thank you for this article. It is a horrible decision to place a loved one in a nursing home but sometimes there are no other options. My loved one(MIL) is still mobile but her dementia gets worse every day. My husband and I have to work full time and my loved one has no money except for Social security. We have no choice but to place her in a state nursing home. This makes me very nervous as I know that nursing homes do not always give the best care. Especially when the patient cant speak for themselves. Nursing homes are also short handed. We are just experiencing too many near misses with her care. We handle the meds, doctor appts, feeding, etc. She is diabetic and during the day goes to a senior center where she eats whatever she wants. she has started a small fire in the kitchen. She ahs fallen at least twice na not told us(we only realized when we saw the bruises and scrapes.) Her short tem memory doe snto exist and ling term is getting more affected every day. With all of this and knwoing we cant be home to care for her and theyrre is no money for outside help, I still feel tremdous guilt.

My wife and I are living in senior housing. I'm 93, she's 92, has Type 2 diabetes, dementia for seven years, uses hearing aids, gets around slowly with a walker. We're fortunate to have a Certified Nurses Assistant caregiver who is with my wife all day long, plus an a la carte caregiver who puts her to bed. I manage all my wife's medications. So far so good.
The memory care facilities I've seen are dumping grounds: four staff for 24 patients, for example. If I were to put my wife in memory care, the change in environment would be damaging. I'd lose control. I'd never be certain she's being taken care of properly. I couldn't do that to the love of my life for 71 years. I'd be more stressed than I am now. As long as I can hold out, that's the way it will be
My sons have power of attorney. I've told them that if I die first, keep Mom where she is today, with a caregiver, as long as possible. That's the least I can do.

My 95 year old mother has Alzheimers , I have been caring for her for over 11 years , in the past 4 months we have hired 24 hour in home care for her but she has changed so much , she won't shower , take her meds and now just yesterday she refused to go to the Doctor . I feel that it is time for her to go to a long term facility with memory care . I have tried to take care of her myself but just find that I can't do it any longer , I moved her to a house two doors down from me 11 years ago and not only her but her home and all her needs I have attended to ,I have my marriage to consider as well , my husband has been a saint through all of this .

.....DareDiffer speaks the truth. I had to remove my mother against doctors' orders from a well-rated nursing home, where she was going downhill fast for many reasons. She experienced some egregious incidents there.
.....I assembled a home-care team: Her condition improved immediately and vastly, and remained at a high level for 5 years.
....An important aside: Staff at nursing facilities and even hospitals do not know how to properly communicate with the hearing-impaired.
....They were not trained in that area; they listened to my suggestions and they saw the notes I taped to the wall, but ultimately they were too busy and distracted to go the extra mile.
...I'm told there is only one nursing home in the United States that specializes in deaf patients.

Lovely article, well written but what a glossy view of nursing homes.
The reality is broken equipment not fixed, in-suffice staff for care needs. Nurses who want an easy life and ignore the obvious, and a disregard of true quality of life.

There was a coroner investigation after my father’s death - his life had been shortened as a result of numerous falls in the nursing home and being forced to walk with a broken hip for 14 days despite my complaints and requests for urgent medical intervention which they ignored.

They were more interested in events than damage to dad’s walker meaning he was immobile. I got one from the Red Cross when they could have easily have got a replacement from one of their other nursing homes.

Christmas he wasn't allowed to join join in festivities and one person commented it wasn’t nice seeing him in pain. To which I replied “but it’s ok to leave him alone in his room in pain and walk past then?” To which they had to concede I had a point!

I wish i had never put him in there . I wish my sister had not refused her consent so I couldn’t remove him. I visited a lot of nursing homes - they all had severe issues behind the scenes. One lady who worked in one contacted me to say she had left in tears as management felt paperwork was more important than a paying resident who had fallen.

I was lulled into a false false sense of security with the new build nursing home - which initially seemed to tick all the boxes - till after the one month honeymoon phase and thus gaining my sisters signature too, meaning it needed both to agree to remove him.

I pray I die at home - I never want to be subjected to the horrors I witnessed at numerous nursing homes in the name of care.

Mr. Phelps, your article was so well written and helpful. I'd like to express my gratitude for all the help you give to patients and caregivers by sharing your experiences.

Thank you, Mr Phelps...

As my health declines, my stress increases as I determine to care for my hubby with a little more than mild dementia. I've joined a support group recently and will learn what decisions have to be made... and learn with helps are available for us.

My husband has Parkinson’s physcosis which has him seeing people and things that aren’t there. Need advice and help.

Thank you Rick; you make some excellent points. But I think I'm going to give up on placing my 94-year-old father with early stage AD in a memory care facility. He is adamantly opposed to leaving his home and going to MC, even though I've taken him to the best of the best to observe and have lunch. The thing is, due to frugal living and wise investing, he has enough funds to pay for 24-hour in-home care for 8 years. Since it's unlikely he'll live past age 102, I think I'll grant his wish to remain at home. And I might attribute his stubbornness to the disease, except in his will and trust he repeatedly says that he wants to stay at home until he dies. After all, it is his hard-earned money so I guess he should be able to spend it as he wishes. He currently has care 6 hours daily, increasing the hours as he shows the need.

If your senior would be considered low income, they can apply for Medicaid (in California-Medi-Cal). They pay for long term care. There are financial restrictions.
Medicare does not pay just for custodial care but if the senior has medical needs, that is usually covered until they recover.

What happens when the senior doesn't have enough financial resources to pay for memory care?

My strong suggestion is to get a lawyer/attorney to write up a Power of Attorney and take your parent to him/her to get it signed and make you the person to take care of your parent and make sure you are doing this in the correct state as some are very sensitive to this. I had to move parent to different state and required another Power of Attorney and hustled to get my parent into memory as he travel with others and walked off in the woods and wasn't found for a day. So within three and great awareness of what was necessary, I got him to a memory care facility one of three that He visited months early in the month. The most challenging event was getting a Doctor in another state to do a Physical to the Memory Care Sheet and pull all this together in another state as well. It was a gift to get it all done in three days!!

Have contacted several facilities - all charge at least #3000 per month.
My son's income is $1009 per month. We simply do not have funds to
meet these expenses. Suggestions appreciated.

Wow. What a provocative article. I am struggling with this decision now as my 84 yr old mom refuses to let me bring in outside help. Her physical and mental state has greatly declined in the past year. From scheduled visits a couple of times a week to take care of laundry, grocery shopping and house cleaning has now become an almost everyday occurrence where she needs something or has some type of issue.

I have two siblings that live within a 150 miles and are no help at all - not even an offer, but are quick to say they don’t want mom in a nursing home. They don’t even visit anymore but the one brother always wants me to bring her to visit him (he doesn’t have reliable transportation).

Since Medicare will not pay for nursing home care unless medically necesssary, I am now looking into getting her qualified for Medicaid and an assessment of her needs. It’s not a decision I look forward to as my mom has already said she will not go to a nursing home. However, I sincerely believe she would benefit from the social interaction.

Rick, You said, "Sometimes placement in a facility is best for both the caregiver and the loved one’s overall health and wellbeing."
Thank you for removing the guilt of not being able to care for your loved one at home anymore. Sometimes we just "need permission" from someone else to do what we know is the best for our family member and ourselves.

I really felt bad after we brought my 94 yo (stage 6-7) mom home with us from a memory care facility. We were 'unraveling' day by day. Both of us have back issues, hubby has an umbilical hernia and I just had female reconstructive/repair surgery. Neither of us should have been lifting and repositioning her. Aside from the physical demands, dealing with the 'mental' aspect was overwhelming. We both thought we were loosing our minds when we explained things 30+ times a day, listened to her screaming at the top of her lungs and walked around like zombies from lack of sleep because they have their nights and days reversed. We finally had to look for another memory care facility and place her before we were put in a mental institution!

Thanks for giving us the freedom to live our lives and know that mom is being taken care of better than what we worn out family members could do.
God bless you and yours on your journey ahead.

I can’t believe how “on point” this article was for me today. I’ve been beating myself up for over 5 months!!! Thank you so much, Mr Phelps.... This entire article was written just for me (lol)...

I can’t believe how “on point” this article was for me today. I’ve been beating myself up for over 5 months!!! Thank you so much, Mr Phelps.... This entire article was written just for me (lol)...

Thanks for the great advice, Ren

Excellent advice. Gives me something to seriously think about. Thanks, Ren

I placed my mom in a memory care facility on Oct. 12, 2015. I was a nervous wreck in the weeks before, but I knew what I had to do.
I realized my mom had "memory problems" in early 2013 and she was tested for dementia on my insistence. She was very upset with the results and pretty much ignored/denied her condition. When I visited her at Christmas that year, I could see that the dementia had progressed. I left after 3 days to find a place for her nearer me. I found a non-assisted senior apt. residence with 3 meals a day, transportation, maid service, etc. within her budget. I visited many times a week and took care of everything but recently her dementia had worsened. She was hiding things, saying people "stole" them, getting up at 4 am and going down to sit in the dining room waiting for breakfast (served at 8 am!), etc.
She would NOT entertain the thought of moving to assisted living, or living with my husband and me. She was in total denial that she needed help. She became mean and hateful with me.
I would lay awake for hours at night, wondering if she would start wandering, winding up outside at night in the street. The defining moment was when I could smell body odor and she would keep the same clothes on for days.

I had to trick her (with an imaginary trip to the "doctor") to get her in the home. I was able to spend the first night with her. The next night, back at home, was the first time I could relax in my bed and be certain that she wouldn't do anything to harm herself or others. I slept like a rock.
The adjustment in the facility was a bit rough. She took to urinating on the floor or in the trash can. The caregivers told me that this is "normal" when a dementia patient is first placed. They said it would stop in a month or two, when she settles in. It's been 2 months and the problem is much better but she still has "accidents". Because the facility is 25 minutes away and my husband and I both work, we can only visit on Sundays (our only day off together).
Thank God she is much calmer than the first couple of weeks, when she attacked me. How difficult to watch the mental decline, being asked what my name is, repeating answers 5-10 times, etc. She is more calm now and accepts that she needs to be there. She'll even say, "Damn this dementia and old age!" She now says she hopes she dies soon (she's 3 weeks from her 93rd birthday).
I never told her that she wouldn't go to a facility, we just never talked about it. I didn't want to have to do it but it was the only option. I'm glad she's safe and I can relax.
I'm the only child. I should have taken the time, WHILE she lived in the senior apts., to check out dementia facilities. I had to make a snap decision, due to her growing confusion. It was really hard to take time off work to go running around and spend lots of time on the phone with social workers and senior placement specialists. It turned out that she couldn't afford even the cheapest memory care (board and care) in California starting at $3,300/month but she didn't qualify for V.A., Medi-Cal or Medicare assistance either. Thank God there are quality (and much lower cost) care facilities in Mexico that her Social Security will cover. So far, so good.

This was a very helpful article! Thank you! My brother and I r currently struggling with coming to terms with placing our Mom in a facility. I live out of state (2 hours away) and my brother is on the front battle lines! It is a disaster! My guilt is endless. The stress is wearing my brother out. We are going to move forward! Thank you again!

Thank you, HelpingHelen! We will send good thoughts and prayers each other's way!

Dear TSM1013. Yesterday was also my mom's first day and night in ALF memory care. I can totally relate to everything you just posted. My mom was also ok, but then quickly became confused. I too have anxiety and sleepless nights. I want to be her daughter again. I no longer want her seeing me frustated or tired with her every need being met. I will remember you this week. I guess we must stay strong and positive thru this. Thanks for posting.

Today is the day. Mom is moving into memory care. In order not to cause weeks of undue stress, we had to wait till yesterday to tell her. She saw her room(which I have already partially prepared with lots of her familiar items), walked around the facility(which she had been to before for lunch but doesnt remember) and spoke with the staff. She was perfectly fine and said she was ok with the move. Then she got home and said she is not moving to that nursing home(it is AL and MC in a beautiful facility, in no way a nursing home), ranted about it for a while then completely forgot she had even been there. I have no idea how today will pan out...I am hoping for the best, preparing for the worst. But I do know that I have to recapture my life and my joy....the caregiving has just gotten to be too much and she was a danger to herself and possibly others unintentionally. I hardly recognize myself in the mirror anymore and want to be back 100% for my kids and hubby. I also want to renew the friendship I have always had with my mom which has somewhat dissolved under the strain of caring for her...I want to enjoy her again and look forward to visiting with her instead of feeling the resentment that was becoming all too familiar. My stomach is a mess worrying about how the next few weeks will go...and like someone else posted, I think the stress leads to many physical problems, one of them being cancer. I do not want to travel that path. Please pray for peace and contentment for Mom and faith and peace for me. Thank you.

Sorry for typos above.

Thank you for your post. Ladt nigjt was the first night my mom spent in ALF. I woke up wirh both feelings of guilt, but also hope to once again be the daughter again. Thank you again.

Thank you for sharing this with us. I really needed to hear this because I am in the process of trying to get guardianship of my mom or try to see if she can be placed in a group home. She is currently living with her oldest daughter who has been abusive to my mom verbally,mentally, mentally and at one time physically. There's alot more to that but my main concern was her safety and being able to be with all her children so ahe could be happy in this last stage of her life. It kills me to see her sad or crying because she being controlled. I told my mom I would be there every other day so she doesn't feel lonely or like she's being disposed of. I would love for to come and stay with me and she qualifies to have a nurse 5 days a week plus I have a medical background. I'm not that crazy to believe that I won't need help because it's only going to get more difficult. My mom should be our priority. This is her time to be cared for and catered to. She did it for us and now it's her turn. That should be a given. I did and at times still do struggle with the question "am I doing what's best for my mom" but in my heart I know I am. It doesn't make it any easier no matter what I do but I know for a fact that's not safe for her at my sisters because she's on vicodin and morphine 24 hours a day and her daughter has seizures so one sleeps most of the and the other one is confused when she comes out of her seizures. I want to see her smile again and hear her laugh and know that she's being cared for properly. I don't think that's too much to ask for.

the best I've ever read on this topic.

I had a nice long answer for you, but it got wiped out somehow. Long story short, my husband and I have been caregivers for first my mother with Alzheimer's, now my father who lives alone in their enormous house at age 87. Daddy expects several phone call every day, we just sent our youngest off to college at University of Oregon and quite frankly we love to visit her. That civil war game yesterday was epic!! It's so rare that we get to have fun anymore, but that's about to change. We are in our early 50's I have had cancer twice, yes I believe partly caused by the stress of caregiving, my husband had a heart attack a year ago, absolutely caused by the stress my father was placing on him. He had no blockages. The doctor said put the phone down or plan your funeral, so we are retiring, and we want to retire from caregiving as well. We both feel constant guilt and anxiety, mostly caused by the cruel comments my father makes such as I know where I stand in the hierarchy of things when we tell him we're going to Oregon to help our daughter with a car problem, etc he seems to be jealous of anything we do for her or for each other. Daddy constantly plans new projects. He wants my husband to be the overseer for everything. When things around the house don't need fixing, he will decide he needs elective surgery of some sort. The last tear duct surgery he decided he needed landed him in the emergency room and I'm sure everyone reading knows who had to go through all of that stress with him. My husband 3 months after his heart attack. This is literally going to kill us. Don't let yourself get to that point. We are worried that we have missed the window in our lives where we have enough energy to enjoy our ultimate dream of building a log home on the river in Oregon. We are so exhausted from the 5- 10 phone calls a day, the rude demeaning comments. My husband looked at me yesterday and said when is our life going to be ours? My husband left his parents at age 17 and joined the Marine Corps. Having to deal with my parents was new for him, having to answer for every move he makes suddenly. Where are you when are you coming over? Where are you right now? Why are you wasting your time spending it with your wife? You're just going to get bored with her... These are things he actually says. I'm telling you this site will be your best friend in your decision process. Remember what everybody says about what's best for your parent...a professional caregiver will not take rude comments to heart. Your loved one will get the best of care and you will get to keep your sanity. People can think what they want, but I have noted that the posts from actual caregivers who have gotten their hands dirty over the years are extremely supportive of our decision to move to Oregon from California. Daddy can have a nurse in home or he can go to assisted living. He flatly refuses both, so we have begun the painful weaning process... We do not pick up the phone everytime he calls. We tried Life Alert, and after hours of phone calls and having everything installed perfectly in his home he simply called us and said get rid of it all. Since then he has tripped and fallen and was unable to get up. My 94 year old uncle from across the street had to pull him off the floor. Of course my father is extremely rude to his brothers just like he is to us. He is running out of people to abuse, but he deserves care so we will provide that for him... It just won't be us. I know you're worried but your loved one ...if they suffer from dementia...will not know if its you or the man on the moon giving them care. Give yourself a break and let yourself off the hook while you still have a chance at a life of your own. I wish you all the best and please go easy on yourself. You are the only one you are hurting by feeling guilty and worry is non productive. In the end what will be will be, and you know you have done everything you can. You can rest easy, put the phone away, and go on with your life. Take good care and stay the course. Things will be much more happy in times to come.
I would like to say things are already better for us, but look for my posts around Christmas time when we will be moving into the guest cabin on the property we purchased right on the river in Oregon. A piece of sheer heaven where cell phones do not work. We can't wait. Daddy won't know the difference, and of course we will go visit.