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Kmi7688 Asked August 2022

The cost of caring for my elderly father is getting out of control. Any advice?

My dad lives in an Assisted Living, and has an aide with him for 12 hours a day. The costs every month are getting so high, and we are running low on finances. I don't know how to keep up with everything, and he is having more and more episodes where he needs increased care. How do I deal with all of the costs while ensuring my dad has the right care he needs? None of us kids can take him in, and he has no place to go if we cannot afford the Assisted Living.

CTTN55 Aug 2022
"We" cannot afford the Assisted Living? Your father should be paying for it out of his funds. Is he?

Is he Medicaid-eligible? It sounds like he needs a higher level of care than AL, so maybe he needs a Nursing Home (NH)?

MeDolly Aug 2022
Why does he need an aide 12 hours a day? AL is for those who need some help, not 24/7 specialized care.

Most likely he needs to be placed in higher level service, like NH, if he doesn't have the money to self pay, apply for Medicaid.

You shouldn't be paying for this in the first place, it is his responsibility.

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groovygal Aug 2022
PeggySue2020 my parents placed my 99 year old grandmother in an assisted living facility when she became unable to live on her own (yes, she was independent for that many years!). At the time she was suffering from Parkinson's symptoms and related dementia, was incontinent, was unable to cut her own food, etc. Brookdale promised to ensure someone was always available, on call, to assist her to the bathroom and for incontinence care, to bring her meals (with the food cut up) to her room, housekeeping and laundry. It was less expensive than care in the skilled nursing or memory care wing and Brookdale was happy to convince my parents they were doing the right thing. My parents were concerned that the skilled nursing care wing would burn through Granny's savings before she passed away and they didn't want her to end up in some kind of state home.

Her time there was completely awful. It seemed that about half the residents in her wing were in the same situation. She was left to sit in her own feces because the nurses "were not paid to clean that up". She was covered in crumbs. Her food was not cut up for her. Her like-new Haywood Wakefield bedroom set was damaged from the staff spilling liquids and food on top of it, and the entire space smelled of human waste and trash. Housekeeping -- if there was any -- must have consisted of vacuuming the room she was never in. The only saving grace was that she declined so quickly that she was basically unaware of her surroundings for most of the time she was there, but it was still a few months before my parents finally found a small group home for her where she received 1 on 1 care. Granny died 3 weeks later. Because my mother was her 'caretaker' at the time and I found it too 'uncomfortable' to visit more than a few times (each of which resulted in my placing an emergency call to management because of the state I found her in), I will never forget leaving my own grandmother to spend her last months in that terrible condition.

Beware. Assisted living facilities may well attempt to sell you whatever service level you seem most comfortable paying. While the individual people we spoke to there -- from staff to the manager -- truly seemed to mean well, the low pay and low skill level combined with pressure to profit from their residents placed them in the position of never being able to live up to their promises. You may tell yourself, each time you visit, that it was a one-off, that they were just short staffed "that day". Don't fool yourself. Don't let a family caregiver fool themselves. A caregiver who is exhausted and burned out may not really comprehend the situation for an awfully long time.

I think these places and the financial agreements entered in to with them require open, objective, caring eyes from the family who make the arrangements. I really wish I had stepped as caregiver in place of my mother, who would probably have resisted but appreciated it all the same. Granny would have ended her days in her own cottage with 24 hour care on top of hospice supplemented by our family. It would have been cheaper, and it would have been better for her.
sp19690 Aug 2022
Totally agree.
JoAnn29 Aug 2022
No one should have an aide for 12 hours when in an AL. If an aide is needed, they need a higher level of care. No wonder Dad is running out of money. MC will cost even more and I think Dad is passed MC. They are just a step up from an AL.

Your Dad needs Longterm Care. Start looking for a nice facility. Then take whatever money he has left, and pay privately. With my Mom she was in an AL and money was running out, she had 20k left. I started the Medicaid application in April. She was placed in LTC May 1st. She paid for May and June. June I confirmed with her Caseworker that they had all info needed and Medicaid started July 1st.
Kristen2037 Aug 2022
This is what I recommend as well.
Yvonneatthelake Aug 2022
When my husband was in late-stage Parkinson's he did better in skilled care than in assisted living. Even with skilled care, I hired care givers to be there when I left.
It was extremely expensive, but the only way.

If I wasn't so burnt out from years of caring for him, I would have brought him back home and hired in home care providers. I never had peace-of-mind.

Today, facilities only provide the bare minimum of care. CNA's and nurses are run ragged. These facilities are run for profit and that's the problem.
Cdriver Aug 2022
Agreed. My father, 90, is in late stage Parkinson's. Just moved him to SNF at the beginning of the summer after he had a bad fall at home. I looked into ALs but was told point blank by several of his doctors and by the PT and OT staff that his needs far exceeded what could be provided at an AL facility. It's crazy expensive for SNF, AL would've been much less, and I am having to clean out his big house and sell it to pay for care, essentially bankrupting him so he gets good care. But I never worry now, he is in a very good SNF and I visit almost daily as it's 5 mins from me. At some point, especially with Parkinson's because it is progressive and can get worse quickly, you have to look into a higher level of care. For a SNF, you can apply for Medicaid once you've exhausted all funds. It's a terrible thing that in this country our elderly family members have to go bankrupt to get care.
lealonnie1 Aug 2022
First off, its time for a new doctor if this one is "not forthcoming" with a diagnosis for your dad! What's up with that?? Meanwhile, he's in the poorhouse from paying astronomical amounts of money each month for an aide to be with him 12 hrs a day in ASSISTED LIVING! What are they assisting him with that he also needs to pay an aide for 12 hrs a day???? What's wrong with dad that he needs such a level of care? That begs the question, then, why is he in AL if he requires THAT much care??? Something is wrong with this picture. He likely needs Skilled Nursing but not before he's seen by a REAL doctor who can properly diagnose him and let you know what type of managed care community he belongs in. The ALF itself should be assessing dad and letting you know if he even belongs there and if so, why it's necessary to also hire an aide for 12 hours a day.

Seek guidance from an elder care attorney about Medicaid requirements in your state BEFORE dad runs out of money. He can go to a Skilled Nursing Facility under Medicaid when he runs out of money if everything works out.

Wishing you the best of luck.

sp19690 Aug 2022
Obviously he is not a candidate for assisted living if he requires someone to sit with him 12 hours a day. But they won't tell you that because it is a lot if extra money fir them. He needs to be moved to a nursing home. That is the solution.

freqflyer Aug 2022
Kmi7688, I am really surprised that your Dad was even allowed to be in Assisted Living, due to the Alzheimer's/Dementia that is on your profile. The facility should have recommended Memory Care or a Nursing Home. And they should have mentioned Medicaid.

Memory Care or a Nursing Home can be quite expensive. As others have written, it is time to see if your Dad can qualify for Medicaid [which is different from Medicare]. If your Dad qualifies, Medicaid will pay the bill for nursing home care. Call your State Medicaid office to get the ball rolling.
Kmi7688 Aug 2022
He does not have the specific diagnosis, but we suspect that is something he has. His doctor has not been forthcoming with the diagnosis, and so he is not eligible for Memory Care.
brandee Aug 2022
Hi,

I live in Florida and I visit what is supposed to be the best assisted living in Florida. It is really, really common for residents to have outside paid caregivers. I see caregivers wearing the smocks of agencies accompanying residents all the time in this assisted living facility in Florida.

You are already paying for 1 caregiver 12 hours per day. It may be cheaper to get an efficiency apartment (standard apartment) and get an overnight caregiver for the other 12 hours.

Sibby58 Aug 2022
Your dad needs more care.
Get out and tour some nursing homes, (some offer memory care, but THEY will decide if appropriate). Put some applications in , make some calls.
You will need to know all his financials. Generally what happens is he might begin as private pay, then when money is dwindling, you apply for Medicaid. They can help you figure when that is. Once Medicaid is pending, you stop paying the gigantic bill and only pay Net Available Monthly Income.

My mom recently had to leave assisted living because she became a two person assist for transfers. The facility sent out a person to interview her to see if she was appropriate for memory care. After a little rough start, she is thriving there. They have more programs/ activities for her and she is getting the care she needs…Not just sitting in front of the TV.
sgp1038 Aug 2022
What city is that good facility in?
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