I live in Seattle and what we call Adult Family Homes are pretty common. They are state-licensed for up to 6 residents, have live-in care givers, and meals etc. they are typically in a remodeled or purpose-built house. They are a good economic replacement for in-home private care or nursing homes. Some are all private-pay and others will accept Medicaid.
The place my mom was in had wonderful caregivers who truly loved her
They are for-profit and like any facility, there are a lot of lousy places so homework is necessary to ensure quality. This home was immaculate and well-run, although we did have issues with the owner.
A large number specialize in care for people with dementia.
We, well mom, paid around $6K/month for her care. We visited homes that were upwards of $8K/month. In-home care here (full-time, around the clock) would run around $15-20K/month, which is largely unaffordable.
The figures @zeebamom gives are similar to here. We are thrilled with the philosophy of care at the home they are at now. It is a family business and the owner is very attentive and involved and works hard to provide the best care for each individual resident.
Thanks everyone for the support. I’d like to note that net cost of care for my parent’s would increase if my dad passes as the pension will pass with him. It is truly a moral and ethical discernment rather than cost of care. But, my mom will have resources to stay where she is at now.
This is such a hard decision. Regarding antibiotics: my mil died in July after several years of decline. She was given antibiotics a couple of months prior to her death for a respiratory infection. She might have died sooner without them but I think her QOL was better with them. She didn’t bounce back after that infection but the cough was better and she died more peacefully. She refused to discuss her end of life wishes so her kids did what they felt was best and I think for them antibiotics was the right choice.
OTOH, my aunt made very clear that she didn’t want medical intervention including water if she couldn’t swallow on her own. When she fell in August, broke a couple of bones and was barely responsive and unable to swallow, my cousin honored her wishes and didn’t do IV hydration or feeding tube and she died 17 days post fall.
So I think the decision depends on what the person has expressed wanting done and what would give them the easiest path to a comfortable death. Hospice is definitely a great resource. Sending hugs
@GTalum , I am sorry you have to make hard decisions. I also did chose no antibiotics for Mom in later stages. She was off hospice once and they hauled her to the hospital and gave her IV and antibiotics automatically…it was sort of per her POLST which they had in writing. But if she would have already been on hospice then she would not have had that trip… it just is hard to pick the right time. I told my old friends niece to NOT do flu shots and skip the blood pressure meds when she moved her aunt to memory care. What is the point? But every family has their own criteria, there are no easy choices, we just chose our own potion.
When the in laws were ready for Skilled Nursing in CA, it was going to be nearly $9k monthly for a shared room, we toured board and care homes ranging from $2-6k depending on shared vs private room, size of room & how fancy the house & neighborhood were.
I think it is a personal thing, but MIL spent several weeks in the SNF for rehab and had no interest in the activities & did not do that great in the institutional setting, B&C was better. For FIL, it was the same, B&C was more able to address his special little needs.
I think the pneumonia decision is exactly right, when our minds are gone, there is no reason to fight the body’s natural processes, obviously no pain, keep the person comfortable, but also no heroics. I would recommend contacting Hospice for a review. We had hospice for each of my in laws, in each case, I did not think they had only 6 months to go and yet, both were gone in the 6 months and benefited greatly from the personal attention of hospice. That attention also helped the B&C home better deal with their needs.
@esobay flu shots are needed to help protect the community and are usually required at any institution. If refused, they may not accept her. I agree about the B&C. They are much more able to meet my parent’s unique needs.
Guess I was lucky in that moms al place had optional flu shots (Oregon) and memory care for friend in CA seemed to not require it. But I was telling friends niece for before she got moved into the memory care lock down. My dads wife tried out three assisted living places and was so much better off in the board and care place. Just different personalities. Good ones of every flavor are good and bad ones are horrid!
Meant to add just got done visiting BIL in a memory care place in Indiana. Quite a complete contrast moms place. There seems to be a reason Indiana is last in assisted living care. Very sad for BIL as his wife is dead and only son is not on top of his dads care. Nurse told us BIL was desperate for clothes since now he is inconvenient, they have to go down to lost and found to for no him pants some times. We got 8 pair of basic sweat pants and pajama pants and brought them back. Broke our hearts a little but we are far away and not really in the loop for care.
@esobay I liked the “inconvenient” spell check Dad is doing better. I broke down with pressure of community safety and he got some antibiotics. We will see. He is confused but not agitated with his new medications and sleeping at night! Mom, who has always been wonderful and laid back, has taken the opportunity to become agitated and angry. She insists on going home and has all her clothes out to pack. She tells me her parents will pick her up and bring her home tomorrow. It’s a pretty dramatic and sudden behavior change for her that started yesterday. Yes, we’re checking for a UTI. I’m not sure what else to do for her.
@GTalum at skilled care facility, my unit has several dementia people that do better some days than others.
Maybe your mom’s agitation and anger will subside - it may be her way to express emotion with the changes and having a hard time with the adjustment. Give it a few weeks, and give her a lot of reassurance. Sounds like a lot of ‘redirection’ is required.
I wonder if the change just flashes your mom back to when she felt the same way (unfamiliar with surroundings, feeling uncomfortable) and her mind has the simple solution. I hope she will go through her adjustment period and be wonderful and laid back again.
We even have dementia room-mates scheming how to get a car to get out to go back home.
My Dad lives in a CA Memory-Care and the flu shot is optional. I suggested he have it, but he is adamantly opposed to it.
My Dad has been there a year, and all of the new residents seem to go through a “how do I get out of here?” phase. My Dad talked non-stop for a year about getting out, but hasn’t mentioned it since his best friend (who used to visit weekly) died. He will say “this place is horrible”, but he hasn’t asked me to call the realtor, etc…
Unfortunately, my mom was so intense on the issue of packing we could not redirect her. One of the aides spent some time and did a great job getting her to take a shower, sitting down with a bowl of ice cream, and watching Discovery Channel. She reminds me a bit of the child who threatens to run away.
It was the dramatic and sudden change that has us scratching our head. I brought my dad into the living room while mom was showering, I introduced him to the aide as my “calm” parent. A new role reversal! I would love to take her for a drive but I’m afraid we would have to drag her out of the car. Yes, obtaining a car (freedom/independence) is a big topic of conversation.
Mom is better today. Since they tried to get a urine specimen from her, and couldn’t, they realized she was dehydrated. Fluids are pushed and she is much better. We were able to have a rational talk about it being fine to leave if we can find a place that will take them both (letting her know this was a difficult task when we looked at options), do the shopping, offer 3 meals a day plus snacks, help dad with the bathroom issues and shower…She was understanding when I left.
@GTalum that sounds so much better. I can only imagine how stressful these weeks must have been for your mom, your dad deteriorating, moving, and then your dad deteriorating some more. More virtual hugs for you! It’s so hard.
When my dad was in hospice in the hospital, they gave him antibiotics because it made him more comfortable. And it seems to have helped with your dad too. Pneumonia can be very painful and frightening…
@GTalum , my mom decided in the last 6-8 months of her life that she couldn’t swallow water (!) and dehydration was a problem. She decided that she loved sprite. This, from a woman who hardly ever drank pop. We got her her own insulated travel cup and provided Sprite to the AFH. We eventually got her transitioned to diet, but the calories and liquid helped immeasurably.
This is my first time posting in this forum, though I’ve been lurking for a while. Your experiences are helping me get prepared for the inevitable decline.
My dad has Lewy Body Dementia, and my mom is his only caregiver. She is really overwhelmed with taking care of the things dad used to do. She’s never been an organized person, and is now really disorganized. Appointments are missed, important papers go missing, etc. I’ve been taking care of their bills online for about a year, but they still get statements, etc mailed to their house. That’s a problem because mom loses them, and Dad get anxious when he sees things laying around that he knows should be taken care of… but he doesn’t have the skills to take care of it anymore. So I am moving most things over to paperless billing now, to reduce the mail load. Here’s my question: Should I put my address on their accounts for those things that still get mailed (like end of the year pension statements)? It would certainly be easier for everybody, but they live in a different state. Would there be problems at tax time if they get some statements mailed to an address in a neighboring state rather than their actual state of residence? I don’t want them to get taxed in both states!
I don’t think taxes would be an issue for bills being mailed. I forwarded all the in laws mail to our place & you should have seen the stack of junk mail I had to fight every few months. Every charity and bladder control scam in the country caught that address change!
Dad is doing better. I broke down with pressure of community safety and he got some antibiotics. We will see. He is confused but not agitated with his new medications and sleeping at night! Mom, who has always been wonderful and laid back, has taken the opportunity to become agitated and angry. She insists on going home and has all her clothes out to pack. She tells me her parents will pick her up and bring her home tomorrow. It’s a pretty dramatic and sudden behavior change for her that started yesterday. Yes, we’re checking for a UTI. I’m not sure what else to do for her.