Re: Choosing a Nursing Home

[Guest guest]

Hi, Diane - Am sorry to hear that your poor Dad isn't settled somewhere. That

means you are unsettled, too, which for a lot of us makes everything else we go

through even more complicated. And what a shame that the best NHs have wait

lists - there certainly are good places, but in general our society allows a lot

of substandard care care for our elders. (And I work in senior care.)

I'm not familiar with your Dad's health status or your parents' financial

situation, so please take this question with a very large grain of salt: Is

there any possibility - or any value - to your dad's remaining at home with a

full-time caregiver? Am asking only because that's been my choice for my mom.

The cost works out nearly exactly the same between a good NH and trained

full-time caregivers.

Does the NH you like say why they won't tell you more about delaying

admission? Does this come from the administrator, or the nursing director, or

one of the other staff. You've likely done this, but if by chance not, it might

be worthwhile to speak directly to the head person.

Your family will be in my prayers for the best solution to your Dad's getting

comfortably settled very soon.

Peace, Lin

Diane wrote:

We didn't have the luxury of choice in our decision, unfortunately.

Dad was slipping rapidly and we finally got him into a 10-14 day

evaluation program, which was where they changed his diagnosis from

Alzheimer's to LBD and changed his meds.

But, since this was supposed to be a 2 week max program, they started

searching out homes for us almost immediately. They have a social

worker on staff who does that pretty much full time, so she knew all

the homes in the area and one-by-one made contact on our behalf. No

beds available in a 2 county area - what are the chances of that? We

started to wonder if nursing homes are particular about the patients

they accept - Dad is easily agitated even with the Seroquel and is

definitely care-resistant most days.

They eventually found a bed for him - after about 25 days in the 14

day program - they said they wouldn't make us take him home and they

stuck to their word, but man! What a difficult process. The home

they finally found is about 45 minutes away from Mom and isn't too

bad, but there are things about it I don't like. But, beggars can't

be choosers, I guess.

We've still got his name on the list for the home near Mom that we all

really like, but they keep saying they can't admit him . . . yet . . .

and won't give us any more information than that he's at the top of

the waiting list. In the meantime, we're hesitant to bring too much

of Dad's stuff to the home he's in now. Wish we could just get him

settled for good.

My own suggestions about nursing homes (NHs) are based on my working

for a non-profit health organization which manages several of them,

along with a hospital. Research them. Stop by at different times of

the day and night unannounced. Most good ones will have a receptionist

to ask who you are and if they can help you. See what the place looks

like, smells like and how the residents appear. Ask family members

coming in their impressions. In addition to meeting with the

marketing/admissions person, ask to meet the Nursing Director and the

person who would be in charge of staff working with your mom. If they

offer such services as therapy, activities or spiritual care, meet

with those staff people too. Find out how they work with doctors. If

they have staff docs, what are the specialties? Is there a

gerontologist on staff? (And not just someone they bring in once a

month to see 30 people in 4 hours - warning!) What is the NH's policy

on hospitalizations: what prompts them,

> what is the turnaround time, what hospital do they use, etc? If a

NH is unwilling to address every issue you raise, be wary. Good ones

want you to be satisfied, to know about their operation, and to feel

comfortable with the care they offer. We would do these things if

moving into a new neighborhood or deciding on a school for a child.

Welcome to LBDcaregivers.

[Guest guest]

Diane,

Unless your state has laws different than most, they can't make you bring him

home. As a matter of fact, unless you want him home and than have a hard time

finding a nh, you really need to refuse to bring him home.

The bad part of that of course, you will be in a nh where ever they find one.

It is hard, depending on how the nh is being paid for by your family. If he is

on or soon going on Medicare, you will have a more difficult time finding a home

that will take him. I was dumb enough to be honest and never could move Mom..

No one would take her once she went on Medicaid.

Hope you find something closer.

Hugs,

Donna R

Caregave for Mom (after I brought her from WI to MI) for 3 years and 4th year in

a nh.

She was almost 89 when she died in '02. No dx other than mine.

Re: Choosing a Nursing Home

Hi, Diane - Am sorry to hear that your poor Dad isn't settled somewhere. That

means you are unsettled, too, which for a lot of us makes everything else we go

through even more complicated. And what a shame that the best NHs have wait

lists - there certainly are good places, but in general our society allows a lot

of substandard care care for our elders. (And I work in senior care.)

I'm not familiar with your Dad's health status or your parents' financial

situation, so please take this question with a very large grain of salt: Is

there any possibility - or any value - to your dad's remaining at home with a

full-time caregiver? Am asking only because that's been my choice for my mom.

The cost works out nearly exactly the same between a good NH and trained

full-time caregivers.

Does the NH you like say why they won't tell you more about delaying

admission? Does this come from the administrator, or the nursing director, or

one of the other staff. You've likely done this, but if by chance not, it might

be worthwhile to speak directly to the head person.

Your family will be in my prayers for the best solution to your Dad's getting

comfortably settled very soon.

Peace, Lin

Diane wrote:

We didn't have the luxury of choice in our decision, unfortunately.

Dad was slipping rapidly and we finally got him into a 10-14 day

evaluation program, which was where they changed his diagnosis from

Alzheimer's to LBD and changed his meds.

But, since this was supposed to be a 2 week max program, they started

searching out homes for us almost immediately. They have a social

worker on staff who does that pretty much full time, so she knew all

the homes in the area and one-by-one made contact on our behalf. No

beds available in a 2 county area - what are the chances of that? We

started to wonder if nursing homes are particular about the patients

they accept - Dad is easily agitated even with the Seroquel and is

definitely care-resistant most days.

They eventually found a bed for him - after about 25 days in the 14

day program - they said they wouldn't make us take him home and they

stuck to their word, but man! What a difficult process. The home

they finally found is about 45 minutes away from Mom and isn't too

bad, but there are things about it I don't like. But, beggars can't

be choosers, I guess.

We've still got his name on the list for the home near Mom that we all

really like, but they keep saying they can't admit him . . . yet . . .

and won't give us any more information than that he's at the top of

the waiting list. In the meantime, we're hesitant to bring too much

of Dad's stuff to the home he's in now. Wish we could just get him

settled for good.

My own suggestions about nursing homes (NHs) are based on my working

for a non-profit health organization which manages several of them,

along with a hospital. Research them. Stop by at different times of

the day and night unannounced. Most good ones will have a receptionist

to ask who you are and if they can help you. See what the place looks

like, smells like and how the residents appear. Ask family members

coming in their impressions. In addition to meeting with the

marketing/admissions person, ask to meet the Nursing Director and the

person who would be in charge of staff working with your mom. If they

offer such services as therapy, activities or spiritual care, meet

with those staff people too. Find out how they work with doctors. If

they have staff docs, what are the specialties? Is there a

gerontologist on staff? (And not just someone they bring in once a

month to see 30 people in 4 hours - warning!) What is the NH's policy

on hospitalizations: what prompts them,

> what is the turnaround time, what hospital do they use, etc? If a

NH is unwilling to address every issue you raise, be wary. Good ones

want you to be satisfied, to know about their operation, and to feel

comfortable with the care they offer. We would do these things if

moving into a new neighborhood or deciding on a school for a child.

Welcome to LBDcaregivers.

[Guest guest]

Hi Diane,

My husband is in a nh and it was not my first choice, but my second choice. My

first choice, because it was so popular, was booked when I wanted to put my

husband in, it was only 5 min. away from my home, but recently I have met two

couples that have moved their LOs to my husband's nh, because they had their LOs

in my #1 choice and were not happy with it and I heard the same from a man at an

Alz. Support Group, that he was not happy with my #1 choice, so now I am glad I

have Jim where he is, 12 min. away from home. So, you may be in the better

place anyway. It seems to me all the nh no matter where, are pretty much the

same. Over worked and under staffed. You have to advocate and keep an eye out

for your LOs well-being wherever they are. One couple I talked to said that

their LO fell and broke his hip at my #1 choice and no one noticed it was broken

until a day or two later. Why didn't they take X-ray or have a doctor look right

away?! He must have been in pain. The

couple of the LO were very upset. Where Jim is they are very cautious about

anyone that has poor balance and are always making sure that they are safe from

falling. Well, it might help that they also have an Orthopedic Rehabilitation

there and are very cautious about broken bones.

Anyway, I don't think that they try to keep you out on purpose. If they are

considered popular there will be a waiting time until someone dies or is moved

out. I was thinking if it was now, I could have probably moved Jim in, because I

know of two openings now, since two LOs were moved to my husband's nh, but now I

don't want to move my husband. I don't think the grass is greener on the other

side anymore.

Hope it all works out for you mom and dad..........Jan

Diane wrote:

We didn't have the luxury of choice in our decision, unfortunately.

Dad was slipping rapidly and we finally got him into a 10-14 day

evaluation program, which was where they changed his diagnosis from

Alzheimer's to LBD and changed his meds.

But, since this was supposed to be a 2 week max program, they started

searching out homes for us almost immediately. They have a social

worker on staff who does that pretty much full time, so she knew all

the homes in the area and one-by-one made contact on our behalf. No

beds available in a 2 county area - what are the chances of that? We

started to wonder if nursing homes are particular about the patients

they accept - Dad is easily agitated even with the Seroquel and is

definitely care-resistant most days.

They eventually found a bed for him - after about 25 days in the 14

day program - they said they wouldn't make us take him home and they

stuck to their word, but man! What a difficult process. The home

they finally found is about 45 minutes away from Mom and isn't too

bad, but there are things about it I don't like. But, beggars can't

be choosers, I guess.

We've still got his name on the list for the home near Mom that we all

really like, but they keep saying they can't admit him . . . yet . . .

and won't give us any more information than that he's at the top of

the waiting list. In the meantime, we're hesitant to bring too much

of Dad's stuff to the home he's in now. Wish we could just get him

settled for good.

My own suggestions about nursing homes (NHs) are based on my working

for a non-profit health organization which manages several of them,

along with a hospital. Research them. Stop by at different times of

the day and night unannounced. Most good ones will have a receptionist

to ask who you are and if they can help you. See what the place looks

like, smells like and how the residents appear. Ask family members

coming in their impressions. In addition to meeting with the

marketing/admissions person, ask to meet the Nursing Director and the

person who would be in charge of staff working with your mom. If they

offer such services as therapy, activities or spiritual care, meet

with those staff people too. Find out how they work with doctors. If

they have staff docs, what are the specialties? Is there a

gerontologist on staff? (And not just someone they bring in once a

month to see 30 people in 4 hours - warning!) What is the NH's policy

on hospitalizations: what prompts them,

> what is the turnaround time, what hospital do they use, etc? If a

NH is unwilling to address every issue you raise, be wary. Good ones

want you to be satisfied, to know about their operation, and to feel

comfortable with the care they offer. We would do these things if

moving into a new neighborhood or deciding on a school for a child.

Welcome to LBDcaregivers.

[Guest guest]

And, Donna, remember that my dad had lived at

a NH for 2 1/2 years when they decided to have

him go to the adult psychiatric unit...AGAIN, to have

his meds checked out. Well, the day he left I asked,

call it intuition, if my dad would be coming back. I

was assured he would be. Little did I know that

shortly after my dad left for the " unit " in my truck

because the NH didn't order an ambulance or any

other transportation...they wrote up an " involuntary

discharge " . This meant my dad was let go. He

was in the psychiatric unit until Sept. 17, transferred

to another NH an hour or so away and passed away

on Sept. 20.

So sorry everyone, but one more thing to think about. Also, then 5 months

after dad's passing

came the letter from the Iowa's Estate Recovery

Program...it never seemed to end.

Sandie

Des Moines, IA

-- Re: Choosing a Nursing Home

Hi, Diane - Am sorry to hear that your poor Dad isn't settled somewhere.

That means you are unsettled, too, which for a lot of us makes everything

else we go through even more complicated. And what a shame that the best

NHs have wait lists - there certainly are good places, but in general our

society allows a lot of substandard care care for our elders. (And I work

in senior care.)

I'm not familiar with your Dad's health status or your parents' financial

situation, so please take this question with a very large grain of salt: Is

there any possibility - or any value - to your dad's remaining at home with

a full-time caregiver? Am asking only because that's been my choice for my

mom. The cost works out nearly exactly the same between a good NH and

trained full-time caregivers.

Does the NH you like say why they won't tell you more about delaying

admission? Does this come from the administrator, or the nursing director,

or one of the other staff. You've likely done this, but if by chance not, it

might be worthwhile to speak directly to the head person.

Your family will be in my prayers for the best solution to your Dad's

getting comfortably settled very soon.

Peace, Lin

Diane wrote:

We didn't have the luxury of choice in our decision, unfortunately.

Dad was slipping rapidly and we finally got him into a 10-14 day

evaluation program, which was where they changed his diagnosis from

Alzheimer's to LBD and changed his meds.

But, since this was supposed to be a 2 week max program, they started

searching out homes for us almost immediately. They have a social

worker on staff who does that pretty much full time, so she knew all

the homes in the area and one-by-one made contact on our behalf. No

beds available in a 2 county area - what are the chances of that? We

started to wonder if nursing homes are particular about the patients

they accept - Dad is easily agitated even with the Seroquel and is

definitely care-resistant most days.

They eventually found a bed for him - after about 25 days in the 14

day program - they said they wouldn't make us take him home and they

stuck to their word, but man! What a difficult process. The home

they finally found is about 45 minutes away from Mom and isn't too

bad, but there are things about it I don't like. But, beggars can't

be choosers, I guess.

We've still got his name on the list for the home near Mom that we all

really like, but they keep saying they can't admit him . . . yet . . .

and won't give us any more information than that he's at the top of

the waiting list. In the meantime, we're hesitant to bring too much

of Dad's stuff to the home he's in now. Wish we could just get him

settled for good.

My own suggestions about nursing homes (NHs) are based on my working

for a non-profit health organization which manages several of them,

along with a hospital. Research them. Stop by at different times of

the day and night unannounced. Most good ones will have a receptionist

to ask who you are and if they can help you. See what the place looks

like, smells like and how the residents appear. Ask family members

coming in their impressions. In addition to meeting with the

marketing/admissions person, ask to meet the Nursing Director and the

person who would be in charge of staff working with your mom. If they

offer such services as therapy, activities or spiritual care, meet

with those staff people too. Find out how they work with doctors. If

they have staff docs, what are the specialties? Is there a

gerontologist on staff? (And not just someone they bring in once a

month to see 30 people in 4 hours - warning!) What is the NH's policy

on hospitalizations: what prompts them,

> what is the turnaround time, what hospital do they use, etc? If a

NH is unwilling to address every issue you raise, be wary. Good ones

want you to be satisfied, to know about their operation, and to feel

comfortable with the care they offer. We would do these things if

moving into a new neighborhood or deciding on a school for a child.

Welcome to LBDcaregivers.

[Guest guest]

Sandy,

I think there is a fine line. And if the nh is responsible, we can't put them

in our cars (or trucks) or we get them back. But I was really talking about

from the hospital to a nh. If you wait a day at home because the hospital says

it is time for them to go home, you may miss an opportunity at a nh. Maybe one

of our SWs who works with them, who are here with us can give inside info.

I think that is why they are put into the hospital in the first place. The

hospital and MDs then has responsibility to put them into a nh. I know I was

told (and this is for parents who are patients, I don't know about spouses,) not

to take her out of the hospital and take her home or she wouldn't get into a nh.

I ended driving her to the nh and realized when they said the nh would be

waiting for me, that I had made a mistake. I should have let the hospital move

her into the nh as best they could. I had no problem, but I realized I could

have when I was half way there. It all depends on what " THEY " want to call it.

And it sounds like they wanted your Dad gone, Sandy, and as soon as you put him

in your truck, it was a discharge. If they didn't order transportation, they

would have had to get some.

Bottom line is no one tells you your choices until it is to late and if you

aren't informed, they can do what ever they want to do.

I go back to having to pay a lawyer who worked on both sides of the border

(MI/WI) to get Medicaid approved. And the lawyer got $5000. for two single

pieces of paper. It was pay him or pay private pay at the nh for the mo. He

told me the Medicaid guy didn't know what he was talking about. But the

Medicaid guy was the one approving or disapproving Mom.

I just had a rough time all along. And a bad nh to boot.

Hope everyone had a Happy Turkey Day!

Hugs,.

Donna R

Caregave for Mom (after I brought her from WI to MI) for 3 years and 4th year in

a nh.

She was almost 89 when she died in '02. No dx other than mine.

Re: Choosing a Nursing Home

Hi, Diane - Am sorry to hear that your poor Dad isn't settled somewhere.

That means you are unsettled, too, which for a lot of us makes everything

else we go through even more complicated. And what a shame that the best

NHs have wait lists - there certainly are good places, but in general our

society allows a lot of substandard care care for our elders. (And I work

in senior care.)

I'm not familiar with your Dad's health status or your parents' financial

situation, so please take this question with a very large grain of salt: Is

there any possibility - or any value - to your dad's remaining at home with

a full-time caregiver? Am asking only because that's been my choice for my

mom. The cost works out nearly exactly the same between a good NH and

trained full-time caregivers.

Does the NH you like say why they won't tell you more about delaying

admission? Does this come from the administrator, or the nursing director,

or one of the other staff. You've likely done this, but if by chance not, it

might be worthwhile to speak directly to the head person.

Your family will be in my prayers for the best solution to your Dad's

getting comfortably settled very soon.

Peace, Lin

Diane wrote:

We didn't have the luxury of choice in our decision, unfortunately.

Dad was slipping rapidly and we finally got him into a 10-14 day

evaluation program, which was where they changed his diagnosis from

Alzheimer's to LBD and changed his meds.

But, since this was supposed to be a 2 week max program, they started

searching out homes for us almost immediately. They have a social

worker on staff who does that pretty much full time, so she knew all

the homes in the area and one-by-one made contact on our behalf. No

beds available in a 2 county area - what are the chances of that? We

started to wonder if nursing homes are particular about the patients

they accept - Dad is easily agitated even with the Seroquel and is

definitely care-resistant most days.

They eventually found a bed for him - after about 25 days in the 14

day program - they said they wouldn't make us take him home and they

stuck to their word, but man! What a difficult process. The home

they finally found is about 45 minutes away from Mom and isn't too

bad, but there are things about it I don't like. But, beggars can't

be choosers, I guess.

We've still got his name on the list for the home near Mom that we all

really like, but they keep saying they can't admit him . . . yet . . .

and won't give us any more information than that he's at the top of

the waiting list. In the meantime, we're hesitant to bring too much

of Dad's stuff to the home he's in now. Wish we could just get him

settled for good.

My own suggestions about nursing homes (NHs) are based on my working

for a non-profit health organization which manages several of them,

along with a hospital. Research them. Stop by at different times of

the day and night unannounced. Most good ones will have a receptionist

to ask who you are and if they can help you. See what the place looks

like, smells like and how the residents appear. Ask family members

coming in their impressions. In addition to meeting with the

marketing/admissions person, ask to meet the Nursing Director and the

person who would be in charge of staff working with your mom. If they

offer such services as therapy, activities or spiritual care, meet

with those staff people too. Find out how they work with doctors. If

they have staff docs, what are the specialties? Is there a

gerontologist on staff? (And not just someone they bring in once a

month to see 30 people in 4 hours - warning!) What is the NH's policy

on hospitalizations: what prompts them,

> what is the turnaround time, what hospital do they use, etc? If a

NH is unwilling to address every issue you raise, be wary. Good ones

want you to be satisfied, to know about their operation, and to feel

comfortable with the care they offer. We would do these things if

moving into a new neighborhood or deciding on a school for a child.

Welcome to LBDcaregivers.

[Guest guest]

Hi Sandie,

I think its disgusting the way your dad was treated! Too bad you couldn't hook

up with a health writer in your major paper and do a little expose on what goes

on.

Courage

[Guest guest]

Yes, Lin, we have thought about keeping him at home with full time

professional care. Especially after a few weeks in the nursing home -

now that we see for ourselves what kind of care he will be getting.

They have the space in their condo to set up a sick room and even have

live in help - not that Mom is very anxious to give up her privacy . .

.. but it might just be necessary. And, since the nursing home is well

over 6 grand a month, and they have a ways to go before having to

apply for medicaid, I'm fairly sure the cost of private care wouldn't

be prohibitive.

My question - and I apologize if this is already in the database and I

haven't seen it yet - is where to we start looking for a qualified

live in care giver? Anybody have any clues for me?

Thanks, Diane

>

> Hi, Diane - Am sorry to hear that your poor Dad isn't settled

somewhere. That means you are unsettled, too, which for a lot of us

makes everything else we go through even more complicated. And what a

shame that the best NHs have wait lists - there certainly are good

places, but in general our society allows a lot of substandard care

care for our elders. (And I work in senior care.)

> I'm not familiar with your Dad's health status or your parents'

financial situation, so please take this question with a very large

grain of salt: Is there any possibility - or any value - to your dad's

remaining at home with a full-time caregiver? Am asking only because

that's been my choice for my mom. The cost works out nearly exactly

the same between a good NH and trained full-time caregivers.

>

> Does the NH you like say why they won't tell you more about

delaying admission? Does this come from the administrator, or the

nursing director, or one of the other staff. You've likely done this,

but if by chance not, it might be worthwhile to speak directly to the

head person.

>

> Your family will be in my prayers for the best solution to your

Dad's getting comfortably settled very soon.

>

> Peace, Lin

[Guest guest]

Thanks, Donna - I think you're right because we were really not given

a choice about the NH he is in presently - they called Mom in the

morning and TOLD her he was going to be moved that afternoon. Luckily

for us, it is not a bad place - just too far away for easy visiting.

The NH he is in now, told Mom that they could " kick him out " if his

behavior got too bad, though. I think what they mean by that is if he

begins to show violence to other patients, but since he is basically

bed-ridden, I have a hard time imagining that happening. Hope not,

anyway.

The evaluation center was covered by Medicare and the first two weeks

at the NH too - until his care resistance made them drop his physical

therapy. So, now we're back to private pay - will see how long Mom can

make that last. Fortunately, she has good financial advisers.

Diane

> My own suggestions about nursing homes (NHs) are based on my working

> for a non-profit health organization which manages several of them,

> along with a hospital. Research them. Stop by at different times of

> the day and night unannounced. Most good ones will have a receptionist

> to ask who you are and if they can help you. See what the place looks

> like, smells like and how the residents appear. Ask family members

> coming in their impressions. In addition to meeting with the

> marketing/admissions person, ask to meet the Nursing Director and the

> person who would be in charge of staff working with your mom. If they

> offer such services as therapy, activities or spiritual care, meet

> with those staff people too. Find out how they work with doctors. If

> they have staff docs, what are the specialties? Is there a

> gerontologist on staff? (And not just someone they bring in once a

> month to see 30 people in 4 hours - warning!) What is the NH's policy

> on hospitalizations: what prompts them,

> > what is the turnaround time, what hospital do they use, etc? If a

> NH is unwilling to address every issue you raise, be wary. Good ones

> want you to be satisfied, to know about their operation, and to feel

> comfortable with the care they offer. We would do these things if

> moving into a new neighborhood or deciding on a school for a child.

>

>

>

>

>

>

> Welcome to LBDcaregivers.

>

>

>

[Guest guest]

Thanks for sharing your story, Sandie - I'll be sure to keep my eyes

open for that sort of thing.

Diane

> My own suggestions about nursing homes (NHs) are based on my working

> for a non-profit health organization which manages several of them,

> along with a hospital. Research them. Stop by at different times of

> the day and night unannounced. Most good ones will have a receptionist

> to ask who you are and if they can help you. See what the place looks

> like, smells like and how the residents appear. Ask family members

> coming in their impressions. In addition to meeting with the

> marketing/admissions person, ask to meet the Nursing Director and the

> person who would be in charge of staff working with your mom. If they

> offer such services as therapy, activities or spiritual care, meet

> with those staff people too. Find out how they work with doctors. If

> they have staff docs, what are the specialties? Is there a

> gerontologist on staff? (And not just someone they bring in once a

> month to see 30 people in 4 hours - warning!) What is the NH's policy

> on hospitalizations: what prompts them,

> > what is the turnaround time, what hospital do they use, etc? If a

> NH is unwilling to address every issue you raise, be wary. Good ones

> want you to be satisfied, to know about their operation, and to feel

> comfortable with the care they offer. We would do these things if

> moving into a new neighborhood or deciding on a school for a child.

>

>

>

>

>

>

> Welcome to LBDcaregivers.

>

>

>

[Guest guest]

Diane,

Some states have a " recovery law " and some don't. When Sandie said she had

gotten a big bill from the state re: Medicaid recovery, I check and MI didn't

have one yet. They are trying to get one. I don't know how many states have

them, but they are all working on this.

It is why legal issues are so important right now.

Hugs,

Donna R

Caregave for Mom (after I brought her from WI to MI) for 3 years and 4th year in

a nh.

She was almost 89 when she died in '02. No dx other than mine.

Re: Choosing a Nursing Home

Thanks for sharing your story, Sandie - I'll be sure to keep my eyes

open for that sort of thing.

Diane

> My own suggestions about nursing homes (NHs) are based on my working

> for a non-profit health organization which manages several of them,

> along with a hospital. Research them. Stop by at different times of

> the day and night unannounced. Most good ones will have a receptionist

> to ask who you are and if they can help you. See what the place looks

> like, smells like and how the residents appear. Ask family members

> coming in their impressions. In addition to meeting with the

> marketing/admissions person, ask to meet the Nursing Director and the

> person who would be in charge of staff working with your mom. If they

> offer such services as therapy, activities or spiritual care, meet

> with those staff people too. Find out how they work with doctors. If

> they have staff docs, what are the specialties? Is there a

> gerontologist on staff? (And not just someone they bring in once a

> month to see 30 people in 4 hours - warning!) What is the NH's policy

> on hospitalizations: what prompts them,

> > what is the turnaround time, what hospital do they use, etc? If a

> NH is unwilling to address every issue you raise, be wary. Good ones

> want you to be satisfied, to know about their operation, and to feel

> comfortable with the care they offer. We would do these things if

> moving into a new neighborhood or deciding on a school for a child.

>

>

>

>

>

>

> Welcome to LBDcaregivers.

>

>

>

[Guest guest]

Ohhh, I'll have to see if WI has one.

That'd be very important to know!

Diane

> > My own suggestions about nursing homes (NHs) are based on my working

> > for a non-profit health organization which manages several of them,

> > along with a hospital. Research them. Stop by at different times of

> > the day and night unannounced. Most good ones will have a receptionist

> > to ask who you are and if they can help you. See what the place looks

> > like, smells like and how the residents appear. Ask family members

> > coming in their impressions. In addition to meeting with the

> > marketing/admissions person, ask to meet the Nursing Director and the

> > person who would be in charge of staff working with your mom. If they

> > offer such services as therapy, activities or spiritual care, meet

> > with those staff people too. Find out how they work with doctors. If

> > they have staff docs, what are the specialties? Is there a

> > gerontologist on staff? (And not just someone they bring in once a

> > month to see 30 people in 4 hours - warning!) What is the NH's policy

> > on hospitalizations: what prompts them,

> > > what is the turnaround time, what hospital do they use, etc? If a

> > NH is unwilling to address every issue you raise, be wary. Good ones

> > want you to be satisfied, to know about their operation, and to feel

> > comfortable with the care they offer. We would do these things if

> > moving into a new neighborhood or deciding on a school for a child.

> >

> >

> >

> >

> >

> >

> > Welcome to LBDcaregivers.

> >

> >

> >

[Guest guest]

For anyone wondering, California has a " Recovery Law " I just got a notice about

it. It will happen upon Jim's death. Of course, it is not my worry, since the

house is in Jim's name only and in a Trust to his kids, so they will be the ones

losing out on whatever MediCal wants out of the house. Sorry, I can't feel bad

for them, since they have never been supportive in their father's care. I never

thought they deserved the house.

Diane wrote:

Ohhh, I'll have to see if WI has one.

That'd be very important to know!

Diane

> > My own suggestions about nursing homes (NHs) are based on my working

> > for a non-profit health organization which manages several of them,

> > along with a hospital. Research them. Stop by at different times of

> > the day and night unannounced. Most good ones will have a receptionist

> > to ask who you are and if they can help you. See what the place looks

> > like, smells like and how the residents appear. Ask family members

> > coming in their impressions. In addition to meeting with the

> > marketing/admissions person, ask to meet the Nursing Director and the

> > person who would be in charge of staff working with your mom. If they

> > offer such services as therapy, activities or spiritual care, meet

> > with those staff people too. Find out how they work with doctors. If

> > they have staff docs, what are the specialties? Is there a

> > gerontologist on staff? (And not just someone they bring in once a

> > month to see 30 people in 4 hours - warning!) What is the NH's policy

> > on hospitalizations: what prompts them,

> > > what is the turnaround time, what hospital do they use, etc? If a

> > NH is unwilling to address every issue you raise, be wary. Good ones

> > want you to be satisfied, to know about their operation, and to feel

> > comfortable with the care they offer. We would do these things if

> > moving into a new neighborhood or deciding on a school for a child.

> >

> >

> >

> >

> >

> >

> > Welcome to LBDcaregivers.

> >

> >

> >

[Guest guest]

My experience in finding a nursing home. I was given a list to look at nursing

homes in my area by the social worker at the hospital where my husband was when

I requested that I wanted to put my husband in a nh. I drove around an entire

day looking at all the nh and having tours. About an 8 hour day. I finally

selected two that I would like for my husband. I told all that I was paying for

the first 3 months of my husband's stay out of pocket and then applying for

MediCal, there was no problem for me. One of the nursing homes had an opening of

the two that I chose and the other was booked. The hospital let me do the

choosing and the hunting for a nursing home. The only time that my husband was

put in a Convelescent Home of the doctor's choice, is when he had a very bad UTI

and had to have a month of IV antibiotics and they transfered him over to the

Convelescent Home to continue the IV after two weeks in the hospital. They said

I could leave Jim there for the long term if I

chose to, but I chose not to and brought him home. That was paid for by

Medicare and NOT MediCal, since he needed medical treatiment.. When it is that

kind of circumstance. It is not a doctor choosing that your LO has to go to a

particular Home and stay there. You have the choice to take them home and it is

very different from MediCal/Medicaid long term stay in a home. When you apply

for MediCal/Medicaid and talk to a social worker, you should be able to choose

your nursing home, not your doctor's choice as I did.

Diane wrote: Thanks, Donna - I think you're

right because we were really not given

a choice about the NH he is in presently - they called Mom in the

morning and TOLD her he was going to be moved that afternoon. Luckily

for us, it is not a bad place - just too far away for easy visiting.

The NH he is in now, told Mom that they could " kick him out " if his

behavior got too bad, though. I think what they mean by that is if he

begins to show violence to other patients, but since he is basically

bed-ridden, I have a hard time imagining that happening. Hope not,

anyway.

The evaluation center was covered by Medicare and the first two weeks

at the NH too - until his care resistance made them drop his physical

therapy. So, now we're back to private pay - will see how long Mom can

make that last. Fortunately, she has good financial advisers.

Diane

> My own suggestions about nursing homes (NHs) are based on my working

> for a non-profit health organization which manages several of them,

> along with a hospital. Research them. Stop by at different times of

> the day and night unannounced. Most good ones will have a receptionist

> to ask who you are and if they can help you. See what the place looks

> like, smells like and how the residents appear. Ask family members

> coming in their impressions. In addition to meeting with the

> marketing/admissions person, ask to meet the Nursing Director and the

> person who would be in charge of staff working with your mom. If they

> offer such services as therapy, activities or spiritual care, meet

> with those staff people too. Find out how they work with doctors. If

> they have staff docs, what are the specialties? Is there a

> gerontologist on staff? (And not just someone they bring in once a

> month to see 30 people in 4 hours - warning!) What is the NH's policy

> on hospitalizations: what prompts them,

> > what is the turnaround time, what hospital do they use, etc? If a

> NH is unwilling to address every issue you raise, be wary. Good ones

> want you to be satisfied, to know about their operation, and to feel

> comfortable with the care they offer. We would do these things if

> moving into a new neighborhood or deciding on a school for a child.

>

>

>

>

>

>

> Welcome to LBDcaregivers.

>

>

>

[Guest guest]

I take Jim out almost twice a week from the nursing home and have heard of

others that take their LOs home for the weekend. I have not taken Jim home for a

weekend, but I sign a book that I am taking Jim out and sign in when I bring him

back. There is no problem. I wonder why there would be a difference for Sandie

when she took her dad in the truck to the unit it was called, involuntary

discharge. It doesn't seem to be any different than taking them out for a

weekend. Jim's nursing home administration staff told me that Jim has 30 days

before his room is given up and he is discharged. So, if he went into a hospital

for a month his room would be given up. I know this happens, because in the

beginning when Jim first arrived to the nh, there were 3 men in one room, which

includes Jim. One man was transfered out to the hospital and they held his bed

for 3 weeks until he came back. Maybe the difference was that to go to a

hospital, her dad was not transfered by an ambulance

transport and that made the difference. It sure doesn't make sense, that they

wouldn't accept him back, unless it is a rule that they must leave by ambulance

transport to another medical building. Jan

Diane wrote: Thanks for sharing your story,

Sandie - I'll be sure to keep my eyes

open for that sort of thing.

Diane

> My own suggestions about nursing homes (NHs) are based on my working

> for a non-profit health organization which manages several of them,

> along with a hospital. Research them. Stop by at different times of

> the day and night unannounced. Most good ones will have a receptionist

> to ask who you are and if they can help you. See what the place looks

> like, smells like and how the residents appear. Ask family members

> coming in their impressions. In addition to meeting with the

> marketing/admissions person, ask to meet the Nursing Director and the

> person who would be in charge of staff working with your mom. If they

> offer such services as therapy, activities or spiritual care, meet

> with those staff people too. Find out how they work with doctors. If

> they have staff docs, what are the specialties? Is there a

> gerontologist on staff? (And not just someone they bring in once a

> month to see 30 people in 4 hours - warning!) What is the NH's policy

> on hospitalizations: what prompts them,

> > what is the turnaround time, what hospital do they use, etc? If a

> NH is unwilling to address every issue you raise, be wary. Good ones

> want you to be satisfied, to know about their operation, and to feel

> comfortable with the care they offer. We would do these things if

> moving into a new neighborhood or deciding on a school for a child.

>

>

>

>

>

>

> Welcome to LBDcaregivers.

>

>

>

[Guest guest]

see jan, you wil have the last laugh against them, hahahahhahaha hugs, sharon m

---- Janet Colello wrote:

For anyone wondering, California has a " Recovery Law " I just got a notice about

it. It will happen upon Jim's death. Of course, it is not my worry, since the

house is in Jim's name only and in a Trust to his kids, so they will be the ones

losing out on whatever MediCal wants out of the house. Sorry, I can't feel bad

for them, since they have never been supportive in their father's care. I never

thought they deserved the house.

Diane wrote:

Ohhh, I'll have to see if WI has one.

That'd be very important to know!

Diane

> > My own suggestions about nursing homes (NHs) are based on my working

> > for a non-profit health organization which manages several of them,

> > along with a hospital. Research them. Stop by at different times of

> > the day and night unannounced. Most good ones will have a receptionist

> > to ask who you are and if they can help you. See what the place looks

> > like, smells like and how the residents appear. Ask family members

> > coming in their impressions. In addition to meeting with the

> > marketing/admissions person, ask to meet the Nursing Director and the

> > person who would be in charge of staff working with your mom. If they

> > offer such services as therapy, activities or spiritual care, meet

> > with those staff people too. Find out how they work with doctors. If

> > they have staff docs, what are the specialties? Is there a

> > gerontologist on staff? (And not just someone they bring in once a

> > month to see 30 people in 4 hours - warning!) What is the NH's policy

> > on hospitalizations: what prompts them,

> > > what is the turnaround time, what hospital do they use, etc? If a

> > NH is unwilling to address every issue you raise, be wary. Good ones

> > want you to be satisfied, to know about their operation, and to feel

> > comfortable with the care they offer. We would do these things if

> > moving into a new neighborhood or deciding on a school for a child.

> >

> >

> >

> >

> >

> >

> > Welcome to LBDcaregivers.

> >

> >

> >

[Guest guest]

Yes, WI does have one too - works with their Spousal Impoverishment

Protection. If Dad has to go on Medicaid, they let Mom keep the

house, a car and a certain percentage of their assets, but the state

puts a lien on that property and when she dies, they claim it. Guess

there really IS no free lunch, eh?

Diane

> > > My own suggestions about nursing homes (NHs) are based on my working

> > > for a non-profit health organization which manages several of them,

> > > along with a hospital. Research them. Stop by at different times of

> > > the day and night unannounced. Most good ones will have a

receptionist

> > > to ask who you are and if they can help you. See what the place

looks

> > > like, smells like and how the residents appear. Ask family members

> > > coming in their impressions. In addition to meeting with the

> > > marketing/admissions person, ask to meet the Nursing Director

and the

> > > person who would be in charge of staff working with your mom. If

they

> > > offer such services as therapy, activities or spiritual care, meet

> > > with those staff people too. Find out how they work with doctors. If

> > > they have staff docs, what are the specialties? Is there a

> > > gerontologist on staff? (And not just someone they bring in once a

> > > month to see 30 people in 4 hours - warning!) What is the NH's

policy

> > > on hospitalizations: what prompts them,

> > > > what is the turnaround time, what hospital do they use, etc? If a

> > > NH is unwilling to address every issue you raise, be wary. Good ones

> > > want you to be satisfied, to know about their operation, and to feel

> > > comfortable with the care they offer. We would do these things if

> > > moving into a new neighborhood or deciding on a school for a child.

> > >

> > >

> > >

> > >

> > >

> > >

> > > Welcome to LBDcaregivers.

> > >

> > >

> > >

[Guest guest]

Dear Diane, My apologies for not responding sooner. Just now looking at last

week's posts. I don't remember seeing info on choosing caregivers at the LBDAssn

site, but have seen it at the AARP and Alzheimer's Assn sites. What size/kind

of community are you in?

That will determine a lot. I'm in Chicago, work in a senior care facility -

and still finding quality helpers takes time and patience. We pay $10/hour ($11

week-ends and $15 holidays) for caregivers for my mom. The cost is less for

" live-in " helpers - around here $75 and up per day. Mom interacts with sense and

understanding some of the time, vis ery weak and highly confused other times. I

know - that's LBD! Sometimes she can help get herself up and can eat part of a

meal by herself, but the caregiver must do basically everything - toileting,

baths, dressing, transferring, etc. Because she is not in full-blown dementia

yet and I want her to have companionship as well as nursing, I have to find

helpers who have good English, some experience with PD and dementia, patience, a

" heart " for older people - and someone looking for a long-term position. I don't

want a revolving door of caregivers. Most of the residents with whom I work (Mom

lives at the retirement community where

I'm employed) dislike frequent new faces. Mom's had 24-hour helpers for nearly

4 years -- it's still a savings over the cost of NHs and she has constant

attention. Not available even in the best of NHs. With a doctor's note renewed

every year, the costs are a tax exemption. In a smaller community, chances are

the cost would be less. Where to look is an issue - I gave up on agencies and

rely instead on " matchmakers " - people who find helpers who I then interview

directly. Agencies generally check backgrounds (which you cabn do yourself via

the Internet for CNAs, LPNs, etc.) and bond and insure their employees. However,

they charge anywhere from $16 hour and up - and the employee usually gets only

about 50% of that. Even the best ones may send you 1 person for a week, and the

second week you see someone else. Matchmakers and word of mouth have brought us

good people. If you know doctors or nurses at local hospitals or NHs, check with

them for recommendations. Local agencies

for seniors often maintain lists, and so often do local chapters of AARP,

American Cancer Society, etc - any reputable group such as that can be helpful.

Even the local state unemployment office here keeps lists of unemployed health

care workers. If you're in a smaller community, newspaper ads - placed and

answered - should be helpful. I always check references and pose " what if "

scenarios. Generally I like to hire helpers who have a lot of experience, and

particularly like those with CNA training. Depending on the level of care

needed, retired (but not frail themselves) RNs and LPNs could be good choices.

I interview as I would for any other kind of employee, and wrote up a job

description. I clarify pay rates, hours (we work on 12-hour days), expectations

on holidays, time-off, etc. All of that would relate to a live-in as well. A key

question is what level of care will be needed? Is any sort of housekeeping or

meal prep needed? Will this be a 7-day-a-week situation?

Are you thinking perhaps about 2 different people? What are your expectations

for night-time care? My mom goes to the bathroom 2-4 times a night, so my rule

for the overnight helper is no sleeping.

My best advice is write up what you and your mom need. Be clear what is and is

not acceptable re experience, behavior, pay scale, how you will pay (amount,

freqeuncy, as a 1099 employee or with taxes and SS deducted, etc. Caregivers

often become part of the family, so your gut instincts will serve you well. Find

out what the going rate is from friends, church acquaintances, etc. who have

used caregivers, and just start asking for referrals. You can also ask the

local hospital what their starting to mid-range pay for a CNA is.

Please let me/us know how it's going. You and your parents are in my prayers.

Peace, Lin

Diane wrote:

Yes, Lin, we have thought about keeping him at home with full time

professional care. Especially after a few weeks in the nursing home -

now that we see for ourselves what kind of care he will be getting.

They have the space in their condo to set up a sick room and even have

live in help - not that Mom is very anxious to give up her privacy . .

.. but it might just be necessary. And, since the nursing home is well

over 6 grand a month, and they have a ways to go before having to

apply for medicaid, I'm fairly sure the cost of private care wouldn't

be prohibitive.

My question - and I apologize if this is already in the database and I

haven't seen it yet - is where to we start looking for a qualified

live in care giver? Anybody have any clues for me?

Thanks, Diane

>

> Hi, Diane - Am sorry to hear that your poor Dad isn't settled

somewhere. That means you are unsettled, too, which for a lot of us

makes everything else we go through even more complicated. And what a

shame that the best NHs have wait lists - there certainly are good

places, but in general our society allows a lot of substandard care

care for our elders. (And I work in senior care.)

> I'm not familiar with your Dad's health status or your parents'

financial situation, so please take this question with a very large

grain of salt: Is there any possibility - or any value - to your dad's

remaining at home with a full-time caregiver? Am asking only because

that's been my choice for my mom. The cost works out nearly exactly

the same between a good NH and trained full-time caregivers.

>

> Does the NH you like say why they won't tell you more about

delaying admission? Does this come from the administrator, or the

nursing director, or one of the other staff. You've likely done this,

but if by chance not, it might be worthwhile to speak directly to the

head person.

>

> Your family will be in my prayers for the best solution to your

Dad's getting comfortably settled very soon.

>

> Peace, Lin

Welcome to LBDcaregivers.

[Guest guest]

Thanks, Lin, for all that information - we've got one more chance at

the nursing home 5 minutes from Mom's and if we ever get a definite

yes or no from them, we can move on to other options. It'll probably

be after the first of the year. Mom and Dad are in the Madison, WI

area, so the pay scale will be close to that in Chicago, but probably

a little less.

I live in ton and volunteer at the Mather Pavillion once a week

on one of the dementia floors. I'm not sure I could do that sort of

work full-time. I do it as a sort of " pay it forward " for Dad -

hoping that somebody is visiting him now and then, besides Mom or my

sister.

Thank you again for taking the time to respond. You've given me a lot

to think about!

Diane

> >

> > Hi, Diane - Am sorry to hear that your poor Dad isn't settled

> somewhere. That means you are unsettled, too, which for a lot of us

> makes everything else we go through even more complicated. And what a

> shame that the best NHs have wait lists - there certainly are good

> places, but in general our society allows a lot of substandard care

> care for our elders. (And I work in senior care.)

> > I'm not familiar with your Dad's health status or your parents'

> financial situation, so please take this question with a very large

> grain of salt: Is there any possibility - or any value - to your dad's

> remaining at home with a full-time caregiver? Am asking only because

> that's been my choice for my mom. The cost works out nearly exactly

> the same between a good NH and trained full-time caregivers.

> >

> > Does the NH you like say why they won't tell you more about

> delaying admission? Does this come from the administrator, or the

> nursing director, or one of the other staff. You've likely done this,

> but if by chance not, it might be worthwhile to speak directly to the

> head person.

> >

> > Your family will be in my prayers for the best solution to your

> Dad's getting comfortably settled very soon.

> >

> > Peace, Lin

>

>

>

>

> Welcome to LBDcaregivers.

>

>

>

[Guest guest]

Dear Diane - So great to hear back from you and to know you are close-by. Not

certain why I find that so heartening, but I do. Your " pay it forward " is so

generous and compassionate. What a gift to others - and in spirit to your dad.

I agree pay scales will be similar in Madison. Aren't there med schools,

nursing schools, multiple hospitals there? I'm thinking semi-retired nurses, P-T

nurses/CNAs looking for additional work, etc. My experience here is that

hospitals and med-related universities are a great source of referrals. Not just

current students or employees, but lots of medical people with

friends/families/colleagues looking for caregiving work.

Please let me know how your dad is doing, and what the NHs decision is. You,

your dad and mom will be in my prayers.

Peace, Lin

Diane wrote:

Thanks, Lin, for all that information - we've got one more chance at

the nursing home 5 minutes from Mom's and if we ever get a definite

yes or no from them, we can move on to other options. It'll probably

be after the first of the year. Mom and Dad are in the Madison, WI

area, so the pay scale will be close to that in Chicago, but probably

a little less.

I live in ton and volunteer at the Mather Pavillion once a week

on one of the dementia floors. I'm not sure I could do that sort of

work full-time. I do it as a sort of " pay it forward " for Dad -

hoping that somebody is visiting him now and then, besides Mom or my

sister.

Thank you again for taking the time to respond. You've given me a lot

to think about!

Diane

> >

> > Hi, Diane - Am sorry to hear that your poor Dad isn't settled

> somewhere. That means you are unsettled, too, which for a lot of us

> makes everything else we go through even more complicated. And what a

> shame that the best NHs have wait lists - there certainly are good

> places, but in general our society allows a lot of substandard care

> care for our elders. (And I work in senior care.)

> > I'm not familiar with your Dad's health status or your parents'

> financial situation, so please take this question with a very large

> grain of salt: Is there any possibility - or any value - to your dad's

> remaining at home with a full-time caregiver? Am asking only because

> that's been my choice for my mom. The cost works out nearly exactly

> the same between a good NH and trained full-time caregivers.

> >

> > Does the NH you like say why they won't tell you more about

> delaying admission? Does this come from the administrator, or the

> nursing director, or one of the other staff. You've likely done this,

> but if by chance not, it might be worthwhile to speak directly to the

> head person.

> >

> > Your family will be in my prayers for the best solution to your

> Dad's getting comfortably settled very soon.

> >

> > Peace, Lin

>

>

>

>

> Welcome to LBDcaregivers.

>

>

>