My DH is now in the mid stages of AD and I am wondering if I should start checking out a couple of places near here. He is still mobile and can take care of his bathing etc. and is not incontinent. I know that you don't have to take a place if your name comes up but I just don't know when the time is right to start checking. Any and all advice will be appreciated.
Jean as soon as you think you should it is almost too late. Yes-start now. I thought I started looking much too early and by the time my husband needed to be placed he spiralled down so rapidly my first choice was already not good enough.
A little research into what's available now wouldn't hurt. You don't have to put him on a waiting list until you're ready - unless you spot one you really like, and it has a year-waiting list. There are no guarantees, and the research takes a while, but a little at a time will give you some idea of what you want for your husband. Hindsight tells me now that the most important thing for me was good nursing care for my husband, which meant a good person(s) in charge.
Thanks Folks, I will try to set some time aside next week to check out a couple of places. I can't let DH know yet because like most LO's he thinks he is doing okay. Of course he can't remember a thing for longer than 15 seconds. LOL He has said in the past if he gets bad to place him somewhere. Saying it and accepting it when the time comes are two different things.
Jean, If possible take a close friend or relative with you. While the decision is yours, it dosen't hurt to have a second set of eyes and ears taking it all in.My dil went with me several times and we compared impressions after. She picked upon some things I missed. While I spoke with the director she observed how the staff interacted with the residents. She saw an aide being cross with a resident because she had to change her bed again. I would have missed that. Needless to say , that facility was crossed off the list. One thing I think is important is the staff to resident ratio. Most states have a mandated minimum but some facilities willingly hire more staff than required. Good luck to you. cs
cs, We don't have any relatives here or anywhere close. DH's sister is in an ALF in Ohio, my relatives are in Scotland and England. We never had children so there are no in-laws. I am not good at asking people for help so I will do the next best thing and ask our Pastor for his opinion. Lord knows he visits everything and everyone around here! Our church is large so there are a lot of older people who's health isn't the best. I'm sure he will have formed some opinions on the ALF's/NH's. Thanks for the suggestion.
The pastor sounds like a good person to ask. He will probably have visited many facilities and formed some opinions. Thanks, Jean, for reminding me of this issue. Although it is much too soon, I do want to get out to see the facilities in my area, starting with those closest to home. It should be an interesting experience.
Teaching hospitals, and those attached to Universities, can provide good nursing care and are a route I would recommend. If you want to e-mail privately, I can give you the name of a company I would not recommend. They own over 200 Private Care Facilities in the States and Canada I found their nursing care of my husband to be substandard.
Jean, I was able to keep DH at home til the end, but I did make use of NH for respite through hospice the last year. I checked out a lot of NH and found for us that the smaller homes worked best. I used a couple of larger ones and although they looked great, they just didn't have the help or the time to provide the more individual attention an AD patient requires. There are good NH, but you need to look at the care and not just at the modern buildings. When checking ask how much training they have working with AD and ask about the turnover of the help. The best ones I found had people working there for 10-15 years.
I don't know how it is anywhere else, but when we finally decided to place Andrea, we started looking around, and found out that most good places have waiting lists of weeks to months. If you are going to wait until you are at the end of your rope, and THEN start looking, you will be in deep doo doo.
Advantages to looking early:
You can get on waiting lists, and not stress over it. This one guy we met placed his wife on the waiting list way before she needed it. When they would call him, he would decline, but his name stayed at the top. He knew that when he decided to place her, her name would be at the top ready to go. pretty clever.
You will be looking while you are NOT traumatized. My son and daughter were frantic, and trying to see as many places as soon as possible, and it was overwhelming. Seeing one place a week is easier. Also not being frantic is helpful. Desperation changes everything.
You may need certain paperworks before you enter. Learning about this ahead of time will allow you to be that step ahead of the game as well. Some copies of things requires weeks to get back.
Always, always, ALWAYS find some place with a lot of middle aged to older people and start asking about NH in the area. Word of mouth is a million times better than any report, and even a visit. You will find out plenty from people...everyone is happy to tell about a good OR bad place.
Jean, I have been putting this off but need to start looking myself esp. since we're still fairly new to this area and don't know a thing about what is available but it's almost certain it will require at least a 45 min trip. I hope you'll keep us posted on your progress.
terry, I was planning on starting looking today but like all good plans it didn't happen. Not sure if I will make it this week but for sure next week to at least one place. You can usually find what is in your area by Googling Assisted Living and adding your zip code.
UPDATE. I stopped at a NH this morning and checked out a couple of things. A semi-private room is $5,000.00...Private is $5,000.500. Laundry is $1.00 a day extra and there are other extra's but I didn't go into detail. The lady did say if you had Long term Care insurance that they would need the information 6 months before.
Our Pastor is in Israel with a church group so I couldn't speak with him. I spoke with our assistant Pastor and his mother is in a nursing home not too far from here. She has AD and he said he checked everything around here and that this place was the cheapest, less than $5,000.00 a month. I am going to see if I can bring it up on the internet.
Now you know why we say see an elder law attorney so you can figure out how to stretch the money as far as possible. In RI, it's closer to $7000/month. When it's a mother or father alone, there's not too much problem spending down their savings, selling their house and using the proceeds, etc - but a lot of us here are several years younger than our spouses, and we have to continue to live on SOMEthing. If you plan, you can most likely survive on what Medicaid will allow you, but you got to plan. Good that you're doing it now.
I think it is absolutely highway robbery the prices they charge and then charge extra to do their laundry. What is the $5000 for? I remember when my sister put her husband in a NH for a month of respite, it cost her $6,000 plus she had to arrange for a hospital bed if she wanted one - they only furnish a flat cot. He stayed a week when it was discovered they would not get him out of bed, even to eat or change his wet bedding, unless he asked which he would not. This was a nice looking, pretty new facility that had lots of help walking around. Next thing you know they will be charging for meals so the owners of the facility can have bigger profits!
What an opposite when she put him into the VA NH for two weeks respite. They had him up first thing in the morning, out to the dining hall to eat meals and interact, would put them in bed for an afternoon nap, then up again for dinner.
This weekend I went to Houston and visited the SILVERADO facility. Each of our two daughters live within about 20 minutes of this location. It was nearly too good to be true. I wonder if any of you 'out there' are familiar with this company. I was very impressed. My daughters were with me and they feel very good about it being the PERFECT place for their dad.
Only one drawback for me was when the lady conducting our tour and then discussing details..suggested that I think about what would PREVENT ME FROM PLACING HIM THAT VERY DAY.. I nearly choked.. Truth is I"M NOT READYyyy..ducks are not in a row. I'm a dawdler..no fast action here. Its 2.5 hours from our home..yada yada. BUT because thus far, it seems to be the best place, I did put down a deposit and felt terrible.. still do. We may never use it.. I may decide I just can't go that far. But if necessary and worst comes to worst..I suppose there IS a place or could be a place if needed. Seriously, if anyone has experiences with any of the Silverado's 'out there'.( I think there are some in California and other places).. I'd really appreciate hearing from someone who knows if this really is as good as they claim.
Judy, there should be the latest inspection report available at the facility for you to read. You can also check your state's department of aging's website and see inspection reports of various facilities.
Also, one thing I did when checking out facilities was to go there unannounced and ask for a tour....sometimes that is more revealing than a set appointment. Try to go at mealtimes and see how that goes or in the middle of the afternoon to see what is going on.
I hope it is everything that you hope it is and I also hope you never need their services.
I live off of Cypresswood and know the Silverado on Cypresswood extremely well. Along with about six of their employees (former). They have a high turnover. The marketing people work on commission and if they don't make quotas, they're replaced. I know two former marketing directors there. They do ASK for the sale. Silverado Hospice turned my husband down flat!..said he wasn't nearly ready for Hoospice. Five weeks later, he died. (We went with Lighthouse Hospice out of Tomball) Two of my former caregiver group people had wives there. One complained that he had to take Ensure and Ice Cream Milkshakes to his wife because she lost so much weight. No one would feed her if he wasn't there. Also, he was very upset because she was always in a wet diaper when he'd get there, but they'd swear they just checked her!...He questioned that. They have several wings, based on level of care they need, but are known to put moderately severe patients with severe patients just to fill the rooms. This is a PERSONAL experience...they wanted to place my husband in with a screamer who was very very severe A.D. I backed out after that experience and kept caring for him in my home. It is the MOST expensive facility in Houston area, the doctors like it, ..and I'd say it was in my top 3. But not No. 1. Number One, by far and above, would be The Barton House in SugarLand. Exceptional!...Beyond all expectations. We all need to remember that the Marketing people are salespeople. They never work with the patients, the aides do. One thing for sure, all agreed that the residents who have the most visitors are the best taken care of. No place is perfect, - we always have to remain involved and drop in unexpectedly. Oh, I forgot to mention, the other man in our group mved his wife to another facility he liked next to the hospital in Tomball. He claimed she got excellent care there. I do not know the name of that facility. Be sure to watch Silverado for "add on fees". They have lots of them...over and beyond their quoted monthly rate.
Oh THANK YOU, NancyB!! I'm so glad someone KNOWS more about the real doings there. No wonder there is such an intense effort to have me place him immediately. The 'model' room, so elaborately decorated, just dazzled my daughters. I looked into a REAL room when they were busy doing something else. I called to ask some more questions yesterday..and kept being told..its TIME..Just bring him down..Why not This weekend? It IS expensive. The dilemma for me has been to try to do what is BEST for DH and this place seemed to have EVERYTHING ..the environment is great...the willingness of the activity person do engage DH in things he liked to do..outside etc. just sounded 'too good to be true'.. The residents I saw were NOT sitting around 'waiting'..as I've seen in nearly every other place I've visited. I really appreciate your comments, Nancy, and will ask my daughters if they can check into the other places you mention. Did you ever use their respite or day program services?
I am only familiar with Florida and Rhode Island, because I live in Florida, and spent years finding different nursing homes for my MIL in Rhode Island. My RI family is in the process now of moving our parents to a different place.
Here in Florida, there are HUGE companies that own facilities all over the country. We have everything from people who turn their homes into care facilities to basic nursing facilities to "cluster facilities" that have Independent Living, Assisted Living, and Nursing Homes all on the same "campus", so to speak. We have places that look like basic hospitals to places that look like 5 star hotels.
NancyB is sooooo correct about the marketing people. Their job is to fill beds and apartments. Period.
As Sandi said, definitely, definitely check the State's website to see the facility's rating. Check with people (if you know any), who have had relatives in that facility.
One thing I can tell you for sure, is that you can usually get a good "feel" for a place by looking at the residents. I checked out one place for my MIL - as soon as I walked in, it smelled of urine. The residents were not particularly clean, and were just sitting around in wheelchairs. The next place I went, the residents were immaculate, dressed as if they were going to a country club luncheon, and were being entertained by a musical group in an area that looked like a hotel lounge. Needless to say, that place cost a fortune.
I know of others who have husbands in the small private homes - maybe 6 residents. Not a lot of fancy activities, but excellent care.
It's important to remember that as our AD Spouses progress in the disease, they will NOT be able to play ping pong, dance, enjoy concerts, etc. What's more vital to them is comfort, nourishment, personal hygiene, and gentle caring people who look them in the eyes when talking to them. The age old saying, "Crystal chandeliers do not benefit the patients" is so true. The marketing people know to show US activities WE would enjoy. I recall visiting one facility in Austin, Tx..where an aide was sitting on a stool next to a woman in the living room. The aide was rubbing hand lotion on her hands and forearms. The most loving expression of caring I had seen. That woman was not able to enjoy games or entertainers, but I can only imagine she was enjoying the touching and comfort the gentle woman was providing to her. That's the attention our dear loved ones need and deserve.
Even though there is a salon where my husband is the aides often give the ladies manicures. I think the aides enjoy doing it as much as the ladies enjoy a change of color.
When my husband was in the mid stages of Alzheimer's, I started looking on the side for assisted living facilities. Once I found some that I thought were acceptable, I talked to my husband about planning for the future and what we should do in a 'worse case situation'. Both his parents had Alzheimer's so he was aware of what they went through. He attended a presentation with me on 'how you know when it is time for assisted living' as well. We made our decisions together early on. As he progressed, he thought I was trying to have him killed every time I brought him to the ALF. Now it is his full time home and he is getting wonderful care 24 hours a day.
I don't know if it's on the state inspection report, but you need to find out what the staffing to patient ratio is. But here's something we just found out--my Dad is in an ALF owned by Emeritus. He's been there about 2 years and it is working out fine, but he's had a number of falls. I mentioned that they always occur on the weekend to a friend--she is a geriatric nurse. She told me that the weekend and holiday staffing level at all facilities is "bare bones". This is something I would definitely ask about when looking for a facility. We have now hired a private aide to be with my Dad on the weekend mornings, and this aide told me that overnight on the weekend, there is only one facility staff person for the entire floor. Not good!
Charlotte, I agree with you about the prices of nursing homes. In Florida, John was being charged 10,000 a month. He didn't take part in any activities, eat at the dining room, ever come out of his room. And the place wasn't a palace. Just average. Here, the average price is between 5,000 and 6,000 a month.....plus laundry and medications, doctors visits, etc. He's now qualified for Medicaid (or so I believe, as my lawyer says so). Don't know how that works, like what am I responsible for now, financially....and how do I pay for it as John has left me with nothing. As for the nursing home, I didnt really have a choice of where he would go. He went to the hospital to the NH, as they said it was unsafe for him at home and he needed around the clock care. They gave me three choices. I chose the one where he is at because I had heard bad things about two of the facilities (one of which I was a patient at this year....ick). I'm pleased with where he is now. He's getting very good care as far as I can witness.