As reported, my mom moved from IL to AL after a fall. One of the ala carte services my brothers and I think she should have is having aides bring her her meds and make sure she takes them. Part of the reason is she will not use pill boxes I set up as she needs to see each pill she takes come out of the bottle so she knows what it is. Part of her OCD. And she would not otherwise take anxiety meds which she desperately needs.
The cost for three times a day med admin is about $800 which seems high to me but it is what it is. She does not want to pay that.
Is that a typical cost for something like that? But for me, whether it is or isnt, she needs it but is screaming bloody murder that she can do it her self.
I did hear from another person the reason the costs for med management is high, is that its not only the time of the nurse to manage this and the aides to give it, but when they take on med management they take on a huge responsibility and could face major liability if somethign went south.
Don't think of it as monthly but daily, because that is how they probably bill. Moms monthly cost was higher on the 31 day months and lower on the 30 day month. Who was handling the reordering of Moms medication, her or the nurse? At Moms AL the nurse handled everything. Calling the doctor for a perscription renewal then making sure the pharmacy got the order. Once the prescription was received she then had to oversee the Medtech. Those meds must be monitored. State checks that out when they visit.
The first thing to know is that in ALF the care levels go according to usually levels I-IV or I-V. These levels have a cost, each one, that in set in stone. That is whether she is getting med delivery of one pill a day or of 5 four times a day. It is a matter of no longer fitting the "self-care". Same would go with needing assist with toileting, with showering, and etc.
You should sit with admins and go over the levels of care and the costs.
I think that when an elder cannot safely take their medications there is no real choice in this matter and yes, you are looking at a real bump up which will only get worse.
You do have to know that the inability to take meds means the requirement of a medication nurse, who often makes a better salary and has much better training than the average worker at the ALF.
So speak to the admins at the facility. They should be happy to explain.
but if thats the safest thing, its the safest thing. Keep in mind, for those in AL, everything does tend to get worse over time, so maybe its best she is starting off with the med administration from the start.
you could try to re-direct what exactly the cost is, maybe fudge it a bit to say $800 is part of overall staff care fees or something
is she still fully competent/ decision maker? did she sign all o fher admissions papers? or are you or someone POA? Keep in mind, once you are active POA and performing your duties as POA (depending on state law and exact details of POA contract of course), but in general the POA is not obligated to show or go over every detailed charge with the resident....... (depending on state law and exact details of POA contract of course)
We had so many problems because FIL wanted to control everything . He felt if he was paying “ the rent “ he got to pick the which services . He was irate when after 6 months went by his meds including OTC were taken away .
The entire time he was there he kept trying to prove he did not belong in AL . He wanted to go to IL, which he could not . He was fixated on being “ independent “. He didn’t think he belonged in AL but he did .
In fact the only way we got him to go live there was because the facility he was in called it personal care , ( a lot of them by me call it that instead of assisted living ). I lied and told FIL it’s a step in between IL and AL . He had been staying in our house after his wife died . We had to get him out of our house , we had no dementia DX , he could not be left alone , my DH had to go back into the office , his boss was not understanding why it took so long for FIL to pick a place and move out . We went on so many tours . FIL found something wrong at every one .
So I came up with a fib , and told him he had to pick a place with a shower he could use . We had been taking him to a hotel to use a handicapped shower since FIL could not get upstairs in my house to a full bathroom . He was paying for expensive showers .
Then of course he stopped showering in AL , and refused help when his dementia got worse .,
The price seems a bit high but some places add a higher charge if they have to do a blood pressure or check blood sugars etc . I’m sure it varies in different states as well .
The other concern is you say she won’t take the anti anxiety pill on her own .
If she asks what each pill is for , she may refuse to take it anyway . The two different AL’s my Mom and FIL were in would not fib and tell them it was a vitamin ( which is what used to be done years ago ) .
We have a member here posting recently this exact issue trying to get his Dad to take a med that he desperately needs for OCD , and may be asked to leave his AL soon due to extreme OCD behaviors .
My FIL did his own meds in the beginning . The facility made him take an oral test . He had to identify each pill , say the name , what it was for , and how many times a day and what time of the day. If he did not pass the test , he could not give his own pills . Unfortunately he passed the test , we did not want him taking them we knew he was forgetting doses , it was also a pain because we had to order his meds . He said he was going to order them but sometimes he did , sometimes he didht . It was a mess. But he insisted and passed the test. He was also supposed to keep them in a locked cabinet in his room , which he wasn’t doing.
When FIL went to the hospital we told him that when he got back to AL he could not do his own meds anymore . He flipped out, but too bad.
He would not have remembered all the changes they had made . By then he had had a cog test that showed dementia
some facilities can policies where the resident can take their own meds if they are deemed appropriate, and for my Dad's one, the physician also has to sign that he is able to do so
(I also realize ALs apportion their costs differently, this ones base rate is very reasonable)
Also, good to know maybe we can get a med professional to make a determination on med management)