Providing 24/7 care or skilled nursing.

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I have been on a merry go round with mom. She broke her upper arm in March, I hired private home care to come in 3 times a week and help with showers. She broke her pelvis on July 12, came from skilled nursing at our hospital on August 7. The next day she had a horrible headache, wouldn't move much, finally got her to go to the ER. She has arrythmia problems. They got her heart back in sync in the ER, admitted her and they had to do it again on Friday. Cardiologist signed off on her leaving, but her primary care didn't think she was strong enough. PT eval today and they recommended back to skilled nursing. After talking with several care managers and residents (who gave other reasons why she couldn't go to that unit), I found out they think she has progressed as much as she can.

They expect her to come home (we live together) and for the family to provide 24/7 care, that will be me. One sibling here, but he goes to Florida in September and stays til May. They all assume since I work from home, I can take care of her 24/7 and she is high maintenance when she is healthy. I am a cancer survivor and don't have the best health to start with.

The other option is to see if a nursing home will take her in their skilled nursing unit and evaluate her over 7 days. If they think she will progress, she can stay there. I don't have any idea if her medicare replacement plan will pay for it, etc... Now she has another UTI and is confused. She thinks she is home and we left her alone, the nurses have called several times saying she wants to talk to me.

My brother that is here, for now, told her he thinks skilled care is her best answer, she will progress better at a facility than at home with a few PT and OT visits each week.

Why do I feel so bad for helping enforce that decision? I am so not ready to do full time care, take care of the house, my son, work full time and have a life. I am not even sure she understands since she is so confused today. Oh, she had a roommate who was calling for the nurse, mom evidently attempted to get out of bed to help her. Her bed alarm went off and they found her on the floor Indian style, she has no idea she did that or why. They moved her to a private room near the nurses station and the last call, she told me Brenda was going home soon and there was no one there to help her. Also, said they won't let her "do" anything.

i don't know how much nursing homes or skilled care costs, she does have a fair amount of money and some investments.

I am at a loss and don't know what to do.




Nancy, it really sounds like Mom needs skilled nursing care. Are you a skilled nurse? And she needs monitoring 24/7. You work, and I assume you sleep at least a few hours each day. How can you provide 24/7 monitoring? (In a SNF they do it in shifts, with people who get breaks, have others to call on for help if needed, work specified hours and have a life outside of the care they give. They even get vacations!)

Thinking along the lines of strictly what is best for Mom, why would you feel so bad about this decision? Is it because it is also the best decision for you and you wonder if you are being selfish? Or are you just sad to see your Mom come to a point where this is the best answer? Whatever your reasons for feeling bad about the decision, I hope you can set them aside and try to be objective about what is best for Mom.

Having Mom in a nursing home does not mean you are abandoning her! Continue to love, support, and advocate for her. Have lunch with her a couple times a week. Visit often. Take her on outings when she is feeling up to it.

If Mom has assets, now is the time to use them for her care. If she outlives her assets she will qualify for Medicaid.

Nancy I'm sure this is a difficult time for you and your brother. I hope together you can make decisions that work for Mom and for you.
I thought I responded this morning, but you all know how it is when we are in the middle of trying to take care of parents. I feel somewhat guilty that I can't care for her, but as the nice care manager at the hospital said "no one could do what your mom needs in a home setting unless you have lots of money and help." It's also sad to hear her keep saying "do you think I will be there longer than 7 days?" The care manager that is handling it now is very upset that the fill in care manager even offered the chance to go home.

I wish I would have been involved when she switched to this replacement insurance. It only covers one nursing home here and I can't get her back to original Medicare until November 1. It's not on my top list of homes, but I don't have a choice. She will be spending her money on these hospital bills, hoping to get her assets down so i can apply for VA Aid and Attendance. Hoping she can come home and be more independent than she was before the falls, then she can have her private home care continue.

I just want to get her moved and settled in now, so I can get back in a routine for my work and my son.

Thank you, it's so nice to read posts and have a place to discuss this. My sister hasn't talked to me for almost a week, she doesn't even know mom is going to a skilled care unit at the nursing home for rehab. My new policy is if they can't call, email or text, they won't know what's going on.


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