Curious to understand:
1. How the initial conversations start (who raised the question) and what the search process was like
2. How did you go about finding the right place? (internet search, referral from friends, doctor recommendation, other)
3. How long did it take to find the right place?
4. How many places did you go visit and what were the key deciding factors?
5. How much did location matter vs activities vs food etc in your final decision?
6. Can you negotiate on rates with places?
7. Any other considerations?
I think when there are changes, whatever family is present in the area should sit with the elders and discuss the fact as they are and the options.
2. In my bro's case he was in rehab after a car accident and there were only so many ALF in Palm Springs. His friend was already at one. He was interviewed by them, and when he was out of rehab we visited each. There are businesses who will take you around what is available in your area (such as A Place For Mom). For some they work (my friend loved them) and for some they hate them. They will take note of all needs, finances, so be aware of that, and once contacted the only way to rid yourself of them is to say you are on medicaid. They disappear at once.
3. In our case the decision took a long time. After visiting facilities the choices were clear and it took no time at all.
4. We visited three. What decided it was the rooms, the size, the meals (we had one) and the speaking with other residents, the facility friendliness and amenities and activities. One had better food but the communal cottage atmosphere in ground of the other was better.
5. See answer 4
6. No, we found there was no negotiating and in a good facility there should not be. What you pay should not rely on what you have. What you pay should be the same as anyone else. But it did vary widely according to need and that was divided up into care levels. You wrote down exactly your needs and expectations and that decided your care level.
I would say it is important how much time they spend with you in office. They should show you (proudly) their rules and levels of care and what is provided and what costs are and under what circumstances your costs will go up (in our case between 3-4% yearly), what is provided in terms of care of place, cleaning, meals. They should be open and open to your touring the kitchen and etc. The place we chose was WONDERFUL and proved to be wonderful the just over one year my brother was there (he died of sepsis shortly after a year).
So when I was frantically hunting for places to put my mom, who had somewhat suddenly become bedbound and needing assistance with most ADLs, I looked at small care homes as well as more traditional AL communities. Mom is in a different state than my husband’s family, so I couldn’t just put her in the particular home of which he’d had such a high opinion. I talked to anyone and everyone for leads. The admissions nurse from a hospice provider ended up recommending the care home I ultimately chose.
We have been so very lucky, I think. My mom is in the personal home of her caregiver and caregiver’s family. There are only 2 other patients/ residents, so our caregiver is constantly checking on my mom. She gets fed whenever she is hungry, not on a strict schedule. Food is home cooked, and has even been hand fed when necessary. Mom has gotten quite attached to our caregiver and her family.
I’m not trying to make some blanket condemnation of AL or nursing home facilities. I saw a couple great AL communities on my search. Just they weren’t right for my mom, because of her personality and the high level of care she required. But given who she is (not the type to self-advocate at all, has a hard time asking for anything), I don’t believe she would have lasted very long in any remotely institutional setting, much less found the emotional peace and comfort she has.
Hope this helps someone. The search for a place to put my mom when she couldn’t return home- I can’t remember a more stressful time. I was literally falling to my knees with anxiety attacks, and not able to sleep for days. In the end, with a lot of help and luck, we found the right people and place. I think that will differ greatly on an individual basis and circumstances. But hugs to anyone in this situation.
the one thing we really looked at was level of care. The sticker price may look good but then you tack on all level of care costs…drove the money they price up. The facility we chose was MC all inclusive which means they do not charge anything extra for level of care….so MIL can be a level 1 or a level 3. Some of them when I calculated the end monthly price, it was crazy. $10 per meal for room service when we knew MIL would not eat in the community room. $ for Foley reinsertion which MIL was always pulling out. The only additional price we pay is for things like beauty salon and if we need a companion to go to a medical appt(but transportation included).
it was a very long process….
My mother was first in a non-profit place that my dad had been on the board of trustees for when he was alive. They neglected her (in skilled nursing!) to such an extent that she had puddles of water beneath her grossly engorged legs because the edema had broken down her skin and it was dripping out. My husband finally said that they'd kill her if I didn't get her out of there, and he was right.
Some will say that A Place for Mom is just a marketing company that gets paid py the nursing homes for placements. That's all true, but at least they ask about your needs and connect you with nursing homes with those amenities. Your phone will ring off the hook at first, but if you ask them to stop contacting them, by law they have to. I had no issues with anyone disrespecting that request, and while they ask what you can afford, they collected no specific information on finances. It's not true that they won't leave you alone unless you tell them you're on Medicaid, and they don't take you around to look at homes. They provide you with a list, and they provide the homes with your contact info. I've ured them for my mother and my brother's in-laws, and they were great both times.
Go check out various places on the list you receive, and ask for references from family members with loved ones there. Check out their dining options, what activities they offer, and ask if they have periodic care conferences with the resident and their family. Ask how they go about engaging new residents to ensure they fit in the community. (Some of those places can have terrible cliques!)
Be 100% certain you know what kind of care a place offers as well as what kind of care you need. Assisted living and memory care aren't the same thing, so don't go for AL when you have someone suffering from dementia.
Good luck.
1. The conversation came up when I realized I could no longer properly care for my wife. Her needs exceeded my capability to care for her (wandering, delusioins, no sleep pattern, etc.).
2. You can Google "ALF near me" to get an idea of what's nearby. You can “hire” (there is no fee) a search agency, (e.g., A Place for Mom and others) to get a list of facilities that may be appropriate for you. Your local Area Agency on Aging may be able to help with that. As for me, I knew of several facilities nearby that I visited. Oddly, it was one that was 20 miles away that I chose.
3. I think it took me a couple of weeks to find the right place. My wife came along to visit all the facilities. Unfortunately, the place I chose had a three month wait, but called after only three weeks to say they had an opening.
4. We visited 5 locations. 4 were within 4 miles and the fifth was 20 miles away. I chose the latter. I looked at how inviting the place looked, staff interaction with residents (I eliminated one facility simply because a staff member was pulling a resident backwards in her wheelchair, an affront on her dignity, I thought), their policy of dismissal, the cost and what was and what wasn't included in that cost, what training the staff rec'd, etc. Certainly, make sure the facility is accredited. This link can help; https://www.elderlawanswers.com/how-to-evaluate-an-assisted-living-facility-3753
5. Location was somewhat important, but not enough so as to eliminate the better facilities. As I said, I chose the one 20 miles away.
6. You can't negotiate rates, but you need to know what you're paying for. Certain amenities are not included like podiatry visits, and salon appts. Also, additional care may cause an increase in price. My wife's fee was $5K initially but increased to $6K in the later stages of her disease.
7. Wherever you chose, get to know the staff. Don't over expect. Your LO will not get one on one attention. You may pass the daily caregiving on to the staff, but you will still be your LO's advocate. Don't be afraid to ask questions. Make sure you and the staff sit down to develop a care plan for your LO. Most places are full so you will have to get on a waiting list, so do that in advance of your need for placement. If, when they call, you think it's too early for placement, you will still stay on the list, and they will call you later. (It would be a good idea to make sure that this is, in fact, their policy).
I'm convinced I could not have found a better place for my wife. So do your homework. Good luck.