Dad has Alzheimer's. Living with companion and her son. Funds running out for homemaker services. Need AL or memory care. Also Medicaid after a few months of private pay. My dad will be so desolate without his companion. Neither understand the situation. Have chance to hire affordable homemaker but afraid only putting off the decision
Your option would be either take what he has left and pay a caretaker or private pay for a nice NH who excepts Medicaid. I chose to private pay 2 months for Mom in a NH. I applied for Medicaid in April, placed Mom May 1st, she paid for May and June and Medicaid started July 1st.
Its not fair to the son to care for your Dad when he has his own Mom. I think now is tge time to make the decision concerning his long term care.
"I am 68 yr old daughter of 96 yr old father. He is living independently with 96 yr old companion. He recently(4 months ago) started some dementia. He calls me almost every night asking about "his papers". His night time confusion is extending to daytime."
His regularly occurring night time confusion is a dementia behavior called Sundowning. They are not quite sure why it happens, but theories are that the shadows that happen in the afternoon and evenings confuse people with dementia, another thought is that they start to get tired towards the end of the day and it affects their ability to process and interpret their thoughts. A temporary fix could be to add brighter lightbulbs in his home and then turn on lights earlier in the day even if you think they aren't yet needed. I have had success doing this with my 99-yr old Aunt. It also helps to introduce a distraction at this part of the day, like going outside for a walk, doing a task (like folding kitchen towels, sorting & pairing socks, anything he's willing to do) or watching a light-hearted DVD (nothing negative, tense or scary). I also had success with my Aunt using these strategies.
Your bigger question is about his care in the near future. Are you his durable PoA? Is anyone his PoA? If he has one, this is the person who now needs to step in. Does your dad have an actual diagnosis of cognitive/memory impairment in his medical records? If not, this will need to happen (and if he hasn't yet legally assigned a PoA, the diagnosis should come *after* him signing PoA paperwork).
With "blended" families, there can often be confusion about which adult children perform what roles for which parent. Has your dad been with this companion a long time? Long enough that it is considered like a legal marriage in his state? Laws on this will differ by state.
What does his companion's son think of this situation? I'm thinking you will need to have an open discussion with him since this may impact his living arrangement and his mom. Knowing this info will help forum participants to give you better guidance on what to do.
In the end much will depend on whether you are his PoA and if his companion is his legal partner and will be moving with him, and who is her PoA. You can start researching caregiving agencies and facilities. Not every state's Medicaid will pay for AL, only MC or LTC, some will provide an Elder Waiver which pays for some of AL so you should find this out for his state.
If he has no PoA and refuses to create one, then you can help him to a point that he allows but then will need to allow the county to help him. They can be called in to perform an in-home needs assessment for some services (light housekeeping, meal prep, hygiene) but in the end it won't be full-time 24/7. Without a PoA and his cooperation the county will need to gain guardianship to manage his affairs. Too soon to go there in this conversation -- sorry it's so long. Any more detail you can provide will be helpful.