If your loved one is in memory care, do you feel like it’s necessary to eventually transfer them to skilled nursing? Which is better suited for someone with dementia? Is there a certain criteria to even enter into a skilled nursing facility? I ask these questions because where I live it’s difficult to find a doctor that will go to her memory care facility. There is only one agency that I know of and they’re not very responsive, hard to get a hold of. Many times I end up, having to send mother to the emergency room because of their lack of care.
Those were our reasons for choosing one over the other.
So kindly do not so casually mis-characterize all dimentia patients the same like they did in the 1980’s. They need respect and to be handled case by case not collectively.
There is mild, moderate and severe dimentia. My Mum has moderate yet has full rifhts to live as she wants. Merely bc one has dimentia doesn’t mean their rights are taken away, doesn’t mean they can’t live on their own home and alone. That is ancient misthinking. So what if they can’t recall the date, time, what they ate. That’s all irrelevant when. It working anyway. And it doesn’t mean they are a threat to themselves or others. Just remove knobs of oven and stove top and any irons. They can heat food w microwave or have Meals on Wheels come daily with food and to ensure they are alive and able to answer door safely. I’m So California they do this. In Northern CA the most liberal area, they just ship weeks supple of food. Ironica hie the liberal part of CA takes worse care of their elderly then more conservative areas like North San Diego coastal where Meals on wheels checks daily except Sunday on these seniors. Great organization.
it is when anyone including dimentia patients are a threat to their own or someone else’s safety or cannot per form five tasks of daily living they cannot reside alone but they can remain in own home.
its important not to just limp all dementia patients as incompetent or needing memory care or assisted liking. Those days and backwards misthinking are long over.
Doctor’s and medical field don’t need a dimentia patient to live in memory care unless they are unsafe or can’t care for themselves.
May everyone be able to learn the modern understanding of dimentia and dimentia rights. Times have changed.
Prayers
A "Memory Care" facility may be any number of arrangements depending on how your specific State licenses and regulates such entities. In my mom's Medicare and Medicaid qualified Skilled Nursing Facility (SNF) which is regulated by both the US Gov (the Feds) AND the State, as part of State licensure: they are a fully qualified SNF, also a fully qualified Rehab (or Rehabilitation facility for post inpatient discharge); they have a fully qualified "Memory Care" unit on site and fully qualified Hospice too. It is all in one facility and depending on what the patient (short term stay) or resident (long term permanent placement) needs; it is all there except for actually inpatient hospital care if there is a new or emergent emergency; they go an actually hospital for that.
There are RNs, and various lower level nurses staff 24/7. Each patient or resident has an assigned physician who is on site many days per week. And there are various MD and other specialists on site weekly, some daily (cardiologist, geriatric psychiatrist, geriatricians, psychologists, social workers, dietitians, physical/occupational therapists, podiatrist and the dental van comes on a schedule too).
Some are private pay, others (many like my mom) Medicaid pays. Some short term patients either Medicare or their private insurance pays.
All to say, folks really need to figure out first how such facilities are named and regulated at the State level as to what they do or do not provide and which may be best for LO's needs now and into the future. And also which are Federally regulated and which may be Medicare and Medicaid approved or NOT. If NOT Medicaid approved; then when their private funds run out and they still need SNF or Memory Care; you'll need to moved your LOV. This later part of "how they will pay" -- private pay if there are lots of resources to cover the expense perhaps for years to come OR if no funds/NOT sufficient funds to pay privately for a long time -- have to be considered for your longer term planning for their care. As once they are spent down does, the facility take Medicaid? If NOT, you will potentially need to moved to a facility that does accept Medicaid.
My mom's facility costs about $15K a month or $180K for a year. She has been there over 2 years. After spending down all her assets; now Medicaid covers the expense. She is 86, has dementia and a host of other medical and psychological issues (clinical depression) and cannot safely/independently handle ADLs or IADLs. She is not a wander as she can only walk about 5 feet with a walker and she will not socialize or participate in any activities at all. Stays in her private room 24/7 other than when they take her to be showered. The "Memory Care" unit on site was not really useful/appropriate as she was not a wander and not a socializer or participator in any way in any activities, she is very oppositional and refuses to eat in their dinning room or do anything.
Sad, but this is not going to change. But some of the what is appropriate for your LO depends on so many things; what they need, what will help them, what they will do (or not), what options exist in your State near where you live, and how is this all to be paid for privately for how long OR is Medicaid likely to have to take over?
Your Area Agency on Aging may be of help. If you can find a good Board Certified Geriatric Physician near where you live, they too can be of help as they will know what your LO needs. Finally, a licensed Elder Care attorney in your State can help with the planning and legal aspects of Medicaid spend down if that is needed.
Good luck w/this.
My husband has a feeding tube for his meds but still can eat a modified soft diet for some of his meals, has mild dementia and is very mobile so he is not home bound. The feeding tube disqualifies him for any AL/MC level of care but the tube alone does not qualify him for skilled nursing. I learned SNFs do not provide respite care. So you may be limited to AL/MC until his level of care requirements increase.
Most facilities only allow doctors they certify to come in but some facilities will allow you to take them out for private care as needed.
I would never but a dementia patient in SNF unless they were on Medicaid and there were no other options.
Mom had 20k left that got her into a LTC facility. That gave me the 2 months needed to get Mom on Medicaid. I had to spend down her money which was her care at LTC, and get them the info needed. I applied April, placed her May. June I confirmed caseworker had all info needed and her Medicaid started July 1st.
There does come a time when MC is not enough. The are not capable of caring for someone with serious health problems.
Mom was wheelchair bound, incontinent, had heart issues and fell 95x while in AL and Memory Care. That did not disqualify her from living there. What is the needs of your loved one? As Grandma1954 explained, Skilled Nursing is necessary when chronic and severe medical issues are at play. And/or if a Hoyer Lift is required to move her into the shower or the bed. Memory Care, as a rule, does not employ such a device HOWEVER, some do.
The Memory Care mom lived in had doctors come into the building to care for all the residents; including traveling lab technicians, xray techs, she was even able to get an echocardiogram at the Memory Care. All her meds were delivered and dispensed to her there as well.
According to your profile, you live in Corpus Christi Texas! A Place for Mom comes up with 14 Memory Care ALs near or in that city here:
https://www.aplaceformom.com/alzheimers-care/texas/corpus-christi
Your profile also says you tend to micromanage your mother's life:
About Me
Living alone. I do my best to manage my mothers dementia. I have some health issues of my own. Mom is in memory care, however taking care of her doesn’t stop when placing a loved one in a facility. I find myself micro managing everything around her. There is really never a day off.
Perhaps that's an issue to address as well; no managed care facility is perfect, that you need to understand. Nobody will give your mother the level of care YOU think is 'perfect', so that's a notion to let go of entirely. What you want is 'good enough' in terms of is she being fed, medicated properly, socialized, showered, treated with dignity and respect, dressed in clean clothing regularly, living in clean quarters that are kept up regularly, laundry done 2x a week as well as bathing, an open line of communication with staff, things of that nature. Being in managed care should mean that YOU do not need to micromanage mom's life anymore; she's paying others a lot of $$$ to do that FOR you. Visiting her daily or continuously kind of defeats the purpose of being there in the first place. You need a life of your own, too, not just a life that revolves around your mother's dementia!
If the MC she's in now is neglecting your mom, then it's time to get her OUT of there and into a new MC, keeping in mind that you will not find a perfect one. A question I have is, has there been a true emergency going on the times you did wind up taking mom to the ER? If so, I'd report this MC facility to the Ombudsman and state your complaints of neglect clearly to them.
Wishing you the best of luck.
visits extremely important for loved one … yourself… and important for facility see you there and proactive!
Memory Care staff can handle most things but there are some things that Memory Care probably would not work.
If your Loved One has any "tubes" (IV's, feeding tube, any "ostomy") they would probably be in Skilled Nursing simply so staff can monitor them more. Dementia patients have a tendency to pull out or off "tubes".
In some cases if equipment is necessary Skilled Nursing would be necessary. So the use of a Sit to Stand or a Hoyer Lift that would be done in Skilled Nursing. there are some facilities that if a resident began living there and was walking and as a result of decline no longer walked they might be able to keep them rather than transfer to Skilled Nursing but it would depend on their staff and their requirements. Some States have prohibited the use of equipment unless it is Skilled Nursing.
If your mom is not getting the required care then you should report the facility. Each State has an Ombudsman that you can contact.
The Memory Care facility should have a Doctor that comes in.
Your other option would be ...If mom qualifies for Hospice the Hospice Nurse would see her 1 time a week, more often if needed. A CNA would come and give her a bath and order supplies at least 2 times a week. AND the Hospice Doctor would be her Doctor and if it is necessary the Doctor would come to her. But in General the Nurse would be able to do what needed to be done after communicating with the Doctor.