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I am just starting the search for an ALF for both parents, ages 84 and 87. Mom has dementia, dad is doing alright with minor health issues for now.
They will likely start in an independent living unit within a Senior Community, then move into the ALF as their needs increase, and assume eventually mom will need memory care.
My question is, once they move into a senior community, who provides the medical care for them as issues arise and they alert the local staff? Also, can they leave their community and still see their current PCP, or does the PCP usually stop seeing them as patients knowing their medical care will be managed at whatever community they live in?



Thanks.

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AlvaDeer, Cwillie, Geaton - Thank you!! Great feedback. :)
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My Moms AL had an RN on duty. No doctor was associated with the AL so Mom continued to see her PCP. The other local AL had a memory care unit and doctors owned it. Not sure if you had to use one of them or not. Would probably be a good thing because the Dr. would visit at the AL.

Geaton mentioned that "straight" Medicare will follow them from State to State but Medicare Advantages and suppliments don't. Each State allows certain MAs and supplimentals to write policies. If you leave the State, you may not be able to transfer the insurance to another State.
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In my state (MN) their Medicare coverage will follow them, but the practical matter of getting them to and from appointments is still their responsibility, or that of their PoA or legal guardian. Some ALs have affordable, short-distance bus service but honestly at their ages I would accompany them to appointments to make sure they get all the proper info and remember it, plus act on any follow-up that might need to happen. My mom is 92 and in pretty good mental condition but because docs do a lot in a short visit she struggles to retain the info. She dislikes that I insist on coming with her but if I didn't, there'd be problems and mistakes.

I personally do not advise sending them with Lyft or Uber or taxis, since they are not responsible for their aid or safety after they get out of the vehicle. These are total strangers and the very elderly are very vulnerable. Even county-funded transport services won't take any rider who has memory or cognitive impairment unless they are accompanied.
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I think it varies, some places have excellent medical staff associated with the facility and other do not. At one AL I know about they advertised having a house doctor but the sad reality was he only made visits ever 6 or 8 weeks, so often immediate concerns were not adequately addressed.
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Your parents are welcome to keep both their supplemental insurance and their own doctors. They will likely require transit to their appointments which many (most) ALF provide. Your questions otherwise should be directed to the DON at the ALF. There are many ALFs that have physician groups who provide care, to patients under supplemental plans; at my brother's facilities there were two choices if you did not wish to keep your own physicians. They often had weekly visits by a Nurse Practitioner who did blood pressure checks, blood work needed and etc. My brother died before he could change from his physician to the ones who worked directly with the facility he was in, which was his intention due to convenience for the most part.
Again, check with your parents' facility. Each ALF is different and operates in a different manner, and there will be choices you can assist with here if you are POA for your parents.
And yes, your parents can leave the facility any time they like if they are not in memory care, and for any reason, including trips to see family, cruises, etc if they are able. Much depends on the level of care they need and mentation. Someone in memory care would be in a locked facility, leaving only when accompanied by friends, family, or staff.
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