We’ve been looking at options for my mom who is starting to need more care, and I’m just wondering, why do they always seem to put Memory Care units with Assisted Living and not Skilled Nursing? Is it because residents of nursing homes are usually bed-bound so there’s little chance of them walking off even if they have dementia? Or is it because the level of care changes at a nursing home and they’re just not going to do as much for the person? Memory Care is very intensive from what I understand, or at least it’s a lot more expensive, but couldn’t some of those people do just as well in a nursing home? Is it about the money somehow?
Or maybe it’s about the level of nursing care they need, so MC gets the people who are physically well but mentally not-there? I’d assume then that people could be discharged from MC into a nursing home if their physical needs got worse, is that how it works? Any insight appreciated.
The SNF my father was in had MC patients but it also was a locked facility. I think most, maybe all, SNFs are locked now anyway. So sadly some, like my husband, who only need MC and some assistance are in SNFs with little stimulation. It takes a special understanding to be a caregiver for someone with dementia and not all staff members in SNFs have that experience.
i have had insurance for multiple years and hope it will provide me with a large portion of the cost of a decent facility now that im older and will need one eventually.
Others have provided good insights as well. Sometimes, it is about the financial side of things that determines where someone ends up - there may be insurance for some levels of care, but not others. And I have seen some administrators flex the rules a bit to fit their needs and the current or potential resident's needs.
I'm about to go visit a friend with Alzheimer's who is in regular Assisted Living. She is not a flight risk, though she is becoming more of a fall risk. I'm not sure where her next move will be. It turns out that early in her disease she could have chosen to stay in her home, but apparently didn't want any of her children to own the home. I suspect this was the disease speaking. :-| The home was sold on the open market, and she ended up in an institution. Ugh. It is a disturbing situation - like I have seen at other ALFs. And while it wasn't great at the beginning of her stay, it was sold to a corporate entity and the impersonal "personal care" got worse, as well as the food went downhill, etc. -- all the while the price went up!
I've seen a lot over the years. It is my personal opinion that people will typically have a significantly higher quality of care (even if it isn't great) if they can stay at home - but each situation is different.
She started out in the ALF section, but as she went downhill incredibly quickly, she was being assessed for movement to the MC section of the bldg. She actually wouldn't have qualified for that b/c she had become violent and too much care for the MC level. I believe that an assessment was made to be moving her to some total-lockdown psych facility. She simply was too much care for the kids (who never left her alone, even after moving her) and on site nursing care.
Luckily, she passed 8 days after being moved into the ALF.
The A in ALF is for Assisted--which means the patient just needs 'assistance' not complete 100% hands on care. She could not do a single thing for herself.
IN MC the patient has to at least be somewhat 'with it' so as to not take 90% of the nursing staff to meet their needs. Even with 3-5 people dealing with her, she was a problem.
Having him in AL definitely was a lifesaver for us since we were getting burned out at home, developing high blood pressure, tension, and able to give less than ideal care for FIL. We might have gone with adding some professional in-home care for him and did look into that for a while, but ultimately it seemed 1) expensive and 2) overwhelming to be bringing outside help into our own home. Also I just didn’t think it would relieve the stress on my husband as much as he needed if his dad were still here as he undoubtedly would still be taking a very active role in his care. Anyway, it was the family’s choice to have him go to AL, which was also expensive, and FIL went downhill fairly quickly there but he did have Parkinson’s and also was refusing to go to meals, take therapy etc. There were a couple of people who worked well with him, got him to go to meals, chatted with him, did the light wound care he needed, and he seemed to be adjusting better after about six weeks but it was too late with the edema.
I share all that to say that we also had mixed feelings about AL, but I don’t know that he would have qualified for a SNF and we had reached the end of what we could reasonably do at home. Everyone’s situation is a little (or a lot) different and we did see residents in the ALF who seemed well adjusted, stable and well cared for.
Now maybe he would have qualified for SN, now that I think of it, and maybe he would have done better there, but we were still thinking this was going to be a short stay for respite only. Probably we were fooling ourselves, it can be hard.
Also, when he left our home he was still pretty cogent and in great shape physically considering the Parkinson’s, as he had been exercising regularly and taking that carb-levo medication. He never tried to walk out of the AL, I think he’d lost his get-up-and-go by that point. The AL did seem expensive, and he didn’t get nearly the attention he was getting at home, but we just couldn’t do it anymore.
Someone with dementia in Memory Care will possibly get more stimulation and activities if they are able to participate.
If a person with dementia gets to the point where they no longer are mobile, or it takes 2 people to transfer they may be moved to Skilled Nursing because most if not all Memory Care facilities can not use equipment to move someone. So no Hoyer Lifts, no Sit to Stand equipment are to be used.
Skilled Nursing is also a much more medically focused care and because of that the cost is higher. More aides are available to Memory Care as they are not doing the Medical Care that is done in SNF.
Many facilities have Continuing Care. This would take a person from Independent Living to Assisted Living to Memory Care then Skilled Nursing.
Often grouped in with Skilled Nursing is Rehab. Often places that do Skilled Nursing are used for Rehab because there is the Medical Care that is often required after hospitalization merging into Rehab.
My Dad moved into an Independent Living facility and then into Memory Care at the same facility. Dad only needed help with showering as he was a fall risk, and his dementia was mild accept at night [Sundowning dementia] as he would try to leave the building at night. He needed to be in a building that was locked. His cost was around $7k per month.
Therefore, different skill sets needed for these different facilities.
NH, LTC, SNF are where residents can get medical care and therapy. These too you pay privately but have the option of Medicaid if care is needed and you have no money. There are more RNs per ratio.
This is just a kind of generalization, you understand.
Individual places define in their own way generally.
Just out of curiosity, might I ask what state you are in and the name of the facility for my own knowledge (I am on the town's Commission on Aging and we like to circulate information). Not sure if we are allowed to put names of companies on this site so if you inclined to answer me, you can private message me. Thanks!
Regarding NHs... I think it may be semantics since NHs and LTC facilities seem to provide the same services. NHs are for when someone needs medical care as part of their daily needs. They have 24-hr monitoring for people who may not have dementia or memory loss, but can't perform their ADLs on their own anymore, or have a profound medical problem or are bedridden.
My MIL went from AL to LTC in the same facility. She is bedridden.