Is moving an elderly parent into a care facility a form of 'betrayal'?

[Anonymous]

Once the person stops recognizing their home as home, all bets are off. My aunt constantly tried to leave (her home of 30 years) to go home and find her mother. When we prevented her, she became violent- we moved her to Silverado in Alexandria and she was much safer and well cared for.

[Anonymous]

Anonymous wrote:Once the person stops recognizing their home as home, all bets are off. My aunt constantly tried to leave (her home of 30 years) to go home and find her mother. When we prevented her, she became violent- we moved her to Silverado in Alexandria and she was much safer and well cared for.

OP here.
My MIL is the same. She doesn't always recognize her house as 'home'. Sometimes she thinks she lives elsewhere and she says she wants 'to go home'.
There are signs on the walls saying that this is her house but I don't think it makes any difference. She doesn't really read them unless someone points them out to her.
She does remember things from her distant past and her childhood though, sometimes in detail, and sometimes mixed up with facts from a different story.

We'll have to wait and see how her illness develops.

[Anonymous]

I think your SIL are living in total denial, and the feelings they're concerned about are their own, and not their mother's well-being. I'd argue that that's the betrayal they should be worrying about, not whether appropriate memory care is betraying their mother. How are they going to feel if she hurts herself badly because her home is no longer the safest place for her?

I've found with my spouse, though, that I can have opinions about what's going on on his side but that generally it's not my circus and not my monkeys.

[Anonymous]

Anonymous wrote:I think your SIL are living in total denial, and the feelings they're concerned about are their own, and not their mother's well-being. I'd argue that that's the betrayal they should be worrying about, not whether appropriate memory care is betraying their mother. How are they going to feel if she hurts herself badly because her home is no longer the safest place for her?

I've found with my spouse, though, that I can have opinions about what's going on on his side but that generally it's not my circus and not my monkeys.

They aren't in denial at all. They are dong the bulk of the work so OP gets no opinion. We had to put my MIL in a facility and it was horrible and she was terrible neglected and at times possibly abused. If I had another option, I would have done it. I visited as often as I could and was very active with her.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Maybe I’m missing something - but if you have unlimited funds for caregivers, can’t you always stay in your home? If she gets worse, can’t you just hire more staff at home?

If you can envision a scenario where her staying home is no longer viable, then THATS what you say. “Oh, of course, we don’t want to put her in a home either. But if X, Y, and Z happen, I don’t think it’ll be viable for her to stay home. So we’re preparing incase that happens. Do you disagree?” And see what they say. Maybe they have some creative ideas for ways they’d be able to keep her home.

Not OP, but been there. Awful. Her are the drawbacks

1.) Caregivers no-show. Then what? The case manager will tell you they have backup. The backup was me getting emergency calls and being expected to be there. I developed blood pressure issues.
2.) Caregiver stealing during night shift.
3.) Parent making accusations and even with cameras you can't catch anything. Brain has deteriorated so much can't trust parent's account.
4.) Total isolation. People stop visiting. At least at a facility you are around multiple people and some try to engage with you. With an aide all day there is only so much engagement and you may think you will be there often, but life happens and you have to prioritize.
5.) Impossible to fully elder proof the house in many cases.
6.) Caregivers quit a lot. The job sucks.

Strongly agree with all of the above. My mother had moderate dementia and numerous physical ailments. We got her 24/7 home aides, AND I visited five days a week, and had my kids visit 3 or 4 days a week. Mom was miserable, lonely, and abusive to her aides. The fact that most aides in our region are immigrants with limited English made things even harder: they could not understand my mother, and between her deafness and their limited English, she could not understand them half the time, leading to numerous conflicts and misunderstandings. Lots of no-shows and aides who quit. My mother was so difficult we had an entire agency decline to provide care. And every time an aide did not/could not show up, I ended up having to drop everything to take over. She also had zero social life.

We finally persuaded her to move to an assisted living place. We continued to pay one of her private duty aides to go by every day to check on her and visit, but the facility handled meds, meals, etc. She went in kicking and screaming, but within a month was vastly more contented: she had more social interactions, she ate more, etc.

OP, there is no one-size-fits-all solution. Some elderly people will do just fine at home with aides. Others will not. Some adult children have the ability to essentially serve as aides themselves. Others do not. I do believe in trying to honor the preferences of the elderly person if at all possible, but by definition, people with dementia have poor judgment and minimal insight. It is no "betrayal" to move someone if the move will improve their care. Adult children have a moral duty to care for elderly parents to the best of their ability, but they cannot be expected to destroy their own lives, finances and health to humor someone with dementia (or to please a sibling who is not sharing the burdens).

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
6.) Caregivers quit a lot. The job sucks.

The job doesn’t really suck, I’ve been doing it for 8 years so I think I have an informed opinion. Yeah the job can be challenging depending on the temperament of the patient and the dynamics of the family (if the caregiver has to deal with family, and we usually do), but it is mostly rewarding work that feeds the caregiving personalities that are often drawn to it.

The pay really sucks. The lack of benefits of any kinds in most cases really sucks. The lack of appreciation from much of society really sucks - like all traditionally women’s work caregiving is considered by many to be a job for lesser thans.

But the job itself doesn’t suck unless you aren’t at all well suited to it. I personally love caring for people and especially elderly hospice status as I’m bringing some peace and compassion to a person at a difficult stage of life and easing their burden. The rewards of such work have immediacy that many jobs don’t.

The companies that run these places SUCK. They are traded soon the NYSE and are FOR PROFIT - that is the problem. Lots of good people work in this facilities but the companies pay them poorly and often they are understaffed or they are staffed with people that meet minimum qualifications and receive little training. It's a travesty what goes on in these places and there is very little governmental oversight or regulation.

Find a .org place in a well-regulated state.

[Anonymous]

Anonymous wrote:MIL is 93 and has developed dementia over the last 5 to 7 years. She lives in her own home. DH and his siblings have hired a team of home health aides and helpers to take care of her.

DH's sisters hate the idea of their mother moving into a care facility. They see it as a form of 'betrayal'.
DH wants what is best for his mother but he is the more rational and practical one of the siblings, and he would support the idea, if her condition deteriorates and she can no longer comfortably live at home, even with aides/helpers.
There have been low level conflicts about MIL's care between DH and his siblings over the years. His sisters are far more emotional about it than he is.

(My own parents passed away a long time ago at a younger age than MIL and I never had to deal with these issues.)

I have a few questions:

1. Who has power of attorney over your MIL? I'm assuming someone other than her does as you indicate she's had dementia for 5 to 7 years. If not, or if she never indicated a preference legally, you need to get that worked out. Ideally it should be a decision that all agree to, but whomever is designated the POA has the final say.

2. What kind of assets does MIL have? I say this because if she's living in a home she owns, and is expected to require care long term, the sale of her house after moving to a facility will help fund that care. Long-term care insurance and eligibility for Veterans Aid (or spouse survival) should also be a factor.

Ultimately, I don't believe it is a betrayal as these facilities are designed to provide the level of care that most family members cannot sustain on a long term basis. If she lives nearby, you can still visit her and be a part of her life. I wish you the best.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It’s a betrayal to pretend you can care for her as well as a care facility.

If you spend significant time in these places you will see that they don't provide nearly the level of care that you think. Memory care units seem to get all the caretakers and those people are watched 24/7 in secure floor(s) but at the expense of the rest of the residents. The rest of the floors are assigned significantly less staff. I have also sen staff avoid more difficult residents b/c they don't want to deal with them. So just go into it with your eyes open. It's a difficult situation for everyone involved.

I’ve unfortunately spent significant time responding to homes where home care givers don’t understand how their care or lack there of causes UTIs, bed soars, falls, etc.

Sure that happens too but the fact is ASL facilities misrepresent the level of care they provide. So families truly don't know how many things are slipping through the cracks with regards to the care their loved one receives. The answer is for there to be better oversight and regulations of these facilities but until that happens these organizations and all the cottage industries that are attached to them will continue to exploit them. The other significant part of the problem is the actual training and hiring practices in this industry. The people going through CNA training receive little training and are paid poorly. There is constant turnover at these facilities b/c they do not provide opportunity for advancement, training, and compensation increases. The staff is overworked and the facilities hire the bare minimum of staff needed to keep costs down. This is also the problem with private care nursing companies. It's a difficult situation to remedy.

[Anonymous]

Assisted living facilities are not for elders who cannot toilet themselves, unless they are paying out of pocket for additional aides to visit them and help them with ADLs such as toileting and washing.

The comments here crapping on CNAs etc. are gross. Yes, many CNAs are immigrants with accented English but very very few are incapable of basic English conversation and those that are typically are matched with elders who speak their language because many elders will begin reverting to primary language as dementia progresses.

There is not a single CNA in this country who doesn’t know how to properly clean a human being after toileting or how to clean and/or prevent bed sores (not SOARS, you elitist a holes) given the proper tools to do so.

Really this comment thread makes me very angry. So unbelievably xenophobia and elitist and smug. I bet most of the women commenting here couldn’t last a day as a caregiver in the home or a facility, much less put up with the kind of abuse your elder demented parents routinely heap on caregivers. Shame on those of you making such comments.

[Anonymous]

Anonymous wrote:Sometimes it can be the most loving, caring, and responsible thing to do if she has become a danger to herself and others. Caregiving for someone with dementia is extremely hard.

This. Sometimes there are major safety concerns that make care at home impossible, even with multiple family and/or outside caregivers.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Once the person stops recognizing their home as home, all bets are off. My aunt constantly tried to leave (her home of 30 years) to go home and find her mother. When we prevented her, she became violent- we moved her to Silverado in Alexandria and she was much safer and well cared for.

OP here.
My MIL is the same. She doesn't always recognize her house as 'home'. Sometimes she thinks she lives elsewhere and she says she wants 'to go home'.
There are signs on the walls saying that this is her house but I don't think it makes any difference. She doesn't really read them unless someone points them out to her.
She does remember things from her distant past and her childhood though, sometimes in detail, and sometimes mixed up with facts from a different story.

We'll have to wait and see how her illness develops.

When dementia patients say they want to go home (whether they are still in their long time home or a care facility), they don’t mean a physical place. They want to go to the place that was familiar and safe. They no longer feel like they are in a familiar place no matter where they are. It’s best to either tap into the feelings (what do you miss about your home?) or do therapeutic lying (your home is being fixed and once it’s ready you can go home). Don’t try to convince them that they are home or that the MC/AL facility is their home. Step into their reality.

[Anonymous]

Anonymous wrote:

Anonymous wrote:MIL is 93 and has developed dementia over the last 5 to 7 years. She lives in her own home. DH and his siblings have hired a team of home health aides and helpers to take care of her.

DH's sisters hate the idea of their mother moving into a care facility. They see it as a form of 'betrayal'.
DH wants what is best for his mother but he is the more rational and practical one of the siblings, and he would support the idea, if her condition deteriorates and she can no longer comfortably live at home, even with aides/helpers.
There have been low level conflicts about MIL's care between DH and his siblings over the years. His sisters are far more emotional about it than he is.

(My own parents passed away a long time ago at a younger age than MIL and I never had to deal with these issues.)

I have a few questions:

1. Who has power of attorney over your MIL? I'm assuming someone other than her does as you indicate she's had dementia for 5 to 7 years. If not, or if she never indicated a preference legally, you need to get that worked out. Ideally it should be a decision that all agree to, but whomever is designated the POA has the final say.

2. What kind of assets does MIL have? I say this because if she's living in a home she owns, and is expected to require care long term, the sale of her house after moving to a facility will help fund that care. Long-term care insurance and eligibility for Veterans Aid (or spouse survival) should also be a factor.

Ultimately, I don't believe it is a betrayal as these facilities are designed to provide the level of care that most family members cannot sustain on a long term basis. If she lives nearby, you can still visit her and be a part of her life. I wish you the best.

This is OP. To answer your questions:

1. All of MIL's children have POA, meaning my husband and his siblings.

2. MIL owns her own house, plus she has savings and investments. She is not 'wealthy' but financially comfortable enough to fund long term care in a care facility (for at least another 7 or 8 years).

She is receiving good 24/7 care at home from her aides and helpers right now but there may come a time where even her private carers can't cope. This is where my husband's opinion differs from his sisters.
Sisters think she will deteriorate quicker in a care facility and she needs to stay in her familiar environment.
My husband thinks receiving care at home is great until it's not.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Your SIL is stupid to look at this from an emotional perspective.

What matters is:
1. The quality of care between the two settings. It will depend on the competence of the aides and the specific facility you're looking at.
2. The evolution of the dementia. Each stage requires different care.

This is OP here. I agree with this.

The system they have in place - private caregivers 24/7 at MIL's home is working well and MIL seems happy. So far so good, however ... my husband started touring a few specialist care facilities because he believes there will come a time where his mother cannot be taken care of at home anymore. He wants to gather the necessary information and be prepared in case of a serious crisis.

MIL's house has stairs and even if they moved her bed downstairs, the bathroom is still upstairs. Also, she seems to get increasingly confused and agitated at night. The aides now lock all doors or she would walk out in the street on her own, nor remembering where she lives (she has tried doing this).

This is where my DH and his siblings differ in opinion. His sisters are super close to their mom and are far more emotional. They really want her to live at home, no matter what. They fear she will deteriorate and die quicker in a care facility.

They may need to move in with her at some point. But the thing is, everyone can be right. Let DH do his research and plan it out. he doesn't have to discuss with the sisters. As long as MIL is happy and well cared for at home, he will be secure in the knowledge that he has a backup plan. If that plan is ever needed, sisters will get on board then. So much can change so quickly.

[Anonymous]

Anonymous wrote:MIL is 93 and has developed dementia over the last 5 to 7 years. She lives in her own home. DH and his siblings have hired a team of home health aides and helpers to take care of her.

DH's sisters hate the idea of their mother moving into a care facility. They see it as a form of 'betrayal'.
DH wants what is best for his mother but he is the more rational and practical one of the siblings, and he would support the idea, if her condition deteriorates and she can no longer comfortably live at home, even with aides/helpers.
There have been low level conflicts about MIL's care between DH and his siblings over the years. His sisters are far more emotional about it than he is.

(My own parents passed away a long time ago at a younger age than MIL and I never had to deal with these issues.)

One of the emotional sister can move her to her house and y'all can help financially and relieving her on weekends.

[Anonymous]

What is the issue? She has plenty of money to cover her staying in her home and caregivers. You aren't a caregiver. They are right, you are not.