I am now faced with the painful dilemna of "placing" my DH. I have visited several Assisted Living Facilities in the area. The newer ones are like Resort Hotels...beautiful dining rooms, wonderfully appointed rooms, great media and activity rooms and all have a dedicated Alzheimer's area. They usually have around 15 to 20 Alzheimer's patients at a time. And I have visited several Board and Care homes as well. Nice homes that have been remodeled to accommodate people with disabilities and they also provide dementia care to no more than 5 to 6 people at a time. There are several in my neighborhood. So here is my question...who gives the better care? I have found in my support group, good and bad experiences with both. So I am confused. I have an in home care giver who only comes in the evenings to help me put my DH to bed. But even with that it is becoming increasingly difficult for me to care for him. This @##$% disease is an ongoing challenge. Just when you have something figured out, BAM, something else comes along and throws everything off balance. I am learning on the fly. When this is over, I will be an expert but who cares??? I have lost my lover, my best friend, my partner, my confidant and what was to be the best years of our life together. When I retired (finally) we were going to travel, play golf, visit friends and family, etc. Then he was diagnosed six months later. We managed to squeeze in a little time but it has progressed too quickly in the past six years.
I would think the facility that has the lowest ratio of employees to those they have to care for. I also think it depends at what stage we are talking about. Once they reach the point of having to be on meds and zonked out, where they do not know or care what is going on, perhaps it does not matter. If they are alert and are still in the here and now, they require more care, as they get worried when their needs are not being met, and they are dependant on someone else to do every task. That is where my DW is now and I know that no place could give her the level of care she is getting at home. I have help 5 hours every day and I am still tired and getting worn out. Sleeping thru the night is the biggest issue and getting her in and out of bed 3 - 4 times per night to go to the bathroom is getting old. Getting her in bed is the biggest issue, she gets out almost on her own. Getting her to move her body to the middle of the nursing bed is the biggest task.
As you said - you have heard good and bad. My mother was put into a foster home (that is what they are called here). My sister checked it out and thought it would be good. Turned out instead of helping her to eat they fed her cause they didn't want to clean up the mess. When my sister checked it out they had the women out in one room with a TV during the day. We found they left mom in the room all day in bed. She was in a nursing home in Redmond, WA that had a high ratio of patient to help but got excellent care. With my bil my sister put in him a foster home originally for 3 months. She needed the rest. She took over bananas and his cereal cause that he ate for breakfast. They never fed it to him - the 'foster parents' ate them. They were from Europe somewhere and thought the residents wanted fancy European foods when in truth they all were happy were 'meat and potatoes'. After a month, I think it cost her $6000, she brought him home.
So until you try, you really won't know unless you can get referrals from someone that used them. I guess a few unannounced visits might help. Again - you can research all you want but until you actually try them I don't think one can know. What is great for one person does not necessarily agree with someone else. Plus, if help turns over the dynamics can change.
If you copied and paste what Moorsb above said into this box it would fit my LO to a "T". I have also hired help to come in five hours a day Monday-Friday. Here we have a group called Granny Nannies and they are great. It is one on one in your home with your loved one and much less than placing would be I'm sure.
I also am beginning to consider placing my DH. We did not have long term ins. He was diagnosed at 52, I was 47. He is now 61. I shower him, cut his food, he is no longer able to carry on conversations,but still tells me he loves me. A month ago he scored 4 on the mini mental. Here's my deli a. I can't afford assisted living, so it means having him evaluated for the 2871b, if hie is approved for a nursing home I then apply for medical assistance. The problem is that his disability check will go with him, and I do not earn enough to keep our home and pay bills etc. I totally understand how hard it is making this decision we Ll have to make. Trying to stay focused to the task compared to the actuality of it happening is frightening. I am so fearful,
I have not seen you here before. Welcome to my website. You are both so young. Since your husband is so far into the disease, it probably won't help you much to read the Young Onset information on the home page - www.thealzheimerspouse.com.
I can so relate to the monetary situation. Unfortunately, the regulations for each State are different, but it is my understanding that they cannot take your husband's disability check (or at least not all of it) if you need it to keep a roof over your head. They do not throw the well spouses out on the street in most States.
If you check with your State agency for Medicaid, make sure you get the name of the person to whom you are speaking and document everything he/she says. I would also suggest calling the Alzheimer's Association in your area and ask to speak with a social worker if you do not already have one. They know the system and can give you advice on the Medicaid system.
moorsb--my husband's situation is different than what you described. He is late stage 6, in an ALF,and on a ton of meds. He does not really know where he is, but he is certainly not "zonked out". In his case, it takes a well-trained staff to get him to comply with care and to be alert to issues like weight loss from constant pacing, dehydration, etc. Bottom line, I think the type of facility and training and caliber of the staff vitally matters at every stage.
savadele--You're right, picking a facility for a dementia patient is difficult. I have no experience with board and care, since my husband's insurance requires an ALF. One thing I would look into is whether the board and care homes are regulated the same way by the State as the ALF. Do inspectors come in as freqently and look for violations? Also, I wonder what happens in a smaller place when, for example, several employees call in sick/quit? Do they have a large enough pool of employees for others to work extra hours until the problem is resolved?
Another issue is the quality of the medical care. Do Board and Care homes have doctors come in regularly? Where my husband lives, the geriatrician and his nurse practitioner visit several times a week; the psychiatrist comes once a week; a nurse is on duty at all times.
You can do a search and will probably find other threads where the selection process is discussed.
Yes, my situation is different. DW thinks she can walk, so she is contantly trying to get up and go do something. She has fallen many times, the right amount of meds keep her calm and relaxed and not zonked out.