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95 yr old mother with late stage dementia who stays in bed. Has hospice care and AL services. Would she get more complete care in Nursing Home?

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It's going to depend a lot on what is available in your area. In my opinion she would get better care in most nursing homes because they are equipped with patient lifts, accessible bathing options, dysphagia compliant menus, and higher staffing ratios.
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I see no need to move her now. Hospice is now in charge of her medications and care. There is a doctor associated with them. You should be getting an aide a few times a week to bathe Mom so no need for one of the AL aides to be doing that so no need for that service. I would just pay the extra for the care the AL aides are now being asked to give because she is bed bound. To private pay for a NH is going to cost maybe 10k.

I really don't see how she would get more "complete care" in a nursing home. Hospice will be in charge there too. The AL is her home and she is familiar with the staff and her surroundings. I would not even go thru the process in transferring her.
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I think it’s better to be in a SNF…an ALF is more for residents who can help themselves more & usually able to walk. Also, hospice &/or Medicaid is available at SNF but not ALF. In addition, most ALF don’t have license for hoyer lift transfers…which she now needs
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JoAnn29 May 2021
Medicare does pay for Hospice in an AL. She will not need a hoyer if bed bound.
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I'm amazed she's been allowed to stay in assisted living. She's far beyond the level of care they provide -- are you paying for 24/7 caregivers? If not, she needs it.

Perhaps she could go to a hospice facility or a skilled nursing facility. Even Memory Care would provide more complete care than what AL does.
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Your mother will get no better care in a nursing home than where she is. Once hospice comes in they become the caregiver and make sure your mom lives out her final days with dignity and in comfort. The ALF or the nursing home no longer manages her care. If you would move her, that probably would require a different hospice agency and also cost you more. Leave her where she is.
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With hospice, I recommend memory care not assisted living. My dad is on hospice but before this lasted 3 weeks in assisted living. He wasn't used to it and I kept trying to up his care levels but no matter what I paid they couldn't give him enough care. even if she has just a little bit of dementia she's better off in a memory care and the sooner the better because she can adjust better.

A nursing home is also a good idea. I disagree that Hospice is going to give her the kind of 24/7 care she is going to need, but they will help you find caregivers if you want her to stay in assisted living. They will also help you choose a memory care or nursing home and get her moved.

Good luck!
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Ask the hospice organization if there is a hospice house or facility for her to stay in. My mom recently stayed in a hospice house for about a month where she died. The care is excellent. You are also provided with a social worker and clergy.

In a hospice house there are caregivers and nurses available 24/7. They are angels.

I am pleased to say that my mom died with dignity, free from agonizing pain. She was 95 and had Parkinson’s disease.
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Ask the facilities you are considering what their policies are. Someone from the facility will do an assessment on you mother to determine what level of care she will need based on her physical and mental state.
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A Memory Care facility might be the best option.
There may be no need for the care given at a Skilled Nursing Facility. And Assisted Living might not be able to give enough care.
With the combination of Memory Care staff and Hospice I think that is the perfect balance.
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In reading this question and all the varying answers, it shows me that it is important to know how much extra care can be provided where she is now, how that extra cost compares to a NH and what would be least upsetting to Mum.

It is also a case that depending on where you are AL and NH may offer different degrees of care.
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My mother is in a similar situation. She's in memory care with her own familiar furniture and pictures around her, and has hospice care. If your mother is bedridden, and her facility can take care of her, she can probably stay where she is. Speak to her facility about your concerns. Do you have reason to think they are not able to handle her care if her condition declines? My mother has to be fed and helped with everything (bathing, dressing, moving from the bed to a wheel chair or geri chair). Moves are usually disturbing to seniors, so you should consider keeping her where she is, if her care is good and they can handle what may come. A nursing home environment is more hospital-like.
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