Help Finding Care for Father in Law

Hi there, what a timely post. I just helped my grandfather move into an assisted living facility. I am happy to share tips with you, because the process can be overwhelming. But a phone call might be easier. Let me know~
Jane 

Have you looked into Medical through the state? Last year before my mom passed away I inquired with a social worker. They indicated that Medical has a program for this. I’m not sure when open enrollment is. 

This is a pretty familiar scenario for me as a geriatric social worker. There is no one size fits all answer, though. A few questions I’d want to know off the bat are these: Does he live in the area? Are family members able to help on occasion with certain tasks? Does he live alone? You mentioned no assets—does he own a home? What are his expenses like each month?

There are new Medi-Cal financial parameters that he might qualify for, which could help in the eventual future if he needs skilled nursing. I’d recommend contacting an estate attorney and also looking on the CANHR.ORG website under resources/fact sheets. 

If he qualifies for Medi-Cal, he may be able to get IHSS; if not, maybe he can pay for a private caregiver once or twice a week, depending on his other expenses. If he is local, he could look into joining Ashby Village. Also, many of the local cities (Berkeley, Oakland, Emeryville, Piedmont and more) have senior service and case management programs for folks on Medi-Cal; sometimes for others too. Some of the senior centers also have additional services like transportation and there are free/low cost meal delivery programs as well if he cannot cook. 

I know it’s a lot to dive into; you are welcome to contact me directly if you want to talk more. 

When you say care, what do you mean? Are you looking to have him placed in a home where he can live with other elders because he can no longer live alone? Or are you thinking of where to place him when his health declines and he requires total care/24 hour care? Or does he need a caregiver at home in order to maintain some of his independence.  

Unfortunately, with the way of the world housing for our elders is expensive. Especially in the Bay Area. And the care is often subpar and neglectful. 

I would suggest touring some places in the community to see what is out there and available. How soon do you want your father in law placed? 

There’s so many factors to consider, hard to offer a concise answer. 

You’re welcome to message me if you would like to discuss offline. 

I think it is always best to start with your local county area agency on aging (the AAA) or city office of aging if they have one. There is typically a wonderful network of nonprofit and local government resources that can help connect you. 

Does your FIL live in California?  If so he may qualify for Medi-Cal, which covers a lot of services to help elders stay in their home (or your home if he lives with you). My elderly mom, who lived with me during her last 3 years, had Medi-Cal and it made all the difference. All her prescriptions and doctor visits were free. Medi-Cal paid for an in-home helper to help with bathing and dressing, driving her to doctor appointments and the hairdresser, shopping, and companionship. The # of hours available depends on the extent of your FIL's need, as determined by a social worker. Depending on the city and county where he lives, he can receive Meals on Wheels, taxi scrip, food stamps, and other benefits. If he doesn't qualify for Medi-Cal check out Ashby Village which is a nonprofit subscription service to help elders stay in their homes.

Nursing homes in the Bay Area are very expensive, if you are talking about a skilled nursing facility (SNF) where they can't get around on their own and nurses care for the patients. Medi-Cal covers this expense, and officially, most SNFs take Medi-Cal, but unfortunately in practice, the nice ones will usually say they do not have any Medi-Cal beds currently available, so it's a challenge to find a good one. Many of the Medi-Cal SNF's that do have availability are not very nice in my experience. If your FIL can walk around and go to the bathroom by himself then he doesn't need a SNF, so you are probably looking at an "assisted living facility" which is less expensive (but still a lot!)  But I don't think Medicare pays for this. Instead, they need to have a supplemental medical policy or qualify for Medi-Cal or pay out of pocket. There are also "board and cares" which are licensed facilities in someone's home, typically much less expensive.

I found it very difficult to figure out what was available for my mom because there are so many different agencies and nonprofits involved at multiple levels: city, county, state and federal, and they don't really interface with each other. There isn't one agency that can give you all the info you need. You have to know which services are at the city level? Which services does the county handle? Which ones are at the federal level? You can pay a consultant and that's something people do if they have the money (but be aware that some consultants are paid by the facilities they recommend). Or you can google google google, make a lot of phone calls, and visit various facilities in person.

This is so difficult. I'm so sorry you have to take this on. It might be a good idea to keep your FIL in his home as long as you can with whatever support you can get for him, but start researching the different options now, so you know what to do when the time comes. 

All the best.

We used Care Quest for my Dad several times (long story) and for my FIL. They cover the entire East Bay and are very knowledgeable. our contact was Helen hlindberg [at] carequest.us (hlindberg[at]carequest[dot]us)

They will interview you and your family member about needs and financials. they then make a list for possible places to check out. You pick a few likely options, and they arrange a lunch and a tour of the place. If as some point you use one of these places, they get paid out of the marketing budget of that place. Costs you nothing! My dad didn't move until a couple years after we started looking. There was no pressure. 

These brokers are a dime a dozen; but really helpful, knowledgeable ones are hard to come by.

good luck