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What’s the scoop with the online senior advisor services— do they all only recommend assisted living or in home services because they are getting a commission?

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Facilities don't readily publish their prices because you'll die of sticker shock so they want you to come in to tour so that you see what you're getting. This was my experience. I'm not sure why online senior advisor services "all only recommend assisted living or in home services", don't know if they're getting a kick-back or not, but maybe because MC and LTC are a whole different thing and more complicated when choosing (IMO). I tried to use a service to find a place for my MIL but because she needed Medicaid we got crickets. Plus I think that by time a senior needs MC or LTC they also usually need Medicaid, so the options are much fewer and there are waiting lists.
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DWinHull Sep 2021
Gotcha! They want you to drain all your funds at the NH instead of spend down at home. It all seems like such a game. I’m trying to keep Mom at home as long as possible but her medical needs increase as each month goes by.
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I called and asked for the price when I placed my uncle. They also told me when I visited the facilities.
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No, you can keep Mom home if you want to bring in someone to help with Moms care. If you hire an agency, the cost will be high but then you don't have to worry about tax deductions. If you hire privately, by law CNAs are not self-employed so you have to deduct taxes and Social Security and match the SS. Hiring under the table could effect the ability for Mom to get Medicaid.

Assisted living and Memory care run from 5k up depending on where you live and what care Mom needs. Private pay.

Longterm care/Nursing Homes/Skilled nursing is for people who need 24/7 care that an AL is not able to give. Cost 10k and above.

There is no help from Medicaid until the person no longer has any assets. Monthly income, Social Security and any pension, go toward Moms care.

So yes, Caregiving is expensive. Its a business.
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Re: NH prices, call and ask. Assume about 10K per month.

Re: senior advisors.
Are real estate agents in the business they are in because they love their community, or because they need a job?

A little bit of both usually, yes?

Senior advisors get paid by the facility for bringing them customers (same as a real estate agent, yes?).

If you want to do all the legwork yourself, go ahead. We used a service. Yes, he got paid. For doing a job. Iy isn't a "kickback".
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Isthisrealyreal Sep 2021
The facility my dad was placed in paid the senior advisor. Didn't cost us anything and I was able to negotiate a discount on the monthly rate.
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DW, if your LO isn't going in from a hispital admissiin, I would simply get him/her on every waiting list you can. Ask if they accept Medicaid after a certain number of months private pay.
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Barb is exactly right, senior advisors are great and worth using when looking for assisted living/memory care because the family doesn't pay for the referral the facility does. Gma adjusted to assisted living and it worked for a little while- We experienced the same thing as you when looking for a nursing home, though. Not a lot of guidance.
Senior advisors are a business, yes?... so I think the whole paying for the referral piece is why they don't work with nursing homes. If the government is paying the bill (Medicaid, Medicare) no one can get the referral fee. So, at that point we paid an elder law attorney for advice. He couldn't advise us on the placement other than looking at rankings, but at least he could help us with financial planning because once you need nursing home care, all the assets come into play.
Sorry- edited to add the rankings link. Not pricing, but you can compare quality
https://www.medicare.gov/care-compare/#search
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A senior advisor was great with my ex, my daughters' father, in the final cancer stages. He and they knew the end was coming, and he didn’t want care at home. A new partner was desperate for him to get more treatment interstate, stay home etc etc. For us, the senior advisor found a great place and also helped with the family dynamics.
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Of course the On Line Senior Services get a commission which is fine..

They can come out and see what kind of Care you want and need and make suggestions.

You can call the local Homes directly and tell them what you need and they'll have you come tour the place.

Take a tour of a fewt and decide which one you like best.

My opinion, they are all understaffed and unless you are in your own assisted living apartment, it's better to be in your own home as long as you can.

If you can afford it, I would rather live in my own home and have a Caregiver come in or if you have an extra bedroom, hire a Live In.
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I used a place for mom and found they didn’t give me the name’s of the places I knew. It was also lots of calls from them. They were the middleman. I ended up using seniorly.com to research and then I called the places that mom could afford and had the amenities she wanted. They were the only ones who had pricing and details online. Mom wanted an apartment and no roommate. She wanted privacy. Seniorly also looks for you but I didn’t want that. They have a search at the bottom of their web page where you can search by zip code. They give you the price, the size of the place and pictures. You have to call to see availability. I set mom up for 3 in one day and we selected the first one. It is 115 residents and has memory care if she ends up needing that. It is clean, nice and safe. Very happy with the seniorly.com website. She is more social than at home and we don’t argue about eating, she loves their food and her table mates. I did hire a friend to see her weekly and show her around. That has worked out great and they do mani pedi and have occasional lunches out or watch movies. If I had a person in moms home, she would not be as compliant and she would fire them. Besides, when my husband and I lived with mom, it took both of us to keep from burnout. Cooking, cleaning, meds, doc appts, laundry, hair. Mom gets excellent care and she is happy in her apartment where she keeps the temp hot.
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Home health care services will usually tell you prices over the phone as well as their minimum number of hours and days. Facilities usually want you to visit. However, these places will give their information to social service workers. It might be worth the money and time to hire a social worker to do this for you.
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My husband has dementia. I have someone come from an agency three times a week for four hours. The agency charges $24 dollars an hour. The ladies do cognitive therapy, play games, watch TV, etc. with him. They do not do any household chores (my choice). Four hours of uninterrupted time three times weekly is wonderful. I have visited three memory care facilities and they gave me brochures with all of their charges. The charges range widely. We have longterm insurance so finances are not a problem. As long as I am able, I choose to take care of my husband with a little outside help. I have an advisor from "A Place for Mom" and she has been wonderful. There is no charge for this service. She checks on us regularly. The memory care facilities we were referred to were all wonderful. If something happens to me, my children know my choices for my husband.
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katepaints Sep 2021
A Place For Mom was excellent and informative.
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Before looking into prices I would look at Medicare’s website to see how nursing homes in your area rate under Medicare’s inspections. There’s a one to five star rating system. The overall rating is a good indicator but for me the most important one is patient care.

My brother has brain cancer and needs 24/7 care and I live 1500 miles from him After his surgery, due to circumstances I couldn’t control, he ended up in two 1 star rated places which lived up to their rating—one place lost his belongings including his phone and wallet. Eventually we got them back—nothing nefarious, just carelessness and lack of real care and motivation. One factor that played in was he’s on Medicare and Medicaid and facilities typically have fewer beds since these payments are lower.

When he went into hospice I poured over the website and found homes with three star overall and four to five star patient care. I gave the list to the social worker and she made the calls. He got into a facility with a five star patient care rating. What a difference! Without research a low price facility might also have very poor care. There are different referral sites including Aging Care, that can give you pricing information.
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Grandma1954 Sep 2021
Often a patient on Hospice can get into a facility (Medicaid) more easily as the facility assumes the person will not be a long term resident. (sounds harsh but it is a reality)
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DWinHull: Imho, if you do NOT want to pay the fee that the online senior advisory service company charges, then it's best to do your own 'leg work' on nursing homes costs.
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When my 95 yo mother needed to go into the care system, I tried using a couple referral services, including the advertised a place for mom. I found that they are the 'middle person' - typically the 'customer service rep' you are assigned to is in a completely different state than where you are and has never ever stepped foot in any of the facilities that they recommend. They are going by ratings only. I also found that they didn't have an extensive list - they sent my name to about 5 NH, whose people then contacted me. Yet, there were like 15 more NH within a 10 mile radius and countless AFH (which they didn't refer any to me).

I tried using other search apps, but they also came back with limited information, and then it would be up to me to figure things out - which can be quite daunting when you don't know 'the system' and the 'players'.

I ended up using a franchised 'advisor' service (they get paid from the facility that the person is placed in). The service I used was far more helpful and informative than the others, and they had done alot of the leg work and knew all the facilities and had personally visited them all. But still, it all comes down to what is available at the moment you are looking. There were some facilities I was very interested in, but they didn't have any available beds. I/we settled for what I thought was going to be a 5 star place (extensive customer reviews with this rating), yet, in actuality, I would have rated it a 3 star. Looked nice outside and in, 'seemed' nice and professional, but in reality, the quality of care that I was expecting (and paid for ($11,000/mo) was not what my mother got. (i.e, AFH was run by a nurse with 15 years experience, but, it was either health aids or caregivers with limited experience who were present 24hours a day. I was very disappointed.

It seems to me that one has to start somewhere, and then as time goes on, might probably have to possibly change facilities, which is a huge hassle, unless one finds that gold nugget in the pile of straw.
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