A little while ago, my mother broke her hip. She and my father were living in Independent living in a large retirement community. When she left the rehab facility, and attempted to go back "home", the retirement community said that she couldn't go back. I asked the community what their options were and they said that my mother and father could move into an assisted living apartment together, but the only option they had was a room that cost well over $10K/month. We then decided to wait until something else opened up there, but in the meantime my mother might be allowed into their memory care unit. Then they said that she couldn't move in there because she was a "2 person assist" and they weren't able to accommodate that. I couldn't believe what was going on. This place advertised themselves as being able to house residents from independent to assisted to memory care, through anything they needed. I floated the idea of hiring outside nurses to care for my mother and for her to stay in independent living with my father. They proposed 24 hour care at $30/hour. And they said that we could do that until a more appropriate assisted living option opened up. Then they said that an option just happened to be opening up this week. Then they said they needed to have a meeting with the director of the community to see whether my mother could even live there at all. We then reached out to another property in the same corporation about whether my parents could live there and they said yes, but they needed to bring in outside nurses to help with my mother's care. The monthly grand total? $17K for the first month. Then possibly $9K/month after that, but that was contingent on how much care my mother needed. While we were listening to both of these communities, offering their services, they started talking to each other about the fact that they were both currently trying to sell their services to us. It was like they were competing with each other to get my parents, but in the end, they were not doing much else than trying to bill my mother and father tens of thousands of dollars a month for care. Meanwhile my mother is stuck in a rehab facility away from my father except when he visits her throughout the day.
So dad went into an AL I found that was willing to take him as a 2 person assist and having a urinary catheter. They were unwilling to do anything BUT empty the urine bag though, so I was schlepping the man to the ER constantly with UTIs and issues with the catheter, it was a pretty bad scenario, in all honesty.
As it turned out, the brain tumor was responsible for dad's mobility issues after all. He lived for 10 months after the hip repair and then passed with hospice care in the ALF who agreed to keep him with hospice on board; so I was able to keep mom & dad together till the end. It was the brain tumor that ultimately took his life.
What other tests have been done on your mom to see why she can't walk? Dementia and/or hospital delirium should not cause her mobility issues; is she scared? What is she saying? Is she having pain anywhere else in her body that would justify a CT scan or MRI of that area? A geriatric psychiatrist is a good idea, but it's really all guess-work on their part. Nobody understands the human brain. All doctors understand is empirical evidence: can I see it on a CT scan or an MRI? No? Then it doesn't exist and I'll lump it into the 'dementia' category and then medicate it. My suggestion to you is to press for an organic reason mom can't walk, and have the docs explore that a bit more.
Best of luck with a tough situation. Hopefully, this is all temporary and mom can ultimately go back to her AL w/o being a 2 person assist once the docs figure out what's going on.
Is she being seen by a geriatric psychiatrist to assess her cognitive skills and whether dementia is in play?
Something I learned from the "senior advisor" we worked with when looking for an AL for my mom--sometimes state laws come into play. In NYS, a 2 person assist mandates NH level care. In neighboring Connecticut, AL can handle a 2 person assist, which at the time saved us about 5k per month.
I recently moved her to a facility that is a for profit one with high standards. Everything about this facility is far more preferable. The staff are kind and polite from the moment we walk in. The room is kept much cleaner. My mother generally looks better. The cost is slightly higher but it is understandable when considering the overall state of all aspects of the facility. I never have to call someone to complain about anything. I realize this can be different in areas and states. It just has been my recent experience.
I worked on getting recommendations. I found that if a facility is really good that all those recommendations ring true.
find a place that meets her needs.. father moves with her… Google care advisors, and find an independent to meet with you , set up and tour with you, they know the area , cost , your needs, reputation, openings… they are paid by the placement place.. great invaluable service. I used a franchise called care patrol 3 times…
Please note there is now a shortage of caregivers to help at these senior facilities, something that wasn't a problem a few years ago. Thus the sale pitch probably was true back then, but things have changed.
I have had experience having both very elderly parents being in rehab and also having rehab at home. It can be very difficult or it can work out smoothly.
Was there a problem with your Mom doing the exercises to help her gain more independence? Did her surgeon recommend more rehab time?
As Cover 999 says, its a business. Independent living is just that. You have to live independently. Assisted living is just that, they assist. They do not do skilled nursing or 2 person assists. You need more than they are capable of doing, you pay for it. Its been years but my Aunt and Uncle we paying 7k for a room together in an AL, so 10k maybe reasonable now for 2 people.
Are they ready to release Mom from Rehab? Because if they are, you don't have much time. Medicare determines the stay according to the progress she makes. As said, if she has had surgery, she should be up and around on her own. If they aren't doing surgery, then maybe Mom will need to be transferred to skilled nursing which in the long run will be cheaper than hiring aides. It does not need to be permanent just long enough for you to maybe find them another place to live.
These Communities you usually buy-in to. Meaning your parents put in a big chunk of money to live there. And probably paying rent on top of that. You need to read their contract carefully to find out what happens if they move out or even die. If there is longterm care there, should Mom use it and at what cost? I may have an elder lawyer look over it for any loop holes. I say this because a friend was handling her SILs estate. The SIL lived in one of these Communities. She had a severe stroke and was moved from her IL apt to LTC. My friend was sent a bill for the LTC. She informed the facility that 90% of her SILs buy-in was to go to pay for LTC when needed.
So sorry for what you are going through but sadly this is how these Communities work. You have to have money to live there.
On another note, a friend of the family had one senior who had a stroke and need NH while the other suffered from MCI and needed someone to provide a structure. Both were accommodated in a shared NH room. It worked well for them. They were together and the one with MCI was able to assist the post stroke LO with movement around the facility, especially to the garden area.
Was her hip repaired? When?
Unless your mother has moderate to advanced dementia going on, I would NOT even think about placing her in Memory Care because that's inappropriate from a lifestyle perspective. Memory Care does accept residents who require more care, BUT, they also need to have dementia as a diagnosis. Unless she'll only be living there on a VERY TEMPORARY BASIS, I'd nix that idea entirely as she'll be miserable otherwise.
The tough part is that you don't want to separate your parents. I was in that exact situation myself in 2014 when dad broke his hip and couldn't go back to IL with mom. I had to get them both into AL but dad was this-close to needing Skilled Nursing which meant they'd have been living separately! I had to find an AL that took more difficult residents who required more care, so I did.
You need to either work with this community to house both of your parents or find a new one that will accommodate your mother as a 2 person assist. If you have Morningstar AL in your area, I know they are very accommodating to elders with higher care needs. You'll pay for the services, but one way or another, you're in the same boat.
The other thing you can consider is leaving mom in rehab to regain her strength and recover to the point where she is no longer a 2 person assist. If the doctor orders it, Medicare will usually pay for up to 100 days of rehab if needed.
Some food for thought for you to consider. Best of luck.