A Place for Mom- any experience?

[ProfessorArtNerd]

Recap- my dad’s older sister lives in FLA. I’m in PA. She had a hemorrhagic stroke. My sister and I are next of kin.

The hospital case manager suggested A Place for Mom to help decide where aunt should end up. I know the service is free. Insurance in this country is a scam. They seem to think they can help with this since I’m so far away.

Anyone have experience with this service?

[donutsmakemegonuts]

I have no direct experience with this but I know that they are the go between for people who may need help finding an ALF or SNF and they may be offering you a "free" service, but I'm wondering if they receive a kickback from places that they refer to. Also, shouldn't the hospital case manager be the one finding her somewhere to go? Is she currently hospitalized? They should be working to find her somewhere, especially since there is no next of kin local. She can't be discharged without a plan. Are they suggesting that she be in an assisted living or a nursing home? They both require very different levels of care.

[midwestmama]

I'm sorry to hear about your aunt. I would check also into the local Area Agency on Aging, which should also be a free resource. They will have local resources and knowledge. (I am not familiar with how well A Place for Mom is for local knowledge, but a friend of mine who is a nurse worked for our local Area Agency on Aging so I know it is a good local resource.)

[thebreakfastclub]

I would use a recommended free service to help place a long distance relative. If they get a cut from the facility, so be it.

[donutsmakemegonuts]

Also, maybe try reaching out to your aunts local Office on Aging. They might be able to guide you or at least provide you with some resources. I work at my local Office on Aging, so I can tell you that we get lots of calls for this type of situation. You can also talk to the Ombudsman which is the advocate for clients in ALFs and SNFs and that person may be able to help you narrow the choices down. They can't necessarily recommend a place, but they can tell you which places have the most complaints and if they are in good standing with the state.

[litskispeciality]

I would be careful with A Place for Mom.

1. My dad looked in to it a few years ago and basically just got a bunch of mail and calls etc. I think it's mostly just a middle person to sell your info.
2. I worked with an advocate this summer to get my dad placed in Memory Care. We had to pay a $250 fee, which I'm told will be refunded after a couple of months pending he stays in the placement that the advocate arranged. If we dropped, or he doesn't stay, she keeps the money for her time. Anyway, she told us she couldn't work with us if we had already used APFM, or if I had called and inquired about places prior to securing her services, but I was never clear why.

You have good advice here. I got the name of the advocate from a social worker, and separate nurse care manager at my dad's PCP Office. I can PM you her info. While she's no where near those areas she seemed quite knowledgable and networked, and might be able to set you up with an equivalent person in your aunts state.

(((HUGS))). I really wish you could catch a break.

[lessel]

Sorry about your aunt. ❤ I don't have personal experience with that service, but I remembered this article from a couple months ago: wapo.st/4g3oMdF (Gift link)

[mokes]

APFM is free to you; they're a lead aggregator that contracts with the senior living communities. If they deliver a lead that moves in, the community pays them. (I believe they get paid about a month's fee.) Some communities won't contract with them since they charge such a high fee (and there are often disputes when someone inquires on their own and through APFM -- they want to get paid on that) and so the reality is they're not likely to recommend you somewhere they're not contracted with.

[gottadobe]

We had a positive, very limited experience. They informed us of a facility we didn't know about, and we decided to use it.
I did get many texts and finally had to tell them to stop texting me after placement.

[k3am]

This was one of my clients, years ago.. it’s fine. They’re backed by big PE money (LOTS of zeros in their bank account). This is a huge, highly fragmented and growing industry.

They get their commission from the facility. At most facilities, you’ll get charged a high community fee to move in (which pays them).

There are also TONS of independent senior consultants who do the same thing under the same model on a more local basis.

I would absolutely work with *someone* though. All of these facilities speak their own language and have their billing practices that make sense to them, but may not to you, since you don’t spend your days doing it. (I was SHOCKED that the first place we talked to when placing my mom didn’t tell us about care fees ON TOP of rent, which took us from $11k to $14k per month. Looking back, it makes sense that they’d have a fee like that in place , but it was never discussed until a couple days before we were supposed to sign the contract… a consultant could have helped us understand before we got so far along.)

[k3am]

Aug 29, 2024 11:43:42 GMT -5 litskispeciality said:

Anyway, she told us she couldn't work with us if we had already used APFM, or if I had called and inquired about places prior to securing her services, but I was never clear why.

Entirely due to commissions and industry wide. She COULD work with you after APFM, but commission would be questionable. Same thing, if you had toured every facility in your own prior to reaching out to her, she’d have a hard time placing you in a facility that could get her commission for her efforts.

[litskispeciality]

k3am, same experience here. We were able to meet with a sales rep from the place we moved my dad in to, but most of the fees were shown once I dropped him off and signed the paperwork. The place charged a $7 or 8K deposit that "couldn't" be waived, even though the advocate told us to push for it. They gave us some BS answer that it's "required by the state" and then pays for the onboarding, but no it's not, you just want to make money. Now I'm irrationally mad if our advocate *only* banks $250 and not a huge chunk of the fee, but I didn't have a choice in placement based on needs and openings. I also think the sales rep got less of a commission because we went through the local advocate rather than an organic (I called) lead or APFM, but I don't care.

Our local advocate was able to call around to a bunch of places to find openings and keep them from calling me, so that was a huge help. She set up tours and held calls with me to tell me what to ask etc. Advocate also recommended I fight my dad's independent place on the 30 days notice regardless of when you give it (first of the month or mid-month), but it's a big corporation that owns lots of places and "policy stated it's 30 days regardless. I fought with the manger siting that they basically needed my dad to move out and we had him out before the end of the month, but after all that we paid for 10 - 15 days of rent in 2 places *sigh*

Senior living, assisted living and memory care are such a racket and need to be better managed. I know there's a LOT of people who care for folks in AL and MC, but they aren't making $30, $40 an hour.

[litskispeciality]

Aug 29, 2024 13:34:44 GMT -5 k3am said:

Aug 29, 2024 11:43:42 GMT -5 litskispeciality said:

Anyway, she told us she couldn't work with us if we had already used APFM, or if I had called and inquired about places prior to securing her services, but I was never clear why.

Entirely due to commissions and industry wide. She COULD work with you after APFM, but commission would be questionable. Same thing, if you had toured every facility in your own prior to reaching out to her, she’d have a hard time placing you in a facility that could get her commission for her efforts.

That makes sense after reading the posts above. Part of me wondered how she kept running a small business if her commission is $250 per placement, but I think that's just the kickback from the facility. Thinking about it further I think we actually paid $250 twice, one to her, and then another to the facility upon move in (on top of all of the other fees I mentioned above).

I appreciated that the advocate was up front and honest, just frustrating if you don't know about APFM ahead of time as I probably would have had to go with APFM due to not having the bandwidth to do everything on my own...only to still do most of the work on my own, just get a lot of sales calls etc.

[mofongo]

Aug 29, 2024 11:30:06 GMT -5 donutsmakemegonuts said:

I have no direct experience with this but I know that they are the go between for people who may need help finding an ALF or SNF and they may be offering you a "free" service, but I'm wondering if they receive a kickback from places that they refer to. Also, shouldn't the hospital case manager be the one finding her somewhere to go? Is she currently hospitalized? They should be working to find her somewhere, especially since there is no next of kin local. She can't be discharged without a plan. Are they suggesting that she be in an assisted living or a nursing home? They both require very different levels of care.

Case managers/social workers can’t pick a place, though. The pt and/or family has to do that. The doctors, and other professionals like PT/OT will determine what level of care is needed, SW provides resources to families, families choose, and SW makes referrals, etc. 

ETA: And depending on the type of place someone goes, it may need to all be done by the family. For example, assisted living.

[simpsongal]

They were in the news recently for making referrals of places w/neglect charges: www.washingtonpost.com/business/2024/05/16/place-for-mom-assisted-living-referral/

That said, you could use the service but I'd probably look for other resources/references.

[mrsslocombe]

I've avoided APFM so I don't have any direct experience, just rumblings from friends that it's worthless.

We worked with a social worker from Penn Medicine for my ILs-since their doctors were all a part of that system. Their primary care doctor actually referred us. So you can see if the hospital case worker or your aunt's primary doctor has info on that. The social worker came and met with us (but could also do phone or zoom meetings) and went through all the local options, gave us general ideas on pricing, helped us set up appointments, etc.

There may also be a local caregiver non profit that has SWs that do the same thing, or you can even see if you have one local to YOU. We contacted one here in Brooklyn and she helped us find services local to my ILs as well.

Your aunt's county Department of Aging will also have resources if you reach out, as others have said.

[TR]

Aug 29, 2024 14:45:02 GMT -5 mofongo said:

Aug 29, 2024 11:30:06 GMT -5 donutsmakemegonuts said:

I have no direct experience with this but I know that they are the go between for people who may need help finding an ALF or SNF and they may be offering you a "free" service, but I'm wondering if they receive a kickback from places that they refer to. Also, shouldn't the hospital case manager be the one finding her somewhere to go? Is she currently hospitalized? They should be working to find her somewhere, especially since there is no next of kin local. She can't be discharged without a plan. Are they suggesting that she be in an assisted living or a nursing home? They both require very different levels of care.

Case managers/social workers can’t pick a place, though. The pt and/or family has to do that. The doctors, and other professionals like PT/OT will determine what level of care is needed, SW provides resources to families, families choose, and SW makes referrals, etc. 

ETA: And depending on the type of place someone goes, it may need to all be done by the family. For example, assisted living.

What happens if someone doesn't have family? Or if the family is estranged or REFUSES to intervene?

[sakoro]

Aug 29, 2024 13:34:44 GMT -5 k3am said:

Aug 29, 2024 11:43:42 GMT -5 litskispeciality said:

Anyway, she told us she couldn't work with us if we had already used APFM, or if I had called and inquired about places prior to securing her services, but I was never clear why.

Entirely due to commissions and industry wide. She COULD work with you after APFM, but commission would be questionable. Same thing, if you had toured every facility in your own prior to reaching out to her, she’d have a hard time placing you in a facility that could get her commission for her efforts.

I heard the same negative feedback about a Place for Mom. If you use their service, then the facility has to go through them and APFM gets a cut.

My co-worker got a very hard sell from APFM and then a big guilt trip when she decided to take her mom into her own home and hire home healthcare workers. (E.g. your boyfriend won’t be able to handle having your attention going to your mom and will break up with you.)

I would try the county Area Agency on Aging first for referrals.

[stemmie]

A Place for Mom 0 stars would not recommend

They're shady AF. You give them your contact information, which they pass on to the sales agents at their curated list of facilities. "Curated" means they represent facilities that pay APFM a considerable "finders fee" (about a month's room & board) for each resident they sign on via this connection. I'd rather the rent went to care, training and salaries.

IME, suburban Philadelphia, they only represent facilities that don't offer Medicaid for those who outlive their assets and tend to be places that cherry-pick residents that are pleasantly befuddled. They miss a lot of quality places that can fill their beds based on word-of-mouth. They also tend to be a little more expensive here. It may be different in FL.

Once your information is out there, they will hound the crap out of you. Every new sales agent or company take-over/rebranding will lead to calls checking in to see if you're still considering care or if you've placed and are unhappy with things.

I made the mistake of calling and actually got a call from a salesperson about 3 weeks after dad died. The call went to Bluetooth while mom was in the car with me, and it took a lot of reassurance that I wasn't placing her.

I would suggest the Area Agency on Aging. The social worker planning discharge should be familiar with the reputations of various places nearby.

[mofongo]

Aug 29, 2024 15:55:05 GMT -5 TR said:

Aug 29, 2024 14:45:02 GMT -5 mofongo said:

Case managers/social workers can’t pick a place, though. The pt and/or family has to do that. The doctors, and other professionals like PT/OT will determine what level of care is needed, SW provides resources to families, families choose, and SW makes referrals, etc. 

ETA: And depending on the type of place someone goes, it may need to all be done by the family. For example, assisted living.

What happens if someone doesn't have family? Or if the family is estranged or REFUSES to intervene?

If the patient is competent they would decide. If not, huge mess! We’d probably have to get the legal dept involved, maybe ethics committee depending on what the medical situation was. This is speaking from an inpatient hospital setting. There are social workers who work privately helping families with placements, but that’s a different world, and usually one with more money than a lot of what is seen in the hospital.

In my experience it’s hard to have incompetence declared, with good reason. And to be honest, I’ve seen these types of things like once or twice in 20+yrs, so definitely not a common occurrence! 

[cricketwife]

Feel free to PM me if she happens to be in the Sarasota, Tampa, port charlotte area. I can recommend a place that we had a good experience with.

[ProfessorArtNerd]

Thanks everyone for answering!

Some clarifying things- I haven’t actually spoken to my aunt, but from her nurses tell me, she doesn’t know what year it is or where she is. It’s been France, and else thinks she’s 18; she’s been trying to order wine from her “hotel in Tokyo” and this morning it was fort lauderale where she had to check on her cars.

I didn’t speak to the call center for APFM- I was put in touch with an RN who goes to the hospital several times a week to see people. She’s going to see what’s up tomorrow, anyway, and she can get the I formation I need to make decisions. Aunt is on Medicare and will have 21 days at the rehab facility anyway. So that gives me a little time.

This is crazy- their sister died in January 2023, my dad in December 2023, and now she’s declining. It’s scary for mine and my sister’s futures for sure

[bee20]

FWIW, my other online community LOVES a place for mom and always recommends it when people are looking for eldercare. I haven't used it myself but it's not necessarily sketchy and it's totally fine if they get a commission, it's a service. You'd let a travel agent get a commission why not a eldercare agent?

[dale]

I've never used them but I did keep getting emails from them with what seemed to be important information, forms and reminders stuff. I called the number to tell them that there was an error. The woman I spoke with was a little loose lipped. Turns out that the person she was helping has a name one letter off from mine and an email address one letter off also. While fixing it on her end I heard all about this woman's husband who has dementia and how the woman was struggling. I just felt like this was info she shouldn't be telling me. Just say "oh, I see the problem. Thank you" Now I know this woman's name, email, and personal issues. I emailed her and told her the worker was very chatty.

[mofongo]

ProfessorArtNerd - i just want to say you are an amazing human being, this is not your responsibility. You are very kind to be doing what you can:))

ETA: And I know your have a busy life and your own health stuff you are dealing with, biggest hugs.

[stemmie]

ProfessorArtNerd, I hope I have a niece like you when I'm old because my son's still clueless.

A couple of caveats. Your aunt could have some dementia, but it sounds like she is having hospital induced delirium which is common in the elderly. My mom who didn't have dementia had a bout after getting her knee done. My friend's older DH had it last summer and called central detectives (he's a judge) to turn his wife in for theft. Hospital security did come check her bag-- with her permission--where they found a bible and a book of crosswords. Dad had dementia and hospital delirium. He thought his neurologist was president and that the man in the next bed was selling kittens. It may be hard to get a sense of where she is mentally and functionally at the moment.

Once home, whether her home or a residential care facility, she may level off to a much-improved baseline. Even dad, while still in the middle stages of dementia became clearer after the move to a SNF and then home.

SNF rehab can be tricky on Medicare. She could actually get up to 100 days under certain conditions. She'll have to be able to participate cooperatively in therapy couple hours a day and she'll have to show improvement, or she could be dismissed before that time is up.

[waverly]

Aug 29, 2024 15:55:05 GMT -5 TR said:

Aug 29, 2024 14:45:02 GMT -5 mofongo said:

Case managers/social workers can’t pick a place, though. The pt and/or family has to do that. The doctors, and other professionals like PT/OT will determine what level of care is needed, SW provides resources to families, families choose, and SW makes referrals, etc. 

ETA: And depending on the type of place someone goes, it may need to all be done by the family. For example, assisted living.

What happens if someone doesn't have family? Or if the family is estranged or REFUSES to intervene?

The other poster who answered this question is correct. We were told it was an option for my dad to go to the homeless shelter but the homeless shelters were full. I assume the hospital would have an in with the shelter, but they weren’t allowed to just put my dad out on the sidewalk.

Most likely they would have asked my dad what he wanted to do and he would have been discharged on his own cognizance to live in a hotel. This wouldn’t have been the best placement for him because he has a disease that he cannot make decisions or live on his own, but he would have told them that he could.

My guess for those in worse physical shape is they would sign their own paperwork for rehab place and then it was rehabs problem after that.

[litskispeciality]

PDQ TW TW

Re: hospital delirium

My brother spent almost 4 months in the hospital this year and had BAD delirium between not sleeping, the meds, seeing the same walls every day etc. It was a balancing act that family can be comforting, but now I have what I assume could be diagnosed PTSD from things I saw. The staff was ah-mazing and probably not paid enough for what they did to calm him down the best they could. Thankfully my brother seems to just laugh at some of the stuff he remembers, although I'm trying to find a way to get him not to joke with me as it triggers it (at least until I can talk it through therapy). Prayers to OP that your aunt is *only* facing that, and not dementia yet. I also hope that the rehab place can get a little better idea of her cognitive state once she's had a change of scenery and hopefully less medicated.

My dad had a series of falls a few years ago and spent 2 or 3 weeks in a PT rehab before getting sent home. My dad should have stayed longer than he did, however someone said he was "ok" to go home with a walker (first time using that) and some visiting services. I'm going to assume insurance wouldn't approve more in-patient treatment. At the time he was deemed competent to make his own decisions, however I worked with a Social Worker (I think, I use that as a general term but know there are many roles and titles under that umbrella) for return home as he lived alone. I couldn't/didn't WFH at that time so we did what we could to piece together help and coverage. The hospital or rehab or someone should be able to schedule a family meeting with OP to discuss discharge, hopefully online for OP if they are the proxy or whatever the person in charge of care is called.

[litskispeciality]

Aug 29, 2024 20:04:26 GMT -5 bee20 said:

FWIW, my other online community LOVES a place for mom and always recommends it when people are looking for eldercare. I haven't used it myself but it's not necessarily sketchy and it's totally fine if they get a commission, it's a service. You'd let a travel agent get a commission why not a eldercare agent?

My issue is how much of those commissions go back to the families. We had to move my dad rather quickly (my fault, I dragged my feet), however we had to pay over $30K to get him in the door, then another month's rent pretty close after. Almost $50K spent before moving expenses and things in less than 2 months. Granted some of that was first months rent and money that's supposed to sit in an account for his last month's rent living there, but as I mentioned above over $7K of that was "deposit and fees". Someone was getting a lot of that money and it wasn't the nursing, kitchen, front desk etc. staff. We were very lucky my dad was able to save enough in retirement to have that money ready to go, but most people either don't have that, or will drain a huge chunk of savings with those payments. I'm still young, but I would have a hard time shoveling out that much money if I had to move in to a MC place right now.

People work hard to secure these placements, but they should be paid another way that doesn't cost the families a LOT of money when they're in a desperate spot to get their family to a safe place. I don't know how much travel agents make, but I'm sure it's not anywhere near the same percentage of what you pay for AL, MC etc. placement. My happy medium moving forward would be a way that a family can make a placement on their own without paying a (silent) commission. Is that possible if you don't use APFM, an independent person etc.?

I understand you can book travel on your own vs. using a travel agent, and you can place your family member in AL or MC on your own vs. using APFM, an independent agent etc. The difference is that the end of life care is a huge decision where if you pick the wrong place (pending you have a choice), your loved one could be in great harm. My state has had a LOT of issues with COVID outbreaks, elder abuse, closures of facilities in the last few years. Plus as we all know, it's really hard to dedicate time to researching, calling, touring these facilities when you work full time, are trying to keep your loved one independent but are doing their care, and have other commitments. I was happy to "throw money" at someone to help me with this step, but I didn't know it was going to cost so much in the long run.

I've told every person who helps me that social workers (and all under the umbrella) don't make enough money. I can't keep up and I'm not even paid to do it! Sorry for the rant, I'm still really raw from the move and the adjustment to my dad being in a facility. I know you're just trying to offer help, this is just another broken system.

[thebreakfastclub]

I agree that OP has a set amount of bandwidth to help this out-of-state, distant relative. Is A Place for Mom the best thing in the world, probably not. Are they going to place the relative in a Siberian labor camp and pocket a big commission? No, so let's move along and take the resource and do the best we can, with the resources we have, to make the best possible decision for the relative.

Not everyone has the time or ability to research state agencies and do all kinds of advocacy.