Nursing Home/Alzheimers Care

[dnico33]

Does anyone have any insight they can provide on my situation which is:

Within two years I think it will be time to put my now 86 year old father into a nursing home that specializes in alzheimers/dementia care. I've had to semi-retire in order to care for him the last 13 months, so a U.S. based facility is not an option. I have heard some very positive things about facilities in Mexico that have better care and cost much less. I would want to relocate and rent a nice place to live nearby the coast, any coast as long as it is a relatively safe area.

Any information or suggestions would be greatly appreciated. Thanks.

[Bevdeforges]

Originally Posted by dnico33

I've had to semi-retire in order to care for him the last 13 months, so a U.S. based facility is not an option.

I don't know anything about the nursing home care in Mexico, but depending on which state you live in, you should consider first looking into what is available through Medicaid for your father.

Basically, if he is eligible for Medicare in the US, he may be able to have his nursing home care covered under Medicaid, without your having to sacrifice your earnings. My father recently died after having spent 4 years in a nursing home, most of that paid for by Medicaid. Admittedly he was lucky - the home was a decent, caring place and I believe he received good treatment. And he was transferred there initially by his insurer - for conditions other than Alzheimers, though it appears he ultimately wound up with that.

The problem with putting your father in a Mexican facility is that, first of all, he'll have no Medicare coverage at all. But even worse (IMO, anyhow) is that he'll be in a foreign country, with few if any of the staff (and probably none of the other patients/residents) who can speak English with him. The food is different, the climate is different, the standards of care are different. For someone with Alzheimers, this is all terrifying, threatening and pretty isolating stuff.
Cheers,
Bev

[RVGRINGO]

Welcome to the forum.
I would agree with the need to investigate all of your options with an eye to what is best for your father. You might find that it would be difficult to get him an FM3 if he is incompetent.

[dnico33]

First of all, thank you for your replies. I have done a decent amount of research and the 'assisted living' industry in Mexico is being strongly encouraged by the government so I know that immigration issues will unlikely be a problem. But I'm glad that the question was brought up because I must be certain about everything prior to such a major change of direction. This is part of the progression of an unhappy journey which must be made, and I'm sure there are others who will benefit from the nice folks who take the time to contribute here. God Bless!

[Bevdeforges]

One other caveat - if what you're looking at is "assisted living" rather than nursing home care, make sure you ask what their limits and ranges are. In the US, the term "assisted living" can be used for almost any type of round the clock care facility - each state has its own limitations and definitions. Mexico may well have yet another series of criteria or regulations.

The reason my father wound up in a nursing home is because he "flunked out of" assisted living. Too many falls, and he reached the point where he needed far more than the alloted time per day for "personal assistance."

At a certain point, when the resident requires more care than the assisted living facility is able or willing to give, they will offload him to a nursing home.
Cheers,
Bev

[synthia]

Assisted living is not appropriate for anyone with Alzheimers. It is designed for people who are reasonably competent. In general, I don't think it includes administering medication. There was some publicity a few years ago about a fairly high rate of problems, including death, from medications not being properly supervised. It really wasn't blamed on the facilities, since administering medications was not part of their responsibilites. It turned out that people were leaving their parents in assisted living long after it was appropriate because of the cost, and the facilities were trying to cope and not doing well.

[Bevdeforges]

Originally Posted by synthia

Assisted living is not appropriate for anyone with Alzheimers. It is designed for people who are reasonably competent. In general, I don't think it includes administering medication. There was some publicity a few years ago about a fairly high rate of problems, including death, from medications not being properly supervised. It really wasn't blamed on the facilities, since administering medications was not part of their responsibilites. It turned out that people were leaving their parents in assisted living long after it was appropriate because of the cost, and the facilities were trying to cope and not doing well.

It can depend on the state and the specific regulations. The assisted living place my father was in had a specific Alzheimer's wing (with specific rates for Alzheimers patients much higher than in the other section). Alzheimers care is seen as a "growth industry" and I think you'll see more and more facilities set up for "top of the line" care in the US. (Though maybe this economic crisis will take a bit of the bloom off that rose.)

Even in the "regular" section, there was some big to-do about administering medications and the procedures for doing that changed significantly during my parents' stay there. In scanning nursing home reviews (on the Medicare website) one of the most frequent "violations" cited - even in the best nursing homes - is some form of mix up in administering meds. And based on my most recent experience with nursing homes (my father and an aunt), taking meds is one of the routines most likely to provoke problems, even in non-Alzheimers patients.

One other thing to look into before making a big move to find care for an elderly parent is hospice care. It can be tricky getting an Alzheimer's patient onto hospice, but once done, it's a real blessing for all concerned. (And there is hospice care within most nursing homes, though you have to ask about it.) Medicare will cover it once you get the paperwork signed off.
Cheers,
Bev

[synthia]

A friend of mine went throug getting hospice care through Medicare, but I think she was told that it is onlyl for people who are within six months of dying. The whole thing is extremely complicated.

It's nice to know more facilities are being developed for Alzheimer's patients, and that the assisted living facilites are developing special sections for them. It only emphasizes that regular assisted living won't work well.

[Bevdeforges]

Originally Posted by synthia

A friend of mine went throug getting hospice care through Medicare, but I think she was told that it is onlyl for people who are within six months of dying. The whole thing is extremely complicated.

It's nice to know more facilities are being developed for Alzheimer's patients, and that the assisted living facilites are developing special sections for them. It only emphasizes that regular assisted living won't work well.

You're right that, for Medicare coverage, a hospice patient has to be determined to be within six months of dying - however, once qualified for hospice, they won't shut it off after six months of treatment. I figured if the OP was considering institutional care after having cared for someone at home for a long time, perhaps the situation was becoming acute and that could be the time to get the evaluation process in motion.

The problem with the Alzheimer sections in assisted living is that the monthly fees are dreadfully expensive and not subject to being covered by Medicare or Medicaid. The Alzheimer units in nursing home, on the other hand, can be covered by Medicaid if the patient qualifies.
Cheers,
Bev

[synthia]

My friends mother's care was cut back, then later reinstated, and it was re-evaluated on a quarterly basis.