Question 

I am the caregiver for my father who now needs round-the-clock supervision. Dad lives with us. My wife and I are doing our absolute best to work and care for him. We have altered our schedules, begged to work from home, and yet feel that we are still falling short. 

Last week he fell while I was on a conference call. Two weeks ago, he left the house and a neighbor brought him home. We have to keep eyes on him at all times, or he does some strange things. It is very difficult for us to be with him every second and work at the same time. 

We do not have the luxury of not both working and still paying the bills, so one of us being the only wage earner is not an option. 

Dad has some money but not what would be considered a lot. I think that he could live in a facility for a couple of years with what he has. We always planned to keep him with us, but we are starting to wonder if we are offering him the best situation.  

We do not want him to run out of money and are having trouble deciding what to do. We feel that we are falling short. 

Answer 

You are in a tough situation and believe me, all caregivers understand how difficult it is for you. There is not going to be any easy solution. 

Since your father is mobile and reasonably independent, you can get by with some home solutions for the short term. A companion to be with him while you are working or an adult day care situation could work for him during the day. The cost should be less than the monthly cost of a nursing home, though it will deplete some of his assets. 

There are also numerous electronic or technical devices to track your father and identify if he falls. None of those devices will keep him from getting into trouble, but they will inform you of his whereabouts in real time or whether he is upright. You can also make use of cameras in key rooms that he uses so that you can see what he is up to while sitting at your desk. All these electronic solutions have a modest cost. 

The reason that I used the expression short term is that your father’s care needs are going to continue and may grow. If you are committed to providing care in your home as he progresses, getting support while you are working will give you the coverage you need. It should cost about half of what a facility costs to have care 40 hours a week. That assumes you are providing all his care needs when you are not working. 

Alternately, if you feel that his care needs may surpass what you are able to provide in the future, you need to assess the money situation now. Most facilities need a mix of Medicare and private pay patients to be financially solvent. They do their best to keep their Medicaid population to a minimum, as Medicaid reimburses lower than their cost to provide care in most cases. If you spend all his money and try to find a facility when he runs out of cash, your options may disappoint you.   

It is time now to make some calls and find out the costs for different types of care in your area. Find out about home care, adult day care, memory care, and nursing home care. For facilities ask about monthly rates, how Medicaid works, will they keep him if his cash is gone, how long does he need to pay privately, and anything else that is on your mind.   

It will be easier to make a decision about care when you have as much information as you can gather.  

These next few weeks while you are making calls, collecting information, and figuring out how to keep your father safe will be quite stressful for you. It is not easy to manage the data collection, decision making, and emotions associated with this time in life. You will get through it.