Decisions, decisions.

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My mother had a massive stroke May 9th and we're on day 65 of rehab after a hospital stay. My father had a stroke 10 years ago and needs help with personal care. They live in VA. I live in OH. I've been in VA the entire time, staying with my father and helping him and staying with my mother during most of the day. My mother is paralyzed on her left side, can't sit without help, can be transferred from chair to chair and is just now getting used to using the toilet again. We are planning on moving them to a small assisted living facility facility near us in OH. I tried everything I could think of to find workers to come to my home to care for them but it was impossible. Place after place, person after person didn't come through. I'm not sure if they will take my mother. We have 35 more days, only about 26 of those will be therapy. I don't know what I will do if she can't go to assisted living. In the meantime, I have them both to care for,(even though I don't care for every need, they are always waiting anxiously for me and have many things they wish me to do for them, including laundry, cleaning, handling finances and medical things) their house to pack up and try to sell, medical and financial things to transfer and get in place. And I have a family still at home. The stress for me has been awful, but my 15 year old daughter now weighs 98 pounds, most probably from the stress of the last 3 months. I don't see a light at the end of the tunnel when they move because it will mean handling many things for them (a 45 min drive from my home) and constant stress for my daughter.
Just feeling at the end of a frayed rope and knowing it's probably not going to get any better.


Do they want to move closer to you? It sounds like mom will need a nursing home. Dad? What sort of assistance does he need? Assisted sounds like it will work for him, but I wouldn't expect him to become mom's caregiver without a significant amount of help. Howold are they?
I don't really see that they have a choice about moving closer since I don't want them to be 4 hours from me in the care of others. Originally, we were all planning on them moving into my house with helpers. I need 6-8 people to do shifts. I couldn't even find one person i could trust to be in my home. I even spoke with the teacher of the cna class at the local career center who said she really couldn't recommend any of her students because they wouldnt even show up consistently for class. My father can't be anyone's caretaker because he has to have help with toileting, bathing, and dressing. His right arm is paralyzed from his stroke and he walks (very unsteadily) with a cane. He's 82 and my mother is 77. Even though my mother has had a severe stroke, she is cognitively fine (mostly), which means she understands everything thats going on and knows how bad things are.
Why are you thinking AL and not nursing home?
Have you had a professional observe them and conduct an assessment of what their needs are? The professional assessment would provide you with information, so you will be able to find the right level of care for them. Then, you can tour the type of facility they need and confirm that it will meet their needs.

Please keep hope, because one they are settled in to a place where they can get proper care, the stress on you should diminish. Yes, there is always the responsibility you have as their adult child. You are still responsible for making decisions and ensuring they have what they need, but, it's not as intensive. It took me a couple of months to adjust. It really is like recovering from a trauma. Be kind to yourself and learn to allow others to help. I hope it works out well for you all.
You may discover after a needs assessment that a nursing home would be a better fit for your parents. The silver lining in this is, in addition to getting a higher level of care - if they are eligible for Medicaid, a nursing home will be paid for. Often assisted living is a self pay deal. Also, assisted living is rarely all that assisted. How it usually works is that there is a flat fee for the apartment and then services such as help toileting and dressing come off a sort of alacarte menu and you are changed separately for every little thing. Additionally, if either parent "wanders" or is prone to falling, you will be asked to move the parent out. I think that for an elder with minimal needs AL is the nicer choice and the alacarte menu works in their favor as they aren't paying for serviced they don't need - yet. But if your loved one has moderate to significant needs, it can be a frustrating pit stop. My mother had been living in Independent Living with a part time caregiver when she had a fall that resulted in a brief hospital stay and three weeks in rehab. When we had moms discharge meeting the rehab people told me and my brother that mom needed 24/7 care. We had a hard time believing them as it was too much of a jump - she was doing fine in IL, right? Well, not so much as both mom and her caregiver were hiding things from me. But that's really beside the point - here we had a group of professionals who worked with mom and observed her for three weeks round the clock. My brother and I were only getting a "show-time" for a couple of hours a few times a week. Also, I thought my mom deserved the chance to make it in the least restrictive environment. Mom lasted ten days before I was told we needed to find a new place for her as AL could not meet her needs level. If we had moved mom into a NH directly from rehab - she wouldn't have liked it but I highly doubt it would have become the nightmare it did, moving her from AL. While a nursing home placement can be a bitter pill to swallow- at least they get help swallowing it without a large add-on fee. So - listen to what the "team" - hate that word in this type of senerio - but, listen to what they recommend and follow it. I wish we had as it would have save me two of the most difficult and trying months of my life. As you look for facilities for your parents, do yourself a favor and get a few NHs lined up as possibilities. At a minimum find an AL facility that has a step NH facility when your parents could be easily moved if AL doesn't work out. Try not to let old fashioned stereotypes of NHs freak you out - sure, there are still some hellish ones around but these days there are also some beautiful ones with a more progressive way of doing things. The NH my mom is in is beautiful - actually nicer than her AL facility, with our only insurmountable situation being the NH wouldn't allow moms cat. Best of luck to you - I'm afraid you've got a bumpy ride ahead - buckle up!
tonya you did not mention if you tried a local home care agency? They work pretty well for some people who want to keep thier elders at home.. BUT they may cost more than NH in the long run if you need them 24-7. At least they cover if someone is unable to show up!
Tonya I feel the best solution would be to move Mom and Dad to a nursing home close to where you live. it would be an insurmountable to task to have them in your home given the stress you have experience so far and clearly your daughter needs your support too. You do not mention a husband are you a single Mom? If you are married is hubby in agreement with the possibility of having them in you home and you not being able to give him any attention.
Assisted living does not sound as though it is the right solution as neither can look after the other but a shared room in a nursing home close to you could work well. Good luck with whatever you choose just remember to take care of yourself.

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