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My mother-in law is 92 years old and still lives at home. She has a caregiver come 2 days a week for 4 hours and receives meals on wheels two days a week. She is unsteady on her feet but can take care of herself. She needs extra help though because normal tasks are becoming harder for her to accomplish. Do we look into 24 hour home healthcare or assisted living?

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What are the normal tasks that are becoming harder for your Mom to accomplish?
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If she is agreeable, assited living would work well for her. She would be around people and activities. It sounds like she can hang on with the current arrangement but I would start discussing the possibility of AL with her. Check out the places in your area and take her for a visit. Many of these places are ver nice and not at all like the horrible nursing homes that older folks remember from days gone by.
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I have been a caregiver at home for elderly / disabled people. We were of opinion that people should be kept at home as long as possible and only to consider placing him/her in a nursing home when he/she was a danger to herself or others. Most people really want to stay at home and die in their own bed. If some additional assistance at home, and may be some more meals brought at home, she would be perfectly happy. There is special equipment you can buy and that she can use because she is not very steady on her feet. During my career I have seen many people die within 6 to 12 months after being placed at a nursing home.
I would discuss the matter with her doctor, the people coming at home now to help her, and certainly not forget to talk about it with HER. As long as she has no dementia of any kind, it is very wrong to take any decision without having discussed it with her. It is HER life. And as long as there is no danger, she has the right to out her opinion. Greetings
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In my opinion if the elder moved to independent living/assisted living sooner than later they can still bond with the other residents.... develop new friendships... eat breakfast, lunch, dinner in the common dining room with a whole bunch of people... and enjoy planned activities.

Sheba, dying at home?... not me... otherwise that room which was a nice bedroom will forever be known as the room that Aunt Terry had died in. I want to be remembered for my life, not the day I died.
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A key thing to consider in this decision, your MIL's finances. The more care she receives the more expensive it is! But, it seems like you are considering 2 options that are quite far apart. She currently has assistance 8 hours a week and the only alternative is a live in or a move to assisted living (AL)? While I agree that the 'right' AL will provide activities and company, she may not be ready for that. Do you and your spouse live nearby? Are you checking in on her? How do things look?? I had a friend who went from a caregiver for 2 hours a day to live in but the development of increased care took over 3 years. The caregiver may be providing shower and dressing help. A (lower cost) companion might help with simple meal prep, laundry, getting into bed, etc. Truly, you need to assess where she is and what she needs. Depending upon the area she lives in, you may get a 'stay at home' Mom to drop by for an hour. It normally wouldn't be worth it for someone to travel for an hour's work but for a neighbor with children, it could be some pin money. At her current age, the needs may change rapidly so you have to be on top of things. Hope this helps.
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To freqflyer : have you been working in the elderly care sector ? I did. And although people sometimes needed a lot a care, sometimes 5 x 4 hours a week, and children or volunteers during the weekend, people who have lived 50 / 60 years in the same house, with the same neighbours etc.. are not at all happy with the idea of leaving it all behind. On the contrary. And if my memory is good, I advised to talk with her mother. Some people never are ready to leave their BELOVED HOME where they raised their children, lived the best moments of their live and now mingle with other elderly people who they don't know, and don't care about.
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My mother is Asisted Living and i am considering renting her a condo near mine with a caretker. She gets very little personl attention, is seriously dehydrated and no one there seems to know when she has a urinary tract infections except me - as the nurses assume all people are constantly confused . The only thing jat keeps me from moving her is that she realy loves her apartment, and her morning breakfast friends s well as the fabulous decor. it's a tough call..But I have to say while all the kids of residents in assisted living hve a wonderful fantasy that their 85 plus year ld parent will make wonderful friends - it is rare. The ONLY close friends in my mothers high end afcility re four omen who have lived in the city their entire life,bleonged to the same clubs and have been frinds since their twenties.
Making new friends is a tall order. the bst you can hope for is that they find one or two friends to eat with regularly.
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As someone who has gone through this with my own mom, I think the one thing that folks are neglecting to mention is maintaining the home that your elderly parent is living in and whether it is safe for them to be alone there. Trying to keep my mom safe and healthy was difficult. But trying to maintain HER home AND mine was very difficult. Now my 90 year old mother-in-law is in the same situation and she is refusing to try assisted living and cannot afford 24/7 care(which has been recommended by the rehab facility). Her house is in need of many repairs and modifications. In light of this, she has persuaded(guilted) her 75 year old widowed sister to care for her.
Based on my experience, I think it is much easier to make the move for an elderly parent BEFORE it becomes unsafe for them. My mom has adjusted to her place and now accepts the fact that it was best for everyone involved. She understand that we were concerned for her safety and health, first and foremost.
My suggestion is to make the move to an independent or assisted living facility sooner than later. Do your research on the facility and make certain that it has a good rating. Find out about whether or not your parent can "age in place" so that they do not have to be moved again. And, maybe most importantly, get to know the staff and be a regular visitor. Your responsibility becomes one of advocate for your parent. When the staff know you are actively involved and understand your reasons for the move, they are helpful and kind.
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JBB, you are so right... it is impossible to try to maintain one's elderly parents home and try to maintain your own. How I wished my parents [now in their mid-90's] would have moved to a retirement community. There is no way I could clean my house, then go over and clean my parents house, so I don't... I can't at my age.

The stress of my parents living in that 3 story house is unbelievable... every time the phone rings and it's their Caller ID, I fear the worse. I know it is their choice since they both are of clear mind [not sure about common sense any more].

I know I am eying the retirement village down the road for myself, in the next couple of years, if not sooner :)
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