Hi everyone,
I posted here earlier this year on my mom’s behalf about my 92 y/o grandfather who was experiencing mobility issues, yet wanted to remain in his multi-level home. My mom (an only child) was frazzled about having to make multiple trips over there each day, co-ordinating home care (he was/is catheterized), preparing meals, etc., and so my query was about how to help her manage.
Fast forward to now: Just before Christmas, my grandfather (despite repeated warnings not to do this) went up a level in his home to get something late one night, and on the way back down, fell and broke his femur. Thankfully, he made it through surgery and spent 2 months in hospital, where he received physiotherapy, catheter care, etc. round the clock.
At this time, everyone agreed that it would be best for my grandfather to go into an assisted living facility or long term care, as his home was no longer safe.
This is where it may get confusing for Americans: We’re Canadian and some terms/procedures I am referring to might be unfamiliar...I will try to clarify:
In Ontario, the wait list to get into a nursing home is often 6-8 years long. The only way you skip the line is if you are deemed crisis (usually this is for Alzheimer’s or dementia patients, who pose a flight risk and need increased care and supervision). Until then, your only real choice is to stay in a retirement home until you can get in. Retirement homes have a lower level of care, and if your needs are greater, it costs more to access that care.
My grandfather is catheterized, immobile, and as such, can’t do almost anything for himself any more...but he is 100% mentally aware. As such, he isn’t deemed crisis for a nursing home...yet it’s clear that he needs to be there and is on a long wait list.
He was a salaried General Motors employee, and gets $3700/month for coverage in retirement or nursing homes. If he were in a nursing home, he would actually be ahead in terms of money. If his needs were less, the cost at the current facility would be manageable.
The other day, my mom (his POA) got a bill from the facility for $13K for 2 months. To care for his catheter and take him to the bathroom is $1800 a month altogether. LHIN (Local Health Integration Network, it’s a system that coordinates care for seniors) already comes in x2 daily to care for his catheter. To take him to meals and get him up and dressed is another $1100. Medication administration is another couple hundred. Otherwise, he is pretty much left alone in his room. This is not a high end retirement home, and he is not a demanding or difficult man whatsoever.
The other night, my mom got a call from the home asking her to buy a funnel and vinegar to clean his catheter...yet we’re paying $630 a month for catheter care? When she asked them about the bill, they said “We’ll see if we can get the costs down.” Her thought is “If the fees are flexible/negotiable, why were the costs so high in the first place?”
This home insists they can care for his needs, which prevents him from going into a nursing home. My mom is afraid they see him as a cash cow, because it would take 2 residents to get the same level of money that they’re getting from him.
My grandfather was fiscally responsible and hardworking his entire life. He has longevity in his genes (sister lived to 102), so this could go on for years. My mom hasn’t even told him what this is costing him, she’s so afraid to upset him. He has the coverage from his employer to leave his life savings intact if he were in a nursing home, but can’t get there because of the long term care system here.
Does anyone have any suggestions on how we can get through this, or to lower the costs? Suggestions we’ve received include writing to our MP and going to the media, but is there something we’re not thinking of?
Note: His house isn’t being sold because he has generously agreed to let me and my partner live there (we would take over all maintenance costs, and pay for renos).
Lack of space didn’t let me clarify that portion of the situation as much as I would have liked. To give you some more context, I’m not presently living there. My partner will be finishing graduate school in the fall, which is when we plan to move in. Right now, I’m only there to do some home improvements, which would be needed if the house were to be sold anyways.
If we were to move in, we would take over all the costs of maintaining the house: utilities, hydro, phone, internet, cable, insurance etc., plus we would pay for renovations to update the home (it hasn’t been updated in years).
I am an only grandchild, and my grandfather wants me to have the home. It makes him feel better knowing I’m there and am personally invested in updating it. The housing market is also out of control, so he wanted to help us out.
I have also made it clear that if it needs to be sold to fund his care, then it will be sold. Yes, it will be sad to see a home that meant so much to all of us go, but his care comes first. I realize what the situation will look like to some people (me taking advantage), but that’s the last thing I’d want to do.
I assume the reason he is not on the crisis list is that there is a belief among some case managers that an AL is able to take proper care of him, unfortunately that is often absolutely untrue. Make them give you an itemized bill and remember it is always negotiable, you would likely be surprised to know how much all costs can vary between residents. Most AL's are run by for profits and IMO some will flat out lie in order to keep rooms occupied, you need to give them a reason to want him out (becoming a demanding b**ch may be one reason). If he is transferred to hospital for any reason (UTI?) and the facility refuses/is reluctant to accept him back he will instantly move to the top of the crisis list.
Those are assets that should be used for his care, yes?
Would it help if you and your partner were paying "rent" that would be another source of income for him.
Or Purchase the house, (fair market value) any money that remains when he passes or is able to be placed in a Nursing Home maybe could be distributed back to you as a beneficiary. (not sure how assets are used in this case in Canada.)
I am sure some others that reside north of the boarder to me will chime in with ideas and suggestions.