I have decided to put my mother in a nursing home, where do I start to get her in one?

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My mother is 90 and still lives in her home, with my unemployed adult brother living with her. Without going into too many details, I'll just say that for financial reasons my brother has been trying to keep her at home for as long as possible. She's had a few stints in a rehab after being hospitalized for illnesses (pneumonia) and they've been nice places, with good food and activities and even visiting entertainers. Each time I've gently suggested that she might be able to stay there one day, but she would start crying and getting upset, saying she has her own home and doesn't EVER want to go in a NH. I think she remembers the awful places my grandmother and great-grandmother were in the 1960s and 70s. She is a very stubborn woman and I've been dreading this NH issue for many years. It certainly hasn't helped having my brother side with her - it's been two against one. I am her DPOA, but do not have a medical POA; stupid, I know.

It's been a rough road the past few years and both my mother and brother, for their own personal reasons, have fought her going in a NH. It's now becoming apparent that we're nearing the end of the road for her staying at home and she will need to go in a NH soon. She is on a cocktail of meds that are keeping her fairly healthy for her age, but she has mild to middling dementia and worsening arthritis in her knees. There was an awful flareup of pain last week and an ambulance took her to the ER. They were unable to do much else but give her a painkiller injection and a lidocaine shot, along with a cortisone shot which didn't work. We didn't think she'd be able to get around the house too well when she got home (get on and off the toilet, etc) so we pretty much begged her doc to admit her, which he refused to do for an arthritic knee. We brought her home (with difficulty, after that painkiller), and she's been in pain but stable ever since. We have an appt with an orthopedic this week.

The helplessness we felt that night in the ER when told they us they wouldn't admit her was just awful. It was really obvious my brother wouldn't be able to handle taking care of her and I work and have my own family to care for. I asked to speak to a social worker about moving her to a NH that very night but was told since it was a Sunday night, there weren't any available. I think that night, coupled with my mother's increasing hygiene problems and dementia, has shown my brother that our mother can no longer live at home. I spoke to an elder lawyer a while back and the house will probably be transferred to my brother, as a "caretaker child". From that moment on, he'll own the house and be responsible for all the bills, which is the reason he's been fighting putting my mother in a NH for so long. Hiring an in-home caretaker is out of the question due to the cluttered condition of the home and other problems which I won't go into. We now have a home health aide coming in twice a week to bathe my mother and, while I'm thrilled that she's finally getting clean, it's been causing it's own kind of problems having someone come into the house.

I always thought my mother would move into a NH after another stint in the hospital and then rehab. I had hoped that it would be a natural progression. But it's obvious to me now that she'll probably need to go in one not due to illness but because of my and my brother's inability to care for her ourselves. My question to the message board is: how do I get her into a NH directly from her home? I can't imagine just loading her up into my car and driving her there; she would most likely throw herself out of the car. Is there a procedure? (I've already picked the NH). Also, does anyone have any advice on what we should do if (more like when) we're back in the ER with our mother and they won't admit her and there's no way she should be going home that night because we can't care for her? We're in NJ, by the way.

Thank you in advance for any advice or stories about your own experiences when moving a parent to NH directly from their home and how you got through it. I really appreciate your support.

Thank you,

Sue

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Just be grateful you don't work for the NHS, love.

Actually I do sympathise. But what you, in return, need to recognise is that the dumping granny at the ER strategy is the last resort, often after years of her being turned away from other options because she's being looked after at home. Then her husband dies, or her child dies, or the caregiver breaks down in some other way...

Plus, you talk blithely about the children's having had years to plan their elders' care. HA! See if you can count the number of people on this very forum whose elders turn purple if anyone so much as breathes the word "plan." The children are not responsible for planning their care. The elders themselves are. They're the ones who've had the most advance notice and the authority to act. Why aren't you blaming them?

You see a similar dumping phenomenon with rescue animals, too. Most times the owners who abandon them are just callous irresponsible bastards. But sometimes there's going to be a heartbroken, grieving family in the background, whose circumstances mean they can't any longer take care of their beloved companion animal. Not don't want to, note. Can't.
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I am an ER doctor. It never ceases to amaze me at the number of people who bring their family member(s) to the ER expecting us to care for them when “I can’t take care of them anymore.” Have you made ANY preparations for their long-term care? No? Then how do you expect me to magically produce an available nursing home bed at 11 pm on a Saturday night? You have known that you probably cannot care for your family member FOREVER. You have probably had months or years to make preparations. Have You? Have you visited and filled out applications to ANY long-term care facilities? Have you evaluated the costs of long-term care and looked at any of the finances available to your family member? And I often hear “you need to put mother in the hospital for three days so that she can go to a nursing home.” More and more cost restrictions are being placed on the medical system (Me) in this specific area. Do you understand that Medicare and Medicaid and most private insurances will not pay for a three-day hospital stay just because “I can’t take care of them anymore”, “she is falling all the time”, “she won’t take a bath or shower”, “he won’t eat”, “I have a job and can’t be there all the time”? I am happy to evaluate your family member for an EMERGENT medical need that MAY require hospitalization. But don’t curse me when I tell you that you will have to take your family member home because they do not meet admission criteria. Hospitals are not hotels. We cannot just check someone into a room and wait for a nursing home bed to become available. The hospital does not have a magic bank account that will pay for all of these services. You may be PERSONALLY financially responsible for these things. Take the advice of many of these posts. Prepare NOW for when these services will be needed by your family member. Cursing me, threatening me and writing letters to the hospital administrator will not help you or your family member.
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As P.O.A am I responsible for my mothers , who is in a nursing home rentsl properties?
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Hi Sue

I have elderly parents myself so I do see the dilemma. I get that you are worried about your mom safety and health. What I. Learned is that a NH is scary because it is the end of the line and they know it. It seems to me you have planned out everything for mom and did not ask her for input. While your intention is for the best you are taking away her rights as a person and what dignity she has left. My advice is to get with a social worker and you mom together and talk about these issues. You have a lot of options like home health and even adult daycare. Give her some choice where she wants to live. Just remember one day you too will be old.. Is this how you want to be treated?
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My mom has dementia and she broke her right hip and her right wrist. She is in a rehab center right now and will transition into an assisted living facility when she is discharged. I know what you are doing through because it is a very hard decision to make. I know that your mom will get the best care possible. I have worked in a nursing home and they did give good care to their residents.
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I moved my husband out of assisted living into skill nursing with doctors approval and the assisted living want give me my deposit back. Can they do that?
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After my mother shattered her hip in her home (she lived by herself), she ended up in a rehab and the plan was for her to go back home again. (I knew how adamant she was about never going into a nursing home. She used to say "shoot me first"). Her rehab stay turned into living in a nursing home for the last 2 1/2 years of her life. Even though I worked full time, had young kids, and was married I saw her every day. I'm an only child so it was all on me, and there were many days when I'd leave the nursing home, I'd cry on my drive home. Mom is gone now. I'm sooo sorry that she ended up in a nursing home, but those were the cards that we were both dealt.
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My mother has been suffering from Alzheimers for many years. She is on Aracept and has had a very slow progression rate. Things were fine until my father died 5 years ago. She continued to live in her own home until a few months ago. During that time, my mother got progressively worse with her hygiene. She had not washed her hair in 2 1/2 years, nor would she cut it. It was long, straggly and filthy. She also was not bathing. Her tub always was covered with dust. She also wore all the same clothes for a month or more at a time. She smelled musty all the time, The house was dirty and cluttered. Whenever I tried to clean or get rid of some old junk, she would start to scream at me that it wasn't dirty and I was just too fussy. She forgot how to use the stove and later the microwave. Her arthritic knees were getting worse and worse and she was struggling to get up the stairs to her bedroom. She also has arthritis in her wrists, so it is hard for her to get out of a chair. -- But she still wanted to live alone. She had a minor stroke 3 years ago which we found out was caused by a-fib. By brother found her on the floor of her bedroom one morning when he went to check on her. She went to the hospital and then to rehab in a nursing home. She hated it there and kept saying she wanted to go home. After two weeks we brought her back. We hired a part-time caregiver to stay overnight with her, give her meds, breakfast and prepare lunch before she left at 10:30 each morning. My mother hated having someone in her house. She would tell her to leave and say she didn't need her. He aide was not able to get her to bathe or wash her hair. My mother would not even permit her upstairs in the house, so basically we were paying some $830 a week (for 4 nights) to sit in the living room, watch TV and sleep. My mother never even knew she was there all night. My mother had another admission to the hospital about a year ago. My brother, who lives next door to her, checks on her several times a day and brings her meals, was there in the evening. He watched her walk up the stairs to bed to make sure she was OK. When she got to the top of the stairs she lay down -- half on the landing and with her legs hanging down the stairs. She said she was too tired to go any further. He could not get her up from that position, so had to call his wife to help. They had to call an emergency squad who took her to the hospital. She had severe hydration because she won't drink enough even though my brother keeps glasses of water all over the house for her, and she will not leave the air conditioner on in her bedroom overnight because she says it is too loud. In May, she went into cardiac arrest 2 times and ended up in a nursing home for rehab. The aides, PT and nurses are wonderful and caring. They have been able to bathe her, wash, cut and curl her hair, have her wear clean clothes every day, give her nutritious meals and snacks and provide entertainment and interaction with others. My mother is still there after 3 months. Therapy is over, but she will stay there as we feel that is where she will get the best care and be safe. She wants to come home and is still waiting form my dead father to come and visit her or take her home, but it is the family that must make the final decision, not the person with advanced Alzheimers.
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She is not always in her right mind. She drifts away at times but some of the times she seems ok. Depends on what is going on...now that I understand what a poa does, I will talk to APS and see about getting someone different to advise me. Thank you..my sisters and I will continue to disagree but until they have walked in my shoes and have seen what I have seen and had to put up with, I will do what I feel is right for mom.
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You might also call you local Area Agency on Aging. They can do a needs assessment. Make that you are there so that they understand what mom can do and what she can't.
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