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OFF-TOPIC Senior care - any suggestions?

Discussion in 'Off Topic: Sports, Funnies, Pop-Culture' started by GoldenEggs, Feb 11, 2008.

  1. GoldenEggs
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    GoldenEggs Contributor

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    My father in law is finally back home, after a 2 month recuperation stay in a convalescent home for breaking his ankle. He is not 100% back to his normal activities. We're supposed to get a nurse to assist with bathing/grooming and a physical therapist to help him get back to full mobility and this is covered under the insurance until he is able to return to his normal activities. By the way, he will be turning 96 this year. Before his accident, he was pretty active, going to the senior center everyday and I made sure he continued his exercises.

    Putting him in a home is NOT an option, because of costs, financials and emotional. Unforunately, we are also unable to afford a part time nurse. (Another reason why I need to get our website bringing in the sales and our apartment issues fixed so it is profitable!) We've looked into Medicare/Medical and it doesn't make sense right now since he has a really good pension. I'm trying to figure out what other options are available for low cost assisted home care or even caregiver relief but from someone with a medical background.

    My husband and I are pretty limited in how far and how long we can travel or just even go out. We have limited family/friends that we can rely upon, especially right now, since my f-i-l needs more than just someone sitting with him.

    In my ideal world, we would have a student nurse/physical therapist assisting us with him and the student would receive internship or school credit. I was part of an AmeriCorps program for service-learning that provided this kind of training but it was for existing businesses and not for personal needs. I'm also thinking there may be a greater need for this in a couple of years but does anyone know it is exists already? What are the other options out there?
     
  2. Sid23
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    Sid23 Bronze Contributor

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    First off, let me say that I sympathize with your situation and what you are dealing with. While I am not in the same situation (yet), I see it coming soon with my mom. And she lives 2,000 miles away. So it will be a challenge.

    Secondly (and not trying to hijack your thread), I see this as an area of real opportunity in the future. There must be millions of people like us, who relatives are getting too old to take care of themselves, who cannot find a suitable place for them for one reason or another. But often its financial and emotional in nature. And many younger people no longer live in the same area/city/state as their parents and do not have plans to move back. I think most senior living and other facilities that cater to the elderly are $40-100k a year.

    I think there is a killing to be made by someone or a group of people that can give the market what it needs and solve this problem by providing affordable, yet still high quality assistance.
     
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  3. BeingChewsie
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    BeingChewsie Silver Contributor Read Millionaire Fastlane Speedway Pass

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    I think your needs could be met with a part time nursing assistant/home care aid...they make about $10-$13/hr vs an RN who makes $35-45/hr...if it is just assistance with activities of daily living...bathing, grooming, feeding then the homecare aide/nurses assistant will do the trick. You really don't need a nurse for those tasks.

    You might get a nursing student through an agency looking to make a couple bucks while in school.

    Be cautious in dealing with homecare agencies this is really a case of you get what you pay for.


    Any other questions please feel free to ask..I'm an RN with long term care/assisted living experience

    Sue



     
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  4. Jito
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    Jito New Contributor

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    My grandparents have a full time live in assistant. The guy is from Fiji, looks like a rugby player, tats and all. Extremely nice guy, very polite, humble and personable. I believe they pay 3k a month, not sure if this is low or high, but he's immensely helpful.
     
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  5. GoldenEggs
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    Sue,

    Thanks for your input! My cousin is going through a nursing program right now and she interns at a VA hospital but can't help us out because she would not be able to get credit for it. The main reason why I want a nurse is that clean up is sometimes required and atleast a nurse has been exposed to that already.

    The lowest price homecare agency I found was $20/hr but I need someone who can speak unaccented English. The things I would need help with are clean up as necessary, making of meals and making sure he takes the corect medication and does his exercises. Also, I need someone strong enough to catch him/stop him from falling. But I also need someone who will not treat him like a child; he has cognitive abilities but he is definately hard of hearing, even with hearing aids. Are there certain things I should ask/look for when looking at homecare agencies? What kind of certifications/training should I look for?

    Thanks!!
     
  6. GoldenEggs
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    SeanS,

    Yeah, I agree. There was a small period of time that the insurance would not cover the fee at the convaslecent home and for a shared room, it was $200/day.

    Even for people that are able to take care of their elderly, it is tough. Before I left my job, whenever my husband travelled, I woke up at 5am to get a workout in, came home to get my f-i-l breakfast and off to the senior center, drove an hour to work to work for 4 hours, drive an hour back home to pick him. Then once I was home I had to take care of him and the house. If I had to run errands, I'd bring him in the car with me for fear that he would hurt himself or eat food that he was not allowed to eat.

    Like BeingChewsie recommended, I may not really need a RN... maybe an adult sitter. I need someone in between a RN and someone just keeping him company.

    I would love to be able to create a business around senior care for that kind of a gap but I don't even know where to begin.
     
  7. GoldenEggs
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    GoldenEggs Contributor

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    Jito,
    My husband keeps asking me if we could sponsor one of my relatives, from the Philippines, to come over to the US to help us out. He's half-joking and half-serious. It's a good idea but not practical. Atleast not for us right now.
     
  8. hakrjak
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    hakrjak Bronze Contributor Read Millionaire Fastlane

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    My girlfriend is a social worker for one of the ritzier "Old Folks" homes here in Colorado Springs, and from listening to her daily experiences -- it sounds like the biggest problem people go through during this stage in their life is understanding the true expectations of the situation. They come in at 99 years old with a broken hip, and expect to go home and live indepently after a little therapy -- and that isn't realistic 99% of the time.

    Look at this case -- The gentleman in question is 96 years old, recently injured, and wants to continue living indepently. This may not be a realistic for this guys situation. I couldn't tell you without looking at the case in detail, but it sounds like he is not capable of caring for himself at this point.

    You said that the guy has a really good pension. How about downsizing his house to a condo, and having him pay for an adult sitter, CNA, or home health aid? After you get him rehabbed, How about having him sell his house and move into an independent living facility? Here in Colorado Springs, they run only about $2000 per month for one of the nicer units in town. There are cheaper options.

    Yes, some old folks can be stubborn -- and not realize how their life is going to change as they enter the late Autumn of their life. They may not want to leave their home, or change their living circumstances -- but this doesn't make it any less necessary.

    I'm informed by my g/f that Medicare would pay for a home health nurse or therapist to come to the house if he has what they call a "Skilled Need".

    Cheers,

    - Hakrjak
     
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  9. GoldenEggs
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    Harjak,

    Thank you for your suggestions. Selling the house is not an option; without going into detail, our legal counsel advised us to let my f-i-l live his final days in peace since there wasn't anything we could do about the situation. We went for second, third and fourth opinions and in our situation, there isn't anything we can do. Even if we do not sell the house, we still couldn't afford to put him in a nursing home.

    We currently live in the home and take care of him. My husband moved back from L.A. about 15 yrs ago to take care of his father so my f-i-l has never been alone for the last 15 years. If we put him in a home, he will die. The change in his attitude and demeanor when we took him home on Saturday was HUGE. His appetite came back, he regained color in his face and he gained back his will to live.

    My best friend's dad recently died from ALS and she told us how Medicare paid for everythng. But, her dad had to give up owning anything. That would not work for our situation; there are other factors tying our hands besides my f-i-l not wanting to go into a home.

    I feel that right now, the best course of action is to find some kind of low cost help so I am looking for what else is available.
     
  10. BeingChewsie
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    BeingChewsie Silver Contributor Read Millionaire Fastlane Speedway Pass

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    Hi,

    What if you got a HELOC on the house and used the money to hire in home care? He must have equity in the house, add that in with his pension and you should be able to afford good quality care for your FIL. It sounds like you only need part time care.

    I don't know of any low cost solutions that I could recommend. In home care agencies you get what you pay for and what you want is the best care for your FIL you can get..at 96 he has kind of paid his dues and deserves it.

    You want an agency that is certified through:
    Joint Commission on Accreditation of Healthcare Organizations (JCAHO)


    Stay away from places that are not.

    You want places that hire certified care-givers..certified CNAs and HHAs..and you want to know how often the field supervisors check in, you want background checks including credit checks done on home health aides..you wouldn't want your FIL being robbed blind of his assets by people he and you trusted to care for him.

    Here is a link to an article on ten questions to ask your home care agency.

    http://www.newlifestyles.com/resources/articles/Hiring_a_Home_Care_Agency.aspx

    Good luck, I really think a refi on his home could provide him the money for his care, he could stay in the home and he wouldn't have to sell.

    Sue


     
  11. bflbob
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    bflbob Bronze Contributor Read Millionaire Fastlane Speedway Pass

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    We struggled with this when my Mom got older.
    She had Alzheimer's, which sort of puts her in a different class, but...

    My sister didn't want to put her in a home.
    She felt they were too expensive, and they didn't really keep an eye on her.
    She thought about hiring a "person", not really a RN, to watch her.

    I pointed out that, even at $8/hour, you're talking $192.00/day.
    You'd need to hire at least four people, working 8-hour shifts, to cover the week.
    Even then, some would be on OT.
    Then there is the cost of vacations, covering breaks and meal times, sick days, etc.
    So, even "cheap" help would be over $6,000 per month.

    Our solution was to place her in one of the "Assisted Living Facilities" my boss owns.
    The cost was about $2,500 per month, including meals, heat, medicine control, etc.
    She had a private room, and they helped her with personal needs for that amount.

    Like your FIL, she absolutely HATED it!
    At first.
    A couple of months later, we tried to bring her home for Christmas.
    She cried because she didn't want to leave (the facility).:smxD:

    My point is this...
    At 96, he's going to be scared about almost everything.
    Falling...noisy kids...money issues...being alone.
    At a facility, there are a bunch of people who are close to his peers as you'll find.
    It will take him a while to warm up to it, but maybe not that long...

    You probably don't want to hear this, but one of the biggest "issues" we have at our facilities is sex.
    With a ratio of 1 man to about 10 women, the old guys "do OK".:love1:
    This is something you'll never be able to provide at home (I assume).
    So re-think the idea of having him move to one of these facilities (not a nursing home).
     
  12. GoldenEggs
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    Sue,

    Thank for the links, that helps me. Because of our situation, we can't do a HELOC. Anything we provide for him comes out of our limited (for the time being) pockets.

    Bflbob,

    Thank you for sharing your story. I have an aunt who lives in an assisted living facility in Napa and she doesn't want to move from it either. My f-i-l doesn't like change. We had him try out a new senior center and he was miserable but he kept going because he thought it made life easier for us. We thought he might enjoy a different place but took him back to his original senior center.
     
  13. yveskleinsky
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    yveskleinsky Bronze Contributor Speedway Pass

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    Start by seeing which agencies accept your insurance and use one of their home healthcare providers. Cross the bridge of finding someone after he gains full mobility once he gets there. Focus on the positives and keep your head up- I know this is a difficult situation for everyone involved.
     
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  14. kimberland
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    kimberland Bronze Contributor

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    No one likes change.
    I still remember my first three months at University
    (in residence).
    I hated it.
    I cried almost every night.
    But after those three months... LOL.

    The thing is,
    you don't have to leave your F-I-L in whatever residence you decide on.
    You can use it like a hotel for him.
    Pick him up for dinner every night.
    Let him stay at your place on the weekends.

    When the hubby's grandma was in a home,
    she had visitors every single day,
    was taken home on weekends (until she got too weak)
    and out for ice cream often.
    She had more visitors than when she lived at our Auntie's place
    because people felt free to drop in whenever they wanted to.
     
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  15. hakrjak
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    hakrjak Bronze Contributor Read Millionaire Fastlane

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    Good one Bob -- my g/f agrees that the old guys are studs in these facilities. Most have 2 or 3 girlfriends... haha ;)

    The bottom line is -- if you keep someone at home, and you're unable to care for them -- Sooner or later the state will step in and become the custodian for that person. It happens every day... Usually when someone falls down, and the ambulance shows up to find the person living in filth, or with nobody else home -- etc... The state ends up determining what is right for that person, and that's no fun for anybody. Don't let it get to that point. The social workers at facillities my g/f has worked very rarely ever let someone return home at this point -- and almost always insist that they stay in a facility for the rest of their lives. At $8000-$10000 a month for full care, it doesn't take long to drain savings -- and once you go on Medicare that is no fun either. If the person is a Veteran, sometimes they can check into a V/A facility -- but the conditions there are really becoming deplorable, and the care is not up to Par at all -- which is really sad, considering that some of these guys living there are war heroes...

    Cheers,

    - Hakrjak
     
  16. hakrjak
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    hakrjak Bronze Contributor Read Millionaire Fastlane

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    Terrible disease Bob -- My heart goes out to you.

    With my g/f finishing her PHD in Neuro-Psychology right now, and working in a geriatric facility - we're exposed to it at a higher level than most. One of the charities we support annually out here is the Alzheimer's art auction at the Broadmoor in Colorado Springs.

    Beautiful paintings from people who don't remember painting them, or who have never picked up a paint brush before in their lives!

    - Hakrjak
     
  17. GoldenEggs
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    GoldenEggs Contributor

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    Kimber, Yves, thank you for your replies.

    Harjak,
    It's not that we are unable to care for him. We just need some relief every now and then! Our 2 yr anniversary is coming up and as much as I would love to go away for the weekend, it's not an option right now.

    Plus... I kinda want to get it sorted now as a "dry run" for me. My husband is the same age as my parents. I'm an only child. I would like to have a plan in place, atleast a skeleton plan even in my mind, if something happened to all three of them.

    My f-i-l's mobility is getting better. We have a chair lift for him and he hasn't used it since he came home. His appetite has definately returned, he's not one of those seniors who pecks at the food. He would eat a whole casserole if I put it in front of him. He plays classical piano and we bought a keyboard for him while he was at the convaslescent home so that he could continue practicing and he is working on a new concerto. I've been working with him on arm and leg exercises but am waiting for the physical therapist to see what kind of foot/ankle exerices he can do.

    After reading everyone's posts, I think I need rephrase what I am looking for... I need caregiver relief! Not all the time... just every now and then would be nice. :)

    Thank you all for your input and support. My husband and I are still trying to work out the best way to juggle everything.
     
  18. GoldenEggs
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    I have a happy update. My f-i-l is doing MUCH better. We went out to breakfast yesterday and we were prepared to use the wheelchair to take him out. When I brought it out, he made a face and was all, "Do I have I use that? I can walk!!" So we let him walk with just the walker and while he was much slower then before, he did it! :hurray:

    Slightly funny story... my nephew came to visit him and he is an electrician. He was working at the Hyatt Residences near us and that one is retirement living to assisted living. He was working on the lighting in the assisted living building and watched as the staff interacted with the residents. A staff member was working with one gentleman and saying, "I'm going to toss the ball to you and you need to catch it and throw it back to me. Ok? Ready...1...2...3" and tosses the ball. The gentleman said, "You go to hell!" and kicked the ball away!! I was laughing but my f-i-l said I'm so happy to be home. Those nursing homes are terrible, I know, I have experienced it firsthand. sigh. But he's getting stronger and we've made it a full week with no accidents!
     
  19. BeingChewsie
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    BeingChewsie Silver Contributor Read Millionaire Fastlane Speedway Pass

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    Ya!!!! Thats is wonderful! I hope he continues to improve :).



     
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