Unhappy with care at SNF - thinking of transitioning home.

[Anonymous]

My father is currently at a SNF in MoCo. We are taking shifts to be there with him from 8a-8p b/c the staff/nurses aren't looking after him (and we understand they have other patients). He needs constant reminders of where he is and to keep drinking water, etc. (he has delirium post-hip replacement) and very weak. He only gets 5 min of therapy a day for his hip, legs, and general strength. He isn't sleeping well there and frankly, the only care he is getting is the daily baths, changing (of which sometimes takes an hour before they come and change his diaper -- again, understand they are short staff, but also sad to see my dad sit in it for that long), the 5 min of PT, and medication. All of which my husband and I can do (in addition to having PT come to help do exercises, that we would also work with him in doing). I am able to take leave from work to care for him and as a family we feel he'd recover better being at our home. Are we crazy in trying this?

[Anonymous]

Have you ever given daily baths to a parent for a long period of time? You could injure yourself easily. Do you have a spouse and/or kids? Have you thought about the impact on them? I know a lot of people like to wax poetic about how it teaches them love of family, but it more often teaches them that their mental health and other needs are not a priority and everything revolves around the elder. I have known of several marriages that dissolved with the elder moving in. Also, the reward and the end was not so much a feeling you did everything for the elder, but guilt because it was too much, you burned out and now you are facing your own serious illness.

It makes more sense to keep him there and maybe hire a professional to assess, figure out what he needs and advocate. Is there more money to throw at this? You can hire an aide to go there too. How are you all doing these shifts? Do you not have families and jobs of your own?

Be realistic. Do you think he will suddenly sleep well in your home? People are quick to blame the facility, rather than just what happens as people decline.

When my father was aging in place with aides and mom, his diaper went unchanged for long periods too. What you think is sustainable for weeks, may not be sustainable for years. People can live a very long time in absolutely atrocious shape. You need to think about everyone in your family and make sure you are realistic about his needs, what you can handle, etc.

[Anonymous]

What happens is he develops dementia and starts to wander or behave erratically? Do you know how to move someone safely if he becomes completely bedridden and are you strong enough?? Is your home set up for it? What happens when he needs you but your kids do too?

… if you’re not happy with the care and can afford it, one option might be to get a private duty cna to check on him regularly at the nursing home

[Anonymous]

Anonymous wrote:Have you ever given daily baths to a parent for a long period of time? You could injure yourself easily. Do you have a spouse and/or kids? Have you thought about the impact on them? I know a lot of people like to wax poetic about how it teaches them love of family, but it more often teaches them that their mental health and other needs are not a priority and everything revolves around the elder. I have known of several marriages that dissolved with the elder moving in. Also, the reward and the end was not so much a feeling you did everything for the elder, but guilt because it was too much, you burned out and now you are facing your own serious illness.

It makes more sense to keep him there and maybe hire a professional to assess, figure out what he needs and advocate. Is there more money to throw at this? You can hire an aide to go there too. How are you all doing these shifts? Do you not have families and jobs of your own?

Be realistic. Do you think he will suddenly sleep well in your home? People are quick to blame the facility, rather than just what happens as people decline.

When my father was aging in place with aides and mom, his diaper went unchanged for long periods too. What you think is sustainable for weeks, may not be sustainable for years. People can live a very long time in absolutely atrocious shape. You need to think about everyone in your family and make sure you are realistic about his needs, what you can handle, etc.

This is all good advice, despite the fact that it is also true that facilities are woefully understaffed. IMO, the best solution might be to keep him in the facility BUT hire your own aide to come in a couple of hours per day to provide additional care.

[Anonymous]

I know more than one person who had to have their own hip replacement, operation for a blown knee, back surgery etc because they got hurt caring for an elderly person

[Anonymous]

Do you have a ground floor bedroom and bath?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Have you ever given daily baths to a parent for a long period of time? You could injure yourself easily. Do you have a spouse and/or kids? Have you thought about the impact on them? I know a lot of people like to wax poetic about how it teaches them love of family, but it more often teaches them that their mental health and other needs are not a priority and everything revolves around the elder. I have known of several marriages that dissolved with the elder moving in. Also, the reward and the end was not so much a feeling you did everything for the elder, but guilt because it was too much, you burned out and now you are facing your own serious illness.

It makes more sense to keep him there and maybe hire a professional to assess, figure out what he needs and advocate. Is there more money to throw at this? You can hire an aide to go there too. How are you all doing these shifts? Do you not have families and jobs of your own?

Be realistic. Do you think he will suddenly sleep well in your home? People are quick to blame the facility, rather than just what happens as people decline.

When my father was aging in place with aides and mom, his diaper went unchanged for long periods too. What you think is sustainable for weeks, may not be sustainable for years. People can live a very long time in absolutely atrocious shape. You need to think about everyone in your family and make sure you are realistic about his needs, what you can handle, etc.

This is all good advice, despite the fact that it is also true that facilities are woefully understaffed. IMO, the best solution might be to keep him in the facility BUT hire your own aide to come in a couple of hours per day to provide additional care.

I think this is a good idea. You could even hire someone to go in and just be a companion. Think babysitter but for the elderly. They don't have to do any of the literal heavy lifting - just be someone more responsible who is there to watch over them.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Have you ever given daily baths to a parent for a long period of time? You could injure yourself easily. Do you have a spouse and/or kids? Have you thought about the impact on them? I know a lot of people like to wax poetic about how it teaches them love of family, but it more often teaches them that their mental health and other needs are not a priority and everything revolves around the elder. I have known of several marriages that dissolved with the elder moving in. Also, the reward and the end was not so much a feeling you did everything for the elder, but guilt because it was too much, you burned out and now you are facing your own serious illness.

It makes more sense to keep him there and maybe hire a professional to assess, figure out what he needs and advocate. Is there more money to throw at this? You can hire an aide to go there too. How are you all doing these shifts? Do you not have families and jobs of your own?

Be realistic. Do you think he will suddenly sleep well in your home? People are quick to blame the facility, rather than just what happens as people decline.

When my father was aging in place with aides and mom, his diaper went unchanged for long periods too. What you think is sustainable for weeks, may not be sustainable for years. People can live a very long time in absolutely atrocious shape. You need to think about everyone in your family and make sure you are realistic about his needs, what you can handle, etc.

This is all good advice, despite the fact that it is also true that facilities are woefully understaffed. IMO, the best solution might be to keep him in the facility BUT hire your own aide to come in a couple of hours per day to provide additional care.

I am the poster you are responding to and I completely agree. Yes, the places are very understaffed, but as you say too hiring an aide helps. Having the person in your home is a nightmare and can lead to the neglect you are trying to avoid because it is so much more work than you could ever anticipate, even with hired help.

[Anonymous]

OP, is it possible to find another SNF? When my mom broke her hip last year, the SNF she was put in for rehab has 30 minutes of PT, and OT came most days also. The objective is to get them up and moving asap.

She was there about 6 weeks-there is NO WAY I could have cared for her at home, she could not have bathed and just wasn't mobile for much of the time. OP, is the plan for your dad to transition back home, or go to a ALF, or SNF or what?

Mom is 75 and broke her hip caring for my Dad-he has Parkinsons, and fell over knocking her down while removing shoes (he should have been seated). So yes, caregiving can be dangerous. Yes, I told her for years before that it wasn't safe and we need to hire help. She's lucky to be alive.

[Anonymous]

I think you can do it and should give it a try. Hire help if you need to. Your dad's care is the most important thing and it sounds like you know that.

[Anonymous]

Anonymous wrote:I think you can do it and should give it a try. Hire help if you need to. Your dad's care is the most important thing and it sounds like you know that.

Yes, OP you should do it. Your own personal safety and sanity and the lives of those who may live with you don't matter! Your dad's care is the most important thing. Give it a try! What could possibly go wrong? I mean really. Who cares if you injure yourself/lose your mind/injure your loved one/have a nervous breakdown/drive those in your home insane, etc etc. Take in your elder and please remodel your home too while you are at it so it is as safe as possible. Also, just go ahead and quit your job. None of this take time off nonsense.

[Anonymous]

Keep him there and hire an aide. Because this is the thing: if you take him home and discover it is too difficult to manage his care and decide to pursue long-term care, it will VERY difficult to find a place to accept him. It is so much easier from the rehab, where they can use his Medicare benefits while they work on transitioning him to a long-term care bed.

Perhaps it’s expected that he will be able to eventually return to baseline and not require around the clock care? But it doesn’t sound like it’s heading in that direction and if he goes home, he will get PT about twice a week for an hour max.

[Anonymous]

Anonymous wrote:Keep him there and hire an aide. Because this is the thing: if you take him home and discover it is too difficult to manage his care and decide to pursue long-term care, it will VERY difficult to find a place to accept him. It is so much easier from the rehab, where they can use his Medicare benefits while they work on transitioning him to a long-term care bed.

Perhaps it’s expected that he will be able to eventually return to baseline and not require around the clock care? But it doesn’t sound like it’s heading in that direction and if he goes home, he will get PT about twice a week for an hour max.

Just to add - you can take leave from work for a limited period of time but again, this might be his new baseline and what will happen when you have to return to work? You will have to hire aides because it will not be safe for him to be alone. I work in a hospital and we get so many patients whose families can no longer manage their loved one’s care at home and are desperate for us to find placement, which can be very difficult. It’s so much easier when the patient has a skilled need or meet criteria for rehab - otherwise, no facility accepts them, or the family has to settle on a poorly-rated facility.

In summary: if you take your dad home, it’s not likely he will be accepted back to rehab, if need be and finding a long-term care bed will be extremely difficult or unlikely. It’s much easier when the person is already at a rehab facility that has ling-term care beds. And you don’t yet know if your dad will get back to baseline.

[Anonymous]

To answer your question - yes, you would be crazy. At the very least you should hire a geriatric care manager to come in and assess your dad, your home and living situation, and make recommendations. Perhaps they can assist you in finding an ALF, once (or if) your dad is more functionally independent. This is not a short-term situation.

Sorry to be so blunt, but it’s like watching a train wreck about to happen (because I see the consequences of this decision every day at work).

[Anonymous]

Anonymous wrote:My father is currently at a SNF in MoCo. We are taking shifts to be there with him from 8a-8p b/c the staff/nurses aren't looking after him (and we understand they have other patients). He needs constant reminders of where he is and to keep drinking water, etc. (he has delirium post-hip replacement) and very weak. He only gets 5 min of therapy a day for his hip, legs, and general strength. He isn't sleeping well there and frankly, the only care he is getting is the daily baths, changing (of which sometimes takes an hour before they come and change his diaper -- again, understand they are short staff, but also sad to see my dad sit in it for that long), the 5 min of PT, and medication. All of which my husband and I can do (in addition to having PT come to help do exercises, that we would also work with him in doing). I am able to take leave from work to care for him and as a family we feel he'd recover better being at our home. Are we crazy in trying this?

I don't understand how these two statements fit together.

All of what you say you can do at home, you can do in the SNF. If you want to do longer stretches of PT with him than is offered, you can do that while he in in their chair or bed, rather than yours. If you think you can change his undergarments faster, you can do that while he is there. And you have the benefit that if this is a new baseline for him, or if you get sick or have another emergency, he is safer there than he would be at your home alone. (If your plan was to pay someone to be a sitter in those cases, you can pay them to come to the SNF, too.) And there is the critical component of being able to transfer if needed.

Of course, he may not be as cooperative with your cares as you think. If not, it's likely that would have been as much a problem at your home, too.