. Were you able to find a standalone respite facility nearby?

3. I see on one continuing care community's website an offering of a 30-day program for people transitioning from the hospital or whose caregivers need a break ("are out of town"). It's a way for them to market their services. But it's 30 days...

4. In-home respite care doable?
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Great answer, cwillie!

Yes, have Plan B. Please do not wait.
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First off you seem to be using AL and NH interchangeably - An assisted living won't accept him if he needs a nursing home level of care, and a nursing home will need documentation that his needs are high enough to qualify there, usually if he is physically capable with dementia you will need to find memory care.
In answer to your question - some facilities offer respite or short stays, you would have to call around to see what is available, Your area agency on aging is also a good resource, they can do a needs assessment of him and point you to the programs and facilities available to you.
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