William, 79

William is a 81 year old man, currently living in an independent senior apartment in St. Lois Park. His children, Dan and Lauren, have been increasingly overwhelmed by the level of care he needs. Witnessing their father’s increasing confusion at simple household tasks, they have consulted his physician, who referred them to Twin Cities Care.

Medical Assessment
A couple years prior to family seeking our help, William had a UTI that went untreated for about 8 weeks (which William’s children believe started his short term memory loss). He was put on prednisone but because of a Quadruple Bypass that he had some years prior, the prednisone led to anemia and internal bleeding. He was dehydrated and eating minimally, and eventually went into A-Fib and had to spend a week in the hospital. His memory has worsened and he started forgetting his medical appointments or major aspects of his life such as being in therapy.

While in TCU, William scored a 23/30 on his MMSE, a 4.5 on LACLS and a 11/30 on the SLUMS – overall a 4.5 on the scale (mild cognitive impair) and the children believe that all the new medications are affecting his memory further and further. However he is not a wander risk, and his clinical team is feels memory care is not necessary at this time. Both family and clinical think William would know when to push a button, or ask for help, however, he needs reminders to make sure he is eating and drinking water (currently his son and daughter are providing his meals and making sure he eats them).

Physically, William is in moderate to good shape. He can walk independently and although he does need some help with showers, he goes to the bathroom independently and can dress without assistance. His TCU team had recommended a walker for stability but he is not always remembering to do this so he is at risk for falls.

He’s had Ulcerative Colitis for over 15 years is now being treated for diabetes – he gets one injection per day that lasts 24 hours, and then takes a pill.

Personal Assessment
William has been living independently since his wife died almost a decade ago, and still drives occasionally. He wants to continue living at home but the family knows this is not possible in the long term. After being discharged from the TCU, Dan and Lauren have been providing 24 hour care (family and Home Care) but they need to find an assisted living since round-the-clock home care is not sustainable financially.


The long-term goal is for William to experience joy and meaning in his life, as he has in the past, and for the family to know that their father is in a secure and caring environment. Most of the family lives around the Twin Cities, with a preference for West metro. William is very attached to his dog so he needs to find a community that allows pets.

Financial Assessment
William owns his condo, valued at $250k, and has a monthly Social Security income of $2,400. He has no long term care insurance or VA benefits, and the family is unable to contribute to William’s care.

After assessing William’s medical and personal needs, Twin Cities Care made a recommendation for 3 Memory Care facilities. #1, #2, #3. Because William’s personal finances were enough to cover 2 years of care, all 3 recommendations had to allow for Elderly waiver after 2 years. After weighing all the pro’s and con’s, the family decided on #1.