@GTalum, I haven’t explored this issue, so this is definitely FWIW advice, but might it be possible to get a camera or some other kind of “smart” technology for your parents’ apartment that could help monitor their safety?
Can the helper drive them shopping, to appointments, dining out, etc. Can the person do drudgery chores–clean, wash clothes?
In addition to being a companion/friend, can you explain that this person really needs a job?
I like that idea @rosered55, I will ask about such possibilities. Yes HImom, those would be things the companion could do! There is maid service once a weak but they do need to do their own laundry. Someone could help them with getting lunch together as they only go to the dining room for dinner and walk to the store with them. They don’t like to leave and go places because it is confusing. Maybe the biggest asset of a companion would be to help them identify activities at the CCRC they would like, especially for my mom who I think can still participate, and arrange to get them there at the designated time. The biggest problem for them since moving to the CCRC has been not being able to participate in all the activities as they are unable to keep a schedule.
Maybe start our with limited hours, maybe 4 hours 2x/week and see how that goes.
@GTalum- that is a challenge. Worth trying bringing the help in. A big part of why I moved my father from assisted living to a skilled nursing memory unit was that when he was in his late 80s, his dear friend in AL moved to SN and with that disruption of his social routine, it became apparent that although he was still very interested in and able to spend pleasant time with peers, he could not coordinate any plans at all. He was interested in lots of the activities, AL did their best to prompt him, but they were not staffed to keep tabs on every resident’s daily ECs. The memory care unit has tons of activities, with meals and socializing all in one spot, with staff members to facilitate participation. It allowed my father to keep as busy as it made sense for him to be, which changed over time.
Also, no memory past 5 seconds translates into different behaviors and risks for individuals and their circumstances. Forgetting to turn off stove burners is an obvious thing, but for some people, not remembering when perishable food was bought and consuming can have consequences, too, as can hygiene limitations. Good to have someone paying attention to how these deficits manifest day to day and the right aides will help by noticing where things are most challenging day to day. People with cognitive decline are often relieved to have a friendly presence around to help them make sense of it all as their confidence fades.
Good luck! I know how hard this can be.
Thanks to all who responded to my posts.
In NY, there is only a three month lookback for in home Medicaid and the house value is exempt. I am not entirely sure how it works but her house is not going to be seized or liened against. If we put her in a nursing home, they would look back 5 years for Medicare and the value of her would be included. We bought a home for less than market value because the Medicare lien was three times what the value was and the family wouldn’t have gotten a penny - the sellers liked H and I and sold it to us dirt cheap. Medicaid, though, is different, at least here.
I can’t put MIL anywhere at this point without her D because even if I did, she’d just let her move in. short of armed 24 hour guards and an electrified face, I can’t keep her away. I can’t put them into an apartment because SIL smokes, drinks, takes too many opiods and passes out on occasion and I am not in the mood to pay damages.
@GTalum - Maybe a young retired person or a student pursuing eldercare studies might be a good companion? Maybe someone else at the facility has a part-time aide that could be hired to check on your parents once in a while?
Lol, an electrified “fence” wouldn’t keep my SIL away, but an electrified “face” might…
@techmom- I feel very badly for your family. Of course you can’t have SiL in the house.
Shame that a residential skilled nursing facility is looking so fiscally undesirable right now. That would, pardon the expression, kill two birds with one stone, giving your MIL the care she deserves and eliminating any chance for your SIL to move in. If mother in law can’t make transfers now, and this is likely to be chronic, it seems very dangerous for her to try to live in situation without reliable, full time care. How would she get out in a fire if SIL is passed out or just out? Investing in a house for the two of them seems particularly daunting. So much to consider: do you already feel like you are administering an elder care facility and a drug addiction half-way house simultaneously? This sounds like super hero stuff to me. Sounds like you have great (even in-house) legal advice and there may not be any power to exercise as long as MIL can’t say no. I’d keep good notes on SIL’s behavior, pass out incidents, etc. in case it becomes relevant down the road. Tough with no straightforward way ahead. I admire your stamina.
Do you mean the Medicaid look back for SNF is the problem (as opposed to Medicare, which as far as I know does not cover SNF care)?
Medicare doesn’t cover nursing homes. The 5 year look back is for Medicaid, but I’m not sure how the house would be handled. My mother hadn’t owned property for more than 10 years by the time she applied for Medicaid.
@travelnut you are correct. The other day, DH and I found raw chicken in the refrigerator. It wasn’t sealed in the original package and was dripping. Mom doesn’t cook besides heat up a can of soup. We asked her about it, and of course she knew nothing about it, and when we brought her to look, she said, “that’s not chicken, it’s beef. Don’t throw it away.” We did. I’ve yet gotten the opportunity to throw our the expired eggs . When dad tries to answer the phone, he is no answering several remotes at once and says that he can’t find the “right phone.” And of course calling me if they need something is out of the question. So yes, safety is a concern. But isn’t safety a 24 hour concern? It would be nice to have someone help direct them to activities they might like but don’t have the executive function to pursue.
I think private care, such as what you are thinking, would be cheaper, but then I have to worry about taxes. I’m pretty sure their facility just has companion service.
@techmom99 I don’t quite understand the issues with the “look back.” The house can be sold and those resources can be used for the Nursing Home and once those are used, Medicaid/Medicare kicks in, correct? And, it would get rid of SIL in the house.
@GTalum - it is sounding like it is time for full time care. The questions may be how and where is it provided.
I was hesitant to move my father to high quality memory care SNF onsite prematurely, yet was able to walk him through the transition when I realized how much effort it took for him to navigate his day, even in AL with nursing care built in. Despite his initial ambivalence, neither of us had regrets and his engagement increased. Looking back is diminished with the illness, so if the here and now works, that is what counts.
With hindsight, it seems that if transitions are on the horizon, there is a benefit in doing it when elders still have some capacities as they join a new environment. Structured routines may be a stress reducer and optimize functioning for some with dementia. All the best with this; it is a lot to sort out.
Whoops, I mean he is trying to answer several TV remotes instead of the phone. In the last week, he has also gotten the thermostat and phone confused. DH has found it helpful to better communicate with dad to call all such gadgets a “device.” Of course, it’s hard to tell if an ER visit for a UTI and head CT (what would we do with the results?) is in order, further increasing his confusion or if I should wait until his regular physician visit next week. Mom scored 5/17 on her memory test so no chance of help from that side. I’m sure you are right @travelnut. It’s just hard for me to reconcile going from independent living to 24 hour care so rapidly. Though, my father, an electrical engineer with a Master’s degree is very intelligent. I’ve always thought he would be able to compensate for a long time and will go steeply downhill at some point as a piece of his brain is much better than a full brain for many of us.
My dad doesn’t regret moving to the CCRC and is grateful. But, I don’t think he is “with it” enough to appreciate or not a move to memory care.
The rapid decline comes as a shock. My mom was basically independent in our home two months ago. After an infection, five days in the hospital, and six weeks in rehab, she now would benefit from 24 hour care. For every little tiny thing, she now asks, “what do I need to do now?” I was not prepared for never leaving my house again! (Honestly, not much of an exaggeration.)
Sadly, sometimes it comes down to being pro-active in advance of a crisis or waiting for the other shoe to drop. Then it can become a desperate or urgent situation, minimizing the chance for optimal choices.
I tried to put the need to grieve my parents’ health declines in one “box” and my pragmatically addressing their needs in another. My success at that was variable, but it was a helpful construct.
Best to all.
I get it @psychmomma. I know you need to work. Are you able to work towards any resolution? I think you mentioned previously that the barrier to being able to afford help was the sale of her house which is cluttered? Can you get an a company to help you with that? It seems your situation isn’t sustainable.
I’m not sure what we’re going to do long-term. Her house is very remotely located but does need to be sold.
So, for anyone who has been a full time caregiver - and I mean doing everything for the person - my hat is off to you. Mom’s been here for 9 days. I’ve partially thrown out my back and have cuts on several fingers from odd changing/wiping/dressing incidents. The prospect of changing an adult that is unsteady on their feet, every two hours, seems insurmountable each morning, but somehow has been accomplished for 9 days. (Thankfully, she sleeps through the night.)
If you’ve seen 50 first dates, and remember ten second Tom, that is the level of short term memory loss we are dealing with. It’s scary. Needing to be told each step in the process, (getting in or out of bed, going to the bathroom, eating your dinner), only one step at a time until it’s completed, is very frustrating for her.
The four prior years she lived here were hard for different reasons, but in comparison to this they were a cake walk.
I can’t stress enough how helpful the agingcare website has been. The people over there have seen it all.
@psychmomma- all good thoughts to you. That sounds daunting.
Hope that you have access to some tips of the trade that may make all you do smoother, less stress on your back and as safe as possible. Are there specific techniques on the agingcare website? I have been awed watching how the pros tackle personal care for people with significant limitations. Still doesn’t make it easy. Just slightly less perilous, with many ideas that only look simple once you have seen them done. Maybe have a PT evaluation in the house that would help things go better.
Are you needing to be home with her at all times?
@psychmomma - I’m really hoping/praying that an answer will present itself to you.
Not to scare you, but my SIL broke her wrist in an incident where she was helping MIL.
What you’re doing is incredibly difficult. I’m so sorry.
At what point are you going to call in help @psychmomma? I’m just concerned as injuring yourself will make you less able to help your mom and you’ve already injured your back in 9 days of this, with no improvements on the horizon. I give you all the credit in the world, but worry about caregivers getting permanent injuries that will affect themselves and their ability to provide care and support for their loved ones.
@psychmomma so sorry you are going through this. My mom had to move into an adult family home after rehab due to being unable to care for herself. We couldn’t afford in-home 24/7 care, nor could we stop work and remodel homes for her to move in with any of us. The caregivers were angels - lifting, cleaning, personal care are so difficult.
Perhaps senior services or another agency can give you training - it is so easy to injure yourself. Knowing how to lift and transfer is, I swear, half the battle. One of my sibs never did learn how to do it.