I am 83, the caregiver to my 85 year old spouse. He has multiple conditions, physical and mental. I just took an inventory of what type care he would need and got the answer, memory. He receives care from an aide 42 hours a week. I need either independent or assisted living. I use a cane or walker. Has anyone had the experience of a couple needing different levels of care, and how it is resolved?
I'm actually kind of doing that right now for my dad and his wife (remarried 40+ years). Both have dementia, although different kinds. My dad has had two strokes in six months and as a result, has vascular dementia, speech dysphasia (scrambled words come out), significant right-side weakness affecting his mobility and history of refusing to take his medications. That was the reason for both strokes. He would lie about it when asked... we really did our best, but he refused to even consider a senior living community and would get quite angry if we even brought it up. His wife is in decent shape physically, and can walk around fine although she's a bit unsteady, but my dad is now using a wheelchair to scoot around because he gets tired very fast with the walker. So, his needs are now more than hers.
I live in WA state and found a great alternative to traditional Assisted Living/ Senior Communities, but it may vary by state. It is Adult Care Homes which are converted houses and generally only have 4-6 residents. It is less expensive, and has a much higher ratio of caregiver to resident by a long shot. It's much more personal, feels like a small family, and caters better to the individual. They also take Medicaid down the road if needed. Best of all, they are very highly regulated by the state (at least in WA), have to meet stringent guidelines, frequently inspected and every resident file is reviewed when inspected, not just a random small sample like is the case with big corporate run senior living and assisted living places. The only downside is you don't have a full apartment to yourself, you have a bedroom with perhaps an attached bath. You share the common areas like the living room/kitchen etc with the other residents... but there are only a small handful of other people, so you get to know them really well, like a little family. They cooking is really great, provide healthy meals catered to your dietary needs (my dad is diabetic). I'm not at all against the big corporate places at all... they are great too, offer wonderful activities and services, have a great community feel, but are more expensive. My husband's parents chose that option and are very happy with it! They need less care at this point, and really enjoy all the activities. I think it's about finding what is the best fit for your personality, lifestyle preferences and budget. I didn't even know about the AFH (Adult Fam Home) option so I thought I'd pass it along.
We went on three AFH tours and liked two of them, but didn't click with one at all. One of them my dad, his wife and everyone liked a whole bunch, and that's what we chose! Haven't moved in yet, my dad is still in rehab facility getting physical & speech therapy, but happy to update you later on our experience if it's helpful. :o)
Bigger facilities may be set up for this & include 1-2 bed apartments (for independant living), bedroom with ensuites that include intermittent staff assistance (assisted living) & rooms for higher needs, also rooms more securely monitored for memory/behaviour support.
I've visited many places over the years & volunteered at a lovely smaller residence too. It was mosly AL but a small MC area. Quite a few couples resided there. One had separate rooms. I believe they had trialled sharing together but it didn't work well. Wife could be agressive + tricky behaviour issues. Didn't want staff ('the girls') with her Husband, wanted to boss him all day. Lacked insight. Was preventing him getting his own care needs met. Separate AL rooms worked better for them. Husband could visit her for a limited time but then was free to join the men's groups, enjoy his own hobbies etc, also get a decent night's sleep.
A few couples shared rooms & seemed happy with this. One man said his mind was good but legs bad. Said his wife was the opposite.
There are many factors to consider for or against sharing a room: mobility, memory & behaviour concerns being big ones (but money & avaibility too of course).
I've met people who just need the 'heavy' work of showering or transfering their spouse into a wheelchair done by staff - they can be mostly independant during the day otherwise. An AL suite could suit them.
Yet others are worn down by their spouse's constant anxiety, shadowing behaviour, need for reassurance, redirection, prompting & supervision. A duo of MC & ind rooms may be needed.
42 hrs a week care may be needed, but how this would be supplied is key. My impressions are MC has more supervised time eg a day room & arranged activities. AL residents are freer to hang out in their rooms (unsupervised) as they wish. This could mean you stay your Husband's main carer for much of the day.
You know him best, what he needs. You also know what you need.
Best of luck with your next steps.
You and your husband could share a room if you wanted or not. The downside is that they do not have activities like the larger facilities but, only you can know what would enrich your life and ensure proper care for your husband and what services you would utilize.
Best of luck finding the best place for both of you.
Oh, Google senior placement specialists for your area and they can help you find the facilities that you can afford, that can meet your needs and ones that take Medicaid if required.
As you tour places look for ones that have "continuing care" that will go from Independent Living (if you do not think you need Assisted Living now) to Assisted Living and Memory Care.
I also suggest that you and your husband talk to an Elder Care Attorney and make sure that you have all the paperwork done that you may need, Will, Trusts (if needed) POA for Health and Finances (Do not be each other's POA find someone that you trust that would be willing to take this on. Or at least do not let your husband be your POA if he has cognition problems now.)
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