Elder Care Resources, Orlando Edition
February 5, 2021 7:36 AM Subscribe
Short version question: Does anyone know of any specific resources in the Orlando area to help an elderly couple find a nursing home? They have a little equity in their house, little to no savings and relatively small income. My mom has been insisting on 2 bathrooms due to long term issues, but that is just not gonna happen on their budget.
Long version: Mom and her husband will be 88-years old this year. They have been living independently near Sebastian, Florida, up until now, which is darn remarkable. But things must change. Mom is currently in the hospital receiving physical therapy after her 4th fall in about 8 months. She worked in elder care as an RN most of her life, and has known for several months she needs a nursing home, but her husband has been difficult and resistant-, insisting he can care for her. He may be finally coming around.
Her husband is still driving (but likely should not be, though he claims to be careful and has been going to dr appointments and visiting mom in the hospital). He has been diagnosed with early dementia and while he is mostly doing ok, it's progressive and he's been saying some weird things. He's also diabetic, may or may not be taking his insulin when mom's not there. But they do have people who check on them, and someone is helping him pay the bills while mom is out. He has 3 sons, one of which is trying to help, but his dad keeps getting angry with him and thinking he is trying to steal their money (he isn't). He may also have some VA benefits and he claims to be working on that, but he has refused to show his son the paperwork (if he even has any). The son is in another state but was there a couple months ago.
I have a sister in Orlando who plans to drive up there when mom is released from the hospital and I am near Chicago and don't know if I will be risking air travel... I just don't know, ugh. But all seem to agree that Orlando will be the best place for them, so we need to figure out how to go about everything - selling the house, the car, estate sale. But finding them a place to live is the primary problem right now. My general understanding is many nursing home facilities are predatory and make you write off your entire income to them, but maybe I've read to many exaggerated news stories (including all those ones about nursing home abuse, ugh). Any Orlando-specific leads or suggestions appreciated. I will be looking through old Asks for general info too.
Long version: Mom and her husband will be 88-years old this year. They have been living independently near Sebastian, Florida, up until now, which is darn remarkable. But things must change. Mom is currently in the hospital receiving physical therapy after her 4th fall in about 8 months. She worked in elder care as an RN most of her life, and has known for several months she needs a nursing home, but her husband has been difficult and resistant-, insisting he can care for her. He may be finally coming around.
Her husband is still driving (but likely should not be, though he claims to be careful and has been going to dr appointments and visiting mom in the hospital). He has been diagnosed with early dementia and while he is mostly doing ok, it's progressive and he's been saying some weird things. He's also diabetic, may or may not be taking his insulin when mom's not there. But they do have people who check on them, and someone is helping him pay the bills while mom is out. He has 3 sons, one of which is trying to help, but his dad keeps getting angry with him and thinking he is trying to steal their money (he isn't). He may also have some VA benefits and he claims to be working on that, but he has refused to show his son the paperwork (if he even has any). The son is in another state but was there a couple months ago.
I have a sister in Orlando who plans to drive up there when mom is released from the hospital and I am near Chicago and don't know if I will be risking air travel... I just don't know, ugh. But all seem to agree that Orlando will be the best place for them, so we need to figure out how to go about everything - selling the house, the car, estate sale. But finding them a place to live is the primary problem right now. My general understanding is many nursing home facilities are predatory and make you write off your entire income to them, but maybe I've read to many exaggerated news stories (including all those ones about nursing home abuse, ugh). Any Orlando-specific leads or suggestions appreciated. I will be looking through old Asks for general info too.
I don't have an Orlando suggestion, but we used an "eldercare advisor" when my mother-in-law was at that stage, and every dollar we paid that person paid off tenfold because she knew how the system worked, how to adjust things so my MIL could take advantage of benefits, knew all the local nursing homes, etc. It was so, so helpful. So maybe start googling advisors in that area.
posted by BlahLaLa at 11:19 AM on February 5, 2021 [3 favorites]
posted by BlahLaLa at 11:19 AM on February 5, 2021 [3 favorites]
When we needed to find care for my mother, the social worker at the rehab facility referred us to someone who was basically like a real estate agent but for assisted living homes.
Also, you should know that there are several different levels of care for people who can't live on their own. A nursing home usually means that there are actually nurses interacting with residents on a daily basis. In my area, these are usually also the most institutional in style - a single bedroom or maybe a double (two people sharing the room) plus a bathroom (possibly shared with the room next door) I believe this is the only level of care that Medicaid will pay for.
There are also a wide range of "assisted living" places. Some of these are what are called here "board and care" homes where you have a house that has been converted to provide care for 4-6 residents plus one or two caregivers on duty. Some of these are more like hotel rooms - each person has a studio or 1 bedroom apartment with lots of shared facilities (dining room etc) and staff available to come in and help out with tasks of daily living. These place all have limits on what they can do: this will vary from place to place in terms of no actual nursing, people needing to be able to help with getting up (1 person assist vs not needing 2 person assist), not wandering off etc.
Also, there are facilities or sections of the facilities designed for dementia care. It sounds like you need to be prepared for her husband to get worse over time and ideally the family should have a plan for how to handle that. It sounds like he is clearly on the downward slope and it is good to be as realistic about that as you can.
Anyway, my point is to think carefully what specific services your mother and her husband will need now and over the next 12-24 months. (In my experience, it is optimistic to hope to find one spot that will be perfect for the rest of their lives. It is great to try but there can be so many unknown twists and turns ahead you would be lucky to have the first situation work long term.)
posted by metahawk at 11:08 PM on February 5, 2021 [1 favorite]
Also, you should know that there are several different levels of care for people who can't live on their own. A nursing home usually means that there are actually nurses interacting with residents on a daily basis. In my area, these are usually also the most institutional in style - a single bedroom or maybe a double (two people sharing the room) plus a bathroom (possibly shared with the room next door) I believe this is the only level of care that Medicaid will pay for.
There are also a wide range of "assisted living" places. Some of these are what are called here "board and care" homes where you have a house that has been converted to provide care for 4-6 residents plus one or two caregivers on duty. Some of these are more like hotel rooms - each person has a studio or 1 bedroom apartment with lots of shared facilities (dining room etc) and staff available to come in and help out with tasks of daily living. These place all have limits on what they can do: this will vary from place to place in terms of no actual nursing, people needing to be able to help with getting up (1 person assist vs not needing 2 person assist), not wandering off etc.
Also, there are facilities or sections of the facilities designed for dementia care. It sounds like you need to be prepared for her husband to get worse over time and ideally the family should have a plan for how to handle that. It sounds like he is clearly on the downward slope and it is good to be as realistic about that as you can.
Anyway, my point is to think carefully what specific services your mother and her husband will need now and over the next 12-24 months. (In my experience, it is optimistic to hope to find one spot that will be perfect for the rest of their lives. It is great to try but there can be so many unknown twists and turns ahead you would be lucky to have the first situation work long term.)
posted by metahawk at 11:08 PM on February 5, 2021 [1 favorite]
Another possibility is to look for what is called continuity of care - you're looking for a place that has a range from independent living with assistance to full on memory care. Places that will shift to taking Medicaid if one runs out of resources so you don't have a situation of having to move them when they run out of assets are work looking at. And yes hiring an eldercare manager who knows the local options can be very helpful. That expertise can also be deeply helpful with the inevitable and challenging task of winnowing down their stuff because no assisted living or nursing home situation will be spacious. Also sounds like it's more than time to get power of attorney stuff in place to deal with the financials.
posted by leslies at 6:30 AM on February 6, 2021 [1 favorite]
posted by leslies at 6:30 AM on February 6, 2021 [1 favorite]
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You really need to consult with someone familiar with elder care law in your area. It may be benifical to speak to the social worker where your mom is recovering care to get local recommendations for someone for advice on these things. There are laws to note about assets, especially if they don't enter a facility at the exact same time.
posted by AlexiaSky at 9:50 AM on February 5, 2021 [1 favorite]