Monday Author: Susanne Skinner
She needed advanced care long before my Dad passed away last November. They shared a small apartment in a full assisted-living residence with light nursing care. I kept them together because they were each other’s support system. Separating them would have caused irreparable emotional harm.
When Dad passed away, I made the decision to move my sister to Florida and place her in memory care.
Finding the Right Place
There is no such thing as the perfect place, but there is a right place. Educating yourself is the first step in the long process to finding it.
Memory-care units are for people like my sister, with mid- to late-stage Alzheimer’s. It is specialized and costly care in a secure (keypad access) environment. Residents are free to move around indoors and there is often an enclosed outdoor space but they cannot enter or leave on their own.
Physical space is designed with visual cues and artwork to help residents find their way easily. Memory care has its own meal preparation, dining area, and medication management. Life-enrichment staff provide enhanced daily activities and personal care.
Some memory-care facilities are connected to assisted-living centers and nursing homes. Nursing homes alone are not designed for dementia patients and are not equipped to provide the needed care.
The most important aspect of any memory care option is one that keeps residents actively engaged in the world around them.
Profit Versus Not for Profit
For-profit and nonprofit facilities charge a monthly occupancy fee. The revenue gained by a nonprofit is fed back into its facilities and to its mission, often affiliated with a specific religion or organization.
Private, for-profit enterprises exist to make money. This is accomplished with lower staff levels and scaled resources. Cutting costs maximizes profits. About 80 percent of assisted-living communities are for-profit, and about half of all those are part of a corporate chain.
For-profits often have more public reports of negative indicators like hospitalizations, residents being restrained and poor levels/ratings of care and compassion.
The most important thing you can do is research your choices and know what you need. Due diligence will reveal the good and bad in all options and guide you to an informed decision.
There are bad nonprofits and good for-profits, and knowing the difference depends on the services you require. Nothing prepares you for the shock of what will become a regular monthly payment for the remainder of your loved one’s life.
I begin by researching neighborhood options. Many have state-of-the-art facilities that initially impressed me but I soon realized they would have minimal benefit for my sister. She needed a small community with emotionally invested caregivers in a space filled with light, activity and engagement.
Finding a location near our home was important for visits and outings. A goal for me included building relationships with management and care providers.
I started my research on-line, listing potential residences. I asked friends if they knew anyone who was or had been a resident and many did. Firsthand input is a bonus.
My first choice is less than one mile from our home. The other two options on my short list did not pan out. The first (even closer to our home) did not accept anyone under the age of 60 and my sister is 58. The second is newly opened and the director candidly told me their youngest resident is 82. She did not feel it would be a good fit. I am grateful to her for putting our needs above revenue.
- Make a list of options based on your needs
- Visit the web sites, but understand these are staged photos
- Make an appointment to visit each facility during a weekday and a weekend
- Meet with staff: facility director, wellness director (should be an RN) and activities director. Inquire about on-site medical staff (LPNs) and gerontologist visits.
- View the daily activities plan and the monthly calendar. Look for special events
- Tour the wing during an active part of the day. Residents should be visible and engaged in activities. The only time they should be in their rooms is for naps or bedtime.
- Inquire about external programs and a van for transportation.
- Look at a meal menu and inquire about dietary needs and considerations. Sample a meal. Observe how residents who need assistance with eating are helped.
- Observe the cleanliness of the facility and the residents
- Resident’s rooms should be comfortable, with natural light and a walk-in shower.
If you’ve come this far, you are leaving your intellectual research and crossing into an emotional and financial commitment. Placing a loved one in a locked wing with the people who will provide their 24-hour care is life changing for both of you.
The Financial Weight of Memory Care
Monthly costs range from $6,000 to $8,000. Most facilities have a set cost with added fees based on the level of assistance needed for ADL – active daily living.
- Level One — Low level of care. This resident is semi-independent, requiring reminders to perform ADLs or requires some supervision or assistance to ensure tasks are performed correctly and safely.
- Level Two — Intermediate or moderate level of care. The resident may be independent with some ADLs, such as eating but needs help with getting dressed or bathing.
- Level Three — Highest level of care. The Individual requires a comprehensive level of assistance from multiple caregivers.
Everything costs something. There are fees for administering medication, charged by the number of times it is given each day. If multiple caregivers are needed for lifting or bathing an individual, the cost is higher than if only one person were needed. There is even a fee for in-room dining. If my sister wants to eat a meal in her room (but is able to go to the dining room) there is a $12.00 fee to deliver it.
It will always cost more than you thought it would.
Peace at Last
It has been a long journey for both of us. We have arrived at last in the place she is meant to be.