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Apparently you haven't had an experience with a quality facility. There is a wide range when it comes to quality, staff to patient ratio, amenities, activities, etc. Contrary to your statement, not all facilities treat their residents poorly. Not all facilties are "horrendous, understaffed, and barely livable." Not all residents are "abused and neglected." Not all people who "end up" in assisted living or a memory care center are treated poorly.
I hope you end up with a situation in which your parents can live safely, either independently or in your home, but I assure you that this is simply not possible in some cases. Some dementia patients in particular are truly a danger to themselves and others. Some are flat out destructive. Some are violent. Some are too heavy or disabled for their loved ones to care for them without injuring themselves. Sometimes it's simply not in the best interest of an elderly parent or their older adult children (or other family members) for them to live anywhere but in a facility with a trained staff who can meet their needs 24/7.
My MIL had Parkinson's and Alzheimer's. She developed bizarre delusions about her family members - that everyone was trying to kill her. She would get up at night and tiptoe into the kitchen and turn burners on. She would try to cook and burn up pans. Several times, she got out of bed very quietly in the night, went down the hall to the guest bathroom, ran a bath, got into the bathtub, and then couldn't get out - and sat in cold bathwater naked till family found her the next morning. Eventually she couldn't make it to the bathroom, she couldn't dress herself, she couldn't feed herself, and she couldn't bathe herself. But even then, she could and would occasionally manage to get out of the chair or bed or wherever, and go on an absolute rampage - even to the point of trying to throw vases out of windows and that sort of thing.
She was not in her right mind. This was not how she would have ever acted prior to the dementia. But family members, myself included, simply could not give her the care she needed. We even tried hiring round the clock care to come into the home (to the tune of $300 a day - which comes to around $109,000 a year - not many families can afford that), but within a few weeks it became obvious that wouldn't work, because it takes five caregivers on the payroll to run that sort of schedule - and one or more of them invariably called in sick, or had an emergency of their own, or whatever, every week, and then guess who was on duty at the drop of a hat? One time my husband and I drove 12 hours straight through, cutting a business trip several days short, simply because there was no one else who could or would sit with them and a caregiver had called in sick - and my inlaws simply could not manage living without that level of care, all day every day.
So before you judge every facility and every family and every situation so harshly, I hope you will consider that you're probably painting way too wide a stroke with that judgmental brush.
I thank God every single day for the good, clean, responsible facility my mother, with her debilitating dementia, lives in. I also thank God that my parents were responsible and affluent enough to save the money for this possible need, because it's expensive - but necessary. And it came into their lives. Even before my dad passed away, he and I were scouting out facilities for my mom's future needs, because we could see it barreling down on us, and her, like a freight train.
Sometimes it simply isn't feasible, practical, or even SAFE for an elderly person to live at home. Sad but very true.
He said 'some' of these places. This is a rather long rebuttal to things that were not said. He did not say either that all are terrible, or that no one should ever be in one.
Unless your wife wants to move her back home with you its time to decide between nursing home, or assisted living care. BIL should make the arrangements.
He said 'some' of these places. This is a rather long rebuttal to things that were not said. He did not say either that all are terrible, or that no one should ever be in one.
As Patrick said earlier, I stand by what I said and make no apologies. He also said this:
Quote:
I would never put them in the glue factory (managed care).
He also said he understands that some families "feel" that's the only option. He doesn't seem to understand that sometimes a facility is the BEST option in a very sad situation overall.
And for the record, since we're apparently mincing words rather than looking at actual context, I never accused him of saying that "all are terrible or that no one should ever be in one." I was simply providing real life examples of situations that unfortunately were best addressed by reluctantly placing a loved on in a good facility.
Look, I know there are bad facilities out there. There are also good ones. Unfortunately USUALLY the better the facility, the more costly it is, and that puts excellent care out of the reach of many families, which is a crying shame. I get that. And what a terrible situation that would be - to have an elderly parent with dementia or Parkinson's or Lewy Body or something like that, who needed round the clock care and frankly often more care than a family member or even two family members is even able to provide -but not being able to find a good facility that was also affordable.
It's also sad even when there's enough money and a good facility, because most regulars here (myself included but not just me) have usually, by the time they place their loved one in a facility, tried every other possible scenario and nearly wrecked their own health, not to mention other relationships, their homes, their careers, etc.
So it's a bit counter productive to hear "I'd never put my parents in the glue factory (managed care)." Note that he didn't say "SOME managed care."
Yeah, I never thought I'd put my mother in a memory care center. I never thought I'd watch either my beautiful MIL or my beautiful mother totally lose their minds, and descend into absolute chaos, become violent, live in wretchedness and filth if left alone for two hours (my mom can't even be left alone in her room during the day for a couple of hours because she will literally begin to destroy anything, including furniture). Both these beautiful, graceful women were well educated, had lovely homes, social lives, my MIL actually had three college degrees and a career she retired from, my mother modeled when she was younger, and both of them loved babies, pets, flowers, birds, etc. Now my mom is carrying around a stuffed cat that she thinks is real.
Yeah this is a "rather long rebuttal" too but so what. I'm going to keep sharing my feelings, opinions and perspective on various caregiving topics.
There are a lot of people around here who have, with heavy heart, had no choice but to put their loved ones in managed care. There are a wide range of reasons why this becomes "the decision" and it is rarely ever made thoughtlessly or without great despair.
Please refrain from using terms like "glue factory" even in jest. It is disrespectful to those who have had this hand forced on them.
Plus, you never know when your own situation might change. I hope it doesn't, but you never know.
Peace.
Quote:
Originally Posted by fluffythewondercat
It's called gallows humor. It helps some people to cope.
Gallows humor would be to help someone cope would be if someone who, however reluctantly, made the decision to place their parent or other loved one in a facility. When it's used as part of the justification against making that decision, it comes across solely as criticism of others who did.
Yes, this should be a safe place to vent. Venting doesn't include attacking a decision that the person venting was in a position to not make.
I believe this thread is going a bit far afield...
as often is the case.
OP - your family will do what is best for it. (and that includes valuing your wife's thoughts/ideals/wishes - as you seem to be doing)
Caregiving (in home / out of home) always comes down to a family by family case. There is no right answer. Everyone's relationship(s) with other family members is different. Some have a tightknit bunch of siblings that all pitch in. Some are only children. Some have a bunch of siblings fighting like jackals over a possible inheritance but totally unwilling to put in any help for mom and dad *now* while they're still living.
Some folks requiring care have dementia, or other advanced neurological conditions. Some are mentally fine but have difficult personalities (always have) and a strained relationship with their families.
Some (and I am lucky in this respect) are mentally competent, of a moderate disposition, and fit in relatively easily to the household where they will receive care.
Every situation is different.
Coming here is fine to get ideas/suggestions - especially for programs you never knew existed, etc.. But as to what someone else did, well, it won't necessarily work for you.
Personally, I care for my father (and until my mother died - mother and father) in my home, with my husband and a paid aide's assistance.
Husband and I both work full time. We also have pets and the normal "running a household" chores/issues.
The issues we saw in long-term care facilities during the near year my father was in one (before moving in with us) - convinced me that was not a solution to their needs. While I'm sure better facilities exist, the best facility for my father, is currently my home.
At some point, his needs may overwhelm our ability to provide care, at that time we'll re-evaluate.
In my case, my husband has been wonderful in helping my father. If my husband had chosen a different course ... well that's silly.. I'd never have married someone who wouldn't have chosen the way he did.
As with every story in this forum - what works for me, may very well not work for you.
Just as what has worked for other people on this forum, decidedly would not work for me.
As Patrick said earlier, I stand by what I said and make no apologies. He also said this:
He also said he understands that some families "feel" that's the only option. He doesn't seem to understand that sometimes a facility is the BEST option in a very sad situation overall.
And for the record, since we're apparently mincing words rather than looking at actual context, I never accused him of saying that "all are terrible or that no one should ever be in one." I was simply providing real life examples of situations that unfortunately were best addressed by reluctantly placing a loved on in a good facility.
Look, I know there are bad facilities out there. There are also good ones. Unfortunately USUALLY the better the facility, the more costly it is, and that puts excellent care out of the reach of many families, which is a crying shame. I get that. And what a terrible situation that would be - to have an elderly parent with dementia or Parkinson's or Lewy Body or something like that, who needed round the clock care and frankly often more care than a family member or even two family members is even able to provide -but not being able to find a good facility that was also affordable.
It's also sad even when there's enough money and a good facility, because most regulars here (myself included but not just me) have usually, by the time they place their loved one in a facility, tried every other possible scenario and nearly wrecked their own health, not to mention other relationships, their homes, their careers, etc.
So it's a bit counter productive to hear "I'd never put my parents in the glue factory (managed care)." Note that he didn't say "SOME managed care."
Yeah, I never thought I'd put my mother in a memory care center. I never thought I'd watch either my beautiful MIL or my beautiful mother totally lose their minds, and descend into absolute chaos, become violent, live in wretchedness and filth if left alone for two hours (my mom can't even be left alone in her room during the day for a couple of hours because she will literally begin to destroy anything, including furniture). Both these beautiful, graceful women were well educated, had lovely homes, social lives, my MIL actually had three college degrees and a career she retired from, my mother modeled when she was younger, and both of them loved babies, pets, flowers, birds, etc. Now my mom is carrying around a stuffed cat that she thinks is real.
Yeah this is a "rather long rebuttal" too but so what. I'm going to keep sharing my feelings, opinions and perspective on various caregiving topics.
Excellent care is out of reach for most people, so the bad places are all they are aware of, they are all that is in reach, after going on Medicaid. Those people sharing their experiences and opinions are not an attack on yours, and you have stated you are aware your family is blessed to be affluent.
My gma was not affluent, but she had a good pension. Even so, she had to re-locate to afford a nice ILF, very similar to your Mom's as you described it. My mother very much wanted to go there when her health went downhill. It was impossible. We were left with the bad places, she didn't want to be there, and we didn't want her to have to be there. (she did have to for temp rehab/skilled nursing care and she is not a whiner, but she HATED it)
Excellent care is out of reach for most people, so the bad places are all they are aware of, they are all that is in reach, after going on Medicaid. Those people sharing their experiences and opinions are not an attack on yours, and you have stated you are aware your family is blessed to be affluent.
My gma was not affluent, but she had a good pension. Even so, she had to re-locate to afford a nice ILF, very similar to your Mom's as you described it. My mother very much wanted to go there when her health went downhill. It was impossible. We were left with the bad places, she didn't want to be there, and we didn't want her to have to be there. (she did have to for temp rehab/skilled nursing care and she is not a whiner, but she HATED it)
I am only saying this so people don't get the wrong impression of things:
My Mother was on Medicaid -- so obviously not affluent -- and was in a very nice, caring nursing home.
When she went in to the facility she was expected to pass away within 1 year per the ER doctors who saw her just prior to that. She ended up lasting 9 years, partly due to the care she received at that facility. And I don't mean she was languishing in a bed for 9 years. Every day they had her up in a wheelchair, dressed, in the dining room for meals, etc.
The people who work in that nursing home -- the majority of whom worked there all throughout those 9 years, were wonderful caring people who did a great job. Were they always perfect? No. Neither were me and my dad.
One thing they WERE though is friendly and caring. The culture there was amazing. The staff always smiled. I felt good just walking in the place. Even a housekeeper or a maintenance man would have long conversations with residents and assist them with any request even if it was outside of their job. They cared.
That's one reason why it bothers me so much that these caring folks -- many of whom aren't paid that well -- would ever be dismissed as providing something akin to a glue factory.
Are all facilities good? NO. But I don't want people to have the wrong impression that a Medicaid facility by default equals BAD or sub par. There are good ones out there, run by good people who take great pride in caring for our nation's elders and others who can't care for themselves. If any of you can't afford in-home care, and your parent has no option but Medicaid supported care, it doesn't necessarily mean terrible things. My mother was always treated very well.
I'm not going to comment any further because it is mostly pointless to. I just wanted to share another side of things so people have a range of information.
At your quoted figures, $75K a year (for an 8 hour shift)..
That's $36 / hour, assuming a 40 hour work week.
Where on earth are AIDES (not nurses, not PT, not specialists) making $36/hour?
A lot of people would be *LINING UP!* to be aides if that was the pay.
(and yet they are chronically understaffed, because *NO ONE* is making $36/hour)
Generally speaking, at $20ish an hour (in this area, it is about $25 an hour through an agency, MUCH MUCH less, if you are paying someone directly) - that'd be about $42K/year.
(8 hour day, 40 hour week, 52 weeks in a year)
Also, if someone needs 24 hour assistance (which, it sounds like this person doesn't necessarily) - then assisted living isn't going to do anything, because assisted living doesn't cover 24 hour assistance. It just covers meals, some light housekeeping, and maybe some transportation. Which means the family would have to pay the assisted living rent (room/board) and *then* pay for 24 hour aides on top of that... Which would be way more expensive than having her in one of their homes (because that's a separate room/board fee).
Assisted living of about $4K a month sounds reasonable, I just doubt it'd do much for this family.
Also - just saw your comment that "chefs everywhere can accommodate". Institutions only care about the bottom line - and the bottom line is that 100 identical plates of gruel is easier than dealing with some troublemaker's specific dietary request.
We've had posters in this forum who've had no end of trouble managing dietary concerns for their loved ones in institutional care. It is ridiculously difficult to manage if you're not the one providing the food. Nearly impossible, actually.
Institutionalizing a loved one is not near the "easy fix" that people make it out to be. It may provide some help, it may open up a whole host of other problems.
With all due respect, I don't think you are in tune with modern elderly care.
Patients need care seven days per week. They don't take Saturday and Sunday off.
So, my math was $25/hour for eight hours, seven days per week, 52 weeks per year.
I am not talking about "institutionalizing" a person, but moving them to assisted living. These facilities are modern , bright, homey and very well staffed with everything from proper housekeeping to nutritional services to medical facilities to a broad range of activities to aides on every shift (yes, depending on whether we are talking assisted living or nursing care, complete moment by moment aides could be extra). The residents are very well cared for and no need goes ignored nor unfulfilled if at all reasonably possible. Nutrition and diet are no brainers for any of the modern assisted living facilities.
Assisted living is not necessarily the panacea for every family, but in my experience it is not the horror show which you describe.
I believe this thread is going a bit far afield...
as often is the case.
OP - your family will do what is best for it. (and that includes valuing your wife's thoughts/ideals/wishes - as you seem to be doing)
Caregiving (in home / out of home) always comes down to a family by family case. There is no right answer. Everyone's relationship(s) with other family members is different. Some have a tightknit bunch of siblings that all pitch in. Some are only children. Some have a bunch of siblings fighting like jackals over a possible inheritance but totally unwilling to put in any help for mom and dad *now* while they're still living.
Some folks requiring care have dementia, or other advanced neurological conditions. Some are mentally fine but have difficult personalities (always have) and a strained relationship with their families.
Some (and I am lucky in this respect) are mentally competent, of a moderate disposition, and fit in relatively easily to the household where they will receive care.
Every situation is different.
Coming here is fine to get ideas/suggestions - especially for programs you never knew existed, etc.. But as to what someone else did, well, it won't necessarily work for you.
Personally, I care for my father (and until my mother died - mother and father) in my home, with my husband and a paid aide's assistance.
Husband and I both work full time. We also have pets and the normal "running a household" chores/issues.
The issues we saw in long-term care facilities during the near year my father was in one (before moving in with us) - convinced me that was not a solution to their needs. While I'm sure better facilities exist, the best facility for my father, is currently my home.
At some point, his needs may overwhelm our ability to provide care, at that time we'll re-evaluate.
In my case, my husband has been wonderful in helping my father. If my husband had chosen a different course ... well that's silly.. I'd never have married someone who wouldn't have chosen the way he did.
As with every story in this forum - what works for me, may very well not work for you.
Just as what has worked for other people on this forum, decidedly would not work for me.
best of luck to you in a difficult time.
This post should be repeated! Thank you, Briolat21.
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