What to look for in choosing LTC for a parent?

January 30, 2012 7:07 AM

What should I look for in choosing long term care and/or hospice facilities for my mom? Subquestion--anyone know of good ones on the SW Burbs of Chicago?

Hi,

I wrote before regarding hospice care for my mom but it looks like for now, she may need long-term care that will eventually go into hospice. She has stage IV metastatic breast cancer and has been treated for 6 years. She lives with my dad but to be honest, he's neglecting and abusing her (always has). Well this neglect has led to pneumonia and she's in the hospital. I don't want her going back home to him but I also don't think I can have her live with me full time so she said a nursing home is fine.

I don't know what to look for to make sure it's not some money-hungry scum place. Her 50 years with my dad has been beyond horrible and abusive. I want to make her remaining time pleasant, treated well, peaceful. I also need them to take her to her primary care/oncologist. Will they do that or will they push having their docs treat her? She's VERY picky on what she wants/likes in healthcare and she can be very difficult so I rather find something in line with her needs.

Also, her biggest fear is for my dad to take away Medicare/BCBS coverage if she has a "new" address in long term care or as revenge for "leaving him". I told her I firmly believe he does not have a legal right to take away her benefits and must pay for the care (I cannot).

Finally, anyone have some listings for the SW burbs of good places? She said she heard of someone go to Alden in Orland Park and I saw they had LTC and hospice so that will be first on my list. I don't even know how much these places cost, what the contract says that I'm committing her to, etc. I want to do right by her. She deserves it.

posted by stormpooper to health & fitness (9 answers total)

The hospital should have case workers that deal with the transition from hospital to nursing home. They will be able to get you started. You shouldn't have to deal with this alone. If your mother qualifies for Medicare, that has nothing to do with your father. You are also able to change your mother's mailing address if you feel your father will interfere with her mail.
posted by crankylex at 7:34 AM on January 30

We are in this process for my mom as well (though under somewhat different circumstances), and have found A Place for Mom to be quite helpful in narrowing down the choices. Our local rep is really knowledgable and helpful. I have found, due to my mom's specific issues, that even the LTC facilities that can't take her are considerate enough to refer us to more appropriate facilities for my mom's specific needs (she has some behavior issues due to dementia/Alzheimer's).

My second suggestion is to start making appointments at places you find. You will get an instant feel for the type of facility you are calling based on their phone presentation. And if you are somehow wrong, the creepy, unshaven, undressed residents milling around will give it away (or the smell will). That being said, over the many, many facilities I contacted, I was only wrong once, and there was a very obvious "correct"/right choice for my mom that was confirmed upon our visit/tour.

Best of luck to you and your mom.
posted by LyndsayMW at 7:39 AM on January 30

Illinois Senior Care Directory

Illinois Department of Aging

City of Chicago Family and Support Services

I am not a lawyer, not your lawyer, TINLA, etc. and if you want to be on the safe side consult a lawyer experienced in elder law, BUT: As far as I know, as long as your parents are legally married, your father is responsible for your mother's benefits and care. You can't just off-load a spouse who becomes ill or is otherwise inconvenient. This is a double-edged sword, obviously - as long as your parents are legally married he is responsible for her care, BUT if you want to be her primary caregiver and he tries to interfere you may be SOL unless there is a legal separation and/or you petition to be made her guardian. Here is a link to the Chicago Disability and Elder Law center if you want to arrange a consultation with them.
posted by Rosie M. Banks at 8:13 AM on January 30

I'm a social worker who happens to help people find long term care as my primary job. First thing you should do is contact your local Area Agency on Aging, and they can tell you all of the options available to you (there's a lot more than nursing homes). Have you considered an Adult Foster Care or Home for the Aged? What's nice about those facilities is that they are licensed with the state and you can go to the DHS website and look up reports on the facilities. The reports will be able to tell you if they've had any violations of any sort, and will generally give you a good picture of what the facility is like.

When visiting facilities, I look at the direct care workers to see how they treat their residents. Do they call people by name? Do they say please and thank-you--even to people who have advanced dementia? Do the residents have any presence in the building? For example, do you see art work that residents have created on the walls? ARE THERE DAILY ACTIVITIES? DO THEY HAVE AN ACTIVITY COORDINATOR? These are all signs of a good facility.
posted by francus at 11:32 AM on January 30

I've heard only good things about Joliet Hospice.
posted by SuperSquirrel at 12:14 PM on January 30

My late-80s aunt broke her shoulder last summer and spent a few months in Alden in Orland Park. I live out of state and never got there to visit, but my mom raved about the place and the care her sister was receiving. I believe she still goes there a few times a week for therapy, but I've seen my aunt several times since she got home and she looks wonderful. From the stories I heard, the food was excellent, the facility was spotless, and the employees all treated the patients with respect. My aunt has a lot of money but is legendarily cheap, so I think Medicare covered most of her expenses. Also, I know she was having some trouble with leg swelling while she was in Alden and insisted that she be checked into the hospital to have it checked out, and they didn't give her any grief. Her biggest complaint about the place was that she didn't like the particular kind of cereal they served!
posted by jabes at 12:51 PM on January 30

Thanks Jabes for the Alden review. That was on our list. Here's the issue.

1. she doesn't want to live with me, even temporary until I find a place.

2. she doesn't want to go home with my dad.

3. It seems that she is in need of a retirment home. She's fine with dressing, etc. so that means she doesnt' qualify for Medicare coverage of a retirement home. Medicare only covers those who need 24 hour care (LTC). So it would be self pay meaning $4-8k a month.

4. She doesn't want to self pay $4-8k a month.

5. I said at the very least, they should move out of the horrible neighborhood that is too far to go to the hospital (reason why my dad wasn't keen on taking her to the doctor). If they move to say Oak Lawn, they are about FIVE minutes from the hospital and Oak Lawn has free transportation via the village to the hospital. Perfect solution. Well dad won't move!

I'm looking to see what the retirement homes like Sunrise, etc. cost. I see some have veterans benefits. My dad served in the Korean War and I don't think he has EVER taken advantage of vet benefits. He better start.

I don't know what to do for them anymore. My mom is now saying since no solution is the solution for her she's going to stop going to chemo.

I'm so worn out, at my wits end, dont' know what to say, think, or do for people who put up brick wall after wall in options. I get the $4-8k a month spending. But even the move option (they totally can afford to move too) isn't on the table.

Now we are waiting to see why her BNP is up (cardiac), why her white cell count is too high, and what is up with her CT lung scan because according to the temp oncologist, her lungs sound clear so maybe it's not pneumonia. I don't know what to to believe anymore.
posted by stormpooper at 5:49 AM on January 31

I know nothing about this place, but what if she moved by herself into a place like this "retirement living and supervised support for seniors" facility? It's in Bridgeview and prices range from $2750-$4150 a month. Or just got an apartment alone somewhere in Oak Lawn?

Also, I just wanted to comment about the veterans benefits angle -- by boyfriend works for a VA hospital and the only veterans who actually get benefits from them are vets who were somehow injured during their military service (and possibly widows of those vets). You might want to inquire about what, if any, benefits your mom would be entitled to before putting too much stock in the veterans benefits angle.
posted by jabes at 4:48 PM on January 31

It's been a whirlwind and I've called so many places and visited one. She was scheduled for rehab at one of three clinics. She's under so much pressure to pick one that she's freaking out and it's making things worse.

While the logical, best thing for her is truly in-patient hospice, her and my dad----it just isn't going to work out. I"m pushing then for in-home hospice. I want things bunny froo froo perfect and happy and you know, I need to realize that isn't going to happen. They are so beyond codependent with each other that they need all of this to happen at home. I hate it. She hates it. But sometimes when you are so far deep, and well, dying, maybe a significant change isn't the right change for them. it should have happened a year ago.

THank you for the input. The place in Bridgeview is a scum place. Thank you for trying though. You do get what you pay for. That's why good places cost about $8k a month. :(
posted by stormpooper at 4:43 PM on February 1