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  1.  
    I am investigating ALF's and it looks like I may need to do this. I'd be interested in hearing from anyone who has done it and how it worked out.
  2.  
    I had to hire a private aid to be with my husband in the evening or the ALF wouldn't have kept him. Eventually with proper medication things eased up enough for me to no longer keep the aide. Very expensive proposition. Be very sure to know what behaviors the facility is equipped to cope with.
  3.  
    Re knowing what behaviors the facility is equipped to cope with: I have been told that generally, they will give you a sales pitch and say they can handle the patient. Then when he/she moves in, something happens (which they previously said they could handle) and they insist that the family hire an aide.
  4.  
    And-if they feel they "cannot meet the needs of the resident" you get a 30 day move out notice and usually don't get your up front money back.
    • CommentAuthordivvi*
    • CommentTimeAug 15th 2011 edited
     
    marilyn, i hate to say this i know you are desperate to find a good facility for younger spouses, but with all the issues you are dealing with DH's medication adjustments, i wonder that he wouldnt be better (and you) in a skilled facility aka lockdown unit. you may have to offset some of the more attractive buyins for his security and your stress levels. i would be very cautious of buying into the upfront comments that they can handle him and like bluedaze says at the least opportune time say they cant handle him. unless you have a LT insurance plan that could help cover the costs, hiring an extra aide can be so costly -
    you sure are doing a good job of investigative work prior for sure!
    divvi
  5.  
    Marylyninmd- My suggestion is that you go to the alf, enter the bathroom, put on an old granny nightgown, with slippers, dishevel your hair, remove your makeup, and wander up and down the halls....See how long it takes someone to notice that you are there....
    Even better, find a wheelchair, sit in it, and see how many people say hello...
    Wander in every nook and cranny that you are able to get into...you might be surprised that someone might try to get you back into your room...fake dementia..tell them you don;t remember who you are or where you are going....Tell them you stopped at Walmart to shop...I bet you can live there for free for at least 2-3 days.
  6.  
    Hi Divvi--the facility in question is an all-dementia secured unit ALF. They do have a geripsych floor as well (all dementia), but they feel it would be too noisy (overstimulating) for him. Just got off the phone with the social worker at the geripsych unit where he is now, and she is going to suggest that someone from the ALF come take a look at Steve. She feels like I do, that he is just not that hard to take care of. But she agrees that more medication shouldn't be the first thing they do to get cooperation for personal care issues. His LTC ins is enough for an ALF but because he got sick so soon after the policy was purchased, it would not be enough to cover the full cost of a NH (and he does not need any medical care that a NH could provide at this point). If you purchase the inflation protection, the amount the policy pays increases each year--however, in our case because it is EOAD, there wasn't enough time for it to increase fully. Clear as mud, huh?
    • CommentAuthordivvi*
    • CommentTimeAug 15th 2011
     
    oh yeah, clear as water. ugh. EOAD just gets so much harder to get things done. i understand it may not be enough. i sure hope you dont have to hire private. i know mary75 did that to oversee her DH care, and boy it cost her bigtime if i remember correctly.

    well thats excellent they have a geri floor there just in case.
    sounds like you are crossing alll the t's. good luck
    •  
      CommentAuthormary75*
    • CommentTimeAug 15th 2011
     
    Divvi's right, it cost $21,000.00 a month for care aides (for 2-3 months); that was in addition to the Nursing Care Home fee. Even then, I went in daily and worked my butt off to make sure he was getting his meds. etc. The Care Home staff didn't always answer the call light (in fact would turn it and the intercom off at the desk), and I would have to go flying down there to get the cortisone puffer when he was choking. I would find them sitting chatting to each other at the desk.
  7.  
    If anyone is interested, I am available as a 24 hr care aid, and I will do it for only $20,000 a month, provided that I have room and board, and a computer....heck that is only about 1/4 million a year...and I am experienced...and I will also make Venetian apricot chicken once a month....But hurry..I might book early and not be available until 2032.
    • CommentAuthorAdmin
    • CommentTimeAug 15th 2011
     
    $21,0000 a MONTH???????? Is that a typo? I know plenty of people who have lots and lots of money, but even they would go broke very quickly if they spent a quarter of a million a year on aides PLUS about $75,000 a year on a NH.

    joang
  8.  
    OK>>>>I just lowered my price....how about $15,000/month??? but I won;t cook the chicken..
    • CommentAuthorkathi37*
    • CommentTimeAug 15th 2011 edited
     
    Phranque...OT..do your share your chix recipe? Sounds as though it must be a winner :-)

    Marilyn, Garv had LTC ins. for 10 years before we used it, and they still wouldn't pay for the extra night time care needed. I had to come up with that. I am so happy to NOT have to deal with that ins. company again (until I need it).
    •  
      CommentAuthormary75*
    • CommentTimeAug 15th 2011
     
    No typo. That's 24 hours a day X 30 days.
  9.  
    Joan--Agencies around here charge about $20/hr--that would add up to close to $15,000 for a month of F/T care. That said, you don't see many private aides in dementia units in this area--you can see why!
    • CommentAuthorLFL
    • CommentTimeAug 15th 2011
     
    Marilyn, the aide we currently have at home previously worked in an alf as a supplemental aide because the alf wouldn't keep the client without it. If you were going to provide a private aide perhaps you could call a Home Health Care Agency (or the one you use now) and find out what they would charge for a 24/7 aide. Where I live and the agency I use now, it's $195.00/day it doesn't matter if it's in-home or at an alf. LTC will most likely not pay for the aide if they are paying for the ALF. In our case DH's LTC has a daily cap and a lifetime maximum on what they will pay. For in-home care they pay $112.50/day (daily cost is $195); daily rate they will pay for an alf or nh is $225/day. Once the lifetime max is met it's all private. We have a family friend who is a Geriatric Care Manager in the Boston area and she advises for the difficult dementia patients it is not uncommon that the ALF will tell the family they need to provide the aide because the facility cannot take care of them. I have well documented Rich's "elopment" from the alf I put him in on a temporary baisis in 2008. They refused to return my deposit and refused to take him back into the facility-sent him to psych hospital. Never received anything in writing advising of the 30 day move out notice. As you know I am looking into facilities for Rich in the future...they are all unspecific regarding what behaviors they can/cannot handle. But thanks to your previous post, I asked alot of the questions/issues you raised when placing a LO. It helped in many ways but when it comes to managing/dealing with behaviors they are mostly non-specific. We too are caught in the EOAD money trap. Let me know if there's anything I can do to help.
  10.  
    LFL--still searching for an ALF; I would not hire a F/T aide to supplement, just considering the minimum # of hrs to handle personal care, only if necessary. If I need to hire 24/7, might as well do what you are doing--why pay double? Thanks for the info.