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In a perfect world my patience would be unending, I would always be happy to do anything asked of me. I would not let her chewing with her mouth open get on my nerves.I would not let her pouting, sarcasm and pretentiousness get to me.
I would not get upset and stressed because a family member did not call me back about dr.s appts.
I would not have to say things 3 or4 times at the top of my lungs to be heard.
I would not have to pick up the trail of used kleenex that is left all over the house.
In a perfect world we would have conversations instead of me listening to the same story or complaint over and over.
In a perfect world I would not have to stay politically correct with family members.
In a perfect world my new puppy would use the puppy pad.
In a perfect world I would not need this sight to help me get thru some days.
But that would mean I would not have great cyber-friends like Cat and others to talk to about our daily difficulties. I would not be able to read others stories and be grateful for my petty gripes .I would not be able to laugh at myself and lighten the h*** up!
So grateful to have all of you in this imperfect world. God Bless

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Char,

Who has the durable power of attorney for healthcare? Can your mother verbalize what she wants? Those are the two most important points right now. If no one in your family has one on file in the hospital, you need to have your mother do one while she is competant to sign it. A DPH lets you speak for the patient if they can not for themselves.

As far as the discharge to a local SNF. If there are none acceptable, you can tell them NO. You do not need to put her into a snf just because the on staff doc and sw want to. They push it for various reasons....but if you believe you are competant and dedicated enough to do it, and you sound as if you are capable, then tell them that a stepdown to a SNF is unacceptable - they may be discharging her to a snf because they feel she needs to be hospitalized, however cannot continue to bill if she is stable. If she needs to stay in the hospital *not a SNF* tell them that. At this point, remember that you must document everything in writing - and keep copies. Don't just have a conversation. Hand them a written copy of what you will say to them and instruct them that it is to be placed in her file. Remember, although everyone is supposedly on the patients side, the truth is that family does need to advocate for frail elders.

Please call her doctor and inform them that is what you are willing to do. If they give you a problem, contact the ombudsman and talk to them. The main thing you care about is whether she is stable enough to leave the hospital, and what can be done for her.

sorry for the lateness of response. Wishing you the best of luck
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Mom was admitted Friday nite at about midnite. Sat AM Dr said you need to check out local nursing homes, so that if Monday they decide to release her we could possibly have some input as to where she goes. If we do not get out to look, they will pick a place. It seems that drs. are only interested in getting her out of hospital.
My mom's actual doctor does not visit her in hospital but rather employs a group of hospitalists for that purpose. SW was most importantly pushing nursing home for the therapy she needs. I wonder if they have ever been to these places.
I know my mom would be happier at home. I am not dillusional and think she is going to get better. therefore I just can't see torturing her in the insitutional setting. My mom's level of functionality has not changed drastically since this last stroke. She had previous strokes too. She knows us. Can talk. Can feed herself, but needs assistance for everything else. Thank you for your encouragement. I think today I will try to contact my mom's real doctor and also her neurologist, maybe he can recommended home therapy. It would be nice to know that Medicare would pick up some cost but if private pay is necessary, we've been managing so far and have the capabilities to continue.
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Hi Char,

I admire you looking at the options for your mom - hope I can give you my thoughts on what options you have. My experience is that if you keep talking and engaging her in activitie she may very well do better than at a SNF. If you have the determination and ability to do so, she will probably do better at home if she is stable. Being in a familiar setting with people who you know may be the best thing for her. You do want to do your homework though. It does take time and effort to be an advocate and provide the best for your parent.

If you have not discussed your plans to keep her at home with her doctor, you should do so and get their support as soon as possible. Many doctors are used to admitting to SNF's because family can't or won't take on the tasks. You also would like to have her evaluated by a neurologist - and get info from them on what they see. Once your doctors are onboard, you will need to talk to the hospital physical therapist and if you are lucky - go find the hospital SW or discharge planner who will support your plan to take her home. PT and OT can be ordered as in home service by the doctor in most cases (check insurance - you will need authorizations and to stay on top of who is sent).

You will need to have a care plan to follow, although most of the real therapy will take place in the time and attention you give. Much of what you will be doing is constantly being there most of the time, attention and encouraging talking
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To Cat, I was reading a comment of yours,posted back in September 2008. I cannot find anything regarding this topic in a more current window. Please comment on SNH vs home health care. My mom is 88 and suffers from vascular dementia. She lives with my dad 89,and has his own early dementia problems but basically independent. They are in an independent living facility. Some social programs available and a restaurant for most meals. My dad employs a CNA service for 12-13 hours of one on one care for my mom. My mom is currently off all meds for dementia, exelon+nemenda. She was dopey and still not totally compliant and we felt meds were causing complications. Her last hospital visits were in January...UTI, dehydration, bracardyia, and last but not least C-diff. Drs. released her to local SNH upon arrival we found her being put in dirty room, dirty bed and no clear supervisor on duty. We made exec decision to bring her home to my dad w/24hr care and home health PT and RN, a couple of times a week. She was definitely not herself last week and returned to ER. She now has possible UTI again and also evidence of a stroke. She is a little more confused than before, she cannot hold conversation as well as before, and is confusing common items like knife for spoon and toothbrush as hair brush. Doctors now want to release her to SNH for PT and OT. Are we robbing her of some significant therapies, by bringing her home again? Her health is fragile and in previous trips to nursing home she withdraws, doesn't eat or drink, like she should. I think that even without the therapies available in SNH she is better off at home with her caregiver and my dad around.
What do you think? Please help with comments. We need to have some answers for doctors.
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In a perfect world the entire country would read the posts on this site and demand change.

In a perfect world all of us would reach out to as many decison makers as we could and carry our message about the future of caregiving and its current state of affairs.

In a perfect world caraegivers would be recognized, have healthcare and accrue social security benefits for the future.

Ahem,

Now that I think of it although a perfect world is subjective and elusive, this site is as close to perfect world as I can think of for what matters most right now. Thanks to Carol and all the people who care to post & participate. Right on Lindam for starting this thread.
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After posting the first time I realized how it was all about me. So I want to add some things I have been thinking about today.
In a perfect world my dad would have had lots of love as a child and been more secure and less self-centered. He would have known how to love my mom and and us kids.
In a perfect world we would have been raised by a whole generation that was not scared of the Great Depression and would have had plenty to eat and new clothes to wear. '
In a perfect world we would not be resentful of our choices of taking care of our elders, we would be gracious, patient, and compassionate. Some of us are only reacting the way we have been taught.
In a perfect world our parents would have had the tools and insight to teach us about selflessness, not martyrdom. We would have been able to communicate and let old wounds go.
We would understand how scared and powerless our elders are and that they have no control sometimes. We would be able to have empathy for them as one day we will be them.
But this is not a perfect world and we can only do what we can do. There are gazillion "boomers" going to need care one day and the thought scaires me half to death. Will I be placed in a substandard nursing home, and if my son gets burdened with me will he have a place to put his resentments and unresolved feelings?
And because this is not a perfect world, nor are we, I am very grateful to have a place to put my feelings. God Bless
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Welcome pink! Keep it coming, and take care!
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Hi guys...Just posted on another topic about venting. Couldn't fit in all my venting in one post, but I really do feel better. Everyone posting is just wonderful, and I'm so glad I found this site.....
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Lindam-I will take the inperfect world as long as you are here
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God Bless us imperfectionists! You are all angels, and I don't think I could get through today without reading and posting. I have a vent, but I'll save it for later, gotta feed the hateful, ungrateful one LOL!
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