Hey Everybody

I have a question regarding nursing homes. At what stage or point should an Alzheimer's victim be admitted to a nursing home? I mean, we all talk about the expenses. I have read in some areas that a nursing home for a dementia patient can run up and over $40K a year! Is this true?

Is there a website that breaks down the cost, what is inclusive on a daily basis?

But again, at what point is somebody ready for a nursing home? I still am having difficulties getting my brother to attend a caregiver's meeting so that he is abreast of what to anticipate late down the road.

Any comments are immensely appreciated. It's 430am, I couldn't sleep, forget reading and I've written in my journal. But this is a question that I cant seem to get an answer to. Maybe I'm not looking in the right place?

Help. Thanks
M

Dear Mary,
Not every AD/dementia patient goes to a nursing home. Many are cared for until the very end by their families, with or without the help of paid caregivers. I think people go to nursing homes if they are aggressive or their behaviors are otherwise too disruptive for the family to tolerate, and there are no other alternatives. Gremlin on the Caregiver's board posted a link for a nighttime AD daycare in New York that took care of patients who wandered all night, upsetting their households and keeping their families from sleeping and being able to go to work the next day.

Medicaid will pay for NH care if you don't have any assets. Otherwise the cost is $3,000 to $6,000/month or more.

Primetime on ABC had a show about a son who had no idea how his mother was suffering from AD. He neglected her although it was obvious that she could not care for herself. It became an abusive situation. Her sister finally took her in and the woman thrived from the personal attention. I'm concerned that other family members don't realize that the LO's decline is disease-related and not due to stubbornness. I think people like us (single) have to make our own preparations and arrangements for our futures.

This is a good topic and I'd like to know what preparations other single people have made for themselves.

Iris L.

Iris,
I haven't made any preparations because I don't have any money. I'm hoping my daughter and sister will care for me for a while and then I guess it's up to medicare/medicaid although currently I have too much for medicaid! Go figure?!

Not everyone who goes in a nursing home is aggressive or has behavior problems. My Mom is a sweetie, but we had to put my Mom in a NH because my 88 year old father was unable to safely care for her any longer. She started falling frequently.

We chose a NH because that's where, in our situation, Mom would get the best care.

There are ALFs, Group Homes, and other facilities that you should look into. Every situation is different.

The NH Mom is in is a non-profit and costs $300.00 per day.

Hope this helps just a little bit.

Good topic and a tough one emotionally and financially. Another question I have, in addition, to the nursing home question is Adult Day Care. Are there programs out there for younger onset dementia patients? When is the time to consider enrollment in an Adult Day Care program?

Having been on both sides of dementia I think what's best for the "patient" and what's best for the family don't always coincide. There are probably no good answers.

Financially, I'm probably better prepared then most as I do have Long-Term Care Coverage that would cover the cost of a nursing home, home care and adult day programs. Not that I was ever good with finances, just an opportunity that became available at work at a minimal cost and it made sense at the time based on my limited experience and being a cautious single, person (I was told by a couple financial planners, I was throwing my money away for an improbable risk....hmmm).

What is more difficult, I think, is what medicare covers and what it doesn't cover.

As Iris, pointed, out nursing home coverage is available for those who qualify under medicare.

Nursing homes may be a viable option, however, I wonder how many people with dementia are in nursing homes where there may be more suitable programs. Programs such as Adult Day Care or something similar they do in Australia such as pay the home caregivers and give the caregivers respite days.

Cindy

$300/day x 30 days = $9,000/month
It's worse than I thought.

Iris L.

Iris - I neglected to mention that our Medicare application is pending. My Dad is still living so it's a little complicated, but we've been working with an elder attorney for about a year now to save what we can for Dad and still allow Mom to get the help she needs. Medicaid only allows Mom to have $2,000 in assets so we have had to take her name off bank accounts, turn a life insurance policy over to a funeral home, prepay funeral expenses, etc.

As Cindy said Day Care programs are well worth looking into as well. We also had someone from Home Instead come into the home for a while before the NH placement. The cost varies from franchise to franchise but for 24 hour care it would be more than the $300 a day which covers meals, Depends, laundry, etc.

Cindy - It's my understanding that Medicare does not cover Activities of Daily Living. It only covers medical needs. Medicaid on the other hand does cover the ADL and will pay for NH if necessary. It's a long tiring process but I believe it will be worth it if approved. I've got my fingers crossed!

I wish you all the very best through this difficult process.

Messed up in the first line, meant to say our Medicaid application is pending - sorry

Speaking of Medicaid....

An attorney told me that getting on Medicaid was essential to help cover costs.

Problem is I don't remember the details on the qualifying part. Sounded complicated at the time and probably is complicated.

However, the problem is navigating the system and or systems out there. That's where some of my frustration lies...not knowing who to contact who knows the in and outs of all these various programs. They all seem to specialize, I'd like to find somebody who knows a bit about a lot of programs, you know, enough to be dangerous

Cindy, call the Alzheimer's Association hotline number 1-800-272-3900; they can answer some of your questions and point you in the right direction for the answers to your other questions. Also, call you local or county Agency for the Aging and tell them you are a disabled senior and you have questions. These two resources should start you on your way.

Also, start a project notebook. That's what I'm doing. There's so much information it's overwhelming, especially for us who already can't remember.

Iris L.

Iris.......but I'm not a senior, early 50. Well perhaps when I was about 10 years old I would have thought anyone my age was a senior but more likely even older like a dinosaur.

The project notebook is a great idea. Do you have any broad suggestions on categories that could be helpful? I need to somehow figure out how to track all this stuff electronically.

So far I have my calendars synched between my computer and phone. Also helps with pill reminders.

Cindy

Hi again, Cindy. What I have found is that there are resources available but we have to seek them out and then figure out how to use them. It's extra hard for us with cognitive difficulties.

One of the confusions is that the qualifying age for seniors varies. It can be 50, 55, 62, or 65. At age 50 I started calling places and saying, "I'm a disabled senior and I need such-and-such." Many programs I'm not eligible for now but at least I get some information I can use or a referral to another program.

The Disabled Resources Center near me has tutoring for the disabled on how to use the computer. Their programs are geared for the visually, hearing, or physically disabled population, not the cognitively disabled. Assistance in using the computer for the cognitively disabled would be a good project for the Alzheimer's Association or some other group to provide.

For now, I have papers scattered all over. I'm trying to organized them into notebooks and file folders and to get rid of duplicates.

Iris L.