Advice on Memory Care facilities (child, parent, spouse, money)
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I've never been on the caregiving forum but DH's older brother just went into a home. We didn't know since they have been out of touch for many years and he is on the Asperger's spectrum so is not social anyway.
I have been slightly worried for years since BOTH of their parents ended up with dementia in assisted living homes. I may have to confront this at some point. No dementia in my family, fortunately but....
So, I've been online checking out memory care facilities in Wisconsin, where both his brothers now live. I don't know either brother, only met them once so don't feel comfortable asking them directly.
Do folks suffering dementia recognize and appreciate their siblings because they are part of their childhood memories? I know they lose recent memories, so he may forget me but is it likely they'd appreciate each other at that stage? Or wouldn't it matter if they were together? They were close as children so I thought maybe if they lived in the same care facility, it might help them both.
This is looking WAY ahead since DH has no impairment now but it scared me when the older brother followed in the parents' footsteps. DH is 69 and the dementia brother is 76.
The facilities I looked up accepted Medicaid which we would need as we don't have 9 grand a month for full-pay.
Can the unaffected spouse live on the grounds in many of these places? Would that spouse also qualify for Medicaid? I ask that because it sounded like the spouse needed to live in WI to qualify, which makes sense.
I don't want to call the facilities or email them as they'd be bugging me afterwards and DH might see/hear what I was doing and be offended. This is probably 10 years in the future but I want to have some idea what to expect.
Thanks for taking time to read and any advice on this scary possible future. Hopefully, we'll just die in bed---faculties intact---down here but one never knows. No such things as "homes" here.
I've never been on the caregiving forum but DH's older brother just went into a home. We didn't know since they have been out of touch for many years and he is on the Asperger's spectrum so is not social anyway.
I have been slightly worried for years since BOTH of their parents ended up with dementia in assisted living homes. I may have to confront this at some point. No dementia in my family, fortunately but....
So, I've been online checking out memory care facilities in Wisconsin, where both his brothers now live. I don't know either brother, only met them once so don't feel comfortable asking them directly.
Do folks suffering dementia recognize and appreciate their siblings because they are part of their childhood memories? I know they lose recent memories, so he may forget me but is it likely they'd appreciate each other at that stage? Or wouldn't it matter if they were together? They were close as children so I thought maybe if they lived in the same care facility, it might help them both.
This is looking WAY ahead since DH has no impairment now but it scared me when the older brother followed in the parents' footsteps. DH is 69 and the dementia brother is 76.
The facilities I looked up accepted Medicaid which we would need as we don't have 9 grand a month for full-pay.
Can the unaffected spouse live on the grounds in many of these places? Would that spouse also qualify for Medicaid? I ask that because it sounded like the spouse needed to live in WI to qualify, which makes sense.
I don't want to call the facilities or email them as they'd be bugging me afterwards and DH might see/hear what I was doing and be offended. This is probably 10 years in the future but I want to have some idea what to expect.
Thanks for taking time to read and any advice on this scary possible future. Hopefully, we'll just die in bed---faculties intact---down here but one never knows. No such things as "homes" here.
Welcome to the Caregiving Forum. First, Dementia is a very vague term that covers many diseases. It's important to know which they are diagnosed with as the symptoms of Alzheimer's Disease are very different that those of Frontotemporal or Lewy Body Dementia. Chances of it being passed down genetically is still open for debate ( personally think it's more environmental rather than genetic based but I'm not a scientist.) Regarding payments for Dementia care, I feel your pain. You don't mention your age but I strongly urge you to seek out an Eldercare Attorney to put steps into place to happen if/when they are needed. I can tell you that I'm into year seven of taking care of my husband. It is a nightmare I can't wake up from. I don't want to scare you but take steps NOW on how you will take care if lock down care is required. I thought I had our whole retirement mapped out only to find that I only have the choice to place DH in a lockdown facility and go broke quickly or keep him at home as long as I can to safeguard my finances for my remaining years. As for living on the grounds, in most instances it would be no in a memory care unit but yes if it's either an independence or assisted care facility. Feel free to ask any questions here. There are a lot of people to help you here.
Do folks suffering dementia recognize and appreciate their siblings because they are part of their childhood memories? I know they lose recent memories, so he may forget me but is it likely they'd appreciate each other at that stage? Or wouldn't it matter if they were together?
Can the unaffected spouse live on the grounds in many of these places? Would that spouse also qualify for Medicaid?
I don't want to call the facilities or email them as they'd be bugging me afterwards and DH might see/hear what I was doing and be offended.
We didn't have facilities calling and bugging us after contacting them so I don't think you need to worry about it. Your husband may be offended but better to broach the subject with him as it is probably on his mind also. Burying his head in the sand may tell you that he already has some dementia.
In terms of WI facilities your best bet is to call and ask them your questions. They all have people who answer these types of questions. The answers are state specific and will be different for each facility within a state.
Medicaid requires you to spend down all your funds. In our case I think it was less than $2K in assets. If you think you won't have the funds to pay for a facility and that you will need to preserve funds for your own living expenses then you should really look at the options for the state you think will be a destination.
We didn't use an eldercare attorney but this may be of benefit in your case so that you understand the options. Will you have to get divorced and split the assets in order to keep half? That is something you will want to know well in advance. Also there are programs to assist with things like memory care once you qualify for medicaid but they are called different things in different states. It is a complicated web so getting some assistance can help.
I can say that the sooner you move to a facility that will accept you on medicaid when your funds run out if you have a couple of years of private pay under your belt, the better off you may be. Waiting until you have no money and then trying to find someone to accept you seems to be a more difficult road. For you to live there also you will need to select one that has independent living, assisted living and memory. Even better if they also have skilled nursing.
In our case my mom does recognize her siblings and us kids (most of the time). Maybe that will change over time. Dementia takes different forms for different people. In my mom's case the executive functions were what went first and memory was mostly good. There is a test that they can do to tell you what parts of the brain are working well, mediocre and poorly. We had a Neuropsych exam and that was really helpful with understanding what was going on with her brain.
"Neuropsychological evaluation. This process lasts around four hours and includes a series of in-depth analyses, such as one-on-one interviews and written and oral tests. These assessments are designed to gauge specific cognitive functions, like attention, problem solving, spatial skills, and executive functioning. The neuropsychologist discusses the person's daily cognitive and memory issues in more detail to better understand when and how often difficulties occur, and the functional problems they cause.
The neuropsychological test scores are compared with what an average person of the same age and education level may experience. "This helps to determine if memory problems are suggestive of dementia or part of normal aging," says Dr. Brody Magid. It is typical to be retested after 12 to 18 months if early dementia is suspected." https://www.health.harvard.edu/mind-...g-for-dementia
My parents both needed assisted living and Mom needed memory care. Honestly, I would not worry about your DH at this time unless he is showing signs of cognitive impairment. If you are living inexpensively abroad, then you can probably do better there then here, where we were paying 11000 a month for memory care. Less for assisted living, thank goodness. Maybe you can see about bringing the brother to live down there.
Unless you want to come back for other reasons, which is certainly possible.
If you are worried about this, you should talk to DH and see what he wants to do.
It's appropriate to have the "end of life" discussion with DH. There's nothing wrong or morbid about it. It's a stage of life through which we all pass.
How much better it is for each of you to understand the other's wishes and thoughts on how to proceed during what may be very trying and uncertain events.
Life is uncertain and illness or an accident can strike at any time. Being well at age 69 does not preclude a sudden stroke or heart attack at age 70. A moped could hit you in the street, causing a brain injury. Neither might be likely but is possible.
I don't know if either of you have retained a legal residence in any state, but that is also something to consider, especially if you think that you might want to return to the US. Each state has individual legal forms for POA, health care directives and the like.
... Do folks suffering dementia recognize and appreciate their siblings because they are part of their childhood memories? I know they lose recent memories, so he may forget me but is it likely they'd appreciate each other at that stage? Or wouldn't it matter if they were together? They were close as children so I thought maybe if they lived in the same care facility, it might help them both...
Memory and recognition can come and go minute to minute. Once the progression reaches a certain point, I don't think it would make any difference.
Memory and recognition can come and go minute to minute. Once the progression reaches a certain point, I don't think it would make any difference.
Be careful about negative comments to dementia patients. While they may forget that you visited them 10 minutes ago, they may latch onto and remember something negative that you said to them.
Yes, this is all new territory for me. We are both 69, and I agree it would be good if we sat down and discussed this. DH seems to never get offended, so I shouldn't worry about that---he is well aware of his parents and brother's diagnosis. I think all 3 had/have Alzheimer's.
I looked at Medicaid in Wisconsin's rules and it looks like the non-affected spouse can keep enough money to live on. I'm aware of the "Spend-down" rules as we all went through that with his parents.
Our legal residence is in TX but knowing that state, I doubt there's Medicaid help. Maybe CA will be more generous, where I'm from.
Yes, we live a very low-cost country BUT there are no "homes" of any kind that I know of. Children are expected to care for their elders but I haven't been able to find out what happens when they are "too far gone".
So, my take-away from this thread seems to be that trying to settle near the brothers wouldn't be that helpful for the afflicted states of mind. Hopefully I have time to look in other areas.
Agree that talking to an elder-care attorney might be helpful, but I've also heard they will recommend placements due to kickback money.
Agree that talking to an elder-care attorney might be helpful, but I've also heard they will recommend placements due to kickback money.
Appreciate all the thoughts!
I don't know what you've "heard" but consider this: now you've "heard" that's not true.
As in any profession, there are good lawyers and there are bad lawyers.
My DH and I spent considerable amount of time with a lawyer discussing options and alternatives, both legal and financial. Very ethical and helpful. Nary a kickback in sight.
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