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[quote=Anonymous][quote=Anonymous]Would love the board’s thoughts on a difficult situation that my family is facing.

My mother is 88 and for the last several years her mobility has progressively worsened and she is now showing signs of dementia.

My family (husband and 2 boys, ages 6 and 2) live with her - we have been here since July 2020.  We were living in another part of the country and moved back in with her when we returned to the area.  Even then, her health was not great and we didn’t think she ought to be alone, certainly not during the first months of the pandemic.  We expected this move to be temporary, but ultimately decided to stay here and have refurbished/updated the house to make it more family-friendly.  And since our arrival, Mom has not had to lift a finger.  Everyone has been happy although living with an 88 year old and two small kids has not been without its challenges.

Fast forward to today - Mom is not doing well.  Her first hip replacement took place in 2015 and the second in January of this year.  She has progressed from walking with a cane to now using a walker, and falls often in the house.  We’ve woken up in the middle of the night several times to find her on the living room floor.  She no longer can consistently remember how to use the television, phone, check her email etc.  She does not feel comfortable showering without assistance.  She stopped driving a few years ago.  (FWIW, my dad passed away in 2006 so only need to focus on Mom)

Despite our best efforts, her diet is terrible - does not cook anymore.  She does not eat very much at meal time, but still likes to snack on sweets throughout the day. She prefers to drink tea and Pepsi (her beverages of choice) - and as a result is not well-hydrated and generally not very energetic.

As this year has progressed, she has been increasingly disoriented, which exacerbates her already being unsteady on her feet.  She was never a great sleeper, and being tired only makes everything even worse.

Over the last year she has been to the hospital 5 times.  Three of these were trips to the ER in ambulances coming to the house - in September she fell in the bathroom and hit her head on the sink (bleeding all over and requiring stitches), and in October she (not her fault) also spent a week in the hospital because she caught COVID.

Earlier this month she fell in the driveway and hit her head on the sidewalk.  They feared a hemorrhage but it “only” was a concussion.  After a week in the hospital, she went to a rehab center - and on the first night, tried to get out of bed and fell once again, only to be brought back to the ER first thing in the morning.  She has virtually no recollection of any of this.

The doctors have said any of these situations could have been fatal.

We now know she needs constant supervision.  However all Mom wants to do is “go home”.  My sister thinks we should honor her wishes and hire 24-7 care for Mom at home, while my view is that bringing her back here solves nothing - and that she needs to be in a nursing home.  DH and I don’t like the idea of random helpers coming and going at all hours, nor having them around the house during the day when nobody is home - or even being here when we are home, as we don’t have a bedroom to spare.  (DH works, I recently started a new job after being SAHM for 6 years, and kids are at school/daycare all day). We don’t want our children to be witnesses to the decline of their grandmother day in and day out.

Mom gets a pension check totaling about $4500 per month. My family could pay ~$2000 a month as well.  So I am hopeful we could find something that is suitable and comfortable for her.  (My sister and her husband are not high earners, and have already told us that they cannot help defray any of the costs.)

I will listen to sister’s input (we generally have a good relationship) but I do not feel it is really her decision to make - The burden for having Mom back home here falls 100% on to me and my family.  Sister does not live here, and furthermore DH and I will be paying.  Mom will not like this decision, but I strongly feel she is at the stage now where she needs to be in a nursing home.

Hope this all makes sense and thanks for reading if you have made it this far.

WWYD? [/quote]

Typically with caregivers you don't get random helpers. We have a core of women. They really are top tier. One is close to getting her RN Degree, one is getting her masters degree in social work, one just graduated with her mortuary degree (she has been working on this for 3 years), one is a new Mom, and two caregivers are close to 70. All are CNAs. Most have extensive Assisted Living and Nursing home experience.

We have never had any theft in 15 years of caregivers but we are in rural Maryland where people have old school values.

At your level of care I'd recommend CNA's only.  Ideally you get CNA's with a lot of Assisted Living experience and also Nursing home experience.  Many unskilled women are called home housekeeping aids. Avoid them.

Does Mom have her own room? Can't you put two comfy chairs in their and a tv in Mom's room so if you have someone in 3 or 4 hours on Saturdays then Mom and caregiver can hang out in Mom's room while the family is home.

We don't have people coming and going at all hours. In your situation you could probably get by with 8-4 or 9-5 M-F.
Give standard shifts. Have the same people on their designated days.

We started with 4 hours per day M-F fifteen years ago and 0 hours on the weekend.  Very slowly we built up to more hours.
Now we run 12 hour shifts but Mom is now bedbound.

Three of our caregivers have been with us over 10 years. We pay well and treat them well. They all get the WiFi code on the first day. Many are in college so do their studies on line.  If Mom is napping caregivers are allowed to nap. Almost all of our caregivers work 2 jobs. Some work 3 jobs. Three have bought their first homes since working for us having clawed their way out of section 8 rentals.

Decline of family members is a part of life.  It has only been around the last 40 years ago that seniors in America got shuttled off to nursing homes.  In much of the world elders are cared for in their homes.[/quote]

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