Board and Care

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  • Home for sometimes-angry 88-year-old with Alzheimer's?

    – Jan 24, 2020
    (3 replies)

    Does anyone in the network have knowledge of small-group-home care situations in the East Bay for seniors with dementia? I'm hoping to find a private home where (four to eight or so?) residents live full-time with caregivers. I am particularly hoping something like this might exist in Oakland. 

    Alternatively, recommendations for local geriatric-care advisors who know all the nuances of Oakland-area senior-care options would also be greatly appreciated. 

    Context: My 88-year-old father is still managing many of his activities of daily living with a modicum of independence despite having fairly advanced dementia. (For example, he can dress himself, but needs to be instructed to change clothes or would otherwise spend days in the same outfit. He can feed himself, but needs to have meals prepared and presented to him, as he would otherwise forget to eat. He can brush his teeth, but needs to be handed a toothbrush with toothpaste already applied.) He has been living in a private room in a lovely, expensive, busy, and fairly large--75 residents--assisted living facility in Oakland for 2.5 years. 

    Recently, Alzheimer's seems to be increasing his level of combativeness and the ease with which he gets triggered to anger: by the "noise" of other people's conversation, by other residents walking by, by someone telling him, "That's my seat, not yours!" Once he's triggered, he lashes out, shouts and swears at people, and has struck and attempted to trip other residents. We have ruled out typical underlying causes for mood changes (UTI and so on), and added a 2x daily dose of "calming" CBD to his med regimen two months ago. His doctor is considering adding an antidepressant to the regimen next. We are looking into hiring a private aide to sit around with my dad during the day to redirect him to prevent altercations, but this will be prohibitively expensive in the long run, and may just piss off my dad further anyway; he prefers to be "alone in company." If my dad's outbursts don't subside or can't be managed via meds, I have been informed by facility leadership that they'll kick my dad out to ensure the safety and peace of other residents. 

    I'm hoping this wise network my have thoughts on alternative, smaller care situations, or care homes with a higher ratio of staff to residents, that might reduce triggers for my dad and keep him (and his fellow residents) safe and relatively comfortable in this painful late stage of his life.

    Thanks for sharing your knowledge. 

    Jan 24, 2020

    Hi, I went through the same thing with my no-88-year old father a couple years ago. He wasn’t aggressive but his dementia advanced past the point that his assisted living home would handle (point at Rockridge). I worked with Linda Wurth to find a small board and care home in Castro Valley where he is now safe and well cared for. Linda has contacts at many facilities throughout the East Bay. Her site is bettercarechoices.com. 

    Very sorry you are going through this, and unfortunately it is familiar territory to my family as well.  It sounds like your father is in Assisted Living - but even Residential Memory Care programs (specifically for dementia) are not set up to be able to handle combativeness or extreme agitation or aggression and I think they are all likely to require the private aide you mentioned if they can't deal with his behavior.  Piedmont Garden's "The Grove" (41st street near Piedmont Ave) has a smaller-than-most Memory Care program, with 16 residents. 

    Another GCM had told me about "Board and Care" places which sounds like what you are describing, where the ratio is something like 2 caregivers to 6 patients, but I don't know any more about that.

    I recommend contacting GCM Linda Wurth, Better Care Choices: http://www.bettercarechoices.com/ to help navigate the process of finding a new place.  She came with us to Memory Care places and helped us cut through the marketing pitches.

    It is great that you are trying to solve this by removing triggers and changing environments, but it might be that med management will also be needed. Your father's agitation may continue and may get worse - it is worth working closely with his doctor (ideally a Geriatric Psych), to find the medications that will make him less agitated.  This may take time, trial+error.  Might be anti-anxiety or anti-depressants, or may be stronger medication.  And in that category - the antipsychotic drug Seroquel proved very helpful in reducing extreme agitation in my mother's case (...I'm not a doctor, and of course YMMV)

    My mother has Alzheimer’s as well and we moved her into a memory care facility ( this is in Sacramento.) My loving and happy mother is now angry and belligerent at times which still shocks me but this is the disease. I recommend you move him into a facility which specializes in Alzheimer’s as they are used to these behaviors and the staff are trained to manage. I have only visited one here in the Bay Area and that is the one in Albany called Belmont village. It was fabulous but also very expensive. I have two friends whose parents are there and they are very happy with the location, facility, and level of care. Good luck!

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I recommend a wonderful board and care in castro Valley where my father was a client for over one year. Fairbanks Home Care ran by George and Dina Driga is one of the cleanest, delicous food and friendliest board and care I know. It is reasonable and provides excellent care. It is located in Castro valley and has private or shared rooms. I am a RN and very particular about the care patients receive and highly recommend this place. Call 510-909-0188 cl

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Seeking a reasonable place for aunt with dementia

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My close friend's aged aunt (92) is in fairly good health for her age, but suffering from dementia. She is currently in a low-quality nursing home in Oakland which just raised its fees to over $6,000 a month. Even before the increase in fees I'd been helping my friend try to find another place for her Auntie, as it's really an unpleasant place that's gone downhill over the time she's been there. There is minimal attention paid to patients by the staff, pervasive smells, ratty furnishings, nowhere for visitors to sit with their loved ones. It's next to the freeway, and there's no outdoor space or garden. The only plus is that there are alarms on the doors, and once her Auntie runs out of funds it does take Medi-cal.

We've been looking for months and we're not finding anything for a reasonable price which isn't equally depressing. We're looking in both the East and North Bay, as Auntie has a niece in Berkeley and a nephew in Santa Rosa. Maybe what we are seeking is impossible - loving care at a clean, pleasant place for under $5,000 a month which will take Medi-cal when funds run out. I've known this dear old lady for many years and just can't bear seeing her in this place. Does anyone know of a kind, dignified place with current openings?

I know just the place for you! There is a place that is affordable, converts to Medical, and has no nasty smells and many advantages. The one disadvantage is that it is in Sebastapol, an hour and a quarter's drive from Berkeley. But the benefits are numerous. My mother-in-law is there, and is very happy. All the residents suffer dementia, and are treated with great love and dignity. The house is a private home, converted to meet State of California standards for dementia as well as end-of-life care and hospice. The residents are beautifully cared for by a medically trained staff who have time to spend visiting with them as well as to look after their needs. There is a maximum of six residents there at any time. There are beautiful gardens and the place is graciously furnished. AND it is only $2500 a month and converts to Medi-cal. It is an unbelievably good deal but true - we are so relieved to have found Ethel, her staff and the delightful home, as we searched for so long. Call Ethel (707) 823-7277/(707)3966735 Philippa
Once you are talking ''nursing home'', the costs are exhorbitant. If your friend's aunt is not so physically debilitated that she must be in a ''nursing home'', the assisted living format with a memory unit is a better option. That said, those are very expensive too but more in line with the dementia person's needs. Another less costly option is a board and care which are single-family homes licensed to care for about 6 people or possibly more depending on the size and license. Those places vary in quality so I would suggest that your friends contact an agency to assist her. I have used Eldercare Services, based in Walnut Creek, for a variety of needs as they relate to caring for an elderly relative and would highly recommend them. 925-937-2018, www.eldercareanswers.com. They cover most of the Bay Area. Martha
My grandmother, who recently ppassed away, live at in a small home-based care setting for about 5 years in Pleasant Hill, called Bonnie Lane. It was competant care for her hip-repair rehab, she had dementia which progressed over the yeras she was there, and had hospice care there , died in her own room there in a supported setting. THye had family meals together with other residents (about 8 total). there were some shared rooms, some private rooms, a nice garden, locks on the doors and gates, loving care, the owner is geriatric nursing specialist. I no longer have their contact information. FYI, I don't drive, and did take public transportation to visit granadma -- a pain, but possible.

My mother found this place by working thru the Family Caregiver Alliance - don't have their web address, but they are good.

There is a really good orgainzatin in SF called the On Lok senior services center. Thye may have references for the East Bay/North Bay. https://www.eldercarelink.com

Check out Aegis elder care at www.aeigisliving.com. They have several locations in the Northern California (including Santa Rosa). I am familiar with the Pleasant Hill location which is really nice. The facility is clean, bright, has a wonderful manicured garden in the back and the staff seem truly nice and committed to the residents. They have a low income program but I'm not sure about medi-Cal and or the levels of care (dementia, etc.) they provide. Good luck with your search. I hope Auntie finds a warm, welcoming place. - anon

Assisted Living for disabled non-senior

June 2006

My relative is 56, very ill (not recovering), living alone, not eating, unable to care for herself. She has dwindling resources, but is not quite down to the $2000 in the bank that would make her eligible for SSI; she applied for SSI Disability last month, but that process could take months or years.

I'm seeking recommendations for any nice assisted living community /board-and-care in the East Bay that will a) take in someone near to the end of their finances, b) and then take SSI once it kicks in, and c) take someone who is under 60 but disabled. Would also be interested in a public social worker who assists in making this type of placement.

Specific recommendations (or info on places you hate) would be most appreciated. Thank you! worried relative

That sounds like a very difficult situation for your relative, and it is good of you to make sure she is taken care of. In terms of assisted-living vs. board & cares, board & cares are generally much less expensive, but they provide more individual attention -- definitely a bargain! Placement agencies could help you find some within her budget (or within your budget, if you are able to help her out). I found my dad's place through California Registry 800-777-7575. Other placement agencies that gave me recommendations were Placement Services (800-348-1979) and Jan Oldenburg (925-699-2295). I don't know if any of them deal with non-seniors, but you could call and find out. They were all very helpful to me...and there was no charge for their services.

One other thought: is she by any chance terminally ill? If so, she may qualify for hospice, and that could make a difference in the services you could afford.

I hope you can get her the help she needs. Good luck! anon