I am primary caregiver.. I do have paid part time help. IF the time comes that we need more help or a different living arrangement, what are the best options? He will not be able to afford to stay in a nice MC place more than a year. The Medicaid places in this area are not very nice. I've been told it's best not to move more than once. No idea what we would do.
As far as future care for him, research good, reputable facilities in your area that also accept Medicaid (many do). Find one that has a continuum of care so that he will be on the same campus for AL, MC and LTC. Also, existing residents get priority for Medicaid beds over non-residents. My MIL is in LTC in a great facility on Medicaid and even has a private room. Wishing you all the best as you help your dad on this journey!
If you are up for it, I would opt for more help at home. Don't wait too late to line up more help as it is soooo easy to get burned out.
I like the idea of home with more help or do the MC ALF while he can afford it. When it gets close to the time he is running out of $, move him to a medicaid accepting nursing home. At the point you need to do this, he will be needing much more assistance than you can provide at home and hopefully he won't understand too much about where he is, etc. Many people ask to go home even when they are home so you need to do what is safe for him. And for you!
The other thing to consider, however, is that you're better off paying out of pocket for a Skilled Nursing Facility for a few months before you apply for Medicaid; that will ensure dad's spot in the SNF b/c they always prefer self-pay over Medicaid. So if $$$ is an issue, you may have to go that route vs. moving him into the Memory Care AL first. Does that make sense?
You may want to meet up with an Elder Care atty for a free consultation to get some advice about the Medicaid approval process in general. That's what I did and I'm happy I went that route.
Wishing you the best of luck moving forward.