Feelings of guilt, stress, anxiety, depression, etc. about placing Mom in a nursing home because she needs 24/7 care.

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I have been a caregiver to my mother for the last 5 years while she lived on her own. Her health began to decline rapidly in the last year and requires more care medically and physically. She fell recently due to a medicine she took that made her unstable. She was in the hospital for a week and now in rehab in a nursing home facility. She has stage 4 emphysema and congestive heart failure and was not thought to make it this long but she is a fighter. She is on oxygen 24/7 and that is what is keeping her alive basically. Without it her oxygen drops down to the 60s and 70s. Just talking sometimes causes her distress. My brothers and I feel she is safer in a nursing home setting because she is getting all the proper treatment she needs and is not smoking. Yes, she smoked a pack or more a day until she went into the hospital and just started hospice before she fell. Her mind is still good but her body is failing. I have thought long and hard about her coming to live with me and my family but I don't think it will work without major construction to our house and her needing round the clock care. She wants to go home but it is not safe. For the first time I feel some sense of peace that she is receiving the proper care she needs medically and physically but we do not have the power to keep her there. I am only 10 minutes from the nursing home and her apartment where she lives before she fell. I have been visiting her 5 or 6 days a week for 3 or 4 hours a day. I cry a lot because I don't know how I am going to cope if she comes home and I am torn about placing her in a nursing home even though I have gotten to know the place and It seems they take good care of the residents. Women especially are supposed to be everything all at once right, wife, mother, daughter, daughter in law, sister, sister in law, friend, organizer, planner, housekeeper, cook, etc. and we are supposed to balance it all and be happy. But, when you cannot be all that to the fullest we crash and I guess that is where I am right now. Sorry for the rambling. I guess I needed to vent.

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You have to take care of yourself first! By not doing so, you allow yourself to become less of a person. Women are suppose to have a balanced life and that balance is to include our own needs and desires.

You have taken care of Mom for 5 years and you recognize she needs 24/7 care....let the professionals take care of her now and stop trying to be the super woman who goes to an early grave! Your husband and kiddos may want to have you around for a few more years.
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Tommy1, I am so sorry you are going through this. I understand the portion where it is so hard to deal with the smoking addiction, and it is darned hard to overcome. My grandfather has been in a nursing home for three months and STILL drives me crazy to sign him out and take him to someplace where he can smoke a cigarette. It isn't even a habit or addiction anymore, it is just something he does because he wants to. It drives me mad.

Ask yourself though, if your mom won't have 24/7 supervision (not just a nurse in the living room of the apartment while she is in the bedroom, but supervision like a toddler needs)... who will stop her from smoking while her oxygen is running? My grandfather tried to hide in a bathroom at the hospital and smoke a cigarette once as if NOBODY would notice the smell, all because that hospital was a tobacco free campus and he couldn't even be wheeled outside to smoke after his heart valve needed replaced. Your mom may take to hiding to smoke and if she does so with her oxygen it could be disastrous.

Believe it or not, the people we care for are not the only ones that have to transition to this new dynamic where their care is not provided by you. YOU needed time to transition away from being her caregiver, and it is solid advice that you have received to start cutting back on the time spent visiting. It helps both you and your mom.

If she gets out and can be sent home, it can be much more difficult to get her placed back in quickly if you need to and you will start all over with the guilt and she will start all over with transitioning as well. It is a torturous place to be where you are with the guilt and conflict in your head, but the thing with older folks is that they aren't really getting much better from one day to the next as they are just getting older and more unwell (and even more so if she is smoking again). The nursing home will provide her with the correct medicines at the correct times and prevent her smoking, this could actually extent the time she has here on Earth for you to visit with her.

It will get stickier however if she is still considered competent to make her own health decisions and says she wants to go home and not stay in the nursing home. Being a caregiver for a parent is so much harder than the care that parent gave to us growing up, because they don't have to respect our authority at all and we had to respect theirs when they were raising us. When they knew what was best for us and we didn't want to comply, we still had to do what they said. Now that you know what is best for your mom and she will not want to comply with it, you won't really have any authority to make her do it. Such a crappy dynamic.

I know that it didn't comfort me much in the beginning when my grandfather needed placed, but everyone said that time would make it easier and it has for me and for him.

I truly hope you get some peace in all of this. If nothing else, cut back on the visits to help you get past your burn out in preparation for how much more work and strain it is going to be if she is going to fight to come home. Take care of yourself so you can be there for those boys of yours!
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Tommy1, you also need to think about what if those services cannot come out to your Mom's house for one reason or another? Like winter... power outages... ice storms, thus no meals on wheels... Caregiver is home sick.... etc. At least in a nursing home you don't need to worry about such things.

With a nursing home, your Mom can develop new friendships instead of sitting at home waiting for whomever is to show up, if at all. I wouldn't be surprised if you start up going over daily to be with your Mom, and eventually needing to sleep over, etc.
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My mom wanted to return to AL, but we knew she needed more care. We pulled her medical team (doc, cardio, OT, PT) together and asked for their assessment. They determined she had to have the 24/7 care and assistance of NH. Can you talk with her doctor about the safety of her returning to living alone?
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Thank you everyone for your feedback. I've listed all those things a woman needs/wants or is to be because I am all of them. I am only 45 and my mom is 72. I have two wonderful teenage boys and an unbelievably understanding husband. I stopped working when I had my first son and never looked back and I'm great full for having that opportunity to watch them grow everyday. I would have liked to go back to work but I needed to be there to help my mom. I do her cleaning, food shopping, laundry, take out trash, get her mail because she couldn't breathe. She has been in rehab for five weeks and so she has not had a cigarette in six weeks. We think she wants to go home so she can smoke again because she says she wants to try it. If she does go home I will make sure I have all the services she needs in place. I know I need to cut down my visits because now she expects me to be there all the time. I have to laugh (and thank you I needed that) at MaggieMarshall's comment about moving in because the front desk knows me when they see me, some of the residents know me and ask me for help sometimes or when we sit outside they come and talk with us and I don't mind its nice. Again, If she does come home, I know I will have to set a schedule and limit my time with her as well but it will be hard.
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Tommy, Gee where do I start? When you listed all the things a woman needs to be, you forgot nurse. But nursing homes have 3 shifts of nursing staff. After 8 hours, fresh staff take over. I can't begin to tell you how hard caring for someone 24/7 is. You need to convey to the discharge planner that mom won't have someone 24/7. If she needs this much care, they may not want to discharge her. Also, Maggie is right. You need to back off from all the visits to the NH. You are running yourself ragged. Know that if mom returns home, she needs to realize you can't be there all the time. Call your county health department, senior services to see if a case manager can do an assessment on her to see if she qualifies for services. Get going. You need to get your ducks in a row now. Don't wait until the day they want to discharge her.
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Tommy I cared for my mother in her home (parkinsons, strokes and dementia) for four years. Eventually, with increasing falls, incontinence, trips to the ER, calling ambulances and stays in hospital,it was clear that I couldn't manage alone 24/7. She's been in a nursing home now for almost two years.

At this point she's unable to sit up or stand and mostly sleeps. She's in no pain, just basically fading away. According to the doctor it's just a matter of time. Unfortunately she was one of those women who should never have had a child and we were never close. In fact I spent a lifetime avoiding her if possible. The nursing home is small, family owned and run and the staff are wonderful. I've done my duty and I have no regrets.
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I'll tell you what's true, Tommy 1. I don't know how long you've been visiting mom 5 or 6 days a week for 3-4 hours a day, but I'm assuming it's been at least 2 weeks, and that will burn out ANYONE.

I know. I did that for 2-1/2 months while mom was in a nursing home for rehab. Except I was there 7 days a week for at least two hours. I was completely burned out. I look back on it now and wonder why on EARTH I did that. Why??

You're right, you don't have the power to keep her there. But promise yourself that you're going to back off a little. My Lord! If she stays in the nursing home, you might as well move in! Starting today, cut those visits down to twice a week for an hour. In most rehab settings, there's plenty of socializing. Give her a chance to bloom where she's planted!

In the meantime, talk to the Admissions Coordinator at the nursing home and see what would need to be done to admit her. Gather all the information you need so that, if/when the time comes, you'll be prepared.

If she goes home, which she probably will unless her health takes a turn for the worse, do the same thing. Get mom Meals on Wheels. Contact Senior Services at the county level and see what services she might be entitled to at a greatly reduced cost - or even free.

Mom had a cleaning lady who came in for two hours every other week and it cost her $28 a month. She had Meals on Wheels for $5 a day. Her assets disqualified her from more help than that, but she paid for other things as well.

You made quite a list for yourself: wife, mother, daughter, daughter-in-law, sister, etc., etc., etc. When you're putting all of your energy into ONE of those things, you're completely off balance.

It's no wonder you feel overwhelmed.
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