What level of care is right for my mom?

When families are evaluating what their loved ones need and at what level is the most appropriate care given the following questions are important to discuss:

1.  Financially, how much money do you have and how long does it need to last.
     Everyone wants to stay in their home but sometimes the math doesn't work out.
     Consider if a person requires 24 hour care and caregivers can't be live-in and sleep at night
     the minimum cost of two 12 hour shifts would be ($16 x 12 x 2 =$384 per day).  That is
     $11,520 per month.  The monthly cost of a personal care home $3000 - 3500; Assisted Living
     $4000-6000; Skilled nursing home private room $7200.   So always look at what will allow you to
     take care of the person for the longest with their financial resources available.  Also look if there is 
     long-term care insurance - how long it will pay, what the time period is before benefits start, etc.

2.  What type of care does the person need?
      1.  Help with activities of daily living - bathing, dressing, medication reminders, etc.
      2.  Constant watching due to wandering and safety concerns with memory issues.
      3.  Is the problem temporary ?  Recovering from a recent fall or illness.
      4.  Is the problem chronic and/or progressive?  ie.  congestive heart failure, dementia, etc.
      Sometimes the need is something that a caregiver can come in the home and provide 4 hours of
      care and handle or the family can determine that the care will only be needed for a month or two.
      However, if the care is needed for a chronic and/or progressive issue than you need to consider
      the following:
           1.  Age of the person:  if a person is in their early 70's they might be able to handle several
           moves, especially if in the early stages of their illness.  So you might try independent living with
           supportive help (meals, caregivers for private hire onsight, etc) and then if the care need is
           greater you can move them to a higher level of care; ie. AL or PCH.  However, if the person is
           in their 80's or 90's and dealing with dementia, you want to make sure the person is in a care
           setting where they can age in place and not have to adjust to another move.  Families have told
           me that their loved ones will not accept anything but a senior apartment; however, within a very
           short timeframe the person's needs are greater and they have to move or a crisis like a fall
           shows that the level of care was not the right one and they have to move again!
           2.  Disease progress and symptoms.   If the person has dementia and is already having trouble
           remembering family or if the person or getting lost outside their home; or has congestive heart 
           failure and their legs have dependent edema to the point they are having trouble walking and
           breathing.....then you know you need to make sure they are in an environment that can meet all
           their needs for the long term.

           Do you need to do this alone....no, there are Professional Geriatric Care Managers that can help do this assessment and help the family discuss options.  To find a caremanager in your area go to
www.caremanager.org.  This service is private pay. Your local Area Agency on Aging can also have some resources and information that can help.  Houston has a 2-1-1 number that is a central place that you can call to get information.

          The issue of care for a relative is never an easy answer.  It is emotionally draining and financially challenging.  Looking at the issue from various aspects allows you to put a plan together that makes sense both financially and emotionally.  As was presented in a previous blog, having these discussions about what a person would want and what they have financially to provide for that care can help make the plan customized to your loved one prior to them actually needing the care.