<p>PhotoOp, my friend did that with her Mom, took her to lunch whilst the guys moved her stuff in. Mom was losing it big time and yet still could hold a conversation with an outsider, like me, and pass for normal.</p>
<p>Mom called my friend and her sister many nights and left “get me out of here” messages. A few weeks later she fell, broke a hip, and a few weeks after that she died. I know 3-4 friends whose parents have died within 3-6 months of entering some sort of AL</p>
<p>It would take quite a tolerant cat to make a visit. His cat is very friendly but I can’t imagine that happening. And FIL is not a dog person. I hope it all works out for the best. It’s possible that he knows what is going to happen but he just does not know the day. </p>
<p>As for me - I absolutely love birds - I hope when it is my turn I can find that place with the birds.</p>
<p>PhotoOp–Many many nursing homes have large bird cages with finches chirping away. These cages seem to have replaced fish tanks for cheerful, soothing atmosphere. I love them!</p>
<p>Edit: I bet a visiting cat would be fascinated… ;)</p>
<p>I see that there is a Frontline on this evening about the problems with assisted living facilities. Going to watch, but not looking forward to it.</p>
<p>^^ I hope it’s not a hatchet job on Assisted Living. There are lots and lots of problems with AL, and if the program focuses only on those, it’s going to sound like hell on earth. I hope they point out the many valuable services AL provides, and the fact that for some families, it is the very best choice among a limited number of less-than-ideal options. I hope they also point out the problems with, say, leaving seniors in their homes when they can no longer care for themselves.</p>
<p>Our NH which was attached to the hospital where I work had a search and rescue german shepherd dog who was retired and old. He used to wiggle his body to get out the automatic door to go outside. He had one of those collars like for injured around his neck one day and I asked what happened. Well he slept at the nursing station and got too close to the shredder and his tail was nipped. He avoided the shredder like the plague and walked all the way around the station to get to his food. It was really funny. He would go up to the residents and sit at their feet or put his head up to be petted.</p>
<p>They brought puppies to my mom in the SNF, which she loved.</p>
<p>I am back now from taking care of my mom for a few days. She told a friend yesterday that she will be driving soon! :eek: Hoping Dad can hold the line on that one…</p>
<p>D2 and I are going down next week again for a few days. They missed D2’s HS graduation in June because of my mom’s stroke (2 days before graduation), and have not seen D2 yet since then. D2 can get time off from work for a few days, so we are going. She leaves for the west coast for college in less than a month, so this seems important to all of us. But my mom was awfully critical of me/everyone else this last week. As one poster said above:</p>
<p>
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<p>I talked with my D2 today and she said, “Okay, I know Grandma will probably insult me several times – I am ready, I can just brush it off and change the subject.” </p>
<p>Momof2kids, regarding your MIL/FIL:
</p>
<p>My FIL used to tell my ex-H that he would kill himself and his wife before he would do that. But then he got cancer… and changed his mind. It took a major health crises (awful for everyone), but they finally downsized in the their late 80s. He recovered and went on to live until 95 – he died while they still lived in a one bedroom apartment (cancer again, but was able to stay in the apartment with hospice care). MIL went pretty readily to AL after he died, and is still going at 95. Seems to be okay there… but she is always pretty cheery and not the complaining type.</p>
<p>Propublica has a 4 part series on assisted living, they also helped produce the Frontline episode on the same topic. I haven’t seen Frontline yet. The article focuses on just one family and their experience with a bad corporate owned assisted living facility in California. It is somewhat interesting, but it would have been much more helpful if they had researched multiple facilities and determined how widespread the problems are. They do have a link to tips on selecting a facility, but I suspect much of the information is not new to most of us.</p>
<p>One comment stuck with me, they emphasized it is more important to find a quality facility than one that is close to a relative. </p>
<p>[?The</a> Emerald City? - ProPublica](<a href=“http://www.propublica.org/article/emeritus-1-the-emerald-city]?The”>“The Emerald City” — ProPublica)</p>
<p>I only caught the last half of Frontline last night, but they were focusing on a woman who CLEARLY needed to be in skilled nursing. Not blaming the family, but the AL should have kicked her up to a higher level of care, and I guess that’s the point. I didn’t know that AL is so lightly regulated, and it does seem there needs to be more.</p>
<p>The problem with this kind of report is twofold – first, it leaves the impression that all ALs are like this, and I have personal knowledge that that’s simply not true; just last weekend, our AL informed me that they could no longer safely care for my dad, and he needed to leave. Second, it offers no solutions to viewers who have elderly parents who really need to be somewhere. Adult children who haven’t learned the difficult landscape of elder care may be left thinking that it’s better for their parents to stay at home, no matter how bad off they are.</p>
<p>I am so sorry I missed this. Do you know if it will be replayed on Hulu or Netflix or something similar?</p>
<p>Getting educated about the different type of facilities has been my life the last eight years. And yes, different locales have different types of facilities.</p>
<p>I like the CCC, the continuing care community, where your parent first moves into an independent living apartment, then can move over to the assisted living, and then to the skilled care. There are no facilities like this in my area, but the last place my Mom lived was such a place.</p>
<p>In January, I attended a memorial service for one of her friends who I was amazed had lived at this community for 18 years. She transitioned from one level to the other, and even went from one side of the skilled unit to the other before her death in a hospital.</p>
<p>I think independent living places are much more affordable, and if you are lucky enough to get your parents into one of those, you can probably stretch out your dollar.</p>
<p>I did like how this last facility, when my mother went into the hospital, told us to not worry about her next month’s rent. My sister and I cleared out her few possessions from her semi private room and put them in a storage locker in her city.</p>
<p>We had learned a hard lesson the year before. Our mother was sent to the hospital with a bad infection, transferred to two different facilities within a month, and we were so tied up with her, we left her belongings, which were considerable, in her one bedroom unit at the ALF. We were not only charged for the month she was in the hospital, but for the month that we finally came and moved out her belongings. This was a national franchise, and I could not believe they treated us like this after my mother had lived there, private pay, for six years. </p>
<p>The last facility, the CCR, was owned by a company out of state, but they owned CCC communities, not just ALF.</p>
<p>As for the location, I have mixed feelings about that. Although I was my mom’s primary caregiver, I found the facilities in the city she relocated to to be excellent. Even though my brother lived there, I probably made more trips to her facility than he did. But, when Mom had emergency transports to the hospital, he was always there to be by her side when she went into surgery or waited in the ER with her. If my brother had not been in that city, I don’t know that I would have moved her closer to me, though, because the facilities where I live are very poor compared to what she had to choose from her new city.</p>
<p>I think you can watch it online at pbs.org. I did watch it last night and took a couple of things away from it. The show focused on several families and their experiences with some ALFs operated by Emeritus. </p>
<p>I was surprised by the lack of regulatory controls on these facilities. I think that will change as more and more of these facilities are built to accommodate the baby boom generation. At least, I hope so.</p>
<p>Emeritus was portrayed as more interested in their profit margins than in their residents well being. I was really shocked at the residents that stayed there even though they were bedridden and obviously needed skilled nursing care. If I am ever searching for this type of facility for my parents, one thing I’ll be sure to look at is the level of independence exhibited by the residents. Emeritus wanted to hold on to these residents as long as possible, whether they were well suited for their facility or not, to keep the beds full.</p>
<p>Another area of concern was the level of staffing and the training they were required to have by Emeritus. One higher level corporate employee was fired after questioning the staff to resident ratios. </p>
<p>Their memory care staff were lax in a couple of the cases shown. The lack of supervision and security was shameful. And these people were paying extra for supposed extra supervision. </p>
<p>Even residents who had family visiting them frequently suffered. It made me wonder if we, as a society, are so frightened of the prospect of having a parent enter a nursing home, that things at an ALF that aren’t right are overlooked or rationalized to avoid the nursing home experience.</p>
<p>This episode is based on complaints filed for 2009. It’s possible that Emeritus’ practices have been rectified since the episode was shot. </p>
<p>I truly respect the advice and opinions that all of you caregivers have posted on this thread. In fact, I’m in awe of the patience and courage that so many of you have shared here. I hope that I won’t need to consider moving my parents into a facility, but you never know what twist life will bring. The wisdom shared here is invaluable.</p>
<p>So, my dad finally got hearing aids. I’m hoping Mom will soon, since 75% of their frequent arguments are due to not hearing what the other person said…
Unfortunately it has made Dad very sensitive to certain sounds and he now speaks even softer than before. Believe me, volume was <em>not</em> a problem for him when I was growing up! Had a stroke at 76 and now at 83 his voice is very weak ( not his body - he spent last weekend digging out a hillside of invasive ivy). He was a smoker from 16 to 45, and there may be some COPD that they aren’t telling me about. Does Medicare cover respiratory therapy to increase lung volume/voice volume?</p>
<p>I have not watched the PBS special, but I had my mother in a for-profit Assisted Living Facility for the last 3 years. They were licensed by the state, but not at the same level as skilled nursing facilities or hospitals. For the most part, the experience was very positive as long as I was the (friendly) squeaky wheel and stayed on top of her needs. I did pay progressively more for additional assistance, but this allowed her to remain at this level of care longer. There were monthly updates on her care which was the first clue that a higher level of care was needed. The aides who provided her care as well as the nurses who passed her meds were very invested in and attached to her. I could have kept her there for the higher level of care but opted to move her to a nursing home which has skilled care and Medicaid beds in case she outlives her resources. I’m sure there are many ALFs which are not this good, but they do exist, and this one was a lifesaver in my situation, as it was no longer safe for her to remain at home. As in many nursing homes, the aides’ pay at ALFs is low; the people who do these jobs well truly have a calling to serve others.</p>
<p>Congratulations, dragonmom! We have never been able to get any of our loved ones to consider hearing aids, but we think it would improve their quality of life. It only helps if they WEAR them, which mom gleefully pointed out in continuing to refuse them.</p>
<p>I’d ask your parent’s doc about whether your dad may have COPD and/or whether he may benefit from pulmonary rehabilitation and/or lung volume/voice volume. Medicare DOES reimburse when docs order pulmonary rehab for appropriate patients, including those with COPD.</p>
<p>My dad wears hearing aids… but a few days ago he got on the phone with someone from an offshore help desk with a heavy accent. Trying to fix the TV/cable setup at his house which only he deals with, I am sure he would not allow me to make the call for him. I guess it was almost comical, but also excruciating to listen on my end for almost 45 minutes… they definitely were not understanding each other! Dad couldn’t hear very well AND I think the help desk person had a strong accent. In the end the cable company agreed to send someone out to look at it in person. I did tell dad that asking to speak to someone in the US if he is having trouble understanding works with some companies. Not sure he will remember to do it next time, though.</p>
<p>HImom, thanks, I was hoping you would chime in.<br>
What has me biting my tongue is Mom needed them first but Dad just wandered down to Costco and spent $3000. Typical of their generation.<br>
I will bring up the idea now that I know Medicare would cover with the right diagnosis. My parents won’t consider care that isn’t covered… I keep telling them that these are the years they saved for but no - if I looks like Medicare won’t cover it Mom just refuses to go any farther. She got great in-home PT twice a week for 5 weeks after recent hip replacement but needs further guidance about how much to do and excercise…nope, just worries that she doesn’t know what to do, won’t call and ask for PT that may be self-pay.
Wow, this thread helps just to vent.</p>
<p>The importance of “the talk”</p>
<p>Finances are very important for older adults, and almost all of us will outlive our resources. Assisted living, nursing homes and related care are not covered by any insurance, including Medicare. So “spend down assets” is an almost universal experience, but one our parents are almost universally unwilling to talk about.</p>
<p>The importance of “THE FINANCES TALK” - Just do it - when they turn 65 and can remember and are of sound mind. It should be as routine as the “sweet 16” party. </p>
<p>Once they get significantly demented they are unable to legally decide or sign anything and you will need expensive attorneys, guardianships and courts. In between sound mind and documented dementia financial ruin is one bad day away, and con men know this and prey on older adults unmercifully.</p>
<p>Say your friend is going under paying for her mother’s care and you want to avoid that happening in your family. Open up the subject and hound them unmercifully if needed until you get them to reveal their finances. If you do not, you will pay the price with the potential of many years of unnecessary misery to them and you, because frankly you will not let them stand out in the cold starving and shivering. You will pick up the pieces.</p>
<p>Perhaps get an elder care attorney involved from the start. You NEED TO KNOW assets, any form of investments, social security amounts, health insurance and funeral insurance, and have a signed health care and financial power of attorney. Assets cannot be transferred at less than market value for 5 years prior to seeking any government assistance, or the amount must be repaid in full. Try to get an agreement to set up a comfortable monthly living amount they come up with, and put the rest of their savings in a secure easily identified location you must access jointly to use.</p>
<p>I speak from painful experience. I did not have “the talk” soon enough - my mother was a very private, controlling person and told NO ONE anything, and did not share that she had lost control of her finances and erratically cashed in accounts. She has now lost, given away and forgotten most of her very substantial savings and investments. We have spent 3 years trying very hard to find what is left. I can describe how one does that - not easy even with a power of attorney and stalker personality.</p>
<p>She is now my financial burden, and this truly could have been avoided with planning and open communication. Very frustrating.</p>
<p>We convinced mom to do PT because we told her she has paid for it all these years and we were SURE Medicare would pay for it. We told her it’s like a personal trainer that others have to pay $100 per hour or more. Mom has done 7 of her 8 sessions. It’s helped a bit, but she has bad habits that are tough to break that slow her down. She’s doing A LOT better than many there, but not was much as she COULD. The PT doesn’t want to push her & figures that mom does well for someone who is over 80 (she is, but at least she should know what to strive for).</p>
<p>Medicare WILL cover PT if the doc orders it and the PT writes a plan after evaluating the patient, showing that the patient needs more and what the plan is to improve the patient further. Many folks are able to regain a LOT of strength and mobility after hip and knee surgery, IF they are diligent about exercising and doing the PT. PT is worth very little with balky patients, so the patient has to embrace it, ideally.</p>
<p>Respiratory therapists can be very helpful as well, especially in helping educate patients on how to stay healthy with a respiratory condition and helping customize their activities to work WITH any breathing limitations they may have. The tendency is to HOLD one’s breath when exerting, when you SHOULD exhale NOT hold your breath!</p>
<p>Hearing aids - if your parent is eligible for VA benefits, the VA provides excellent hearing aids free of charge or for a low copay.</p>
<p>Yes, my dad gets his hearing aids (and medications) thru the VA. Regarding PT, my mom is actually doing better physically after her stroke than she was in the months leading up to it. She had some foot pain (too many years of high heels!) that kept her from getting much exercise. But the stroke took her off of her feet mostly for almost a month. Then after a considerable amount of PT, she is getting around better (walking) than she did before the stroke. Of course there are other impacts from the stroke (aphasia mostly) that aren’t good. But the PT is really helping. And so far Medicare and their Medigap insurance is covering it. She complained about doing it when I was last there, but if reminded she was doing it. </p>
<p>And… my dad (who is usually Mr. Organized) has no documentation at all on the supplemental policy they have. He has a brochure that shows three options from when they purchased it, but the options don’t show really detailed coverage AND he doesn’t know which of the three options he has. His card doesn’t show it, either. He has had this insurance for years, so I am kind of surprised that he doesn’t have the info – normally he would whip out a file and have it there. We tried to call BCBS I was there but it was a holiday for them (day after fourth of July, Friday) and no one answered. I left him a short list (2 questions) to ask them to try to get them to mail or give a web address for details on his coverage. He called, they said they would mail, but nothing has arrived yet… so we really have no idea what their supplemental coverage is. At least they have something, but we need to know exactly what it is supposed to cover.</p>