Send Mom to nursing home?

[Anonymous]

I have been down a similar road with my father. The kind of nursing home you can afford will be horrible. Why subject her to that for her last few months/years of life, while you live in her house?!? You make half of the payments on a 100k mortgage and think that entitles you to kick your mom out of her house because you don’t want to deal with the kind of care she requires?? No. In home care is much much better than putting her in some horrible home where they will drug her to keep her in bed and she will be miserable. Maybe it’s time for you to move out of her house.

[Anonymous]

I feel for you as my elderly aunt needs a nursing home and refuses to go. She has a caregiver come in for 8-12 hours a day but is basically bedridden. She can use a walker with surpervision but doesn’t have the mobility to get in/out of bed or a chair without a lot of help. She can’t use the bathroom so she is in diapers. I can’t force her to go to a nursing home because she is not “incompetent” She needs 24/7 care, not 12 hours a day and has already endured multiple ER visits where I was shocked they released her home. For reference, the nursing aides that come to her home are $34/hour and the nursing home that she was in for a time was about 13k a month. Your budget isn’t high enough for either. What you should do is sell her house and use the assets to pay for her care. Once she spends down all her assets, she will qualify for Medicaid.

[Anonymous]

Neither op or her mom can unilaterally sell the house because it’s in a life estate (this situation is also why a life estate can be risky; you transfer a lot of power to your children or whoever the remaindermen are). Essentially mom continues to pay for house but it’s transferred upon death to kids without being subject potential claim by Medicare etc. because op and her family are living there is only fair that she pays rent (eg half the mortgage and should kick in for moms care. The only way to sell the home would be both kids and mom agreeing to this. I am not sure about the Medicaid issues with a life estate: it should be free and clear from claims but any other assets will be used first; and the waitlist for Medicaid (not to mention quality of facility) is long.

Op: get home health and realize that even in a nursing home it’s not ideal. If mom exhausts all other funds you can either sell the home with everyone’s agreement or apply for Medicaid benefits.

[Anonymous]

OP if I were you I would have a long talk with your sister about how Mom is doing. Here's what I have gotten from your post:

- ER 5 times in a year
- Poor diet, only eating sweet things
- Dehydrated because she won't drink most things
- Disoriented
- Frequent falls
- 88 years old
- 1 traumatic head injury

It's tough but I think you should look into a hospice evaluation. She will qualify if they believe she has 6 months left to live. They usually can tell pretty accurately. If you go this route, you have to really embrace the idea that you are switching from a diagnostic/treatment focus to comfort care/helping her pass peacefully. Hospice does not provide caregivers or anything like that, though you might be able to get 2 weeks of in patient hospice respite care after rehab to get things in order for her to return home. The focus becomes minimizing pain/suffering and helping her in her last six months through medication.

Honestly, doctors are terrible at recommending hospice. They will push endless rehab/hospital stays, which can be traumatic and useless. They will advise treatment plans for patients with less than 6 months left to live because they are scared of having frank conversations with family members. If she is eligible for hospice, that would inform how you handle things.

Nursing homes (or rather, in your case memory care) are not some kind of panacea. When you move your loved one there, you give up care which has pros and cons. You deal with management issues, staff issues, having to stay on top of care quality, and a whole host of issues that are also exhausting. No nursing homes will 100% prevent falls, because the supervision is not 24/7. It really sucks to see the falls happen. Often times nursing homes might push for private duty on top of the monthly rate if the resident falls a lot.

[Anonymous]

Most hospice is in home nowadays. OP does not want her 2 kids to see Mom decline in health or die in the home.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Since you can’t keep her safe at home, she needs to be in a nursing home.

News flash. Safe is not necessarily the ultimate goal for the infirm. Sometimes you respect their wishes to live as they’d like and let the chips fall where they may.

This is SOOOO true.

[Anonymous]

Anonymous wrote:Most hospice is in home nowadays. OP does not want her 2 kids to see Mom decline in health or die in the home.

You can have hospice services anywhere including nursing homes and memory care. It really enhances quality of life if they are eligible and the family is on the same page (some people want treatment, heroic measures, no DNR so hospice wouldn't be for them). Once you elect hospice, Medicare covers hospice 100%, but then you agree to not pursue things like rehab, hip replacements, etc. though you can always disenroll from hospice at any time and renroll later if you want to. The hospice layers on top of the memory care and manages qualify of life oversight, extra bathing, special equipment, and medications that nursing homes won't have like Ativan and Dilaudid (In the last 6 months, terminal agitation with dementia patients can be brutal). Also the hospice provides support to families and prepares them and their loved ones to have a comfortable remainder of life.

It's tough. I hear your point about your kids but it seems like if you push your mom out it could cause a permanent rift with your sister. These things turn ugly fast. She might even turn on you and refuse to sell her portion of the home to you. Can she take FMLA and come help? She probably needs to see first hand what is going on to get on board with the nursing home.

[Anonymous]

Anonymous wrote:

Anonymous wrote:You hire help and make it work. You are living there for free, so you should do the cooking, cleaning, and updates. Who is paying utilities, insurance and taxes? The agreement was you live there and care for her. She cannot help if she's having dementia.

+1. You moved into her home and now you want to kick her out? Your sister is right--you hire 24/7 help so she can live her remaining time at home. It won't be long with her current rate of deterioration and the falls.

+2 she’s stays put and you hire help.

[Anonymous]

OP, I'm going to chime in here, as I am quite literally in the middle of a similar situation with a parent/s. I'm not commenting on the housing issue because that's not something I understand or applies to my situation.

My dad, like your mom, has had multiple falls and hospitalizations-the most recent being this past Sunday, came home late Tuesday. He was discharged home because he refused rehab, said 'I want to go home'. He cannot walk, is not continent, cannot shower and is losing weight (he has advanced Parkinsons). My mother is his POA (legally, due to cognitive decline from the parkinsons) and she went along with it!!! I've posted about them before-she got a broken hip last year caring for him and never fully recovered.

He belongs in a rehab and he needs full time care! I am POA for them if SHE is unable to make decisions-but right now I just get to get calls from case managers and oh yeah, panicked calls from Mom when he's on the floor, like on Sunday. Anyhow, he's now home, she REFUSES to get home care help and I have NO IDEA what will happen when my visiting brother leaves tomorrow and I go back to work. I'm TERRIFIED to be honest. I'm so scared he will fall or even worse, she will get hurt/fall caring for him. Then what do I do???

OP, you are right to find a safe home for her. I love it when people say 'hire help'. Have they actually TRIED to hire help? It's very difficult, and then hopefully they will actually show up. Easy for sister to say 'hire help'...she's not the one who has to handle everything when help does not come. YOu have a job and young children. I have a full time job, a young dc with sn whom I am a single parent to, and commute 2 hrs a day. What exactly am I supposed to do?

I'm sorry OP. It's so difficult. I'm heading over for Thanksgiving (I live 2 minutes away) and at least today I can keep them safe. But this stress is taking a toll on me.

[Anonymous]

Totally valid that you don't want your kids to see her decline. Sounds like it's time for you guys to move out.

[Anonymous]

Anonymous wrote:OP if I were you I would have a long talk with your sister about how Mom is doing. Here's what I have gotten from your post:

- ER 5 times in a year
- Poor diet, only eating sweet things
- Dehydrated because she won't drink most things
- Disoriented
- Frequent falls
- 88 years old
- 1 traumatic head injury

It's tough but I think you should look into a hospice evaluation. She will qualify if they believe she has 6 months left to live. They usually can tell pretty accurately. If you go this route, you have to really embrace the idea that you are switching from a diagnostic/treatment focus to comfort care/helping her pass peacefully. Hospice does not provide caregivers or anything like that, though you might be able to get 2 weeks of in patient hospice respite care after rehab to get things in order for her to return home. The focus becomes minimizing pain/suffering and helping her in her last six months through medication.

Honestly, doctors are terrible at recommending hospice. They will push endless rehab/hospital stays, which can be traumatic and useless. They will advise treatment plans for patients with less than 6 months left to live because they are scared of having frank conversations with family members. If she is eligible for hospice, that would inform how you handle things.

Nursing homes (or rather, in your case memory care) are not some kind of panacea. When you move your loved one there, you give up care which has pros and cons. You deal with management issues, staff issues, having to stay on top of care quality, and a whole host of issues that are also exhausting. No nursing homes will 100% prevent falls, because the supervision is not 24/7. It really sucks to see the falls happen. Often times nursing homes might push for private duty on top of the monthly rate if the resident falls a lot.

Be very careful with hospice. There are good programs/facilities that carry on the tradition of treating people with dignity and helping them be comfortable until natural death. Others are factories with a one size fits all program of “more morphine.” If a hospice program tells you that antibiotics are “treatment” that must be discontinued rather than a comfort measure because infection feels lousy, run.

[Anonymous]

OP it sounds like it is not (yet) your house.

If you are looking to move your mother into a facility for her own health and safety, that is one thing.

But if any of your reasoning has to do with what you want to happen in that house, you need to set that aside. You chose to live there. You can choose to leave if. It doesn’t shit your family.

[Anonymous]

Anonymous wrote:OP it sounds like it is not (yet) your house.

If you are looking to move your mother into a facility for her own health and safety, that is one thing.

But if any of your reasoning has to do with what you want to happen in that house, you need to set that aside. You chose to live there. You can choose to leave if. It doesn’t shit your family.

Umm *suit* your family. Oops!

[Anonymous]

Anonymous wrote:

Anonymous wrote:Most hospice is in home nowadays. OP does not want her 2 kids to see Mom decline in health or die in the home.

You can have hospice services anywhere including nursing homes and memory care. It really enhances quality of life if they are eligible and the family is on the same page (some people want treatment, heroic measures, no DNR so hospice wouldn't be for them). Once you elect hospice, Medicare covers hospice 100%, but then you agree to not pursue things like rehab, hip replacements, etc. though you can always disenroll from hospice at any time and renroll later if you want to. The hospice layers on top of the memory care and manages qualify of life oversight, extra bathing, special equipment, and medications that nursing homes won't have like Ativan and Dilaudid (In the last 6 months, terminal agitation with dementia patients can be brutal). Also the hospice provides support to families and prepares them and their loved ones to have a comfortable remainder of life.

It's tough. I hear your point about your kids but it seems like if you push your mom out it could cause a permanent rift with your sister. These things turn ugly fast. She might even turn on you and refuse to sell her portion of the home to you. Can she take FMLA and come help? She probably needs to see first hand what is going on to get on board with the nursing home.

Hospice is not daily care and nursing homes do give Ativan.

[Anonymous]

A nursing home is not going to be safer. They are usually short staffed. Private care at home is going to give your parent much higher quality of life. And being home is what she wants. And it sounds like it is **her home** that you are living in!

Believe me, I know that arranging home care can be hard, and it was a big adjustment for everyone, having people come into the house. But my father was incontinent and having falls, dementia, etc. and what saved us was at home caregivers during the day.

You need to at least try home care. Based on everything you’ve said, to me it seems wrong to try to get your mother in a nursing home while you live in her house.