Elder Care Questions

You need to speak to the social worker at the hospital. He/she will provide you with all of the possible options.

Also, if she is on medicare, they provide up to 100 days of rehab per year. Once again, ask the social worker.

My friend went through this with her mom. She had home care nurses coming in. It was cheaper than the rehab or nursing home, of course not 24 hour care. If/when your mother starts to have severe anger or aggression, she and your father will likely be better off with her receiving 24 hour care in a facility. Also, some nursing homes are wonderful. If you do some research, you may find one that is very well suited for her. They can both most likely move into an assisted living center together.

yes the doctor can stop her from being discharged if she is not going to be given the care she needs. My advice is to hire a company that does 24 hour care...just gotta make sure they are bonded....because we had trouble with 2 different companies...they were robbing my parents blind. After that...the 3 of us sisters took over.

I am dealing with this very thing right now and have been for 10 years. My Mom divorced my dad in 2001 and bought an upper lower duplex, no mortgage, paid for it. The plan was I would share the home with her until her death and then inherit the house and everything else she had including a considerable sum of money. The problem is she refused to get long term care insurance or transfer the deed to the house into my name. She also refused to pay me to stay home and care for her. At first the only help she needed was laundry and cleaning and I made dinner for everyone daily. Then in Feb of '07 she had a dizzy spell and fell hitting her face on her walker and breaking her arm. Luckily my son was home with her and heard her fall, 10 minutes later and he would have been gone for the weekend. He called my daughter and she called me at work, I rushed home to find the street filled with fire trucks, police cars and an ambulance. I got upstairs and Mom was on a streacher and they were taking her to the ER. She had surgery the next day and spent a few days in the hospital then we moved her downstairs into my daughter's old room. The hospital set her up with physical and occupational therapy, and a bath aide. As soon as she was released from therapy--she stopped exercising. And has continued to get weaker and weaker where now she spends most of her day in bed. I had to stop working to care for her but she acts like I am stealing her money if I write a check to myself to pay necessary bills. I am her POA but apparently until her death I am supposed to live on air. I can't leave my house unless someone is here with her. I haven't left the house except for errands for 4 months. I can's work, spend time with my friends, I missed my kids and grand kids birthday parties. My mom should be in a nursing home. But a nursing home costs $5000/month and the home will attach all of the money she has in the bank and the house. When she dies they would own everything to pay for her care and I would be homeless and broke. Not something I look forward to at 56.
Medicare will pay for hospice (end of life care) for her so we have a CNA coming in 2x a week for a shower and a Nurse to come in 2x a week to check her vitals and meds.
I looked into elder day care for my Mom and the cost was $600/week and she has to be picked up by 6 PM and it is all self pay.
Before you make any decisions about the care for your grandmother talk to the county elder care services and medicare. See who will pay for what and if respite care is available. Nothing is available for my Mom because she has money. If her money would run out Medical Assistance would pay for a nursing home.
Your grandma will no longer qualify for long term care insurance but your grandpa might. A nursing home should only be able to attach half of your grandparents assets since your grandmother technically only owns half and your grandfather the other half.
The best way to protect their combined assets is to transfer everything into someone else's name. But this has to be a person they trust not to wipe them out and it has to be done a certain number of years BEFORE they enter an assisted living or nursing home situation. In Wisconsin that is 7 years. It differs in all states.

My mom cares for my dad at home. She got a lot of good help from a Geriatric Care Manager when deciding what to do. They will assess the situation and give you various options. They work for the caregiver and the patient and are THEIR advocate, not the hospital, nursing home or insurance company. They do charge but a good one is well worth it if you can afford it. They can come in do a one time assessment and assist, or you can have them do an ongoing assessment as things change.

http://memberfinder.caremanager.org/

Even nursing homes are expensive. Probably not much less than the rehab facility.

The least expensive choice is in home care. I don't think it would have to be 24/7 because I assume she sleeps.

Another choice is they have villas. I think there is over 20 such facilities in St Louis and we are always behind the times. How these places are set up is they are on the same campus as a full care nursing facility. You can order up what ever level of care you need and they send the staff down to your villa. Generally on the same campus they have apartments but the problem with them is you would pay the same for him as her and you cannot adjust the level of care.

I am surprised the hospital and her doctors aren't providing you with options.

I went through this with my father in law.
My mother in law was trying to take care of him but it especially got too hard when he had to have a hip replacement. He went to a rehab facility to get strengthened up before being allowed to return home.
Because of his Alzheimer's, my mother in law was in no hurry for him to go home. It sounds bad, but she was in failing health herself.
We hired caregivers to take care of him at home. It was much cheaper than a "facility". I'm in California, and facilities are incredibly expensive.

I actually work for an agency that helps keep people in their homes. I don't know what is available where your folks are, but I would recommend contacting a senior resource center in their area. They should be able to give you resources or contact information as to what your options are. At least in my area, there are agencies that will help with respite care, meaning giving your grandfather a break and support because taking care of someone, especially with Alzheimer's isn't easy.

I wish you the best.

I would also suggest hiring a caregiver - even if you hire one for 24/7 (which may not be needed) that should come out to less than 10 K.

BTW, I don't think that her doctor can refuse to discharge her to your Grandfather's care. He may mean well for your gandfather and grandmother, but I doubt that the hospital can require a certain type of care arrangement for her unless they go through the legal system.
Good luck.

Assisted living might be a good option. That way, he could live with her and he'd have help. Won't Medicare pay for home health care?? At least for a period of time?? I'm not sure but her Dr.'s office could answer that question, they probably deal with it daily. At the end of my Dad's life, I hired someone to come in daily to help care for him, bathe him etc. That was worth it's wait in GOLD to me. He was able to be in his home but I didn't have to worry about doing the heavy lifting etc required to keep him clean etc. I think you have lots of options.
My heart goes out to you all. It's a tough time.

I worked for a place that did home health. The nurse went in a couple of times per week and the aides did all the basic care. If she needs 24 hour care they may have some sort of plan like that. I would think assisted living might be where they should go though.

I am sorry but she is not going to get better but worse over time. He should get to enjoy spending time with her and not have to do the daily caregiver things for her, like wiping pooh from her hiney when she has an accident, or washing her genitalia on a daily basis. He loves her, but he is older too and should be able to just remember her like she was when they were both mentally there.

So supported or assisted living. There would be a help button and there would be a nurse on duty 24/7/365. They would have all the same things a nursing home has but live in an apartment that would be private.

You have several options. I worked in hospice for several years and learned a lot about the system. If she needs skilled care ie: rehab then Medicare will pay for a certian number of days in a skilled nursing facility or a rehab hospital, Medicare will not pay for home health unless it is hospice (end of life care) if she can qualify for Medicaid then she can get nursing home coverage.
If your family is against putting her in a facility home health care would be the best option, many have nurses as well as certified nurses aids that will come into the home and make sure her meds are admistered correctly the aid will assist with bathing, light housework and meals. Speak with the social worker at the hospital, although many can not come out and recomend a certian provider they can at least point you in the right direction. BTW we had several families contact us at hospice with these same types of questions even though their family member did not need hospice care but we were able to get them in contact with the right resourses. Try contacting your local hospice provider.

My family just hired around the clock care for my aunt, who was sent home from hospice because she did not die.

We are all chipping in and found an in-home care company that charges $100 per day, meaning 24 hours. We hired 3 elder care gals just out of training. The in home care taker take is allowed 6-8 hours of rest per period. But the family all goes over to help and provide them with more rest. So that is $3k a month, not $10k.

I would suggest contacting a hospice center, or a geriatric specialists, or a long term nursing facility, or a church, and request if they have people who are willing and able to provide this in home care for a reasonable rate.

I would also suggest your dad calls his insurance company back and ask for a 'Nurse Case Manager' be assigned to his wife's case so that they can help him manage her care until the end. The insurance must offer this once asked. They will come to the house and assess her needs and they should be able to help offset the cost of in-home care as well. It's just based upon their findings.

And one more noteworthy item....a friend of my aunts, who went with this in-home care option, was stolen blind. The gals she hired to help her mom at home, STOLE EVERYTHING....Here's how....they emptied out every cupboard and and left a fake facade of items lined up. Even the china was stolen, they left a front line of wine glasses, or cups and took everything behind it.

GL!

Look into Home Health Care and respite care... they also have daycare centers for the elderly, tho honestly an overnight place with days at home would be a much better option.

Are you able to hire a live-in caregiver? Seems like that'd be MUCH less money than $10k/mo! Probably could get one for a few thousand.

ASSISTED LIVING. I've been down this road twice with my parents. I've researched this for years. If your grandma doesn't wander, then I would look into an assisted living facility for both grandparents. As long as your grandmother doesn't need a fully licensed nurse to help care for her, check into it. I've found that in the long run, assisted living can be cheaper than hiring a full time caregiver. The benefits of assisted living is that it offers housekeeping, meals, laundry, entertainment, and personal care such as incontinence, medication administrating, assistance with dressing and bathing. They can also offer onsite beauty salons and visiting physician services and rehab services. They also offer church services. It's a community within a community, unlike a hospital style setting like a nursing home.

My mom has lived in an assisted living community for 3 years now. At first, both she and I were opposed to it, but it has actually helped her live better and she is healthier as a result. I also have peace of mind. Some places will actually give a discount rate for the spouse. It's also great because your grandfather can be independent and do his own thing while grandma is being cared for by the staff. Also, some states offer rental subsidies to cover rental costs. A good website to check for your area is: www.aplaceformom.com. It's a free service and they are wonderful at finding a nice place.

I hope this helps.