Yes, unfortunately it is likely legal. ALF'S and MC facilities have wider latitude in deciding who they want to keep as residents than SNF's. It sounds like it may be time to transition your LO to a nursing home, and to start the process of applying for Medicaid. You can contact your ombudsman for guidance, and also it may be beneficial to hire an elder attorney if you haven't already.
What is the "trouble" that they say your LO is causing? Some dementia patients, even though elderly, can be a physical or sexual threat to other residents and staff. They can only hire and schedule so many employees to mind a single person. Most likely it is not financially feasible to do this.
He gets up and falls or doesn’t user walker/wheel chair. When in a bad mood will yell at staff. He’s definitely not a model resident as some are. But the monthly fee is high. I just wonder how they could get all these well behaved dementia patients to pay the required fee plus a charge for meds. The staff is minimum and sometimes the main phone line goes unanswered. I have since moved my LO to a SNF who is well staffed and tolerant to ill tempered dementia residents. The building is clean and well maintained although not as fancy as former one. I definitely made the right move at the right time.
You don't mention why the MCF wants your LO to have 24/7 care? The LO a threat or nuisance to him/her, staff and other residents? Is the facility totally secured against wandering residents. AL and many MC units are geared to provide an "assist" to the activities of daily living. They can not provide 24/7 care (somewhat questionable with staff ratios if many SNFs (skilled nursing facility) can do that either) but in many states if that is what a resident needs the AL is required to ask the resident to move because they can not "meet the resident's current and probably future needs". This is where many people have to transition to a higher level of care ie nursing home level of care and why many people try to locate a facility that can accommodate multiple levels of care on the same campus.
If that is indeed the case, see if the facility has a social worker who can give you guidance on researching new SNF's. You may also want to get in touch with the states Office on Aging for guidance and assistance. Be aware of the fact that Medicare will not pay for custodial care at a SNF. State Medicaid pays for about 80% of the custodial care provided in SNFs in the United States but each state has it's own criteria so this is where the Office on Aging can definitely assist you if you need to apply. Good luck on this journey.
Good point on getting guidance. In my case the social worker at the present facility was less than zero help. In Richmond, VA we have A Helping Hand, a consultant who knows all the facilities in town, sees who has space, arranges the tours/meetings, and his fee comes from the facility you choose. GOD-send!
This memory care seems not to have the ability properly care for your LO. Maybe time to transfer to longterm care. Yes, LOs money will go faster but you then apply for Medicaid to cover their care.
mstrbill is correct that ALF and MC facilities have wider latitude and are not governed by the same rules. I agree that it is likely necessary now to move on to nursing home care. It is unfortunate, and the fact is that ALF/MC is often a business, and yes, they can and do often "cherry pick" residents. Do understand that if this is a matter of severe acting out the only answer often comes down to medication cocktails, and the elder is between the devil and the deep in terms of either being in a condition to act out and cause much disruption and potential danger to self and other residents or to be sitting in a state of withdrawal and near unresponsiveness. Some dementias comes with such cruel choices. I am so sorry you are facing this.
MC, ALF, NH, etc... all are a big business! They can choose who to stay there. Meaning, those with money will be their first picks. And then adding the cost of 24/7 caregiver, it is very expensive. For those of us who have no money, we are least desired.
24/7 caregivers are not added to the charges being charged by the MC! They are separate and paid to whatever agency or person is being used. Also, residents who are dangerous or problematic to OTHER residents require extra care, unless you would like YOUR loved one bothered or threatened by a resident who doesn't have extra supervision. For those w/o money, there is Medicaid nursing homes.
This happened with my mom, and it wasn’t for physical care (ie, fix it with NH level), it was the troublesome that you refer to. We had to do 24/7 people for about six weeks until I could find her another MC place (ouch $). At the first, she hated where the rooms were (partially underground, I think that’s old school, where they felt they could secure the doors better), and several people there were much further gone than her. The whole place freaked her out. I found another that was more bright and beautiful, ground level, had luck in that the wing with a vacancy had people in as good or better shape than her. The administration at mom’s first one was mixed AL, MC and NH. The one she’s in now is a dedicated MC. That made a big difference, for her and for me. Here I feel like MC is not just an advanced level of AL to them, they’re more ready for outbursts and such. Also I think the first MC was just a shock to her; moving to a second, she maybe subconsciously understood that this IS the type of way she has to live now. Also, we upped the medication a bit. :/ I hope this helps, and maybe you too can find one that may be more to her taste, and maybe better at doing MC. Use their dedicated geripsych to help with meds. Sending you all best wishes in this. 💐
I would ask WHY does my loved one require 24/7 sitters. If my moved one is in memory care, the staff should be able to handle minor issues. If he/she is displaying troublesome behavior I would want to know right away, The primary care doctor or a geriatric psychiatrist can be consulted to deal with troublesome behavior. Also, most problem behaviors would require changing some handling by the staff and probably some medication changes.
If the memory care facility is unwilling to work with you or give more details, it seems like time to find another place.
I am just waiting for moms assisted living facility to kick her out. She hasn't "wandered" out of the building, but she is causing a scene. Apparently she walked from her 2nd floor apartment down to the lobby entrance in her bra and when they asked her where her clothes were, she said none of the clothes in her apartment were hers. She has also been having episodes in the evening...what I am calling sundowners. It is usually 5 pm or later and she gets all worked up and thinks that my brother needs to move in with her and I need to help them both and come pick her up. Or she'll say I need to get out of here! She makes these calls from the receptionists phone in the lobby because she can no longer figure out how to make a phone call from her apartment phone. I totally understand why an AL facility would not want the risk and responsibility of that, but I didn't know that memory care would kick someone out for bad behavior. What is your family member doing that they can't handle?
Your mother needs to be in memory care, not assisted living. She isn't getting the kind of care she needs. You need to take care of that ASAP. If they "kick her out," it's because she isn't a candidate for assisted living.
Move her as soon as you can, because the difference in her care will be like night and day once she's where she needs to be.
Read your contract with them about limits this memory care has in regard to her abilities. It may be spelled out in the contract. You can also call the ombudsman's office for your area and ask them about level of care and being in memory care facility.
Memory care is specifically for people who have dementia issues and sometimes that means the behavior changes for the worst, too. What kind of troubles is she creating that staff can't handle? Seems that if you pay for 24/7 care - the facility isn't really providing care, so are they going to reduce the cost of facility to just a bed?
If he's violent or otherwise a danger to the other residents, they certainly would be smart to require extra care for him. My mother's place had a great big man who had a violent temper and would punch the glass doors. Fortunately, they got him out of there quickly, because the caregivers couldn't have handled him much longer.
It sounds like you moved him, so you definitely did the right thing. Some nursing homes are better than others, so you were correct to find one that could handle him.
Glad to hear you moved your DH to a SNF. Memory Care ALFs are not staffed to care for residents 24/7, and that's just how it is. My mother lives in a MC ALF and has fallen 28x in the past 21 months she's lived there. They have come up with a new care plan for her which includes getting her Depends changed in BED, which she hates, but it's what has to be done to avoid falls. If she continues to fall, they will ask her to leave and I'll have no other choice but to place her in a SNF which I'll have to do eventually ANYWAY b/c she's running out of $$$ for private pay. It is what it is. My mother is big time trouble, not from a behavioral standpoint, but from a care standpoint and it's just becoming too much for any MC to handle. Oh, I'm sure I could hire an outside caregiver to sit with her 24/7 to see that she's not doing things w/o help (as she normally does and then falls), but naturally, she cannot afford that in addition to the MC base rate of $6500 a month.
I do know that the place my mother was in told me they wouldn't accept "committals." This came up because mom wanted no part of moving anywhere and the EC atty told me we couldn't force her to move. Of course we can't, I wouldn't take her kicking and screaming! So, he said guardianship. When mentioned to the facility admin, nope, won't take her then. That's how I ended up here, between a rock and a hard place! Sure, we likely could find another place, but not close by and probably not as nice. She wasn't that far down the dementia path either, so I suspect she would have "passed" the court tests and we'd spend all that time and money for nothing!
It may be that some "committals" are "problem children", so they DO want to avoid them. Mom wasn't, but if they accept one, it sets precedence. We just had to come up with something plausible that would push her into going - same thing we all have to do, including staff, sometimes to get the person to do something they are refusing to do (bathing, medications, medical treatment, etc.) Fibs, coaxing, whatever works!
While I can understand requiring some additional help, I don't get the 24/7. The MC staff can't provide that, but they SHOULD be providing some! A friend's MIL had to move to MC and they were told the same thing - hire someone 24/7, she needs help! It was really a combination of the move and surgery that left his MIL in this befuddled state. If 24/7 is to be permanent, well then take them home!
I generally show how MC, although expensive, is less costly that keeping someone home with 24 hr care, but THIS case does not fall under that. 24/7 aide cost adds up quick, but people forget they have to add in the cost of the home and all that goes with that. Paying the high cost of MC PLUS someone 24/7 is ridiculous! Then it is way too much. Home plus 24/7 is LESS than MC with 24/7.
Glad to hear that you found another place for him. Hoping it all works out well for both of you.
For anyone still reading, I see several queries about why the facility isn’t providing 24/7 ‘care.’ I can’t speak for the OP, but the order for 24/7 for my mom was as a guard/sentry, not for care. It was to contain the potentials of her behavior issues. Certainly, the people were caring and there to assist with whatever, but they were guards.
If that is indeed the case, see if the facility has a social worker who can give you guidance on researching new SNF's. You may also want to get in touch with the states Office on Aging for guidance and assistance. Be aware of the fact that Medicare will not pay for custodial care at a SNF. State Medicaid pays for about 80% of the custodial care provided in SNFs in the United States but each state has it's own criteria so this is where the Office on Aging can definitely assist you if you need to apply.
Good luck on this journey.
At the first, she hated where the rooms were (partially underground, I think that’s old school, where they felt they could secure the doors better), and several people there were much further gone than her. The whole place freaked her out.
I found another that was more bright and beautiful, ground level, had luck in that the wing with a vacancy had people in as good or better shape than her.
The administration at mom’s first one was mixed AL, MC and NH. The one she’s in now is a dedicated MC. That made a big difference, for her and for me. Here I feel like MC is not just an advanced level of AL to them, they’re more ready for outbursts and such.
Also I think the first MC was just a shock to her; moving to a second, she maybe subconsciously understood that this IS the type of way she has to live now.
Also, we upped the medication a bit. :/
I hope this helps, and maybe you too can find one that may be more to her taste, and maybe better at doing MC. Use their dedicated geripsych to help with meds. Sending you all best wishes in this. 💐
If the memory care facility is unwilling to work with you or give more details, it seems like time to find another place.
Move her as soon as you can, because the difference in her care will be like night and day once she's where she needs to be.
Memory care is specifically for people who have dementia issues and sometimes that means the behavior changes for the worst, too. What kind of troubles is she creating that staff can't handle? Seems that if you pay for 24/7 care - the facility isn't really providing care, so are they going to reduce the cost of facility to just a bed?
It sounds like you moved him, so you definitely did the right thing. Some nursing homes are better than others, so you were correct to find one that could handle him.
It may be that some "committals" are "problem children", so they DO want to avoid them. Mom wasn't, but if they accept one, it sets precedence. We just had to come up with something plausible that would push her into going - same thing we all have to do, including staff, sometimes to get the person to do something they are refusing to do (bathing, medications, medical treatment, etc.) Fibs, coaxing, whatever works!
While I can understand requiring some additional help, I don't get the 24/7. The MC staff can't provide that, but they SHOULD be providing some! A friend's MIL had to move to MC and they were told the same thing - hire someone 24/7, she needs help! It was really a combination of the move and surgery that left his MIL in this befuddled state. If 24/7 is to be permanent, well then take them home!
I generally show how MC, although expensive, is less costly that keeping someone home with 24 hr care, but THIS case does not fall under that. 24/7 aide cost adds up quick, but people forget they have to add in the cost of the home and all that goes with that. Paying the high cost of MC PLUS someone 24/7 is ridiculous! Then it is way too much. Home plus 24/7 is LESS than MC with 24/7.
Glad to hear that you found another place for him. Hoping it all works out well for both of you.