Articles Posted in Real Life Story

I recently worked with a family whose Dad contracted an infection in his foot. The infection lead to further complications coupled with the fact that he had mid-stage Alzheimer’s disease. He was using his Medicare days in a nursing home. His wife was very dissatisfied with the care he was receiving. When the family realized he probably wasn’t going to be able to return home, they hired me to find a better nursing home for him on a permanent basis.

His wife was in her 80’s and still working part-time. Monthly income was limited. When I sat down with the family to tell them the cost of his nursing home care would be in excess of $6,000 a month, tears began to flow from her eyes. Thank goodness this was a wonderful family. They insisted upon the best care for their father. The kids offered to chip in and pay for the best place possible. I suggested that they look into the VA Aid and Attendance benefit because their Dad was a World War II Veteran. Although the benefit isn’t huge, it lifted some of the financial burden from the kids, thus alleviating some personal and work-related stress.

Assistance may be available whether at home, in assisted living, or in a nursing home. There are specialists authorized to provide Veterans with assistance in filing a claim and interpreting the benefit. Please see the VA Aid and Attendance article or call me for details.

I recently experienced one of the most difficult placements since the opening of my business in 2006. Members of a family contacted me to place their elderly relative who was diagnosed with Alzheimer’s and disruptive behavior disorder. My prospect was 88, frail, ambulatory, prone to slapping other residents at the current community, and demanding one-on-one attention from the staff. Medicaid was the payor source in this situation. After two admissions to different hospital psychiatric units, my prospect was asked to leave the community.

I was able to identify four communities that would be able to handle these sorts of behaviors and accept Medicaid as a payor source. The first two had no Medicaid beds available. The third option wasn’t optimal due to the floor layout. My client was a pacer, and the hallways in this community were excessively long. Placement at the end of a long hallway would not allow the staff to keep an eye on my client and would increase the risk of falling if my client became tired. The last option had a special care unit that included a trained staff and activity programming to suit the issues I mentioned previously. The residents were separated into high, middle, and low functioning groups for meals and activities. The home had a very good reputation for being able to handle these sorts of issues. The problem was that the unit was not aesthetically appealing, with the carpet, doors, and hallways showing a lot of wear and tear.

When the family toured the community, my expectations of their reactions were correct. Less pretty than others, the look of the place gave them some misgivings. However, we were up against a release date from the hospital. I was able to convince the family to give the new community a trial run since they had successfully dealt with these sorts of residents in the past. They were also able to accept Medicaid.

One of my prospective clients asked me if any of my placements had ever not worked out. I responded, “Yes, only once–early on in the years I have been conducting placements.” Here’s what happened.

My client was a baby boomer whose part-time occupation required intermittent air travel during the week. Her mother, who had mid/latter stages of Alzheimer’s and ambulated with a walker and a wheelchair, was living with her. My client’s mom had a part-time caregiver. My client expressed that she wanted to work full-time, and that taking care of her mother was physically and psychologically exhausting. She wanted to place her in a community rather than have a caregiver on a 24 hour basis. Yet she told me that no one could take care of her mother better than she. In retrospect, that should have been a red flag to me.

I noticed that during my assessment the daughter gave her mom her undivided attention; i.e., bringing her water, placing the glass in her hand when she was capable of grasping it on her own, answering every call of her name and repetitious questions, and incessantly checking her diaper. The daughter also told me her mother’s bedroom was on the second floor and she was assisting her up the stairs on a daily basis. Since her mom was still ambulatory to some extent, the stairs presented a falling hazard..

My client had travelled to Florida to bring her parents back to Chicago to live. On the way home, my client’s elderly father suffered a heart-attack in the car and died in a hospital in Tennessee. To make matters worse, this happened over the Thanksgiving holiday.

My client’s mother has mid-stage Alzheimer’s disease. My client had no idea how much her father had been doing for her mother until she moved her in with her family. After a while, the tension started to mount. My client’s mother would often ask to be sent back to Florida or ask to move to a retirement community. At her mom’s request, they looked at one community and liked it. But they wanted a second opinion and hired me.

Upon visiting with my client and her mom, I realized that the community they visited would be inappropriate for her in the long-run. It didn’t offer any activities that were geared toward mid-stage Alzheimer’s disease. The choice was either to attend the activities for the regular assisted living residents or participate in the activities offered in the locked unit where she eventually might have to move. There was nothing offered for those residents who fell in between those two categories. I was able to place her in an assisted living community that offered a structured program geared toward mid-stage Alzheimer’s. The program is much like adult day care with mind-stimulating activities. These are conducted under the guidance of a team leader. But, unless you have thoroughly investigated the available programs, the average consumer would never be aware of their existence. If my client’s mother needed to move to the facility’s more secure, higher level of care section, there would be no change in price. I was also able to negotiate a two-year rate guarantee.

My client is 85 years old and a former resident at an independent living community that fits his very limited budget. He is ambulatory with a cane, but uses a scooter when he becomes tired. He takes medication for depression. He is fortunate to have a very devoted nephew, who religiously visits him several times a week and takes him fishing (weather permitting). This nephew noticed that his uncle’s physical appearance was deteriorating, and he wasn’t keeping himself or his apartment clean. His personality, which was normally pleasant and gracious, was becoming cantankerous.

One evening during a bingo game at the independent home, my client was involved in a disagreement with another resident. An argument developed, and they began to threaten each other with their canes. The police were called, and my client was issued a ticket for disorderly conduct. He was also given a letter of dismissal from the management.

His nephew didn’t know what to do. He and his wife both work and didn’t have the time to research and find an appropriate community. He informed me about his uncle’s declining physical appearance and the disorderly conduct incident. I told the nephew that it sounded like his uncle just needed some help with taking his medications, bathing, and dressing. I was able to find three supportive living communities within reasonable distance of the nephew’s home. I arranged for a determination of needs screening through the appropriate senior agency, which is a requirement for support through the Medicaid program. The family chose a home that was within five miles of the nephew’s home. When I checked back with the nephew to see how things were going, he told me, “He’s very happy, the care and staff at the home are great. Your services were worth every penny!”