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DarlingRhadamanthus's avatar

Dementia/Alzheimer's---Any options available for homecare (USA)? (Details follow)

Asked by DarlingRhadamanthus (11213 points ) November 9th, 2011

I am writing to ask anyone (who lives in the USA) if they are familiar with dementia/Alzheimer’s and what options there are if you want to care for someone at home. We have a relative who is 88 years old, and losing her memory (probably more age-related honestly). She currently is staying in a not-so-nice (though not appalling) nursing facility. My nephew wants to take her in, but doesn’t know how he could afford to care for her (he has a full time job) but his wife (who is unemployed at the moment) says that if they could get some sort of help (physical help with things that she could not do…and also relief care ) they both might be able to do the job. They are a lovely young couple. Their greatest fear is that they might take her out of the facility and then realize that they have taken on more than they anticipated and they have a fear that no one else in the family will pitch in with help and/or the fear that they might not be able to find carers for relief. (I know these are problems that all people with elderly parents/relatives face. My parents were solvent enough that they were able to find the best care possible and never went without, thankfully. But not everyone is that fortunate.)

She does not have full-blown Alzheimer’s and has a lot of lucidity still. We both feel that living in those conditions is simply contributing to her demise, not solving them and that she has a right after caring for so many people to live her last days in dignity. For example, there isn’t a garden for her to sit in and she was an avid gardener. They don’t have any sort of outings or any stimulation…no arts, no music. It’s really sad. She was put in there by another relative. Once again, it is just a matter of finances and finding the right care. I wish there was a way for her to live out her days with family in a proper home…is that even possible when one doesn’t have savings/money? I am willing to help, but I know that my contribution would never cover possible full expenses. Which is why I am asking if there are other funds/options, supplements for people in situations like these.

I am not familiar with the system in America. If she has no income (and no savings, etc) does the government have any sort of homecare stipend? Or any programs to help people in this situation and members of their families who don’t want to institutionalize them?

I welcome any ideas/options…as not having ever had to deal with this…and living over here…I wasn’t sure what goes on in the USA.

Thank you for your time in answering this. I hope someone can share their ideas and/or experiences.

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17 Answers

YARNLADY's avatar

In our area, there are day care facilities for elderly that are very reasonably priced.

bkcunningham's avatar

Financially, the only thing that I can think of, @DarlingRhadamanthus, is her Social Security benefits. I don’t know the financial situation of your nephew and wife, but the addition of a household member/dependent would mean their tax burdens could possibly be lower on their annual income taxes.

It is a life changing decision they are considering. God bless them for even considering doing this. Someone needs to consult with the physician and a social worker at the nursing home facility and discuss the possibility of removing her to come live with the nephew and wife. If the person the helped admit her to the facility has Power of Attorney over her, it may not be an easy task having her sprung.

Assuming she can leave the facility freely, her doctor could help her get home health care services through her Medicaid coverage if she meets certain criteria. That is why I’d talk to the doctor and social worker.

Depending on their state, there are many Senior Volunteer Services programs that offer free in-home assistance to people, including the elderly and their caregivers. These programs are amazing. The are made possibly because senior citizens volunteer to help other seniors.

Here’s a link to search by state for Senior Companions programs. The search is on the right side of the page:

http://www.seniorcorps.gov/about/programs/sc.asp

Here is a link for the Retired and Senior Volunteer Program by state:

http://www.seniorcorps.gov/about/programs/rsvp.asp

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janbb's avatar

A lot will depend on what state they are in since some social welfare programs are administered by the states. Before contemplating such a move, the young couple should try to make an appointment with their local state or county social welfare agency and see what assistance will be available. It is not likely to be anywhere as good as the aid provided by the National Health in Britain. They are taking on a daunting task but I certainly understand their desire and applaud them. There are some charitable organizations such as Visiting Nurses Associations which provide home visits and they could possibly look into these. They should also realize that the dementia may well progress to the point where they are unable to care for her at home any more but certainly some good time is better than none. Good luck to them!

Judi's avatar

Does she have social security or social security disability? How is she paying for the facility she is in?

marinelife's avatar

It depends on the financial situation. They could definitely get respite care. You can have personal care assistants come in for about $25 an hour if you get them from an agency. Or you can hire someone for about $12–15 an hour (then you have to hassle with taxes unless you hire hem under the table).

As for the family helping, have the young couple sit down with them and get a commitment as to what they are willing to do. Will they bring the aunt home for a meal? Will they come and sit with her for half a day while the young couple has an outing? Will they contribute financially to getting help in?

Good luck

SpatzieLover's avatar

The best advice I can give in this situation @DarlingRhadamanthus is for them to contact a social worker with the HHS (Health & Human Services Department). The social worker should be given all of the details of the 88 year old’s situation.

They should ask about “Memory Care Units” at local nursing facilities. A Memory Care unit is a wing of a nursing facility dedicated to Alzheimer’s/Dementia/Strokes/Brain Injuries. Generally, the patients have dedicated nursing care. The patients are “locked” into their wing and are free to move about and do as they please.

After our aunt had her stroke we visited a few of them. The best ones had a fenced in yard, piano, sitting room, laundry room -etc. Some of the patients hung laundry out to dry every day in the yard, some played piano-etc. Often the memory unit will have a pet or two dedicated to the area, as well.

Under no circumstances would I recommend they take her into their home. There are just too many hazards (fire, flood-etc) that they probably haven’t considered. If they are determined to get her into a home-like situation, I’d tell them to get onto waiting lists for small group-home facilities.

jca's avatar

Get them Medicaid.

Linda_Owl's avatar

Realistically, the only help that can be depended upon is what you can pay for – so this means that wealthy people can hire nurses & aides, but non-wealthy people usually cannot. It is not a ‘fair’ set of circumstances, but it is the prevailing situation. It is sad that older people are no longer valued in our society, but with society coming apart at it’s seams, the older people who can no longer contribute are going to be considered not worth making any effort. Our government is doing it’s best to make sure that there are no funds to help anyone caught up in such situations.

jca's avatar

Wealthy people often hide their money legally by putting it into trusts, which give them a stipend to live off of, but enable them to declare themselves poverty-stricken, and thus eligible for Medicaid. If the OP can afford it, they can hire an eldercare attorney to do this.

DarlingRhadamanthus's avatar

Thank you…..all of you….for being so kind in answering.

I am attempting to find solutions. This person was a loving, giving person…took care of everyone, worked and supported her parents till they died and never asked anything for herself and never married. Lived extremely simply all her life, full of life and dignity…and stunningly beautiful, I may add. It is so incredibly sad to see this happening. She never did smoke, drink, and was slender and ate healthily. She has a rich spiritual life and never missed church on Sunday.

I have no idea what/how she is getting her care paid for as she is currently under someone else’s care (someone else is her caretaker at the moment.) Living so far away (as I do) it is difficult to get the full story——but I am working on it. I am guessing (not sure now) that she must be on some sort of help as she is staying in a facility.

As I was dealing with other issues in my life, this came up and made me realize that the options for people with Alzheimer’s who are not solvent are minimal…and honestly, appalling for the most part. Here in the UK, the elderly are treated abysmally especially in our NHS hospitals. There have been dozens of stories in the last few years of the appalling conditions. (I’m not saying all hospitals are like that, but there are a lot of them that are not up to par.)

Blessings to all of you for being so caring….and for answering. I really appreciate this…as this has been fairly emotionally wrenching for those of us who truly care about her welfare.

A thank you from the heart to all…..lurve is coming.

DarlingRhadamanthus's avatar

Just a follow-up…she has been moved into a nicer facility…now that her situation was brought to light. Moves are being made to get her full-time professional care and move her back into her little house so she can live out her days in peace. My nephew and his wife will not be living with her, but will be nearby to help and facilitate the full-time caregiver.

Thank you for your help…I just wanted to share a happy solution to an often difficult situation.

janbb's avatar

@DarlingRhadamanthus Thanks for the update – it’s nice to get such a happy one.

bkcunningham's avatar

@DarlingRhadamanthus, it was so thoughtful of you to update us on what is happening. I hope she has continued good news in her life.

DarlingRhadamanthus's avatar

@bkcunningham @janbb…..Thank you and thanks to all for your help….I cannot tell you how happy this Christmas will be, knowing that she is in good hands…and that she will be back where she can see her lovely gardens.

And just to let you know…as well….for those of you in similar situations, she was being over-drugged and is now having to undergo a huge detox. This apparently happens often in a lot of facilities because Big Pharma has their hands in the pockets of these places as well as the fact that many would rather just drug their occupants than have to care for them fully.

bkcunningham's avatar

Merry Christmas, @DarlingRhadamanthus, to you and yours. I’m glad she had advocates looking out for her.

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