Live-in care versus facility: How do I figure out what to do?

Yes,Hiring help at home is a good solution,They allows a person with special needs stay in their home and home care services available to help you maintain your independence within the comfort of your own home.

momobrien - I can't thank you enough for posting the link to the Front Line expose' of the Emeritus chain of assisted living/memory care facilities. This program was aired a little over two weeks ago - and is excellent info after a year-long investigation. Now, I'm not saying all facilities are like this because I know they're not - as evidenced by comments on this forum - but it does give one pause when making an informed decision. Facilities that are 'for profit' might need more checking into, however. Regardless, I would highly recommend taking 30 min. to watch this program as a heads up.

What would You want if it were you? One huge reason I have Mom is so when she does cry or need something I am right here for her and she is never alone or afraid. They are alone in nursing homes, talk to someone who has worked at one before you decide please. I have hired cna's to help me and the most gorgeous nursing homes still have too many patients, if they dont eat in time, they take it, and they can fall and get infections there. I cannot imagine having a 90+ year old move, home is best if you can get the help. Home is 1-on-one care, placing them means 7-12patients to one person. Its a sacrafice but so worth it, I've had mom Mom over 5 years and will never place her, she is with me forever. She is in late stages, cannot walk, incontinent, and I puree and feed her foods to her. I wouldnt trade it for any nursing home. Think long and hard and good luck to you and make sure its the right decision for you both.

I'd like to thank all of you for your thoughtful and thought provoking answers. I have visited one Memory Care facility and plan to look at two more in the area. I have also talked with the care coordinatior of the home care company we are using during the work day. Live-in care would cost about the same as my dad is paying now by the hourly rate. Still don't know what I'm going to do. But I'm looking at all the options. Thanks again.

momobrien - I think you have hit the nail right on the head and said it so well. Of course home care what always be preferable if the space, finances, time physical capacity and assistance all come together to work out in the favor of the patient. There is truly no right or wrong answer as each situation must be individually evaluated based on the needs of the patient and caregiver.

Mrs. O'Brien, You seem to have a very caring attitude regarding home health care. Good for you, and may you continue to "know what to do" under any and all circumstances.

I think AL and memory care facilities are a much better option because of the security and balance they can offer. In most cases much more economical than 24/7 in home care. Consider finances and long term prognosis and therefore skilled care needs that may be required in the future.

This would take the day to day burden off of you.

Maybe consider visiting a couple places and having him stay in one place for 2 weeks as respite care. You can see how he does and he might just like the dining, social and activities offered.

When you have exhausted all forms of self-help and used all the equipment that we now have on hand for disabled persons, then you may say to yourself, " I need more help". If you simply can not manage anymore, then you'll know that the time has come to seek outside help in a facility.

I think it depends on cost, unfortunately. In home care would cost $5000 a month here in NYS. Once your money is gone and you are eligible for Medicaid then you have to take a nursing home that will accept you. With funds, you have a better choice of homes. I feel terribly guilty even though mom is in a good place, but I also felt that I couldn't exhaust her funds and leave her to the whim of the Medicaid system.

If you get live in help, be sure and set the boundaries early and even write down what is ok with you (friends visiting) and what is not (boyfriend issues, smoking). Be clear and both should sign the agreement and periodically review and update any adjustments.

I could not agree more. My husband is in late states of dementia and Parkinson's disease and no way will I place him. I have had home health care and they are wonderful as long as you get the right person. It is well worth finding the right person.

I posted that I have live-in care. We went the day care route, and I'm grateful to the staff for their help for 1-1/2 years. My husband progressed to the point where he couldn't be in daycare. It worked for us, but daycare beginning/ending hours can make it difficult to drop off or pick up if they overlap with job hours. Even with bus pickup, if lgregg's father is unable to get himself out of and back into the house, that can be difficult w/o assistance. PBS Frontline had a show on 7/30 about assisted living: http://www.pbs.org/wgbh/pages/frontline/life-and-death-in-assisted-living/
Although there are undeniably excellent AL facilities, at this point they are regulated very lightly, unlike NHs. If a person can participate in actitivies in an AL or NH, that's great. But some dementia patients are so far gone that those activities are of very little benefit to them. My husband is safer at home, whereas in the NH he fell, hit his head and had to go to the hospital for stitches, Xrays, etc. He wanted to walk, and the NH wanted to keep him in a wheelchair. That's one reason that they required a 24/7 sitter after he fell. I'm glad to be able to do this at home.

I wanted to see if there is any help for some one that has Parkinsons, His wife needs help with bathing as he is over 250 lbs and she is a petite 90lb little lady. They are on a fixed income and are looking for some help a couple times a week. ,

I would also agree with the third option of adult day care if one is available in your area. One is not available anywhere close for my dad. I would love for him to be involved but honestly he doesn't interact with others anymore except for me and his caregiver. Geewiz brought up an excellent option.

Let me add a third option, adult day care. This would provide activities and company beyond the caregiver. The ones by me pick the person up and return them to home, though I am sure each area differs. I had live in help for my Mom for several months and then moved her to a specialized AL (memory care). The AL costs vs the cost of her staying at home + live in help + food for both --- actually had the AL cost less!!! I chose one that was near me and visited every day. They were busy all the time. And even though my Mom wasn't always participating, at least there were others around and the sound of humans. If you go the AL route, choose carefully. Some centers actually have well trained aides for dementia care, others it's a side line. Good luck

I have 24 hour in-home care for my dad in an apartment. This equals to the cost of a nursing home. Much better care in my opinion. I have a nursery cam and can view all happenings. I am in control this way. I visited nursing homes and couldn't get out of there fast enough. Again, this is just my opinion and what works for us.

the nursing homes sedate agitated patients like my father who has dementia. each staff member has lots of paitents and other duties. the care is not great and pretty expensive. we have 24/7 in home care with my mother at home also. even more expensive but the care is expceptional. what you can afford will determine course of action.

Depending on what state you live in, adult foster care is another option. It pays the caregiver of an elder who needs care. Its tax free and nonreportable income. This allows you to earn money at home and helps defray the cost. I know there are programs in Mass. RI IN and OH. there will soon be in other states as well. You also get free services of a nurse and case manager to help you manage your loved one at home. Caregiver Homes is one company that does a great job. You may also want to try a day program while you are at work. Most insurances cover most/all the cost and he will be supervised with the ability to have activities and meals. This would help you conserve cash for in home care on weekends or early mornings to get him up and dressed for the day.

Your dad can't KNOW that he won't like living in and AL or SNF.
Let him try it.
Tour a few in your area, pick one and insist that he go for a respite stay of a few weeks (if necessary, you can tell a little white lie about needing to work 10-12 hours a day on a special project or something). You'll get a much-needed break and he'll see that life can be more interesting if he's not just sitting with a caregiver all day.

Hiring help at home is a good solution but placing a loved one in a facility can offer many benefits to you and your father. Being in the right environment with stimulation and support is essential for someone who is suffering from dementia. Reminiscent activities, socialization and structure have been proven to delay the progression of the disease. Moving into a facility that offers specific memory care provide all of these things to your father. It not only provides the safest environment, it will also allow you to become the 'daughter' again. The staff takes over the tasks of caregiving, cleaning etc. and you will be able to spend quality time with him again. He may have said that he never wants to go into a facility but once you see what they can offer and that the environment can be very homelike and comfortable, the decision can become much easier. It can't hurt to explore all of your options.

I'm taking care of my 68 Y.O. husband at home with live-in help. He has young onset Alzheimer's disease and is under hospice care, 9-1/2 years after diagnosis. He was in a NH for 3 weeks following 4 weeks in the hospital getting his meds adjusted. The NH was recommended to us and -- not faulting the NH but due to his agitation -- we were required to have a 24 hour a day sitter. The cost for the NH and the sitter combined would have been prohibitive. I hated having him in the NH. The kind social worker at the NH suggested hospice care, and the hospice recommended a licensed agency to provide caregivers 24/7. I've been extremely happy with the in-home caregivers I've had, and after a certain number of hours, live-in is less expensive than come and go. It's expensive but I'm happy that my husband gets one on one (& often two on one when I assist) care and showers as needed. We keep him very clean, as well fed as possible, and comfortable. In a NH environment, there are usually about 6 patients to each caregiver and 1-2 showers a week. The hospice people maintain that quality in-home care is far superior to NH care when it's possible. I couldn't agree more!

I would advise hiring help whether it be live-in or 9-5pm. Only you can decide which is best for your situation. From experience with mom for 10 years and 2 years home hospice, help is invaluable!