Expert: Michalene Peticca - 8/16/2009

Question
My father has been diagnosed with mid stage dementia probable Alzheimer’s. Since his initial diagnosis almost 4 years ago, my sister and I have explored multiple options to prepare for future needs. Since he is relatively young - 70 and in otherwise exceptional health, we have been expecting to need long-term care for many many years.

An ER visit in September 2008 confirmed that he was no longer safe living alone. After navigating the myriad of options of Assisted Living in Massachusetts where he has lived his entire life and has a strong support network, we selected a facility that could take him right away (we did not have time to deal with wait lists) and that offered slots for lower budgets. However after he settled in we learned that they had calculated his pre tax pension incorrectly and he was in fact ineligible for reduced payment. Moreover, they had not mentioned that the wait list for those slots was multiple years long. Due to his SS and pension totals, my father does not qualify for any Massachusetts state aid for assisted living. Because he is still mobile, alert, and continent, he does not qualify for Nursing Home Care. Yet he (and the contributions my sister and I can make) is far short of being able to cover the monthly costs of care. Especially since, we need to plan for the possibility that his overall good health could cause him to live for many years. Due to our family's financial shortfall, our father's relative stability AND the final, complete depletion of his meager IRA savings, we need to move him out of the Assisted Living facility in his home state.

My sister plans to place him in her own home several states away with no other support network for her or him (no family or long time friends nearby) and she has 2 young children and her and husband work full time. He cannot live alone but he does have trouble coping with commotion and confusion and when anxious he refuses to eat and wanders. Therefore, I am a bit concerned how he will settle in this new environment. But we are unable to find an alternative. Of course the family will make it work and do what needs to be done. My expectation is that inevitably the Alzheimer's will cause enough of a regression that he will require Nursing Home care and there is more financial assistance available for that. But can you recommend ANY alternatives at a monthly cost of care less than $2,000 in any state outside of Massachusetts (where we have researched extensively)? Georgia would be good. Or is there a different type of facility than Assisted Living we should consider? Originally we were committed to maximizing his quality of life, maintaining the independence that he is still capable of and allowing him some dignity - hence the appeal of Assisted Living. Now we can be more flexible in considering any place that can provide care and safety and calm at a cost that is feasible to pay out over many years. Any direction that you can provide would be appreciated! He has Medicare and 1 of the prescription supplements to that but does not qualify for Medicaid. Thank you for your time.

Answer
Hello Megan,

Thank you for writing.   My major question is that if you find a state that will accept his level of income...is someone in your family willing to move there to be of assistance to him?

Most Assisted Livings are private pay....although a few do offer Veteran benefits.....if he is a Veteran of the U.S.

I suggest you start with the State Depts. of each State if you are "shopping" states.

Best of luck,

Michalene Peticca, MA