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Hello,

My mother fell and broke her hip. She has been in a rehab for over a month. She is deeply depressed and is not making progress. Her time is almost up there. She has been approved for Medicaid. She is not able to do for herself and since she has been in the rehab they put her in diapers. :( She did not have a problem until she got in the rehab.

What I need to know is how can I keep her out of a nursing home? I live 200 miles away from her and have RA and in a wheelchair and reply on my husband to assist me and know I cannot burden him with helping to care for my mother, but I cannot see her put in a nursing home. I have called Medicare numerous times and been put on hold for 20 minutes or longer and also inquired of the social worker at the facility what Medicaid will pay for if I bring my mother to my home. How can I save my mother from her worst fear???

Please help me.

Thank you.

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The eldercare locator (www.eldercare.gov) is another place to go to see what is available in your area, though you need to do the inspecting yourself. County, state and federal sites that give nursing home ratings are okay for a place to start, but some homes can have hits against them for very minor things that don't affect patient care or safety, and others can have fewer strikes against them, but the are far more serious. If you go yourself (or send someone you trust) you will get a much better feel. And visit at different times of day.

Geriatric care managers are a great idea, but there is no regulation. Anyone can hange out a shingle and be one. It's best to get a nurse, social worker or someone in the field, if you can find one. We don't even have any geriatric care managers in my area. But the right one, though expensive, can be wonderful, indeed, and they are often available in large cities.

Just like nursing homes, in-home care, assisted living and other elder services, the managers need to be checked out.

A place for Mom (www.aplaceformom.com) is a good resource (mentioned above), as well. I agree with the statement that if you can have your loved one placed in a center where family or friends can visit often, you are way ahead of the game. Even the best homes are going to be more on their toes if they know that familiy is around and this person gets visited. That is key.

When my folks were in a nursing home, they did everything possible to keep people out of diapers. There's something lazy and not good about the rehab center doing this, if there was no need for diapers prior to her stay. I would, indeed question that.

And every state does have ombudsmen to look into complaints. You can find them through your state human services. Always try, first, to settle complaints in a more friendly manner, but if you need help, it's there. That's what these people are paid for.

Carol
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I believe that placing ones parents in a nursing home is not a crime...it's abandoning them there that should be a crime. Why not have the Social Services Coordinator at the current home help you to transfer her to a facility nearer to your home? Also, there are many services available to the elderly and those who need some assistance in every community. You can have a service drive her to your home for a few hours a few times a week or you can go to her for a few hours a few times a week. Also, nursing homes are not all the same. Look for one that is done for service, such as a Lutheran Nursing Home, and not for profit. The profit ones start to cut services and personnel in order to save money. The service ones are done for service in every sense of the word. I learned this through a very difficult period after Dad had a stroke.
Just make sure you go and check on her and call daily. They need to know your presence and it will make you feel better. There is no such thing as "TOO" busy to not see your parents for at least 1/2 hour per day at the facility or calling to speak to them to remind them that you are still there and they are not forgotten.
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Have you considered a geriatric care manager? In instances when your elderly loved ones are far away, but require care, a geriatric care manager can be a godsend. They evaluate your parent's situation and needs -- with an objective, third-party eye, often difficult for adult children to do. Based on your mother's needs, the care manager will make recommendations as to housing options and even make the arrangements.
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B- I feel deeply for what you are going through. I wanted to comment because each of us make suggestions based on what our experiences are. Here are mine.

Before you engage a geriatric care manager you need to understand that in that profession there are many good, some "bad" (the bureaucratic ones) & downright ugly. You may get an angel who helps shepard you & your mother to a positive outcome, or you may get someone who steers you to the solution she knows. Think back to your elementary school days and use the teachers you had as a template for what you would look for in a geriatric care manager. Please don't be afraid to interview several - *before* you tell them your situation and get a sense of whether you would really trust their advice. If you contact National Family Caregiver Alliance, or your local area council on aging, they may be able to put you in touch with a caregiver network that can give you personal mentoring and support -

You say your mother is depressed - you need to take a hard look at what meds they have her on - - - combinations of meds + an injury and being in a facility that give residents diapers rather than CNA's to help the to the bathroom is cerainly grounds for depression....I can joke, because my mother has been there - done that. she now lives with me and does not need diapers and is not depressed.

In reality, you have a tough road ahead of you - we are here for you because we have all experienced it ourselves. There is lot of information available on this site and people who will always listen.

take care & stay strong.
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Bkuchau,
I got some pretty good free advice from "A Place for Mom". It's a free service which will give you names and places of Nursing Homes, Assisted Living apartments, adult day care facilities etc. They have a web site where you fill out a little survey about what your looking for and who needs it. They will email you back with information and follow it up with a phone call if you are interested. Their web site is www.aplaceformom.com

The woman that helped me find a great daycare for my dad still calls me a year later from time to time or emails me to see how he is doing. She has encouraged me to continue my quest for bringing down these nursing homes that are neglecting the elderly or denying them admission because they are not the perfect role model patient.

My dad was in a nursing home for short term rehab after being sick. They immediately put him in those disgusting diapers so they don't have to worry about them making a mess all over their beds or floors. It takes away the persons dignity and my father was extremely depressed. To make matters worse I would find him in a soaked diaper every time I went to visit him. He ended up being rushed to the ER in an ambulance from there with CHF because of the nursing homes neglect. I have filed a formal complaint against them with the Dept. of Health.

I'm sure not all homes are bad, but the 5 that my dad has been in and out of have been nightmares and it will be over my dead body before he goes to one again even if it is only short term rehab.

I would call the dept of aging in your county and get all the info you can on homes in your area. Go inspect them yourself, look at the other residents that are there long term. Do they look happy, are they clean, do you see enough staff around to handle the amount of patients and beds they have? Make a list of things to check for. Go on the web and do searches for reviews about the places. See if there were any formal complaints filed against them and what the outcome was. Then if you find one that your satisfied with that honors Medicaid, I would have your mother transferred to be close to you so you can monitor her care at the home. Your mother and all elderly have rights in a nursing home. They can refuse to be put in diapers. It is the job of the aides to make sure they are there to help these people when they need to use a bathroom. Trust me, this was a major case of neglect when I spoke to the health dept. Remember, your mother sets the rules, not the nursing home and if you're her caregiver or power of attorney you can act on her behalf. She cannot be forced to do anything she doesn't want to do. You should also look into becoming her Health Care Proxy, if you're not already. This way you have a say in what medications she is given and any other concerns that have to do with her health. You have the final say in the matter.

Good luck, I know how hard it all is...been there done that 5 times so far. I won't be doing it again. I will continue to take care of my dad for as long as possible. I never thought I would see the day that I would be wiping my own fathers butt, but we have to do what we have to do to keep them healthy and happy. My main goal is that my father enjoys whatever time he has left with us, and I'll be damned if he is going to spend it depressed and neglected.
God bless,
Cindy
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before you put you put anyone in a nursing home, check out the facilities ratings at www.medicare.gov. then go the "nursing home compare" link. that will tell you all the citations a nursing home has received, if it is a "for profit" facility and how old the place is. you still need to do a visual check and do unannounced visits to tour the place. there is an organization called long term care ombudsman- www.Ltrombudsman.org. they can help you with nursing homes and any problems you may have if you have a loved one in a nursing home.
if you file a complaint AFTER you remove someone from a nursing home, there is not much that can done because they only investigate complaints on that particular resident and once they are removed there is nothing for the agency to see.
been there, done that and still doing it. i had to take my mother out of a nursing home, then i filed a complaint with the State and because of that complaint no other nursing home will take her-and nothing happened to the nursing home.
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To Cindy and Mgrady
You both gave good advice it good to know there sites to help navigate through the caregivers needs. I'v always encouraged people to choose a nursing home close to their homes because that is the only way you can really get a good idea. I have a dear friend in a nursing home and try to get into see her twice a week one day her call bell was out of reach and she was not able to call for help she said they told her she called too much, this N.H. does have meetings with families and friends so things can be brought up as needed.
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I am literally walking in your shoes... My mom fell in late Feb. and broke her hip. She was very very active before her fall, and it's been a literal nightmare for her ...and us. When her time in rehab was ending, we had to figure out a bunch of stuff - quickly. She was emphatic that a nursing facility was not an option. I have a 2 level house so that wouldn't work. I have a young child, a job, a marriage, etc...each limiting the time I could dedicate to caregiving. So... been there doing that..
Here's what we did. We found a personal companion to assist mom with her everyday needs. They do not provide any medical or theraputic support however, so we had home healthcare come in a couple times a week. With a hip injury really your mom will only require wound dressing at this point. Then we completely revamped her household with assistive products and technology (check out enablemart.com). Things like a lift chair and a dressing stick will make her life much easier to handle. There are tons of great products, and technology out there these days to help her if you decide to not go the nursing facility route.

Best of luck to you. It's a very hard situation. Keep her spirits up if you can, and take care of yourself as well.
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Nursing Homes certainly vary in competence - here in UK as well as in other countries. We were so lucky that we finally found a good one - after very many others. But it is a basic fact for so many of us that you reach a time when you can no longer cope at home. Not getting a full night's sleep for even just the 6 weeks we struggled through can erode your love and caring abilities to a degree you cannot comprehend. A good nursing home can be a positive solution, allowing you to spend quality time with your loved one. It really is worth looking, because they DO exist. If only they could be found FIRST....... how much energy and heartache could be spared, and how positive Respite care could have been.....
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A couple of thoughts on these great suggestions.
1. If your mom qualifies for medicaid than she probably can't afford to pay for a care manager, or to hire her own home caregiver. They are both usually out of pocket expenses. Also note, hiring a caregiver yourself may put you in a position of being an employer for tax and liability purposes.
2. A place for Mom, and other placement consultants do not typically charge the individual, but keep in mind that the way they earn a living is by contracting with nursing homes and other senior care services, and they are paid by them for each placement. That's not necessarily a bad thing, but be aware that the options they will give you will likely be limited to those they are contracted with, and that they have a vested interest in placing your loved with with one of them.
3. PACE Programs are alternative to nursing home programs for those who wish to remain at home. They accept medicare and medicaid. You can check to see if there is a program in your area, here is their website:
"PACE provides all the care and services covered by Medicare and Medicaid, asauthorized by the interdisciplinary team, as well as additional medically-necessarycare and services not covered by Medicare and Medicaid. PACE provides coverage for prescription drugs, doctor care, transportation, home care, check ups, hospital visits, and even nursing home stays whenever necessary. With PACE, your abilityto pay will never keep you from getting the care you need."
4. Your local Aging Office probably has home care programs she could qualify for if she is medicaid eligible. That would also be an alternative, but their programs aren't as all inclusive as PACE.
Hope this helps!!
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