Move Parents to Local Nursing Home or Far Away with Me?

[Anonymous]

Long story. What would you do?

My parents are in their 90s, using walkers, and living in their own home. They both got covid last month and are recovering at home. It really knocked them down and left them very weak and needing 24 hour assistance with getting to restroom, showering, preparing meals, medication reminders, etc. Brother 1 has lived with them many years post-divorce and is getting married in June. Our parents were fully independent when he moved in. Over the years, he has become their caregiver as they've gotten older. He has adult children in the same town. Brother 2 & his family live in the same town. My family & I (the only sister) live 1000 miles away. I have been here 2 weeks helping Brother 1 care for them.

My parents can no longer be left home alone while Brother 1 works full-time and has his own life. Also, Brother 1 is getting married and moving out in June. My parents will no longer have him here to help them.

Other info: Dad has no other family. Mom has a sister & brother 30 minutes away. They see my parents about 4 times/year. They are very close despite not seeing each other very often. Dad has early stages of dementia, forgets where he puts things, repeats questions, confused sometimes as to time/day/place. Mom had a stroke 10 years ago that affects her speech and sometimes comprehension. She sometimes sounds completely normal. Other times she mixes up her words or says nonsensical words. I can usually understand what she's trying to say and I'm good at rephrasing things to make her understand what I'm trying to tell her. I'm afraid if she goes to a nursing home they won't be patient with her speech difficulties and just write her off as a dementia patient who doesn't know what she's talking about. She is still there inside and understands way more than it appears.

My parents cannot live alone and Brother 1 is done being caregiver. Brother 2 cannot help to the degree that's needed. The choices are:

Option A. Parents go to nursing home. They are beyond Assisted Living care. Last week, Brother 1 and I toured a very nice nursing home 10 miles from home. It has availability. Parents have not seen it yet. If they go there, Brothers 1 & 2 will likely visit them a total of twice/week. Grandkids maybe 3 times/month total. Mom's brother & sister will likely visit as usual 4 times/year. I can visit about 6 times/year.

Option B. Parents move in with me & my family 1000 miles away. I have never wanted them to go to a nursing home and my brothers know that. I have always been willing & able to take care of them in my home. My husband & kids fully support me on this. When they require additional care, or if we need respite care, we will hire outside help to come to our home.

If they move with me, mom will likely never see her brother & sister again which is heartbreaking for all of them. My aunt & uncle cannot travel that far. My parents would rarely see my brothers and rarely see 8 of the 10 grandkids. They would come visit about once a year.

Option C. For now, in a week or two, move them to the nursing home as it would be an "easier" move. Give them a month or two. See how they like it. See if it's still a good place. If they are miserable, they are still welcome to move in with me 1000 miles away.

What do my parents say? They don't want to leave their home. But, sadly & unfortunately, they cannot stay. We temporarily hired 24/7 non-medical caregivers for a week before I got here to help, but we cannot maintain that long-term nor do my parents like having strangers in their home 24/7. It makes them very uneasy. Parents have not made up their minds as to what they would prefer-- nursing home or move with me 1000 miles away. Nursing home is super expensive, they would spend their life savings then go on Medicaid. They could stay in the same nursing home on Medicaid, but they'd have to switch to a different wing. Very soon, this week, we will have to force them into a decision because Brother 1 "cannot take it anymore" as he put it, and I have to return home. Brother 2 cannot care for them.

Other note- If they move with me and one of them dies, we will bring the deceased back home for funeral and burial per their wishes. However, my living parent might not be well enough to travel back for the funeral.

Also- if they go to nursing home they must have a POA (power of attorney). Right now they have no POA. Brother 1 is the assumed choice but I want Brother 2 because I do not really know the woman Brother 1 is marrying and I don't know about her influence on him. If they move away with me, I want POA. I wonder how hard it is to change POA from a brother to me in the future if needed.

What would you do? And are there other things I'm not considering? We have to decide this week.

[Anonymous]

How much is the nursing home for both of them? 10,000 a month each? So 20,000? Why isn’t there a 4th option you get a home health agency to send staff to their house for the next 2 months? Just to buy you time.

[Anonymous]

Anonymous wrote:How much is the nursing home for both of them? 10,000 a month each? So 20,000? Why isn’t there a 4th option you get a home health agency to send staff to their house for the next 2 months? Just to buy you time.

Nursing home is $10,000/month for both. If that is cheap, I'm shocked. They do live in a rural area so maybe that is cheap by DC standards.

We started with that 4th option but it was nixed after 1 week. They had aides 24/7 for 1 week before I got here and it was too upsetting for mom & dad to have strangers in their home every time they woke up from a nap or in the middle of the night.

[Anonymous]

OP here. Clarification--they would be going to the "dementia care" unit at nursing home because of my dad's early stage dementia diagnosis. Mom & dad would room together which is good.

[Anonymous]

There isn’t a wrong option, so please give yourself some grace. Whichever option you/your brother/they choose will be the right decision at the time you are making it, with the information you have at the time the decision is made.

Know moving at their age is tough. Even moving to the local nursing home. So if it were me, I would only move them once, either way (I wouldn't make option C an option, because moving twice would likely be a disaster)

[Anonymous]

I agree with the PP, this is a tough spot and you’re trying to do best by them without knowing what’s going to be best. But there is no wrong option. And moving and settling in to a new routine is hard.

I think you should move them to the local nursing home and ask your brothers and their families to step up the visits for a bit as they get settled. It’s going to be an adjustment for them no matter what but at least they have each other which should make things a bit easier wherever they end up. And honestly twice a week visits at the minimum from loved ones is much more often than most people receive in those places- and if they are able to get settled in and enjoy the place the visits may not even need to be so often.

I’m suggesting the nursing home for a few reasons-much more family around and, even though you are ready and willing to take care of them, caregiving is incredibly difficult. I start out my mornings fresh and by the evening I feel like I’ve been in a boxing match. Physically, psychologically and emotionally beat up. It takes a toll.

[Anonymous]

We lived something similar and the local nursing home is absolutely the right choice. Keeping as much familiarity as possible AND having trained medical professionals doing the bulk of the caretaking is absolutely the right call.

OP, with all due respect, you have no idea of how difficult it would be to move your 90yo parents with serious health issues into your home, 1000 miles from anyone or anything they know, and take care of them while managing the rest of your life.

Even if you're a SAH parent, caretaking for two very elderly people with memory and other health issues is not something you can easily balance with any other responsibilities in your life. It's grueling and demeaning in many ways - you will have to be prepared to help them use the toilet, shower, etc. You may not be able to leave them alone even for a few minutes.

If you want to be more engaged, make a commitment to visit more often and/or find an outside caregiver who can supplement the nursing home care. We had someone come visit my dad a few times a week on top of local family and friends, and it was helpful to have another set of eyes to make sure he was being well taken care of.

[Anonymous]

Local nursing home. They will only get more difficult to care for. Visit more often. I’m sorry you are having to make these decisions.

[Anonymous]

Local nursing home: keeping social contacts is important. Moving to your home would be very isolating for them.

And, consider the toll moving them to you will take on you and your family. You'll spend most of your time with them and they'll need more help as time goes on. I'm not trying to be crude, here, but do you want to remember your aging parents as the people whose butts you cleaned?

[Anonymous]

With you. More opportunities to honor them and get your kids to have a good model for how to treat you

[Anonymous]

Anonymous wrote:We lived something similar and the local nursing home is absolutely the right choice. Keeping as much familiarity as possible AND having trained medical professionals doing the bulk of the caretaking is absolutely the right call.

OP, with all due respect, you have no idea of how difficult it would be to move your 90yo parents with serious health issues into your home, 1000 miles from anyone or anything they know, and take care of them while managing the rest of your life.

Even if you're a SAH parent, caretaking for two very elderly people with memory and other health issues is not something you can easily balance with any other responsibilities in your life. It's grueling and demeaning in many ways - you will have to be prepared to help them use the toilet, shower, etc. You may not be able to leave them alone even for a few minutes.

If you want to be more engaged, make a commitment to visit more often and/or find an outside caregiver who can supplement the nursing home care. We had someone come visit my dad a few times a week on top of local family and friends, and it was helpful to have another set of eyes to make sure he was being well taken care of.

I have been through this also and nursing home is the right answer. You don't know what you don't know. It is harder than you think and a move of any type will set them back further. You want professionals dealing with this. Also don't discount the stimulation and activities in a facility. There are positives to nursing homes including socializing, music therapy, etc.

[Anonymous]

I saw your update that the reason for not having home caregivers is that it upset them etc.

I don’t think that’s a good reason. Moving to either your place or a nursing home will probably be even more upsetting.

My mom didn’t tolerate home caregivers at first but now she does.

I think you should take FMLA for a few weeks and go out there are try to get caregivers set up. Try to get brother one to be willing to do this with you for a few weeks as well. That gives you six weeks or so to get eh caregivers sorted out.

I think that would be the least upsetting thing to your parents.

Thank brother one profusely for all the care h has given over th years

[Anonymous]

Having the local caregivers will be much less upsetting to your parents than relocating to a dementia wing of a nursing home.

I'd run the local caregivers 6-8 weeks and then reevaluate.

Understand Mom (without dementia) will find moving into a dementia wing alarming and very upsetting.

What does Brother I want? He sounds really burned out from elder care. Ultimate decisions need to take a lot of the workload off of him.

[Anonymous]

Having the local caregivers will be much less upsetting to your parents than relocating to a dementia wing of a nursing home.

I'd run the local caregivers 6-8 weeks and then reevaluate.

Understand Mom (without dementia) will find moving into a dementia wing alarming and very upsetting.

What does Brother I want? He sounds really burned out from elder care. Ultimate decisions need to take a lot of the workload off of him.

[Anonymous]

Another vote for the nursing home. Getting parents to your home will take a huge toll for many reasons. Plus, very quickly, I believe, they will need more care than you can physically provide. You will either have to bring help in or find a nursing home near you.

As to POA, I would have it established now that you share it with whichever brother gets it. My sibling and I have POA for our 90s parents. Also, you need Medical Power of Attorney as well--and is almost more important in the high care years.