BarbaraLoy Asked September 2009

I am getting burnt out. Is it time for a nursing home??

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I am getting burnt out. My mom needs 24 hours supervision. Cannot dress herself or go to the bathroom by herself . She is also incontinent. She has diabetes and need oxygen. My husband is suffering also because he is 68 and I am 66 and he wants to have some time for traveling before anything happens to us. She has been with us 3 years and has had a stroke. I hav e no living brothers or sisters. I don't think she will forgive me if I put her in a nursing home.

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EXPERT Carol Bradley Bursack Sep 2009
It's certainly time for outside help, and a nursing home could be the answer. What are the nursing homes like in your area? Have you toured them? I would take a good look, observe the residents and staff and ask to talk with family members of residents, if possible.

Your mother will be upset and angry at first, but she also may make friends and she could be much happier among peers. She's have access to more help. Any move like this takes adjustment time, but most people adjust once they realize this is their new home.

You can't keep this up alone and it could have serious implications for your marriage. You have done a lot for her. You will continue to be a caregiver and advocate, even if she is in a nursing home. But you will have help and also have some time to yourself. This is not too much to ask.


Carol
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AACE Sep 2009
When you have determined that your quality of life has been so impacted by managing a clinical situation in a non-clinical setting it is time. Never feel guilty. You have changed "the roof" but not the responsibility. Your "job description" changes from hands on bed pan patrol to being an "active advocate" for her in a facility. This allows three shifts of people to do what you are doing in 24 hour loops at the expense of family, friends and normalcy. being an advocate and making sure she gets what she needs is plenty for any family caregiver. Guilt comes from placing expectations on yourself about what you can do or imagine yourself to be responsible for doing. Whatever you "promised" no one ever contemplated where the situation has now degenerated to.Now you have to become a good consumer and learn how to shop for a nursing home.

Good Luck.
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Past time!! Go get the fhelp you need.If you are not a health care professional, you are not equipped. If you are , you still need help. Get it right away!
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ksue5036 Sep 2009
She needs full time care for sure. You must decide if you want to be that care or put her in a home. Do want is best for you and your mom will be ok in a home. Than you can go visit her has her daughter instead of her caretaker. Tour all the homes in your area. Surprise them don't make an appointment . Just go in and look around and listen whats going on. Than when you decide what to do make an appointment and check out the staff and there services.
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Sounds like you have done your best, Barbara. Hope you find a caring nursing home environment for your dear Mom. God bless you for all you have done already for your Mom. A nursing home will afford her the best support available to anyone facing similar health decline issues. I am very sorry you are having to face what so many of us dread. Even if she does not forgive you for long-term care placement, you will still be doing her a favor. The situation you describe is also my own cue for when my loved one may be better cared for by individuals trained to handle chronically ill patients. You and I are not, much as we might wish we could go the whole nine yards. There is nothing to forgive when you have done it all. There is no more you can do above and beyond the enormous job you have done and are still doing this very minute. No wonder you are exhausted. You need a breather and a whole lot of rest.
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ddarkangel Sep 2009
I am a nurse and I would have trouble doing what you are doing. I am currently caring for my mom in her home. She is currently able to do some of her own activities, I dont know for how long, she is in hospice care but at least has a catheter and uses a walker. I did have to get a caretaker to come in for days and nites so I can work and go home for a few nites. Its expensive, its hard and sometimes I have to stuff the resentful feelings that come up from time to time and go into the shower where no one can see me cry. Then when I get up in the am I see a note she leaves me on the bathroom mirror that tells me how much she loves me and appreciates all that I do. I will miss her hugs most of all. I promised her I would not put her in a nursing home unless she was too out of it to know. I pray every nite that God takes her swiftly so I dont have to see this remarkable woman continue to fade, and wither away but then again I feel so blessed to have her for another day. I hope I dont have to make the decision you are facing. My point is that even as a nurse, everyone in the family expects you to step up and take on the responsibility, but I am in awe of everyone here and all they are dealing with and how they are doing it. It is overwhelming for even me and I am supposed to know how to do this stuff....some days I am just a daughter who is overwhelmed and has no clue whats next. Good luck. Its ok to let someone else take on the burden, its been easier for me since I got the caretaker for half the week. I hope you can get to that point too where you can enjoy your mom not be swallowed up by the constant burden of care.
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AACE Sep 2009
No one should every presume that because you are trained as a nurse that family caregiving as a daughter for a mother is one bit easier. Family caregiving is 15% clinical and 85% practical problem solving. How can you be expected to be a "nurse" when you are emotionally mired in the problem. Resentment is a terrible emotion, because the other person/people never know how much it eats you up inside. Simplistically, it is like taking poison and hoping the other person dies."
Family caregiving doesn't come with a plan but you can certaining try and sit down and write out over the next few weeks what is going on: Meds, Hospice, preplanned funeral arrangements, change in behavior, all of the paperwork for acting on her behalf is in place, a good living will and advanced directives, durable powers of attorney with medical language, etc.

You are overwhelmed by the experience and your emotions are real. It is tough to do your "day" job as nurse and come back to your other "job" as a family caregiver. I say "job" because if I told you to take the same responsibility for a person just like mom, but not your mother, you would set the ground rules for the job. Hours worked, reimbursement, time off, relief shift, etc., etc. You didnt negotiate this job it was deleivered to you. Dont get me wrong, you love your mother and you made the promise and I understand that. However, no ones prior training, including a nurse, can ever really prepare them for family caregiving. It is okay to cry in the shower - we all do it. I am a non-clinical family caregiving expert doing this exclusively for the last twenty years and when I have personal family caregiving beyond the flu, I seek outside help. We have no capability for object perspective when our feet are in emotional quicksand.


Hopefully the caregiver and Hospice will allow you to keep your promise regarding the nursing home. Remember, nursing homes are there when the logistics and emotions get so overwhelming and the clinical condition warrants it.Especially since Hospice would follow her there and you would have the same palliative treatment going on now. As I said in another e-mail yesterday to another family caregiver - you may change the "roof" from home to SNF, but the responsibility of the job changes to less hands-on work and more advocacy and oversight that mom is getting the very best of care. Between you and Hospice that should be very good care. That is also where your nurse training will be invaluable and end-of-life has a few more clinical components that you will better understand although totally palliative in approach.

Good luck. Your are doing a great job.
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Annlidiot Sep 2009
Forgive the obvious question, but I don't see any options being considered. Why not try stepping into care by hiring an inhome person first? In reading many posts, I see people talking about nursing homes as a solution to "getting their lives back". A consult with a Gerontologist would be a good step to consider.

Since caregiving is such an individual issue I felt I should weigh in on the subject. I understand that most of what I read here is people validating their own care decisions, but do think that there has to be a balance, and some of the emotion whether it is caused by exhaustion or feeling used should not enter into the discussion. I cannot help but wonder if Baby Boomers will think differently when we are the aged parent, and our kids and their spouses are having that same discussion.
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I disagree, though understand the point you have eloquently made. Although I am a full-time stay-at-home caregiver to one of my parents, I will never accept guilt in the form your alternative infers if the day comes for me to place my parent in a nursing home. I wish with all my being to keep my parent away from a nursing home and pray that my dream will come true. If it doesn't happen that way, and I decide one day that in-home care after almost 10 years of my caregiving in my home is the option I choose without considering anything else, why would I feel poorly about that choice, and why would I have to explain myself to anyone? If any individual gets to a point of exhaustion and says I am exhausted and no longer physically and/or emotionally equipped to continue doing this, your "first" option is a non-option, as you have not walked a mile in that individual's shoes, even if you and I are caregivers. I see nothing wrong with supporting a fellow caregiver who is at that juncture. Caregiving is not a please others feel-good contest, at least not for me. Your individual option is cool if you are the driver and decisionmaker.
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Carol,
Well said. Thanks for the balance you always bring to these discussions. I never want to put mom in a nursing home, but I know that my feelings may change and I may have to change my decision and way of thinking. Thanks,
Linda
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