Nursing home vs. assisted living - Alzheimer's Disease & Dementia Message Board

marypar · 07-28-2005, 06:34 AM

Hi, it's me again.
I was thinking, if mom will need care as alz progresses, wouldn't it be wiser to have her live in assisted living and use her savings for that since it is about half the cost, then when money runs out, she will have to go on medicaid and go into nursing home. I don't understand why anyone with money in bank would put someone directly in nursing home when assisted living facilities care for alz patients, charge half of what nursing home costs, and is very dignified living. Am I right in this thinking? thanks again
maryann (again)

Martha H · 07-28-2005, 08:55 AM

Maryann, my understanding is that assisted living is for fairly independent, early stage patients. Once they get to a stage where they can't really think for themselves, they need more intense care than that. By the time we even noticed that Mom had dementia, it was already too late for a place where she would only get a minimum of assistance. I am not sure if these places are the same in different states/countries. Maybe someone out there knows exactly what the difference is between assisted living and full care?

Thanks.

Martha

Twinlynn · 07-28-2005, 09:05 AM

Hi Maryann,

(I'm Lynn. I post when I can. My Mom died 6 years ago from heart disease, but the real disease--the one that took her mind--was the onslaught of TIAs (tiny strokes causing dementia).

Although we were able to keep my Mom at home (we got her a separate apt in our apt building and got two aides), we did look into assisted living first. I never inquired about nursing home expenses, as she was pretty much able to manage, as long as there was assistance.

Here in my NYC neighborhood, there's a very lovely old hotel that was turned into a combined assisted living/nursing home. The architects managed to fully convert the building, yet still retain the striking 1920's "grandeur" of the lobby and old ballroom (now the residents' dining hall). I spoke with some of the residents and all seemed extremely happy there (well....as happy as you CAN be, when you suddenly need Assisted Living!!)

At the time, the cost for a room for my Mom in the Assisted Living section would have been $4,000 a month. So...you have found that the nursing homes are double this?

What we liked about the place was the fact that Mom could take advantage of the assisted living section (which involved trips to concerts, theater, etc) while she was able to. But, if she got worse, she could move to the nursing section (same building) and still have the same familiar environment. I think that Assisted Living homes that have this "switch-over" are real life-savers. They prevent the constant worry of that dreaded phone call from the building administrators, telling you it's time to find your mother a new place.....one that runs 24/7.

From my few visits to nursing homes here in New York (I did volunteer work in one), I decided that the move from our old family house into an assisted living situation would have been far less "shocking" for my Mom, who was still very much "with it", in many ways. And, with Mom's TIAs, there was no real timing anyone could give us on how long she might stay at each descending level. (Whatever the type of dementia--they all leave us carers in limbo. You just cannot "plan or plot" this illness.There is no way to time the decline.)

At any rate, it turned out that we got that apt. in our own building for Mom...so we never needed to make a choice. But, my own feeling is that my Mom would have done 100 percent better in Assisted Living--she was such an independent person. (SO independent, that, once she was in her new apt...our doorbells often rang. You'd open your door...and there would stand one of her aides...to say that my mother had insisted that she was just fine,and that, say, Sabrina should "go on home now, so you can enjoy being with your two children.!!!" LOL! And, Mom was so convincing that, in the beginning, they would both allow themselves to be escorted out!!!

Have you visited some Assisted Living places, yet? The location---how far away from your own home--will aso make such a difference, depending on how often you will visit. We wanted to be close enough so that if Mom phoned, feeling mentally or physically unstable in any way, we could just get a cab and go to her.

(The Medicare/Medicaid situation is insane, isn't it--being forced to spend down to poverty level. It cost such a huge amount just to keep Mom in this new apt (with aides) that in a couple of years we realized that we had had to spend half of her life savings. I'm so glad she was not aware enough by that time to see how she and my Dad's money had to be spent. And I was soooo glad that she'd taken her wonderful trip to China, just before she got ill!)

I feel so much empathy with everyone on this board going through all these similar situations. I remember not knowing WHERE to turn and having to do so much extensive research that I should have been awarded a Ph.D.! (...the "D' standing for "Dementia"!!!) Yes....extracting each bit of information I needed along the way was like falling down that "White Rabbit's hole straight into the world of "Jabberwocky"!!! Aaarrrggghhh!

I'm sure others here will have more specific info to answer your question. A lot has changed since the '90s, when I first wandered through the maze. Wish I could help you out more.

take care...and hello to those who know me (and to those who don't!)! Lynn :-)

marypar · 07-28-2005, 09:30 AM

Hi Lynn
I actually live in Rego park in NY and work in NYC. My close friend checked out Sterling Glen Assisted Living which is right near my apt. (it's in Kew Gardens) and said it is unbelieveable. They are right by the Grand Central Parkway and my plan would be to take mom out of the Assisted Living and bring her to her house in Mineola NY on the weekends. This would be down the road since my dad is still doing okay (at 89) and she is in early stage - so I am just gathering information. Can you tell me the name of the place in NYC you were talking about? Maybe I can get the information if I need it in the future. This situation is causing such stress in my life - I worry about things that didn't even happen yet, and the different ways I can handle them, and the scenarios play in my mind over and over and I get more distressed. It's hard not to do this, but I am trying. I live in a small apartment with hubby in Rego Park; parents in mineola, we visit every Saturday and I help with laundry and shopping. Nursing homes are a big rip off and it is very annoying to think of the cost. I also feel that a live-in is very expensive (about $3200 a month) and that would not be a nurse (believe it or not a nurse $50 an hour, yes $50 an hour). I don't know how she would react if dad goes first; that moment will change my life forever. I hope I don't just fall apart. I have two brothers who live near my parents and I hope they do more than they are doing now in the future.
thanks for listening, and I would love the name of that residence in NYC>
maryann

CARAT414 · 07-28-2005, 10:17 AM

Maryann,

Here in NV they have several different types of assisted living homes, residential senior homes, and then full nursing assistance homes. It would depend on the level that your family member was at as to where they would be accepted. We have several alzheimers facilities that patients with dementia from the first stages that only effect small parts of their daily routine and life to the extreme end of the "imposter" stage. A few can handle the full range such as the one that Twinlynn mentioned that is in NY.
My mothers physical ailments that were causing the dementia would have caused her to be placed in one area, and my father with the alzheimers memory and retention issues only would have him placed in a separate building. They had been married for over 50 years and never apart once my dad came home from the military, I was not about to tell them they cant be together in the end so moved them both in with me and this is where they both died.
Different states and even cities handle the elderly issues differently... You will need to see what facilities are in your area, but what I did discover here in NV when I was looking into the situation that medicare will only pay a portion of any facility depending on the amount of assets the person has, and they go back sometimes 2-3 years and question transactions. Medicaid will not pay if the person owns any property or has income beyond their actual required financial obligations. So basically you have to be homeless and pennyless to get medicaid, oh and the fact that my father gave 23 years of his life to the protection of this country, fought in three wars, and received the purple heart did not help him in this. It actually did more harm because he qualified for the assisting living facility that is 2 hours away from our home, but moms condition was to severe and she did not qualify for that home but did qualify for a home that was government approved 3 hours in the opposite direction from my house. So basically it would take me 7-8 hours to get one or the other to each other when the time came for them to say good-bye. Oh and if that was not enough the real kicker that had me storming one day is that medicare and medicaid accepting facilities here in NV require that you fill out an application, and then you will be notified if the person is accepted. One place actually said that they require that you are on the waiting list for at least 3 months and they also required documentation supporting the illness and care that would be needed. My moms illness was a rollercoaster ride and they wanted me to tell them what type of care she was going to need three months in advance? Heck I couldn't have told you what was going to happen with in the next hour concerning her health.

I wish you luck and the strength to restrain from choking anyone from frustration. It frightened me enough that at 40 years of age and in perfect health, to sit my teenage children down with me and my husband and explained our wishes, and we even made arrangements that all our entire life's savings wasn't spent on our decline. It is sad to think that is only seems to get worse.

And hello to you also Lynn :-)

C