Ray, 83, Barbara, 79

Ray and Barbara are a couple, currently living in their house in Wisconsin, just outside of Madison.  Their daughter Amy lives in Edina, and is looking to relocate her parents so she can keep a close eye on their care. Amy has called an assisted living facility near her to arrange a tour, however, the facility does not provide Memory Care (desired for Ray) so they referred the daughter to Twin Cities Care for further assistance.

Medical Assessment
Ray has later stage Parkinson’s, diagnosed in the early 2000’s, with some mild medication-induced dementia. He is currently redirect-able and not exit seeking – not a wander risk per se but prone to confusion (Amy said he would not be safe to go out alone).

Physically, Ray can still walk ok – some minor issues with gait and freezing up, it can take a while for his limbs to move and he needs to be careful not to trip but but most of the time he is still walking independently. Transfers are getting more difficult for him, he does sometimes need help to get out of bed or a chair – right now his wife is helping him when he has these moments but it is not safe for her, and is causing a strain on their relationship. He is getting to need more and more help with dressing – he can’t do buckles or buttons (Amy had to dress him over Xmas vacation) but his wife is helping. He is still showering on his own but his daughter has noticed a decline in hygiene, and does think her father will need help with shower and laundry.

Ray is a Vietnam Vet so he currently has a VA nurse helping to set up his medications once a week while Barbara reminds him to take them, so both wife and daughter think he would benefit from a medication management program.

Ray is not diabetic, no special diets and no swallowing concerns – he just cannot eat grapefruit due to medications he is on. He has a mild infrequent incontinence but still is going to the bathroom on his own.

Barbara has Multiple Sclerosis, diagnosed in 2006. She is mentally alert but physically weak, and is using her wheelchair for longer distances more often. She has a lot of difficulty walking but can navigate around the house, and walk up and down the stairs and around the kitchen. However it is becoming less and less safe for her to be walking, and she is experiencing periods of immobility where she loses her ability to walk and is more of a fall risk. Walking outside of the house, she needs to hold on to someone’s hand so she will likely need escorts to dining room and activities.

Barbara can dress herself and she can do her own medications. She can also shower on her own – it is difficult but she can do it independently (although stand-by assistance may be helpful).

Barbara is not diabetic and has no special diets. She does have incontinence and uses adult products.

Personal Assessment
Both Ray and Barbara are on board with moving to a senior community but anxious about leaving their home of 30 years. (For Amy, the biggest reason for her parents’ move is to keep both Ray and Barbara safe, and to avoid a crisis.)

The couple’s declining health has put a lot of strain on their relationship, with Barbara getting increasingly frustrated as a caregiver, so to have them go back to being husband and wife is very important. They want to find a place where they can stay together for as long as possible, and remain in the same facility even if Ray’s dementia becomes less manageable and he needs to move into a memory care environment. To facilitate this, the daughter is looking for a 2 bedroom or 1 bedroom plus den in a facility that has Memory Care on-site.

An lively social environment is high on Amy’s priority list and she describes both parents as socially active. Ray used to go golfing with his high school buddies – it has been getting harder for him to get out but he still enjoys watching sports with his friends (although he has a hard time focusing and following conversations, and is more irritable than he used to be). Barbara has a big personality and would enjoy movies, bingo and most activities that would be offered.

Meals are also very important – currently the couple are getting Meals On Wheels and otherwise eating frozen food so switching to a better diet is high on the priority list.

Financial Assessment
The family has sufficient funds to privately pay for many years of rent and care in an assisted living facility. Financial aid or waiver programs are not needed.

After assessing the couple’s medical and personal needs, Twin Cities Care made a recommendation for 3 assisted living facilities located in the West suburbs, with Memory Care on the same campus as Assisted Living. […] After weighing all the pro’s and con’s, the family decided on […].