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Nursing Homes and Assisted Living

proteanmix

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Does anyone have any experiences or advice they'd like to share about their encounters with assisted living, nursing homes, or long term treatment facilities?
 

Halla74

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I work for the Medicaid program in Florida. Although I have limited first hand experience with nursing homes, I have been to a few to see relatives in need. It is not the happiest of environments, it is usually somewhat institutional.

If you have a relative who might require that level of care, either for a short duration or on an ongoing basis, look into whether or not your state has any HCBS (home and community based services) programs. Often, an elderly/disabled person can stay in their home with some help, like cooking, light cleaning, bathing assistance, etc. These services are often cheaper than full on nursing home care, and the patient is happier as they are in their home, in their neighborhood, close to their friends & family.

I hope that helps, if you need any other info let me know, I'll try to help.

:)
 

prplchknz

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I know both of my grandmas head nurses come and take care of them until they got too sick, and then went to nursing home 5-10 minutes from family, and someone who lived in the same area would go for all the meals and visit everyday. But yeah, if you can avoid it I would, but sometimes it can't be avoided like their just too sick, and also do research find which ones are the best and which ones suck. But I would defiently use it as a last resort.
 

Anja

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I worked for one for about three months and presently volunteer in my Mother's care center. I'll be glad to answer any questions that I can.
 

Udog

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What kind of things are you looking to know? I've had my grandmother in an assisted living home (not enough care for her needs), nursing home (way to frantic, very bad for her Alzheimer's), and finally settled on an Alzheimer's unit.
 

proteanmix

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I worked for one for about three months and presently volunteer in my Mother's care center. I'll be glad to answer any questions that I can.

Why did you leave? What do/don't you like about your mother's care center?

What kind of things are you looking to know? I've had my grandmother in an assisted living home (not enough care for her needs), nursing home (way to frantic, very bad for her Alzheimer's), and finally settled on an Alzheimer's unit.

How did your family go about evaluating where your grandmother went? Did you pay for it privately, through her health insurance, Medicare, or Medicaid? What made you settle on the facility you did?
 

Udog

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How did your family go about evaluating where your grandmother went? Did you pay for it privately, through her health insurance, Medicare, or Medicaid? What made you settle on the facility you did?

First question: Go visit homes in the area. Does the place smell like urine? How do the patients smell? Have they been cleaned recently? What's the nurse and nursing assistant : patient ratio? Do they have activities?

EMS (Emergency Medical Services aka ambulance) employees/volunteers are also a good resource. They are in and out of all the various homes to pick up patients, and can tell which ones take good care of them and which ones don't. Elder care lawyers may also know.

Second question: Grandma has about $200,000 that my grandfather left her. We pay privately as the private pay places are MUCH better. However, the good ones will cost $5,000 *or more* a month, so that combined with medicine and other expenses will give my grandma ~3 years. She will probably outlive her money and then have go into a medicaid facility. We are hoping that the Alzheimer's has advanced enough that she won't notice the difference.

Third question: Great reputation by those in the know. Relatively close location. Our first choice, which wasn't quite as nice but cheaper and closer, was booked indefinitely and we needed to get her out of the nursing home ASAP. (She had a stroke, went to the hospital, and then went to the nursing home on medicaid under doctor's orders.)

Ugh... this was a hard post to write.
 

proteanmix

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Thanks Udog, the info about asking the EMS techs is a great idea.:hug:

Unfortunately, paying privately is not an option so we have to go through Medicaid/Medicare.

I'm so becoming a socialist after all this.
 

kyuuei

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Generally.. the nursing home that our grandmother is in is wonderful, for what the facility is. She hated the move, and she resented it. Now that she's settled, I think it's a sort of grumpyness that may not ever settle down.

I was adverse to them for a long time but.. in the end. after 8 years of living with us, we just became unable to keep up with her needs. I think as long as you make regular visits it's well and all.
 

CzeCze

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Nursing homes are always a hard choice. Especially in traditionaly Asian families, retirement/nursing homes are a last and sometimes, never, choice. When my grandmother got too ill to be home-cared for, we looked for assisted living centers for her. They can be very expensive. The really expensive ones are like resorts (not kidding). I think our choice ended up being decided on proximity and cost. Personally, they all just reminded me of state hospitals and were slightly depressing.

Good luck with your search!
 

cherchair

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nursing homes and assisted living

I work for the Medicaid program in Florida. Although I have limited first hand experience with nursing homes, I have been to a few to see relatives in need. It is not the happiest of environments, it is usually somewhat institutional.

If you have a relative who might require that level of care, either for a short duration or on an ongoing basis, look into whether or not your state has any HCBS (home and community based services) programs. Often, an elderly/disabled person can stay in their home with some help, like cooking, light cleaning, bathing assistance, etc. These services are often cheaper than full on nursing home care, and the patient is happier as they are in their home, in their neighborhood, close to their friends & family.

I hope that helps, if you need any other info let me know, I'll try to help.

:)

+1 this is what my roomie and i have and in colorado we have a consumer-directed program that allows us to hire, supervise and fire our home health aides. we are also able to pay them a living wage, which many home health agencies do not. our aide has been with us 11 years and she is more like a member of the family than an employee. even her extended family--her daughter and son-in-law live a block from us--have pitched in during emergencies. i realize this isn't the norm, but it's certainly more possible than when having to work with an agency. one disappointment with obama's disability platform--at least he had one--is that there wasn't more on the promotion of consumer-directed programs. NOTHING ABOUT US WITHOUT US!!!
 

Udog

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Thanks Udog, the info about asking the EMS techs is a great idea.:hug:

Unfortunately, paying privately is not an option so we have to go through Medicaid/Medicare.

I'm so becoming a socialist after all this.

It's a horrible situation to be in. People shouldn't have to make decisions where they lose no matter what choice they make. I wish you the best.

This is important... Medicaid/Medicare facilities, especially the good ones, usually have a waiting list. This list can be from weeks to literally a year or more (!). What often happens is that the good nursing homes get most of their money from private pay (which is how they earn enough money to be good), and therefore only keep a handful of Medicaid beds.
 

Anja

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I left, Protean, to go to volunteer at my mom's care center which was closer to me.

I've answered a few questions via PM.

But I will say again, most professionals who go into the business do so because they like to help people. There is a high turnover among the para- and nonprofessionals but the ones who stay usually are people who take satisfaction from providing care.

As I mentioned in PM, everyone is being overworked these days which is hard to see and creates problems of its own.
 

Udog

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As I mentioned in PM, everyone is being overworked these days which is hard to see and creates problems of its own.

Yes, my boss' wife is a nurse that works in a medicaid home. One nurse and 3 nurses aides are responsible for 70 patients.

Anja, if that information included any insights from your experience, any chance I could get a PM with of some of the information? I'd be interested as well, if you don't mind.
 

Halla74

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Thanks Udog, the info about asking the EMS techs is a great idea.:hug:

Unfortunately, paying privately is not an option so we have to go through Medicaid/Medicare.

I'm so becoming a socialist after all this.

Yes, socialized medicine is the only way to go for quality, sustainable health care for the masses of any large industrialized nation. It's all about creating a huge pool of enrollees, the largest of which is obviously everyone in the nation, or at least those that do not wish to seek private care elsewhere.

I manage the actuarial consulting services contract for Florida's Medicaid program. We look at historical fee for service claims of a given region, for a given eligibility group when a new program is pitched and calculate a monthly per member per month (PMPM) rate that would need to be paid if the population in question were to be covered by an approved Medicaid HMO that covers the services of the new program.

Statewide the average monthly PMPM for the TANF (Temporary Assistance for Needy Families, essentially mothers and young children) is $200; the monthly PMPM for the SSI (Social Security Income, Aged and Disable people) population is about $500.

These rates vary by age and gender, as a means of risk adjusting them to more accurately pay plans for their enrollees. We also risk adjust by analysis of pharmacy claims, lab claims, and certain physician claims.

A pilot program was in the works for over two years, called "Florida Senior Care." It would have integrated HMO-type medical coverage, HCBS/waiver services, and nursing home care for an enrolled population of persons 60 and older. There were 3 levels of care considered, and their draft monthly PMPMs are below:

Community Well (Those in Good Health): ~$160 per month
HCBS (Those at Nursing Home Level of Care but Living at Home): ~$800
Nursing Home (Those Residing in a Nursing Home in a Given Month): ~$4,700

Do you see how expensive nursing home care is?!?!?!

Nursing Homes and Inpatient Hospital care account for more than half of our annual costs. Last year the Florida Medicaid budget was $16 Billion, and it will continue to rise...

IMHO, I don't see any other way to keep costs down in the long run than a good quality social medicine system...
 

kiddykat

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I worked as a candy striper at a nursing home/retirement center/hospital for the elders. I think that was probably the most heart-breaking experience for me (I get a bit sad when I think about it)..

I remember watching an old man who was in his diapers dripping with diarrhea for hours in his wheelchair. I asked a nurse if he could help change him, and after I worked there for 4 hours, the elderly man was still left to sit there in the corner all by himself. I couldn't change him, due to legal reasons, my status as a non-employee.

I would say.. I notice that there was A LOT of neglect from my experience at that place.. It was a WHOLE different world.

I think there's a lot of ageism that exists in our society, and I wish it could stop. I mean, these are people who paved the way for our future? We wouldn't be here if it wasn't for the older generations' hard work, dedication. Yet, that's how they get treated. I also feel sad to see that families aren't close-knit enough so that grandparents/great-parents cannot stay at home where they are needed, and that the situation for the families don't really make it as easy. I still made the best of the situation by doing whatever I could, and listening to their stories. They were cute.

I give much props to nurses who work hard, ethically, in those types of environment. Hopefully, trends and lifestyles will change so that families will be able to better take care of their loved ones.
 

uberrogo

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I used to go to those places as an ambulance driver. If you leave your parents there you must be in jail, oblivious, or hate your parents. I'd rather starve homeless on the street then be put in one.
 

heart

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There are horrid nursing homes, bad ones, medium and then there are excellent ones, staffed by professional, caring people. It takes work and research to find out which are which. A doctor's office might be able to steer one in the right direction.
 

Udog

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I used to go to those places as an ambulance driver. If you leave your parents there you must be in jail, oblivious, or hate your parents. I'd rather starve homeless on the street then be put in one.

Sometimes it's not an option, and it's a heartbreaking decision. As the child that works full time, it can literally become impossible to provide the level of care the parent requires. Then, if you add parent/child dynamics into the mix, it becomes a physical and emotional nightmare.

Of course, my boss told me of a [big name] Nascar driver who had his father in the horrible Medicaid nursing home in the area. My boss' wife works there as nurse (she is responsible for 70+ patients), and would see him there occasionally. This dude earns a ton of money through Nascar, and he could easily afford a better place. THAT, I admit, is pretty rotten.
 
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