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My 96-year-old father-in-law has been in assisted living for 10 months.

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He needs to transfer to another level of care, either memory care or skilled nursing facility depending on what his needs are.
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In our case, LO was moved from AL to MC (in the same facility), when her care required significantly more supervision than could be provided in her AL environment.
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My father's assisted living had different levels of care that you paid for as he needed them.
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Blue85, I am surprised the senior facility hasn't mentioned it is time for the Dad-in-law to move to the next level.

Where my Dad lived, the facility called me in for a meeting and stated it was time for my Dad to move to Memory Care. Dad was fine with the moving as I told him a "therapeutic fib" that the new room would cost less. Dad joked about his "college dorm room". He got that extra level of care that he needed.
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TriedandTrue Oct 2022
Can I have your dad?
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If his current facility does not have higher levels of care, you need to look for a facility that does.
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TouchMatters Oct 2022
yes yes. Thank you, too !
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Step him up to the next level of care. It’s time to discuss this with his doctor and case manager, who can advise you about options.
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TouchMatters Oct 2022
yes. thank you.
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If he doesn’t need memory care, my dad’s facility suggests hiring out for an extra caregiver to be there more hours since assisted-living does not provide that service. My dad is 96 soon to be 97 and doesn’t need memory care.
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If he is in a facility that have progressive care I would think his social worker would be talking to you about needing to move him to long term care. I know here in the state of Mo it was cheaper to keep my dad in the nursing home at $8,000.00 a month until Medicaid would step in and then make the payments retro. If we would have taken him home for 24/7 care it would have cost us around $20,000.00 a month. If I remember correctly medicare or Medicaid will come for around 2 hours a couple days a week. Which gives you a little break. If he was a veteran you could possibly get aid in attendance benefit which I believe he could possibly get $2,000.00 a month which if he was at home would help pay for his care and other medical supplies he needs. This benefit will go away once he goes into the nursing home.
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There are two levels of care above Assisted Living: Nursing or Memory Care. There are programs like Visiting Angels who can fill in the holes where you feel he needs: that can be a trial period to see his comfort and safety enhanced.
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TouchMatters Oct 2022
I believe memory care is another level of care completely... Not an extension of assisting living.

Where I reside (in the County of Marin, California) facilities' mMemory care units [generally] provides checking in every 2 hours or so w/resident. And, their responsibilities, legally, are much more 'hands-on.'

* Memory care units are locked facilities as residents could / would wonder outside and could go anywhere
* Assisted living divisions do not have locked doors.

Assisted Living is a title of a dept or division of care.
It isn't a verb and noun, as if a person, may have a friend come over and assist by washing dishes. I'm not being flippant, I am trying to differentiate between the language / words to clarify.

Gena / Touch Matters
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Some facilities allow you to hire caregivers to be with a resident (if if your FIL's finances can handle this). If he is a candidate for hospice care, hospice also provides people to come in and supplement what the staff does. Hospice care is for people who are close to death and it needs to be certified by his doctor. All the best to him, you and your family.
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Sorry dad is declining. But that's pretty good that he could handle AL at his age at all. My MIL is in a nursing home and wouldn't be a good candidate for AL.

Anyhow, you will either need to hire private caregivers to fill in the gaps of his care or have him moved to the appropriate facility. Memory care if his needs are due to dementia, nursing home if they are more medical or general.
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Why is it skilled nursing? When what they need is toileting, help showering, dressing, meal prepared,dressing, and housekeeping? It’s not skilled nursing care. It’s a caregiver and assistance with living. But ALF don’t want to pay staff to do all that. That’s the gap that needs to be filled.
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TouchMatters Oct 2022
Yes, helping a person in a shower IS skilled nursing. CNAs are certified nursing assistants and taught how to do these things. While I work(ed) with clients for over 10 years as a care-giver, I NEVER participated in assisting in showers. Most 'untrained' people do not realize that if a person falls:
(1) do not move them (could cause more injury)
(2) do not move as care provider could be injured
(3) immediately call 911.
Facilities DO NOT move residents if they fall. They call 911.
Many people wouldn't know this - nor how to provide medication management w/o training.


Touch Matters
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Blue85: Perhaps your FIL's physician can recommend the proper managed care facility for him NOW.
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My question is....what exactly is "assisted living"? Doesn't that mean the client is assisted in with their needs....cooking, medications, laundry, some light cleaning, etc. From what I am seeing all it seems to be in some cases is a room to sleep in and a cafeteria to have meals. There needs to be more to that for the cost to be so high.
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TouchMatters Oct 2022
Need to look up / reserach.

While some state/fed rules and regulations dictate what is required, each facility may have their own rules and regulations beyond that - and / in their job description.
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* Depends on finances and MediCal or Medi-Care availability.

* Sounds like more private caregiver care/time is needed or moving into the next level of care.

* Contact the social worker / case manager at facility and discuss options.

* If care is needed, and no funds, while perhaps a long shot - contact University social work / health related fields dept heads and see if they can post for volunteers for experience. And then be very thorough in training and follow-up.

Touch Matters
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HAve you looked into Adult Foster Care facilities near you? Often about the same price, but, in my experience with my mom, the care was SO much better! ALF's were a disaster for us. I moved her back to my home , until we found a really wonderful AFC. might take some searching, but it was worth it.
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Most of the assisted living facilities have additional levels of care you could purchase. For example giving meds, assisted bathing, assisted dressing, transport to the dining room, etc. If it is more "medical care" that your dad needs, he may need to go to more of a nursing home setting.
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