Living facilities and “dumping”

[Anonymous]

I’m 51, my mom is 88. She is getting ready to go into a transitional independent living – assisted living – skilled nursing facility near where 3 of my siblings live. It is past time – beginning signs of dementia, fall risk, etc. As expected, her emotions are all over the place. She knows it’s time and I cannot care for her, but she wants to stay at her apartment and keeps saying she won’t bother me anymore. Every few weeks I am taking her to the ER for one issue or another. And most times her issues are dismissed because... she’s old. It is hard to diagnose causes of pain (my whole body is sore!), “wobbliness”, etc. when someone already has many underlying conditions (COPD, thyroid issues, kidney issues, compressed spinal cord, etc…). She falls, they do x-rays, but if nothing is broken, home she goes. I have been taking her out once a week for shopping over the last year – most Saturdays I spend with her. I take her to all her doctor appointments. It has been exhausting. Add in the dementia… I need someone else to take over.
A co-worker (2nd generation child of Vietnamese immigrant) made a comment about how sad we dump our elders at a time they need us. She is old and confused, she should be taken care of by family. My cousin (a doctor) said a big move like this at an advanced age decreases life expectancy.
I work full time – no way I could stay home and take care of her. Plus I have 2 teenagers that I want to be there for. Running my mom around takes time away from my children.
Honestly, I don’t feel guilty, but I do feel sad for her. Her mom was in a transitional facility for her last few years. I plan on moving into some sort of community that offers transitional care well before “it’s time”. I do not want to be a burden to my children.
However, it is an interesting observation. I know “dumping” is the American way. It is also compounded by larger age gaps. If I was retired and my children grown, I may have been more willing to do more for longer.
Thoughts? Anyone else in this boat?

[Anonymous]

If your coworker hasn't personally been through this she is likely just naive. You're not dumping, you're moving her into a place where her needs can be met and she is near to 3 of her adult children. Yes a move is hard for people with cognitive impairment, but living alone is also bad for that, and unsafe. Living alone massively increases the chance of falls, accidents, and elopement which can be fatal. People who are with families, well, they're having un-skilled nursing and they don't have 24/7 awake supervision. The risks of that are real. Some elders are safer and happier with a residential setting and professional care.

[Anonymous]

Choose a facility wisely. Unfortunately, with a fall risk an institutional facility may not be in her best interest - or ours. Each time she falls they will still send her to the hospital and call you to go with her (or she will be entire alone). Each hospital visit will cause the dementia to progress. Eventually they may require you to hire a daytime aide to monitor her for her safety. It can get very expensive very quickly and you lose control.

You can hire support in the home - not only aide support but also a caregiver to coordinate care and go to doctors appointments with her. Thus also can be very expensive, but you will have more control.

[Anonymous]

My father died about 2 months ago. He had been living in an assisted living facility for about 2.5 years before his death.
Prior to that, he and my mom were living in just a regular apartment (not for senior citizens or anything) with a hired team of round the clock care givers for my mom, who was in the final stages of dementia. In the last few months at that apartment, his health also declined and he hired a caregiver for himself.
When my mom died, he moved into the assisted living facility.
I am SO glad he did.
He was active in many of the clubs and activities there. He made new friends-something he would not have done if he had just stayed in the apartment with a caregiver.

[Anonymous]

My husband is Vietnamese, OP.

His mother decided she did not want to live in a home. Luckily she has just enough money to live a frugal life with 24/7 aides in her own home.

But my MIL did suggest, at one point, that she live with one of her children. EVERYONE SAID NO.

So please don't think that all Vietnamese people are like your colleague.

Also, regarding the doctor's comment. Yes, they're right. But prolonging the life of the elderly person in dementia or in advanced stages of illness is NOT the goal, here. The goal is trying to balance everyone's needs as well as possible, and keep the patient as comfortable as their old age and ailments will allow.

[Anonymous]

I would feel no shame at all. It's just what happens and part of life.

[Anonymous]

She needs to be in memory care. There is no happy ending here, only worse outcomes causing pain and fear. Find a place nearby that you can check in regularly and drop off meds and supplies as needed.

[Anonymous]

Give yourself some grace op. You’ve likely already extended her life by a lot. She’s 88. It’s time. She’s lucky to have lived this long in relatively good health.

[Anonymous]

Anonymous wrote:My father died about 2 months ago. He had been living in an assisted living facility for about 2.5 years before his death.
Prior to that, he and my mom were living in just a regular apartment (not for senior citizens or anything) with a hired team of round the clock care givers for my mom, who was in the final stages of dementia. In the last few months at that apartment, his health also declined and he hired a caregiver for himself.
When my mom died, he moved into the assisted living facility.
I am SO glad he did.
He was active in many of the clubs and activities there. He made new friends-something he would not have done if he had just stayed in the apartment with a caregiver.

Thank you for sharing your experience. My mom lives in just a regular apartment. She wanted to go with the in-home health aids visiting daily - but without some of their 24 hours a day, it wouldn’t help when she falls in the evening. I also know that would be a lot of work for me, and I’m the only child nearby. My siblings live in another state, and all their children are grown. So even though she will be in a facility, they have more bandwidth to visit her. Plus there’s more of them.
Currently, she just lays in bed all day watching TV. I am hoping at the independent living facility she will become engaged with the activities. She says she doesn’t want to do any of them, so I can only hope that she does.

[Anonymous]

The only way I have seen this work out was when a neighbor subdivided their lot and then two kids built homes on the property and a 3rd moved in with the parent.

This way the burden was always shared among multiple siblings and the grandparents also provided childcare when they were younger and healthier

It’s hard to swing this kind of arrangement and requires all the children stay close.

[Anonymous]

You learn that there are some people you cannot vent to. I laughed at the doctor in your family chiming in. While yes, a big move can se off decline she's completely neglecting all the research on caregiver burnout and what this could do to you. Thew doctors in my family love to tell others how it needs to be done, but when the sh&t hits the fan they were utterly useless to do anything other than try to be backseat drivers. My friend's brother, yet another doctah, was the same way. He pontificated about what everyone should be doing, but refused to do anything himself.

We have a lot of friends from traditional Asian families (Vietnamese, Korean and Chinese) due to DH's line of work. The parents along the way did live with each of them at some point but they contributed to the household making meals/babysitting. Once they were no longer willing even when able in 2 cases they had their children buy them homes, which they then refused to live in and moved back to their home country instead. Another family put the mom in Memory Care because it was dangerous to have her at the home. No shame there. In yet another case, the house was chaotic, the wife was miserable having the MIL live with them and the teen daughter did a suicide attempt. That is when they decided it did not work.

Again, for your own sanity, don't turn to people who don't get it and/or have rigid and judgmental ideas. You want to make sure your parent is safe, well cared for and visited, but you don't set yourself on fire to keep them warm. Your physical and mental health matters.

[Anonymous]

Facility situation you’re going to put her into is not any safer than living at home. She’s not going to get better care there so don’t fool yourself with that idea. But I’ve done caregiving for my in-home parents and I understand your burnout feeling.

[Anonymous]

People fall in facilities all the time. I am not sure why people think they are so safe.

[Anonymous]

Anonymous wrote:People fall in facilities all the time. I am not sure why people think they are so safe.

Because someone picks them up when they do. Unlike living alone where you could go a very long time with no help, possibly in pain or with a head injury.

[Anonymous]

FWIW we just put my dad in a memory care facility and it was 100% the right choice. It is appropriate care for his level of needs. He is a social person, too, so he is enjoying being around people rather than just sitting home with only my mom. 24/7 in home care was prohibitively expensive for them.

People who say we should care for elderly dementia patients at home need to walk the walk before they talk the talk. Reality is so different from whatever they envision in their heads.