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ldstarr

Elder Care and the stresses it creates (long)

ldstarr
6 years ago

My DMIL is 88 and still lives in her own home. She had a fall on ice in a parking lot this past December and ended up hospitalized for a couple of days for a concussion. One of the doctors chose to recommend her for a driving evaluation. Well, as we suspected, she failed. That was a blessing, as that way we weren't "the bad guys". She has had some gradual decline of her memory going on for several years, but the concussion seems to have hastened it. She has 4 children, 1 of which is mentally and physically disabled and lives in a nursing facility. My DH is the only other one in the area, so the brunt of this is falling on him. DH has POA for her and has taken some steps to simplify and control her investments, but is still allowing her to control her checkbook and take care of her daily bills etc. We keep an eye on the account from afar, as we have online access, but she has forgotten and we choose to leave it that way.

She has always been meticulous (OCD) with her records, but suddenly seems to find filing an impossible task. I spent about an hour recently making sure all the paperwork was correct for the various accounts and then filed it appropriately. Ultimately, she needs to moving to some type of assisted living and we are aware of that. His brother and sister are in agreement. DH's mother has always said it is important that she go to a facility that is in "her neighborhood", but we think that is shortsighted. The place she has in mind would require a 50 minute drive east to get her, then a 45 minute drive west to go to the doctors, visit her daughter in the nursing home etc. There are several very nice assisted living places that are much more centrally located DH and I would like to look at. Is she being unreasonable to want to stay in her neighborhood? We feel that her facility will become her "neighborhood" and that proximity too us and her daughter is more important as it will allow for interaction between the family members. Would you respect her wishes or insist on looking a places that allow better access? We need other views as the burden of all this is making us myopic. Sorry this is so long and thanks for your thoughts.

Comments (105)

  • blfenton
    6 years ago

    We are 65 and had funds set aside for our kids education. Once our kids graduated from high school and became busy with their own lives we became very frugal. Strictly to save enough for retirement and whatever comes along. Between our savings, my DH's pension and a mortgage free home we will hopefully be ok.

    My mom's monthly fees for private care facility for memory care is $10000 a month (CDN). She has the money for about 3 more years and then she'll have to go into government care. By then she won't know the difference. The pretty entrance, the extra activities, etc will no longer mean anything. The care will still be good but the frous-frous will no longer be necessary.

    My mom has no physical frailties beyond some arthritis in her knee but, at 89 with Alzheimers, she has outlived her mental abilities. And that is so sad but it is reality.

    ldstarr thanked blfenton
  • User
    6 years ago

    My two comments were probably the ones Elmer mentioned. One was that some with dementia return mentally and sometimes physically to the "Terrible Twos". Which others have covered better than I did.

    The other one was actually assessing what level of care is needed. As some of you know my husband is in a nursing home. He had mild dementia and was basically stable. I had been looking at assisted living and dementia units for later if they would be needed. He had a health problem compounded by a UTI that left him unable to stand or do anything for himself. The doctors at the hospital would not allow him to return home. This happens more frequently than most people realize so any plans should be made for both current and worst case. I had wasted months looking for the right home. In this state if a person needs more assistance than one person can provide they are not eligible for assisted living. Also if they weight over 250 they are not eligible my husband was over that. Each state has their own rules but both of these are general guidelines for most.

    Look for a place that has multiple levels of care so that when the time comes a new facility does not have to be found. Some assisted living and dementia places will not allow a person to remain in them if they become bedridden. The level of care that is needed which can include bed-baths, feeding, and moving the person so that sores do not happen is beyond the scope of an assisted living place.

    After viewing several dementia units there may be good ones but many seemed to lump all of the patients together. I found it disturbing when I thought of the horror of someone with mild dementia being placed with people whose minds but not their bodies were totally gone. Another thing that disturbed me was the use of memory books that I saw residents being asked to look at and try to relate to the therapist what and who the person or activity in the picture was about. A futile effort and could create anguish as the residents memory slipped.


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  • blfenton
    6 years ago

    @maifleur = I always thought that the concept of a memory book was a great idea. We did up a photograph family tree for my mom for her room to help her remember her children and grandchildren. It use to work and now it just upsets her. She doesn't know the names and no longer recognizes faces. So I agree with you about them. They have their place until they don't.

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  • sealavender
    6 years ago

    ldstarr, I wish you all the best with this. Reading all the comments here, I am having flashbacks of dealing with moving my the 90+ Mom from East to West coasts. It's tough all around. I hope it all works out well.

    ldstarr thanked sealavender
  • mojomom
    6 years ago

    Idstarr, just adding my best wishes. I am going through the same with my Mom. She basically turned over her finances (at least the day to day parts and bill paying) to us several years ago although she keeps up with balances etc. because I read the statements to her every month. Fortunately, she agreed to move to a lovely senior facility near us when we moved to Colorado and despite her trepidation has settled in well found she enjoys it -- especially the social aspects, dining and happy hour and she has always been a real introvert. She is currently in independent living with her two cats in a lovely 1300 sq. ft. apt., but I can see the time for assisted living approaching. Fortunately, her place has independent, assisted, memory care and full nursing home. Because she is on a specific floor she can transition from independent to some assisted without moving apartments.

    Her important thing was the church and we have a nice one here that she enjoys. I promised to take her every Sunday I can and have kept that promise, but when I can't the facility provides transportation. Her other important thing is that she didn't want to give up her home in the south. Fortunately, she can afford it and my brother lives nearby and keeps an eye on it and keeps it maintained. I took her "home" last week and she really enjoyed it and likes the idea that she can go "home" when she wants, but she told me on the drive back out, that she was looking forward to getting back to her "new home" in Colorado and that she was actually thinking of it as home now, not just a place she was staying. Quite a step!

    The hardest part now is dealing with her diminishing mental capacity. So far, she is capable of taking care of herself, but often gets confused and makes some illogical statements, confusing family members (cousins), losing names and facts, and forgetting things that were once so important to her. These issues aren't so bad yet, but it is so sad to me watching my formerly very intelligent and vibrant Mom failing like that and I had to learn not to correct her when she says something off the wall because she makes some very irrational arguments trying to either cover or convince me she is right. I know it's only going to get worse and that's depressing to me. Honestly, I think she is handling her mental decline emotionally better than me, but she also is a bit oblivious to it.

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  • User
    6 years ago

    chisue how you cope with the other person allows you to know what will happen to you. Each person needs to start being aware of what pitfalls or things that should have been handled better and take the steps to prevent those happening when you might need care. You need to save as much as you can and make your family aware that any assets that you have should be used for any care that you need. LTC for some has been good but for some/most that I have known it ends up being lost when the premiums rise too much. You pay the premiums until you need the care. Some double, triple, or more if you purchase when you are younger, 30's. 25% increases every five years is not unknown. If you are paying for two people that could be over $1,000 a month. You could elect to save the premiums and depending on how long before the plan is needed your savings could cover what the plan provides. Most plans only pay a set amount a month for 2, 3, or 5 years. There are some that will pay for lifetime care but those are becoming fewer. I decided that saving the money was better than taking a chance of loosing it.

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  • chisue
    6 years ago
    last modified: 6 years ago

    maifleur -- We dropped LTC insurance after paying in for ten years -- thereby salvaging a teeny benefit -- supposedly!

    I am seeing posts here about caring for 'the other', but I'm not seeing that many of us -- including me! -- are prepared for exactly where we would move in a fast-approaching future. We see 'others'; not ourselves. (I'm speaking of Seniors like myself here.)

    It's the same on the Building a Home forum, where people who are now still vital at 62 are designing multi-level Forever Homes for the way they live *now*. They are not aware of how inappropriate these houses will be, or how fast that will happen! Couples just 'planning' children are also designing homes for their present lifestyle without the amenities required of a house full of growing children. It's definitely hard to see around the corner and down the road. But we should.

    Now 77, I've found that the downhill grade past 70 increases more rapidly than I anticipated -- never mind the stories of some outliers who are 'perfectly fine' at 100. We moved into our Forever House 17 years ago. It is still good for us, yet I would never be able to undertake the strain of building it now -- as I was able to do *then*.

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  • User
    6 years ago
    last modified: 6 years ago

    I am now 70 and for the first time starting to feel that my body is slipping. I am needing cataracts removed. My mind is slowing which I can tell because of the way I spell some things that used to be automatic and now I have to think of the word. This was our forever home and I would still like it to be but I can tell that the plans I made will probably not happen. I think most people do not want to think that they could easily be the person that they were caring for. They feel well and that their mind is just as sharp as ever. Probably a survival mechanism from our early ancestors. It could also be that they have never had a plan that did not have to be changed so refuse to make a plan. I worked early in my life in either industries that changed constantly or as a temporary moving from job to job knowing that each job would come to an end so I am more flexible than many.

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  • PRO
    Anglophilia
    6 years ago

    I've had a plan now for about 15 years - we made it when we decided that the "good" LTC insurance was WAY too expensive and the affordable did't justify the cost. I'm living in my LTC plan and will sell it to pay for the care. I have a large enough IRA and enough income, that I won't have to have a "fire sale" to get money for care immediately - I could manage for a couple of years if I had to do so. I keep my house in excellent, updated condition so I would expect it to sell within 3-6 months if priced right.

    There is really only one retirement home I would want to go to and it's very hard to get into - I might well not qualify. There are a few others I saw when I looked when my parents decided they wanted to move here 30+ years ago (must my father, not my mother). There was no place here that met their requirements, my father died a year later, and my mother decided to stay where she was so long as she could drive - then she would move here. She died before that happened.

    Perhaps I should be visiting retirement homes, but I find it depressing enough having my health decline and being inundated with phone calls and mail about "senior aids", incontinence products, walk-in bathtubs and hearing aids. Today, I saw a junk ad on my Facebook page about pre-planning and paying for my funeral!

    One can only take so much....

    ldstarr thanked Anglophilia
  • joyfulguy
    6 years ago

    How about thinking of a possible term/period of years, when thinking of our home, whether current model or projected one ...

    ...as 'forever" ... seems a bit long, don't you think?

    Maybe 25 ... or 35 ... or 10 ... years ... or whatever possible term to consider might be more helpful/useful?

    Also ... when considering what future accomodation we might favour ... it might well be somewhat gracious of us, and more kindly toward our offspring/caregiver(s), etc. ... if we could discipline ourselves to be a little less stubborn as we envisage that possible situation?

    ole joyful

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  • User
    6 years ago

    I was thinking about this yesterday when I was at the bakery and purchased stuff for several days. My doctor always is after me to eat healthy so that I would live longer. I would rather eat so that I was healthy and content for the time I do live. I have always had friends in almost all age groups. From the outside it has always been sad to me when a person has outlived all of the people that they know or have lost the ability to recognize the people they should know.

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  • User
    6 years ago

    Old joyful your comment brings to mind your problem while out driving this winter. Think of how you reacted when someone asked you if it was time to give up driving probably several did or wanted to. Would have to change your lifestyle but it is something if you live long enough the changes in many things will be there. You may or may not have but it is the reaction to the question that you need to think about.

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  • nickel_kg
    6 years ago

    My parents set such a good example for us kids. They saved money, visited several possible Continuous Care Communities (CCC), signed up for one central to us kids. They were about to move, when Mom's cancer came back so Dad ended up moving into a one-bedroom Independent Living unit a month after she died. He was 78. It was so good for him -- company, clubs, no maintenance responsibilities.

    So, the general plan for all us kids is: save money, keep our LTC insurance paid up, and move into a CCC independent living apartment around age 75, about fifteen years from now, whether we "need to" or not. There are two excellent choices in town. We've toured both, seen the amenities, the assisted living, the full up nursing options, the memory units. My husband favors one, I favor the other -- it has better mountain views, more trees on campus. Do all us sisters want to be in the same facility? I don't think that's necessary. But I might change my mind as we (God willing) age. My daughter is the only blood relation us sisters share. She's aware of our general plans. I don't know what we'll do, if she lives far away when we're in our "old, old age", but we do not want her to sacrifice her life for us. Knock on wood!





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  • User
    6 years ago

    nickel you state that you do not want her to sacrifice her life for you but if she does live far away when you need care she may need to do so. If you have to go to a hospital several times like many do and she is your medical POA she may have to take time from work to handle your needs. Most couples age at different rates so one may stay in independent living but the other one may be in the nursing home.

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  • nickel_kg
    6 years ago

    maifleur, that's true -- we don't know what the future holds. Right now, "that point" in time seems so far away, we can't get more specific.

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  • chisue
    6 years ago

    nickel_kg -- Thank you for posting. You've done what we need to do -- toured your possible choices to 'get your ducks in a row'. DH and I need to do that once we get home from Maui next week. I will want to speak with people whose relatives have moved on from the 'independent living' parts to the nitty gritty of skilled nursing care.

    My late mother moved into a then-new CCC that was very nice -- as long as you didn't need skilled nursing care, which she did, only three months after moving into her apartment. I had to place her in another nursing home and fight to get her CCC contract cancelled. I had to dig to discover that the nursing center director was an ex-convict with no qualifications. The nursing wing was severely understaffed and completely unsupervised -- no good RN would work there.

    A national 'care business' had developed the place, using a group of local ministers as 'fronts'. I learned that there is seldom state or local funding to perform 'required' inspections or verify that 'on paper' plans are met.

    I had to take my finding to the media to get cooperation. These are big businesses, with the same concerns about the bottom line as any other business.

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  • User
    6 years ago
    last modified: 6 years ago

    Be wary of the ones that are supposedly religious as some as chisue mentions use either the religion as part of their name or ministers in their advertising. If long running at one time there may have been an affiliation but that was long ago. I toured one in Minneapolis that is that way when my niece wanted us to move there. I have since found out that while on the surface it may appear nice the bad vibes I was getting were real. There is a nice one in this area but the religious connection was severed when the new complex was built in the 60's. Be wary of how your family can cancel a continuing care arrangement. The one in Minneapolis you made a large payment. Then you basically paid rent every month including extra for any services. The only way to end the contract was to sell the unit. To sell the unit it had to be stripped and redone at your expense.

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  • raee_gw zone 5b-6a Ohio
    6 years ago

    There are a few exceptions (my father was in one of the exceptions, and there is a story behind why it is an exception) I believe that for-profit nursing homes/extended care facilities should be banned.

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  • User
    6 years ago

    raee why since there are so few non-profit and not for profit nursing homes? Even those have to have a profit to maintain the facilities and take care of the residents.

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  • Judy Good
    6 years ago

    I have worked in Nursing homes and assisted living for the past 40 years. I have come to realize as our parents age, we need to be more like the "parent". Advocating for them but also remembering what is best for us as their children and grandchildren. I am sure she is reluctant to move out of her home, no matter where it is. If she is able to understand, she needs to be given rules, just as she did to her children when they were young. If this means you must keep her close to your home, then she needs to know why. If she is an hour away, she will not see you as often. Doctor visits are a real issue with transportation and time involved for all involved. Be strong and take the lead. Not making it a decision but a choice of a placement near you.

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  • raee_gw zone 5b-6a Ohio
    6 years ago

    Maifleur, they need to break even, but those who operate for the purpose of producing a profit for owners and investors are typically the worst in terms of staffing numbers, staff pay, turnover, support, education, cleanliness, facility maintenance, even up to Medicare/Medicaid billing (for example, shortly after my mother was admitted to her rehab, she had her toenails "debrided" by the facility's partner podiatrist, supposedly because she was diabetic and had overgrown, fungused nails. Neither was true -- & I had trimmed her nails just the week before so knew their condition. She also had just gotten new eyeglasses and a full eye exam, due to cataract removal 3 weeks before admission - she had her stroke the week after -- but the facility had their partner optometrist examine her and order her another pair -- which, incidently, I never saw her wear. Repeated the year after, of course, because the gov't would pay for it. I suspect the home got a cut of that)

    Of course there are exceptions, as I said.

    As to why there are so few nonprofit facilities, I don't know. Most hospitals are non-profit. Could it be that the need for custodial care has grown so much in the past several decades, coupled with the need for the traditional nonprofit players to focus more and more resources on their existing facilities that they've not been interested, plus the squeeze on reimbursements? I imagine it take a substantial investment to build and run such a facility. I know that the better non profit extended cares in my town limit the number of Medicaid patients they will take, and there are waiting lists for their "Medicaid beds"

    ldstarr thanked raee_gw zone 5b-6a Ohio
  • User
    6 years ago
    last modified: 6 years ago

    In this area the hospitals other than KU Med are all ran by corporations hired by their boards to manage the hospital so no non-profit ones in this area. KU probably receives much of its funding from grants for research as do many teaching hospitals. Notice I did not say not for profit which were the ones traditionally ran by religious or other social groups. Non-profit ones to keep that status needed to write off a certain amount each year to maintain that status.

    When I was looking for a place for my husband I quickly realized that the facilities that accepted Medicaid patients were generally cleaner and brighter except for one. There are no non-profit extended care facilities in this area. Many are like the hospitals managed by a company that is hired for that reason. I do not know what company is currently being used but when I first placed my husband it was Golden Living but their contract was ended. I am expecting to need to look again because either because of the number of newer places being built or perhaps they are just not accepting new patients the number of residents have shrunk to about 60% capacity. Other than the residents that have moved from the dementia unit into nursing unit I think there has only been three new residents this year.

    Edited to add that your mother would have needed her eyes examined after she had her stroke because strokes can change your vision. The rest may or may not have been needed but unless she was on Medicaid or living in a veterans home the government would not have paid for the glasses as they are only covered by Medicare once after the surgery

  • Elmer J Fudd
    6 years ago
    last modified: 6 years ago

    rae, I don't doubt the experiences you've had but I don't think it's reasonable to take experiences in one location or with one or just a few people and make broad assumptions assuming what happens elsewhere is the same. I suspect there are great facilities operated by for-profit entities, and awful ones operated by non-profit ones, and everything in-between.

    I've been on the boards of several non-profits. A break even financial result is seen as a poor year, all strive to have surpluses to have money to expand activities and to have a financial safety cushion. Deficits are cause for great concern.

    What a non-profit calls a surplus, a for-profit calls a profit. Desired for all the same reasons. And deficits=losses and can be a similar sign of big problems.


    It's the facility, its management, and its people that make a difference.

  • raee_gw zone 5b-6a Ohio
    6 years ago

    Of course Elmer, you are right -- no place, no hospital, is truly "break even". I know that. My belief is that those that exist to profit investors and owners, though, are more attentive to the profit margin than to the needs of the residents.

    And, yes, my experience is regional and therefore limited. In my career of 41 years, I have heard and seen a lot of the extended care facilities in my city and the general rule seems to hold -- the non profit (or not for profit, I am not clear on what the distinction is) offer better facilities, staffing, and so forth. Better care overall.

    And, as I said, there are exceptions. My father was fortunate enough to be in one -- fortunate enough to have the resources to be in the best in the area. My mother was indeed on Medicaid.

    Maifleur, I am not clear on the facilities near you. The ownership hires a managing company (and apparently that contract can be terminated) but how does that define the facility as not a non- or not-for - profit? My hospital contracts with outside vendors for certain operations (food service and laundry for 2) but it is still a not for profit organization, despite the fact that the vendor is in business for a profit.

  • chisue
    6 years ago
    last modified: 6 years ago

    I am grateful for the opportunity to learn from the stories on KT and from friends with relatives 'in care'. We have yet to observe this directly, not having friends who are living in care facilities.

    I guess it is human nature to merely 'observe' a problem without applying the obvious to yourself. I've been slow to realize that we need to educate ourselves on our own options for care. Deciding to "Age In Place" in our "Forever Home" can end. We must plan for care that only an earlier death would make *inevitable* -- a need that could become immediate next week or next year.

    In considering a CCC facility, I'll relate a friend's experience with her MIL. The lady was content to leave her large apartment for a smaller one in a CCC facility. She 'bought in' and paid monthly fees.

    However, as her health deteriorated, she required more than 'assisted living'. Her contract required that she vacate the apartment for a single room in the skilled nursing area. She refused. ("I'm not going to live with the Loonies!") The money she'd invested in a contract for continuing care was for naught. Her family paid independently to hire what became 24/7 nursing care in her apartment. This went on for two years. She might as well have stayed in her own home.

    Note to self: Be prepared to accept a CCC facility's decision about where they place you. Be prepared to move if an assisted living facility no longer considers you eligible.

    As I'm writing this, I'm wondering if we would need or want to move to an 'assisted living' situation. Maybe we need to research *skilled nursing facilities*, planning to hire our own 'assistance' to come in to our own home. (Please give me arguments for or against this!)

  • User
    6 years ago

    Raee and Elmer can correct me since it has been a while since I had to help fill out the forms but it is how the company was organized when it files with the Secretary of State in each state. All non-profit employees are normally paid a salary. Boards of directors may receive a fee of a sort but are not considered in most states employees. Some not for profit ones may rely on volunteers, or part volunteers and paid. Not for profit ones may pass any earnings on to others such as those that send sick children to camp.

    My comment about hiring outside "experts" to run a nursing home is an example of how many nursing homes across the country are run. People see a name on a facility, Methodist, Catholic, Free, Caring etc. and think the owners of the facility are the ones that run it. I do not know of any non-profit nursing homes of any type in this area and the only not for profit one is run by the Little Sisters of the Poor.

  • User
    6 years ago

    chisue after looking for a place for my husband I would advise you to look at skilled nursing facilities. Most of the care for an individual who needs little assistance such as making certain that they take their meds, eat, are clean and are observed every day is the same at both assisted and skilled. Most skilled facilities have a list of "life skills" that if you can not handled several on your own make you eligible. For early stage non-violent dementia patients I feel it would be easier to see others that are just sick than how some later stage dementia patients become. Depending on your area skilled facilities can also be cheaper which will make your funds last longer. One of the shockers at one of the Minneapolis places was that there was no observation or checking other than a wooden board on a shelf that was put in place every night and if not moved by the third day if no one answered the phone that day the apartment would then be entered. It went over my niece's head that if you decided to do something to yourself you would have time but for a place that was supposed to be looking after people was just a stomach turner.

  • User
    6 years ago

    I forgot to add when looking at skilled nursing units ask if couples can live together if you find any that look like a fit. Some do but others still keep the sexes separate. The two that I saw that allowed it discounted the monthly fees.

  • Elmer J Fudd
    6 years ago
    last modified: 6 years ago

    I spent a few minutes (not more than 3) poking around with searches and found Bishop Spencer Place near St Luke's Hospital in Kansas City, affiliated with the local Episcopal diocese. 20 minutes away is Cedar Lake Village in Olathe, KS, run by the Lutheran Good Samaritan Society .

    "Raee and Elmer can correct me since it has been a while since I had to help fill out the forms but it is how the company was organized when it files with the Secretary of State in each state."

    Articles of incorporation, bylaws, and other formation docs for a non-profit are just that. And the same, docs of the required type and content of docs for a for-profit entity. Comparing one to the other, they're very different .

    In the US, entities are formed under the laws of a state - any one state, not more, call that State M. If later it begins with activity in State Z, it registers with usually just the tax authorities as an "X" type of entity from "Y" state. Non profits do the same.

    Non-profits also need to file a request for non-profit status with the IRS. Some states require a separate similar filing but I think most piggyback on what the Feds do. During my active working years, I tried to avoid dealing with non-profits (other than as a board member). Having such entities as clients wasn't my cup of tea. I did work with several large ones at different points in time, it wasn't something I liked.

    People are paid however they're paid, it has nothing to do with the type of entity. Board members of for profit entities typically are paid, and paid very well if it's a public company, while board members for non-profits of most types volunteer their time unless they're also employees of the exempt org.

  • User
    6 years ago

    Elmer thank you for that but I was doing a comparison of non-profits vs. not for profits not the for profits you mentioned. The way people are paid that I stated seems to be what most not for profits follow. Some do have one paid manager or several paid managerial positions but the lower stratus workers that carry out the functions are mostly unpaid and volunteers. The local Assistance League is of this type.

    Cedar Lake is one of those that on the surface appears religious but is also ran by the Olathe Medical Center which is why I did not list it. Bishop Spencer is an odd duck. Several times the diocese has attempted to sell the property and close the facility. Since it is a facility that you have to pay an upfront charge the original agreement that the residents had to agree to the sale. Articles about this appear in the local paper about every two years. There was one person in the Alzheimer's group when I was going that talked about what he was going to do if he and his wife had to move.

  • mojomom
    6 years ago

    What I'm seeing with the place my Mom lives is that it is run and operated by a (very good) non-profit, but the property itself is owned by the for profit developer. I will say it is well built and lovely on in a very expensive large piece of property in a high end area. Given that arrangement, I suspect that the "profit" ultimately flows to the developer in the form of rents or fees. I do have a great deal of confidence in the non-profits board -- made up of community leaders and medical professions. Mom's unit had a by in option -- $435,000, plus a reduced fee of around $6,000 a month or a no buy-in but the rate for the same apartment was 8,200 a month (independent living only, no medical or caregiving services but it provides three meals a day, a cocktail hour, and various activities and entertainment, and housekeeping, plus some transportation. At her age, it would take so long to break even with the buy in we chose the higher monthly.

    At any rate, we're pleased with it so far. The staff is wonderful! (I am there daily) Prices will go up if she needs assisted living at some point in time, but she lives on a floor that has the option of ala carte assisted services (at an additional cost, of course) because the her floor connects to the assisted living part of the facility and if she needs more than the ala carte services she will have the option into moving to a smaller unit, but still nice and the unit fee will decrease as the care fees increase.

  • Elmer J Fudd
    6 years ago
    last modified: 6 years ago

    "Some do have one paid manager or several paid managerial positions but the lower stratus workers that carry out the functions are mostly unpaid and volunteers. The local Assistance League is of this type."

    Now you seem to be talking about a small charitable organization that runs on a shoestring budget. I thought you were talking about elder care facilities. Your words would hardly describe anything as large or organized as a nonprofit elder care facility or even a health facility.

    I only know what the website says. Cedar Lake is run (not ran, that's past tense) by the Evangelical Lutheran Good Samaritan Society. If you think otherwise, you need to let them know.

    https://www.good-sam.com/locations/cedar-lake-village

    You said a few other things, I don't know what you're referring to and I don't think you do either, like

    "Non-profit ones to keep that status needed to write off a certain amount each year to maintain that status." Huh?

    "facilities that accepted Medicaid patients were generally cleaner and brighter". That may be your experience but I know lots of people with very different experiences.

    "so few non-profit and not for profit nursing homes? Even those have to have a profit to maintain the facilities and take care of the residents" Sometimes true but often not.

    "KU probably receives much of its funding from grants for research as do many teaching hospitals. " Research grants can't be spent on hospital operations and few teaching hospitals (in their hospital ops divisions) do research.

    "Boards of directors may receive a fee of a sort but are not considered in most states employees." An individual who doesn't work for an entity other than as a board member is NEVER considered to be an employee. Never.

    Not for the first thing, you're taking what you've observed and thought you understood and then are using that to describe many things you really don't know much about. Stick to what you know.

  • User
    6 years ago

    Are you talking about Silver Lake or Cedar Lake. From Cedar Lakes own website, "The trusted capability of Olathe Medical Center and the caring tradition of The Evangelical Lutheran Good Samaritan Society have joined to create Cedar Lake Village".

    I was trying to explain the difference between the two types of non and not for profit organizations to Raee as she appeared not to know that there were two type

    Where do you see that I said the grants were used for operations????

    Once again you are reading what you think I wrote.

    The Assistance League has a small by California budget of under $5 million budget

  • Elmer J Fudd
    6 years ago
    last modified: 6 years ago

    Sorry, it's Cedar Lake, the one I linked to. I edited above to change it.

    Two types of non profits? Under the Internal Revenue Code, there are more than 30 "kinds". What are you referring to?

  • ldstarr
    Original Author
    6 years ago

    maifleur01 and elmer - once again you've managed to hijack a thread. This was NOT about the tax status of care facilities. I would appreciate it if you'd start your own post when you feel like arguing!

  • User
    6 years ago

    idstarr to make it easier since there is apparently nothing that I can post that Elmer does not tear apart I will simply not post. I stepped away for a week only to have my first posts once again diverted because I did not know what I was talking about. It was interesting being here but time to move on.

  • PKponder TX Z7B
    6 years ago

    Elmer, why is it so important that you always be considered the 'authority' on every single topic? You don't know everything, regardless of whether you believe that you do. Others have a right to say what they feel just as you do. It seems that you are constantly trying to discredit certain folks. Why is that?

  • Elmer J Fudd
    6 years ago
    last modified: 6 years ago

    pk, that's not my intent.

    How would you describe the difference between someone who needs to act like an authority versus someone whose interests and knowledge are broad (though for some matters not always that deep) concerning a wide range of things? The latter describes me (sorry for the immodesty) for a variety of reasons, some because of my efforts, some not.

    People in the real world know and think that about me. From my side, it's easier to manage and temper when in face to face situations. Just as comparing communications verbally versus by email, the written word is often a difficult way to feather in a comment and both communicate nuances as well as to see reactions to it and sense the direction of a conversation. Any forum makes that difficult.

    I speak up when I disagree or, as others do, when I want to add something to the conversation.

  • Hareball
    6 years ago

    I agree with PK. Why not contribute something pleasant? Why not show us your sense of humor more? I'm sure you're a nice person, but you do seem to go out of your way to prove everyone wrong. Sometimes I will stop myself from putting something specifically because of you. There have been a few posts where you follow right after me to discredit anything I say. I know I'm younger than you and have a lot to learn but it's no reason to make me feel like an idiot.

  • PKponder TX Z7B
    6 years ago

    It seems to me that your method of speaking up resembles browbeating certain others. Maybe we do lose something in the translation.

  • Hareball
    6 years ago
    Idstarr - I’m sorry your post got off topic. I know my last comment was off topic so I apologize.

    I hope everything works out with your mom. Please keep us updated.
  • zippity1
    6 years ago

    when my grandmother was 75 she met her son, who lived 60 miles away, at the door on his weekly sat morning visit, she was dressed had her bags packed and told him she'd made arrangements to live at an assisted living facility about 20 miles from her home, no one was aware of her decision to go there at this point. she had been in a wheelchair for 25 years and felt that even if they house was on fire she'd not be able to get out of it.....at any rate, they were expecting her and if he didn't take her she'd find someone who could.....so off they went. sure enough, they were expected and her room was ready. on the way past the nurses desk, she told the nurses she wanted to be moved to the corner room between the living area and the common areas as soon as it was available (not a quiet place) but exactly what she wanted. She would sit outside her door in her chair greeting people as they entered the building, doing handwork every single day. Never once did she mention "going home." She lived there for 8 years before having a stroke and being in a coma for several months. Even then, people who came to visit would drop by and speak to her in her unconscious state. The facility was about 45 miles from my uncle's home and about the same from ours. She was one in a million.

    ldstarr thanked zippity1
  • Elmer J Fudd
    6 years ago

    Maybe we do lose something in the translation.

    Yes. And most certainly to the ears of a crowd that's majority female, I'm direct.


    I'll be mindful of your comments, pk.

  • PKponder TX Z7B
    6 years ago

    I am sorry for intruding ldstarr, wishing you well on your MIL's future safe space.

    ldstarr thanked PKponder TX Z7B
  • chisue
    6 years ago
    last modified: 6 years ago

    I've just sent an email to the licensed social worker at our local senior center, asking her to meet with us next month. We'd like to hear what's worked -- or failed -- with other seniors similar to us. (Actuarial tables aren't necessarily 'us'.) She should have recent and historical information about most of the options in our area.

    I'd don't see us moving merely for 'room and board' as long as one of us is able. If one of us needs assistance the other can't provide, I might see 'assisted living'. However, I think we need a 'backup plan' in the event of an extreme/sudden change in our health or capabilities -- something possibly short term, and something longer term.

    Actually, I am a little puzzled about why couples move to obtain only 'room and board' (and a mini-bus to shopping). I can see the appeal for a single person or for someone otherwise isolated. For many people, I only see the appeal of a CCC where you could be confident of receiving *good* skilled nursing care when you needed it. (For us, right now, that seems very 'belt and suspenders'.)

  • blfenton
    6 years ago

    chisue - where my mom is there are couples living there as well. One of the couples has one of the partners (I don't know which one) that requires more care than the other and so they would be separated should they go into government subsidized care. In private care they are not.

  • chisue
    6 years ago

    Thanks, blfenton. I get that. Maybe I'm reflecting what I see in the ads for these places: A couple 'enjoying their senior years' living in a cottage with a garage and a *basement*, walking across to the dining room to eat with other similarly 'intact' couples. My first thought is that they are afraid. I suppose it's possible they wanted to downsize, but why to an expensive CCC?

  • sushipup1
    6 years ago

    It's an ad, Chisue. Like a picture of the streets of Disneyland with a few happy families and kids behaving.

  • nickel_kg
    6 years ago
    last modified: 6 years ago

    Chisue, if your point is 'why move to a CCC if you're not going to take advantage of the social side, don't need the medical side, and don't find upkeep of your current home burdensome' then I can see that it would be moving for no advantage.

    Except that -- as in my MIL's case, moving before you "need" to might allow you to imprint the facility as your home and make friends, before dementia robs you of your ability to deal with new situations (oh for a crystal ball!).

  • chisue
    6 years ago
    last modified: 6 years ago

    sushipup -- Oh, I know those are ads, but I do see people living in those cottages in two of the nicest, most upscale places near us. Really, cottages with basements and garages? If the average (non-mental-deficit) person spends fewer than a few months 'in care'...I just don't understand it.

    Speaking of ads, don't you love the casino ads showing glamorous young people, laughing and flirting, not the sallow old people imported by bus from nursing homes to sit hunched over slot machines?