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Assisted living might still be an option in many cases. The assisted living where my dad was allowed him to be there while in a wheelchair and unable to transfer himself, as long as he was willing to pay the separately contracted organization that provided extra care. He contracted for a complete package, morning and evening assistance for dressing and undressing, wheelchair assistance for getting to and from meals in the dining room, bathroom assistance, and lots of little service calls for things like putting the blinds up or down, bringing him a snack, getting a book, etc. Hospice provided showers, but if not, he could have contracted for that too. And if you’re able to stop by daily for a visit, to help sort out personal care requests, maybe to hang out for supper and some tv, all the better.
With respect to in home care, I should clarify that I would be looking for one person to provide in home care and pay them a salary. Rather than having three people rotate 8 hour shifts at $20+ an hour through an agency. It’s been so exhausting just trying to find someone who has experience doing this. Is 24 hour one person live-in care really that rare? Just trying to understand why.
She’s 5’2” 120 lbs fyi
I should clarify in case it wasn’t clear in my original post that I know this is a lot of work and I do not want to attempt to do any of this alone which is the entire reason I’m looking for a live in caretaker.
You would need two people, because you would be required by law to give the caregiver days off. There will also be times when the caregiver is sick, has her own medical appointments, family emergencies etc. When we were looking for a live in for my grandmother via agencies, most were from Jamaica or similar and hard to understand. $2500 to $3500 sounds low from an agency. When we were pricing them for my grandmother, it was about $120,000 a year and that was 25 years ago.
Yes it would be cheaper to hire someone on your own, but make sure you background check thoroughly, and remember that you will need two, not just one. And you will have to take payroll and other taxes out of her check. Of course you can give her days off on weekends when you are at home, but there will be other occasions where you will need fill-in help. At my last job, my boss had caregivers home with her mother all day, and there were multiple occasions where she had to leave work and go home for some emergency or other where the caregiver had to leave.
We would also have had to renovate her entire home as it was very old with doorways too narrow for a wheelchair. We ended up leaving her in the SNF. For her I think it was better not just because of her care because it provided many more opportunities for socializing, while when she was at home she was quite isolated. We were fortunate however, because I actually worked in the nursing home that she was in at that time so saw her every day.
As other said, Medicaid coverage varies by state, but it is normally not much more than 2 to 3 hours a day a few times a week. You are in a very low tax state, so it’s likely the coverage will not be as good as it is in a high-tax state. I’m sure you should be able to find that coverage information online however. You might want to actually go to the South Carolina board as well and ask people there.
Can you take mom out on a day pass and see how you can handle her for the day to get a better idea of how much help she needs?
That’s a good idea, she also needs to know if mom can get in and out of her car for medical appointments etc, which is much more difficult than getting in and out of bed/wheelchair/toilet. OP can actually arrange with the therapists to bring her car to the facility and the therapist can transfer her in and out to see how she does with her there. She can also see how she does transferring to a bathroom in a doctors office etc which may not have wall rails/high toilet as they do in the home. If she does OK with the car transfer, perhaps OP can take her to her next doctors appointment just to get a taste of what it may be like. But she should also be able to get a day pass and take her home for the day.
Assisted living might still be an option in many cases. The assisted living where my dad was allowed him to be there while in a wheelchair and unable to transfer himself, as long as he was willing to pay the separately contracted organization that provided extra care. He contracted for a complete package, morning and evening assistance for dressing and undressing, wheelchair assistance for getting to and from meals in the dining room, bathroom assistance, and lots of little service calls for things like putting the blinds up or down, bringing him a snack, getting a book, etc. Hospice provided showers, but if not, he could have contracted for that too. And if you’re able to stop by daily for a visit, to help sort out personal care requests, maybe to hang out for supper and some tv, all the better.
I believe OP however is looking at an ALF under Medicaid. When my mother was in an assisted living facility, they agreed upfront to allow her to stay once she transferred to Medicaid, but she had to pay privately for 18 months first. And she required practically no care at that time, even took her own meds, and we paid about $3500 a month. Once she required extensive care years later, that increased to about $9000 a month. Had she been at that level in the very beginning, I do not think the ALF would’ve even consider taking her. It is one thing to enter an assisted living facility independently and then decline over the years, it is quite another to try to get in from the very beginning when you need extensive care, especially if you’re going in on Medicaid.
The last two years of her life, I believe my mother probably would’ve been better off in a nursing home than the assisted living facility. Assisted living facilities do not have nearly the staff that nursing homes do, and really her care suffered a lot in the last couple of years, and plummeted during Covid. They wouldn’t allow even the visiting nurses who cared for her legs twice a week into the facility during the first 6 months or so of the outbreak, yet they lost staff too and didn’t have enough people to properly care for them themselves.
This was based on a social worker who I'd been speaking to who knew two CNAs that were willing to do live in caretaking work; so it wasn't through an agency actually fyi.
Based on convos with said social worker, I'd only expect to get this rate through knowing someone else or 'possibly' through Care.com.
That’s a good idea, she also needs to know if mom can get in and out of her car for medical appointments etc, which is much more difficult than getting in and out of bed/wheelchair/toilet. OP can actually arrange with the therapists to bring her car to the facility and the therapist can transfer her in and out to see how she does with her there. She can also see how she does transferring to a bathroom in a doctors office etc which may not have wall rails/high toilet as they do in the home. If she does OK with the car transfer, perhaps OP can take her to her next doctors appointment just to get a taste of what it may be like. But she should also be able to get a day pass and take her home for the day.
We have been practicing transfers to the cars the past week. She recently had surgery a few days ago so I likely won't be able to practice with her again for another week or two.
I'm in a 4 door 2020 Civic, so you're right - it's not easy. My door openings aren't that wide. I just bought this car a few months ago and am already wondering if I should get something different.
Anywho, she did well transferring into the vehicle with the therapists - with me as well, but I want more practice. So when I took her out I didn't take her out of the car (we just went out to restaurants and ate the in car). The therapists would take her back out of the car when we returned to the SNF. I'm hoping that by sometime next month we'll have the car transfers down (I just bought her a transport wheelchair) so I can start getting her out more. Her depression has gotten her being almost completely nonresponsive to me verbally on most days lately (will just stare and not blink or respond to me) so I really want to start getting her away from the SNF more for some 'fresh air' and for her mental health. I want to start taking her possibly to a few Adult Daycare places nearby that maybe she can start going to once a week hopefully.
In short, we're working on the transfer stuff. She had to be transferred to a different chair for a type of scan at the ENT's office and did okay with that. I have started to transfer her every once in a while at night to the bathroom and we do ok with it as she has enough strength to do the pivoting part of things fairly well.
I've thought about bringing her home sometime soon but just realized I need some type of ramp to get her in through the front door.
Last edited by southkakkatlantan; 09-10-2022 at 09:07 AM..
I believe OP however is looking at an ALF under Medicaid. When my mother was in an assisted living facility, they agreed upfront to allow her to stay once she transferred to Medicaid, but she had to pay privately for 18 months first. And she required practically no care at that time, even took her own meds, and we paid about $3500 a month. Once she required extensive care years later, that increased to about $9000 a month. Had she been at that level in the very beginning, I do not think the ALF would’ve even consider taking her. It is one thing to enter an assisted living facility independently and then decline over the years, it is quite another to try to get in from the very beginning when you need extensive care, especially if you’re going in on Medicaid.
The last two years of her life, I believe my mother probably would’ve been better off in a nursing home than the assisted living facility. Assisted living facilities do not have nearly the staff that nursing homes do, and really her care suffered a lot in the last couple of years, and plummeted during Covid. They wouldn’t allow even the visiting nurses who cared for her legs twice a week into the facility during the first 6 months or so of the outbreak, yet they lost staff too and didn’t have enough people to properly care for them themselves.
Ugh...this makes deciding what to do for my mom even harder.
First thing's first though - I'm starting with just trying to get her out of the facility more (once a week to start, once we get comfortable with me doing these car transfers). My hope is that I can find someone to serve as backup to take her out when I can't.
Next, I want to decide if coming home or an ALF is best. Researching the ALFs has been hard; I can't seem to find just a list of ones that take Medicaid. In parallel it sounds like I need to find better SNFs in the area as maybe 'that' is really the next best step to take just in case she doesn't come home or go into an ALF either. My hope for a better SNF is low as everyone keeps saying they're all the same; I'm going to have to pray about that as I'm going into it a bit discouraged that I'll find something nicer that has good care.
You are correct that I need an ALF that accepts Medicaid if we go that route - she is still pending it by the way. I'm speaking back with an elder law firm again next week to discuss this.
Can you take mom out on a day pass and see how you can handle her for the day to get a better idea of how much help she needs?
Yes; I'm not ready to do it just yet though.
I got a wheelchair that came in the mail yesterday from Amazon. I couldn't get into the kitchen or bathroom with it
Well, to clarify actually - I can actually get into the kitchen. I just can't open the fridge at all. I guess that's solved with a separate, smaller fridge/freezer combo of her own.
I didn't try the bedroom areas but in short, I'm seeing that the door openings in this home are too narrow. I do believe that she would have to place her arms in her lap and have someone push her carefully into the bedroom every time she wanted to enter/exit.
I'm renting a home from my friend at a rate that's at about a 40% (at least) discount compared to other homes for rent in the same subdivision (there is no way I can get a 3/2 anywhere in this city for anywhere near what she's charging me).
Assisted living might still be an option in many cases. The assisted living where my dad was allowed him to be there while in a wheelchair and unable to transfer himself, as long as he was willing to pay the separately contracted organization that provided extra care. He contracted for a complete package, morning and evening assistance for dressing and undressing, wheelchair assistance for getting to and from meals in the dining room, bathroom assistance, and lots of little service calls for things like putting the blinds up or down, bringing him a snack, getting a book, etc. Hospice provided showers, but if not, he could have contracted for that too. And if you’re able to stop by daily for a visit, to help sort out personal care requests, maybe to hang out for supper and some tv, all the better.
Hhhhmm...so they just don't have 'one' assisted living rate, but rather the rate varies greatly dependent upon what the resident's needs are?
I may just go by one that's a few minutes away from me to tour and get an idea of how they break down costs.
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