My mom needs to be placed in a nursing home. Where do I start?

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My mom has been living with us for over 2 years and her Parkinsons is progressing to the point that I cannot meet her needs anymore. I do have a lady come in on the days that I work for 4 hrs, she gets her meals ready and spends time with her. However, my mom is failing fast and I don't want to come home and find her laying on the floor... she does have an emergency button, but is not compliant with wearing it. I have laid ground rules with her, and limits! I am a single mom of 3 children, my youngest is 12 and is going through a lot herself seeing her grammy like this and needs me. I'm torn between the care of my mom and what my kids need from me. I also am an only child without any extended family in the area. I'm a Pediatric RN, and as a nurse my mom expects me to know everything and coordinate everything. However, this type of nursing is not my expertise. I work three 12 hr shifs per week. My sons ages 18 and 21 are great with her, but they have lives too w/ college and jobs... It's very stressful and I am having a very hard time. I feel that I have done my best and it is time to find others to care for her needs. I can be a better daughter if she doesn't live with me. I have been anxious, depressed, and overwhelmed. I tried to call her PMD today, but she is away until next week. I thought that would be a good place to start in order to start the placement process. Does anyone else have any suggestions for me? Thank you.

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Expert Answer
3930 helpful answers
You are right that you'll be able to be a better daughter when you aren't handling all of this care. There's only so much you can do and you've done more than most people ever could.
The doctor may need to sign some papers and will eventually get back to you. Meanwhile, tour some nursing homes so you know what you like. Many have waiting lists, so you may need to wait for a good one. If this doctor doesn't help out, and I can't imagine why he or she wouldn't, then find a different doctor to do the admittance exam.
Take care.
This is a tough situation for you, but it does sound like you are thinking it through logically. The primary care physician does typically need to complete paperwork for a nursing home admission as well as typically for assisted living--but it can also possibly be completed by another doc. Does the doctor have someone covering for him/her?

The first step is really determining what type/level of care is needed and then researching places. Medicare.gov does have a nursing home compare tool, and most states also provide nursing home survey/ratings online (or you can ask the facility to see their survey). Assisted living is a bit trickier, though most states survey them and also may have info. online. You may want to start with referrals if you know anyone who has experience in this area.

I speak as a geriatric care manager, so of course that is my bias, but I cannot tell you how many notes we get from families about how much difference the care manager made in the process (i.e. just knowing where to start, getting a handle on her needs/level of care from an independent party, getting input as to good and not so good facilities, advice on the transition and actual help making it a more smooth transition). Care Managers know a lot about the eldercare landscape, everything such as programs and resources you may not even have heard of before.

Two links that might be helpful to you also include: which is a "step by step" we created on how to go about this process in general and we have a few articles with additional tips on our blog including one daughter's story about her two experiences (helping in laws and her parents) and her advice:

Have you all talked about this with her yet? The emotions and transition are tough in addition to the actual process of moving/finding the right place. It will help to explain your concerns and worries to her and how much you want to be there for her, and can best do that by having help to ensure she is safe.
Thank you both so much for your helpful answers. Yes, I have spoken with my mom about this. In fact, she is the one that brought it up 2 weeks ago. We have been through a lot together. I would like to talk to her PMD and not just someone in the practice. She knows my mom best, and also she is my doctor. I can wait until next week to talk to her. I also have intermittent FMLA at work if I need it to get things done. Thanks again, I appreciate your time. I will look at the 2 links suggested. Any info I gather at this point will help.

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