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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
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By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
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First step is to figure out what YOU want him to do. Do you want him moving in? That includes all the "stuff" that goes with it. He is declining. How long can you care for him? At what point will you say.."I can't do that or I won't do that"? When he reaches that point he will then have to transition to Assisted Living, or Memory Care. That could be in 6 months or 12, 18 you never know. If he is willing to move to Assisted Living that might be a good option. He will have a community of people that he can relate to. And if needed a move to Memory Care would be smoother. You mention that he is in Independent Living now I would think the transition to Assisted would be very easy for him. If you are traveling a few days a week would he manage on his own or would he need help? Will HE hire caregivers to come in while you are gone and also to help relieve you of some of the care that he needs?
WIth you traveling often IMHO I think having him at home will create more problems and stress than if he were in a community with peers and lots of help, as Grandma1954 mentioned. In your home you will be managing aid schedules and problem-solving on the fly during your work day. When my MIL went into AL she needed LTC in less than a year. Everyone's journey in decline is different but just saying you may go through a lot of effort just to do it all over again within a few months. As a working person myself, I'm sensitive to this issue. Does his current IL residence not have a continuum of care living and care arrangements? Before committing to have him in your home please read some of the thousands of desperate posts made by well-meaning and generous adult children who could never have known what in-home giving would wind up being as they suffer from burn out and depression. Whichever you do, just go into it with YOUR eyes fully open. I wish you all the best!
Start by doing a Google search of ALs in your area. Ours is presently offering a bonus for residents who will sign up during the present Covid restrictions.
Ours also has a lovely Memory Care unit AND a second equally handsome Skilled Nursing building, so facilities are available if care needs increase.
Sites closer to caregivers are nice because it’s easy (and hopefully, fun) to visit according to your schedule.
As you can tell, I LOVE my family member’s residence!
First decision is the basic one. Do you wish to do at least a decade of 24/7 care for an elder? For me that decision was a known and a given in my own mind all my life. If this is as easy a decision for you, then this part is done already. If not you must consider how willing you are to basically give up your own lives, renovate your home, and should be discussed with all family members, all having to be on board. This is an all or none decision. There would have to be a lot of home renovations for Safety over time, and for mobility. So first discussions start in home, without your Dad present. Once that basic hurdle is over it is time for A) Frank discussion with Dad, re paperwork he has done or should do, wills, POAs, Advanced directives. Re his wishes for any end of life care if he is unable to make his own decisions. And of assets available Monthly for Dad's care. B) Discussion with Dad re options of Independent living (likely unwise at this late date) , ALF, Board and Care (more family like and smaller but often fewer activities organized or availability of friends). C) helping Dad make a decision for himself. You may want to start discussions now, but visits to sites may have to wait at least six months due to Covid-19.
If you've read the previous posts, it's a no brainer... Assisted living. I think your dad is very gracious to suggest an ALF. Many parents will request that they never be placed in a care facility which puts a an awful strain and stress on the family to try to keep that promise. I think he realizes that and offers a better option with AL. He will receive the care he needs and you can take comfort in knowing he's cared for.
I vote for an AL. He will decline. My Moms decline was monthly. There was an aide at her Daycare (living with me at the time) that later was hired at Moms AL. She couldn't believe the decline in Mom in just a few months.
Where do you start? Where does he start, I think you mean. What sort of ALF would he like? What's important to him? - e.g. small but homely, less personal but more elegant, sweeping gardens or cityscape? Round the corner from you, or a good half hour drive? Plenty of activities, or peace and quiet? Haute cuisine or proper food (!) ?
Facilities are not all the same. You might like to start by doing a sweep in, say, a twenty mile radius of your home and gathering some brochures to compare.
As to deciding whether to live with you... If he really wanted to do that, he'd have started on the "don't send me to a home! I'm never going to one of those places! You'll have to carry me in - !" shtick. Since he brought up ALFs I think it's a reasonable assumption that he would much prefer that, and be grateful! But in any case I'm afraid he can't decide he wants to live with you: only you can decide who lives in your house.
I agree with the posters here who support AL. Take some time to review a variety of posts where the family moved an elderly parent into their home. Such a move will inevitably strain the family resources, relationships and ultimately lead to a bad situation for all involved. Also, after your father moves in with YOU, he may not be as agreeable to going to AL if the home caretaking takes a turn for the worse. Keep in mind that AL has trained nurses/techs/CNAs/staff who are best equipped to deal with your father's condition, which will inevitably (and sadly) get worse. Good luck with your decision.
Start by giving thanks that Dad has included AL in his living options and then grab the AL option as fast as you can. Moving a parent into the home without often changes the relationship dynamics with them and frequently it is not in a good way. If and as they decline, you become a full time (aka worn out and dog tired) caregiver and that sometimes overshadows what you really are..... a loving child. Include Dad in your research.... what type of atmosphere does he desire - quiet and bookish or "cocktails at 4"; suburban area or rustic countryside; close to you or a leisurely drive. When you find a few that you like, make at least 2 visits taking Dad with you on one. Don't let sign any type of contract until your attorney casts his eyes over it; you should sign it unless you have Dad's DPoA. Pay particular attention to clauses that pertain to the sale of the facility - like how much notice you will get of a sale - and the "fees" regarding medication management because these can go up significantly with the addition of one or more meds. ALs vary and there is no "one size fits all". In any state most have a very limited number of Medicaid beds which could become a problem down the road if Dad runs out of funds (I have heard of a very few that have indicated that should this happen they will apply to have Dad's bed turned into a Medicaid bed but they are fast disappearing and the process can be long and complex depending on your state).
Keep in mind that AL offer just that an "assist" in the activities of daily living - eating, toileting, transferring, bathing and dressing. If a person gets to a point where they actually need to be fed, the AL may no longer be able to keep them which means the marketing statement that "Dad can stay with us always as he ages in place" is not always guaranteed. If Dad has the resources, he may want to consider an AL that is on the campus of a CCRC (continuing care retirement community). Still expensive on a monthly basis but if his needs increase on a medical or custodial basis, he can transition to their SNF/LTC unit. Of course, the downside to a CCRC is the rather large one time entrance fee.
Good luck on your journey and give lots of thanks that Dad is willing to go the AL route. Get moving on that before he changes his mind.
Assisted Living is your friend! Usually the issue is getting our parent to accept the idea of assisted living that they need and you don't have to deal with that. My suggestion is first for you to make preliminary phone calls and visits to nearby assisted living apartments. I say "nearby" because the best advice I was given when looking for assisted living places for my dad was to find one close to my home. You'll still be making trips to visit and stop by and having it be 5 minutes from home as opposed to 45 minutes from home makes a big difference in the long term. Then once you've pre-selected a couple of places, and you've checked on their fees, services, etc and know they are acceptable to you, take your dad to them to make a final selection. Be ready to move quickly so he doesn't change his mind about moving. Second thoughts are common and you can't give in to them. You'll get lots of advice here on how to evalute the assisted living facilities and there doesn't seem to be any try industry standard of what is included/excluded etc. One thing that I didn't think would be a big deal when my father moved to assisted living was having a primary care physician available for visits on site. That is a godsend for basic, recurring medical appointments. He can still keep any specialists but I love not having to make special arrangements, transportation, etc for a blood draw or a quick visit for a rash.
Do your homework first, explore the options, prices, activities, residents, etc. Your dad will be in the minority of about 10 women for every man so if male companionship is important check out that ratio.
If your dad is showing signs of dementia look for a place with a Memory Cate unit so he can be transitioned there if needed.
Getting your dad a place now will be helpful if finances might be an issue in the future. Most AL places require a 2-year residency before they will accept Medicaid waivers.
Ask about hospital affiliations, and what your options are if your father declines and needs Skilled Nursing placement.
When we were searching for an AL for Mom I took her on a tour of each place and arranged to eat lunch with the director. One to see how the meals were served, to see other residents, and to be able to ask questions. On your tour stop and talk to residents to gauge their attitude.
You're one step ahead of the game already if dad is open to assisted living. I say go that direction. He's ok with it, he will be around other people his age, they have activities and he will be much more engaged in that setting. At your house, it will be you and him. Unless you have a lot of company in and out of the house, the days drag on. It is quite easy to begin waiting on the elderly person in the household, but it really the worst thing you can do. Better to let them struggle a little than to do the task. When you do it 2 or 3 times, it's a task they can no longer do. Facilities will have exercise areas and you can request that he be encouraged to go. The physical movement and engagement with others will help, to some degree, to keep mind and body active.
Set him up with a way to do video calls with him at the facility when you take him there. Amazon - echo show (I think it's called) is kind of a small screen, but easy to do the video call. Grandkids are able to call my parent with it and it's enjoyable to be able to see them.
Another good tip written in the posts - find a facility that has AL and memory care areas. Saves on another move later on if memory care is needed. I would at least give this a good try before moving to your house. Hard for both of you, but being around the other folks his age will be much more beneficial.
My2 cents,is right ,, And If YOu Find A Place within minutes from home or work, you can visit as often as needed... Let the facility and residents know, he has family, and now they are part of your family, so bring treats for everyone if you are allowed. Let him have activities. You are on the right path. n :)
I am not sure where you are located, or if this resource is available near you- but local Assisted Living Locators; (They are typically franchised meaning a local rep supports your local community) and they are FREE to you, and paid by the community once you find the right fit.... may just offer a relief to some of the heavy lifting that can come with this process. :)
Check out the web site of the facilities and not what they offer. Note the one you feel would be doable. Before COVID you could have a tour of the facility even have lunch. Some now have virtual tours. Some you might get an abbreviated tour.
From the tours and speaking you can whittle down the possibilities. Where I live the state have oversight of the A/L facilities. Ask the facilities you are checking for to see the last visit by the state. In my state they have to let you see them; some may give you a copy; some only let you look while at the facility. You can also contact the state directly and you might be able to see the results of the state's last visit.
If able take your father to a couple see what he thinks and choose the one that appears to be the best fit.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Do you want him moving in?
That includes all the "stuff" that goes with it.
He is declining. How long can you care for him? At what point will you say.."I can't do that or I won't do that"? When he reaches that point he will then have to transition to Assisted Living, or Memory Care. That could be in 6 months or 12, 18 you never know.
If he is willing to move to Assisted Living that might be a good option. He will have a community of people that he can relate to. And if needed a move to Memory Care would be smoother.
You mention that he is in Independent Living now I would think the transition to Assisted would be very easy for him.
If you are traveling a few days a week would he manage on his own or would he need help? Will HE hire caregivers to come in while you are gone and also to help relieve you of some of the care that he needs?
Ours also has a lovely Memory Care unit AND a second equally handsome Skilled Nursing building, so facilities are available if care needs increase.
Sites closer to caregivers are nice because it’s easy (and hopefully, fun) to visit according to your schedule.
As you can tell, I LOVE my family member’s residence!
Once that basic hurdle is over it is time for
A) Frank discussion with Dad, re paperwork he has done or should do, wills, POAs, Advanced directives. Re his wishes for any end of life care if he is unable to make his own decisions. And of assets available Monthly for Dad's care.
B) Discussion with Dad re options of Independent living (likely unwise at this late date) , ALF, Board and Care (more family like and smaller but often fewer activities organized or availability of friends).
C) helping Dad make a decision for himself.
You may want to start discussions now, but visits to sites may have to wait at least six months due to Covid-19.
Facilities are not all the same. You might like to start by doing a sweep in, say, a twenty mile radius of your home and gathering some brochures to compare.
As to deciding whether to live with you... If he really wanted to do that, he'd have started on the "don't send me to a home! I'm never going to one of those places! You'll have to carry me in - !" shtick. Since he brought up ALFs I think it's a reasonable assumption that he would much prefer that, and be grateful! But in any case I'm afraid he can't decide he wants to live with you: only you can decide who lives in your house.
When you find a few that you like, make at least 2 visits taking Dad with you on one. Don't let sign any type of contract until your attorney casts his eyes over it; you should sign it unless you have Dad's DPoA. Pay particular attention to clauses that pertain to the sale of the facility - like how much notice you will get of a sale - and the "fees" regarding medication management because these can go up significantly with the addition of one or more meds. ALs vary and there is no "one size fits all". In any state most have a very limited number of Medicaid beds which could become a problem down the road if Dad runs out of funds (I have heard of a very few that have indicated that should this happen they will apply to have Dad's bed turned into a Medicaid bed but they are fast disappearing and the process can be long and complex depending on your state).
Keep in mind that AL offer just that an "assist" in the activities of daily living - eating, toileting, transferring, bathing and dressing. If a person gets to a point where they actually need to be fed, the AL may no longer be able to keep them which means the marketing statement that "Dad can stay with us always as he ages in place" is not always guaranteed. If Dad has the resources, he may want to consider an AL that is on the campus of a CCRC (continuing care retirement community). Still expensive on a monthly basis but if his needs increase on a medical or custodial basis, he can transition to their SNF/LTC unit. Of course, the downside to a CCRC is the rather large one time entrance fee.
Good luck on your journey and give lots of thanks that Dad is willing to go the AL route. Get moving on that before he changes his mind.
If your dad is showing signs of dementia look for a place with a Memory Cate unit so he can be transitioned there if needed.
Getting your dad a place now will be helpful if finances might be an issue in the future. Most AL places require a 2-year residency before they will accept Medicaid waivers.
Ask about hospital affiliations, and what your options are if your father declines and needs Skilled Nursing placement.
When we were searching for an AL for Mom I took her on a tour of each place and arranged to eat lunch with the director. One to see how the meals were served, to see other residents, and to be able to ask questions. On your tour stop and talk to residents to gauge their attitude.
Set him up with a way to do video calls with him at the facility when you take him there. Amazon - echo show (I think it's called) is kind of a small screen, but easy to do the video call. Grandkids are able to call my parent with it and it's enjoyable to be able to see them.
Another good tip written in the posts - find a facility that has AL and memory care areas. Saves on another move later on if memory care is needed. I would at least give this a good try before moving to your house. Hard for both of you, but being around the other folks his age will be much more beneficial.
Let him have activities. You are on the right path. n :)
Check out the web site of the facilities and not what they offer. Note the one you feel would be doable. Before COVID you could have a tour of the facility even have lunch. Some now have virtual tours. Some you might get an abbreviated tour.
From the tours and speaking you can whittle down the possibilities. Where I live the state have oversight of the A/L facilities. Ask the facilities you are checking for to see the last visit by the state. In my state they have to let you see them; some may give you a copy; some only let you look while at the facility. You can also contact the state directly and you might be able to see the results of the state's last visit.
If able take your father to a couple see what he thinks and choose the one that appears to be the best fit.
Good Luck.