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You need to research the SNFs in your area. If Medicaid is in the person's future make sure they take it. Once you found the one you like, you sit down with their representative and find out when a bed will be available. If the person you are placing is paying privately, thats good. Easier to get them in if private pay and then go on Medicaid. Then you work it so you give the AL 30 days notice (or whatever the contract says) and a bed will be available.

In my situation, Mom had 20k after being in an AL. That covered 2 months private pay in LTC. I started the Medicaid application in April, placed Mom May 1st in LTC, she paid May and June. In June I confirmed with the Medicaid caseworker that I had supplied all info needed and Mom was spent down. July 1st Medicaid started. My State gives 90 days from date of application to...get the caseworker info needed, spent down and find a facility. If not done in 90days, the application has to be started over.

Usually someone going into SN needs more than an AL can provide. My Mom got in because she was in the last stages of Dementia. She needed 24/7 care. When you research facilities, this is question you need to ask them. Having a letter from a doctor saying the person needs 24/7 care in a facility may help.
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Bayou5 Oct 2022
Hi, as much as I like reading these alternate plans it would be helpful if everyone would write out fully what all the initials mean. Some of us are very new to all of this and don’t know all the abbreviations that well. Thank you
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Sorry that your wife is having so many issues. How advanced is her dementia?

Does the AL say that she needs too much care to live there anymore?

I wonder if she needs a nursing home or memory care? If the reason for her needing to leave AL is her dementia, then maybe MC is a better fit? If her needs are more medical, then a nursing home might be more appropriate.

Good luck.
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bkoropchak123 Oct 2022
This question and the replies reflect a dilemma produced by how long term care is funded. Skilled nursing is for individuals with “Primary medical problems that need monitoring.” Memory care is “for dementia.”
Although dementia IS a medical problem their is no public funding for assisted living care for folks on limited income. The cost for assisted living is out of reach for many. Hope I’m wrong about this, and welcome information.
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Skilled nursing is for people with primarily medical problems that need monitoring. If your wife has dementia, I'd say she needs memory care.

My mother had heart failure, macular degeneration, and dementia. She started in skilled nursing and she nearly died in there because she was largely neglected. She was "sick" enough to warrant much attention.

I finally wised up and decided I wanted to focus on what would improve her life the most, and since the heart failure was controlled with medication but wasn't going to be cured, I decided to focus on her mental health more. Yes, the dementia progressed, too, but in MC she had activities, had caregivers who engaged with her constantly, and it was a more sociable existence. They were able to handle all her medical needs as well, so she was able to remain there the rest of her life. She was infinitely happier there.
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bkoropchak123 Dec 2022
So very glad your mom is well cared-far on memory care. I’ve had the opposite experience. My 91 yr old sister is in a MC unit in a California assisted living facility. Although she’s not AT ALL a wanderer, she’s in a locked unit which doesn’t bother her. But her fellow MC residents are basically non-communicative and her basic care needs - like toenail care and not wearing her daytime clothes to bed - are ignored. She is very lonely. The facility refuses to allow her to be transferred to a regular assisted living unit saying that by law she can only be in MC since being diagnosed with dementia.
Any advice. Her son and family have tried to get her transferred but the facility says it’s California law that a dementia dx requires a locked MC placement. I live in MN so only see her 2x a year but common sense suggests that the unit someone lives in should be based on need not diagnosis. ????
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ELDER ABUSE

Hope you filed complaints at the state level for nursing negligence: silence is probably the biggest cause of suffering in that industry.
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lepleydm: As your wife unfortunately suffers from dementia, she most likely requires residence in a Memory Care facility.
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