How do I know which type of home is more appropriate?

3 answers | Last updated: Sep 14, 2017
Nik52 asked...

I am the guardian for my grandmother who has advanced dementia and just had hip surgery. She is non-combative, non-verbal, incontinent, and will now be wheelchair bound. She can eat regular food, but cannot feed herself. How do I know if assisted living in a memory care unit or a nursing home is more appropriate?

Expert Answers

Maria Basso Lipani writes a popular website on geriatric care topics, where she puts her expertise as a Licensed Clinical Social Worker to good use answering care planning questions. Maria is a graduate of Columbia University School of Social Work and is licensed in California and New York.

Choosing between care homes can be tough, but the good news here is that you don't have to know which is better. Each facility has a set of criteria and will decide whether it's staff can manage her needs.

The best thing to do if she is still in the hospital is to ask to speak with the social worker who covers her floor for an opinion. The social worker sees hip surgeries (and people like your grandmother) all the time so is really in a good position to let you know which setting is likely to be the most appropriate. The social worker is also your link to the rest of the hospital team (physical therapist, and physician) who together will determine where she would do best after discharge.

Long term there is a significant cost difference between a nursing home and an assisted living facility which is worth mentioning here. If an assisted living facility would accept her, she would undoubtedly require a high level of care - most likely 1:1 for at least 12 hours per day. This could be extremely costly and depending upon where she lives, could be upwards of $10,000 per month. Although the cost of a nursing home would be similar, Medicaid would pay if your grandmother could not afford it. Depending upon her assets, this is may be the deciding factor.

All the best and please ask follow-up questions if you need to.


Community Answers

Malarky answered...

Is it true that recent legislation has medicaid covering assisted living?

Redbeard answered...

Availalble services can vary considerably in Assisted Living facilities. I recommend that you search for facilities that specialize in memory care. We moved my father from an Assisted Living facility to a Nursing Home when he had a stroke, and the Assisted Living facility could note take him back due to his limitations. But later we found another Assisted Living facility that specialized in memory care and offered higher levels of service. We moved my father there and he received more personalized service at a lower cost.