Mom thinks she's fine and wants to come home.

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I have written about this before but here is some updates that I need help with. My mom has been in a NH since March 4th 2013, She was diagnosed with dementia. She has been having some really good days and it bothers me to think that maybe she should not be there. I used to see her every day and usually 5 of those days I saw her twice a day albeit short visits. I started to get burned out so I cut out the two a days to once a day. It still wore me out so now I am down to about 3 days a week. The problems are that every time I see her half of the visit is her wanting to come home, when I do not show up she will call me and leave nasty (to me) voice mails. I am POA along with one of my three sisters (mom lived with my wife and I) 10 years ago she signed the house over to me because after Dad died I paid the bills which has been 20 years now. She signed it over to me because she did not want to lose the house just in case she ever went into a NH. She did not want my sisters to know at the time. Now my sisters know and one of them is furious and has been trying very hard to get my mother out of the NH and back with me. She says I own the house legally but not morally. But I did what mom wanted to do and even tho I did not have an actual mortgage I paid for it thru the bill and making sure mom had a place to stay She had a stroke 5 years ago and came home a broken hip 2 years ago and came home but I can not handle dementia. We have a burn mark in our dining room carpet where she dropped a hot iron that she didn't know was on. She has left the stove/oven on the water running and food burning on the stove. My sister has talked to the case worker at the nursing home and said that I should take her home and take care of her. The woman needs professional care 24/7. I do not have the time or money. I am wracked with guilt, hatred and mixed emotions towards members of my family. I did what was best for mom and now need to make sure her safety as well am wifes and my health and safety come first. The furious sister does not like my wife but my wife has done more for my mom in ten years than my sister has done for her in the 20 years since Dad has been gone. Thanks for letting me vent!!! God Bless you all!

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"..who's hair." Tsk. Whose hair. I do beg your pardon. x
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Yes. My great aunt (then 95, lived to 99) went through this process.

A lot depends on the quality and expertise of the Nursing Home. Find out what you can about it, and if you're not happy do some fast talking and get her out of there to a good one. You need it to have: high staffing levels, a positive attitude to active therapy, and a strong track record in terms of outcomes.

The fractured pelvis is probably (you can ask to see x-rays if you like, this is only a guess) at the front, the symphisis pubis, which is a fragile joint and separates easily in very elderly people when they fall. Good news: it's not as bad as it sounds; be grateful it wasn't a hip. Bad news: it hurts like a bastard, does take a while to heal, will need your mother to work hard at her PT, and will cause her toileting trouble as well. Very distressing.

Your mother will likely need pain relief. The NH should know to watch out for drug interactions, but you'll feel better if you've checked that they are doing that. If your mother's on codeine, mind out for constipation (which can get severe and - see above - incredibly painful) and make sure it's being addressed. Codeine can also have side effects including nausea and hallucinations. If your mother's dementia is troublesome at the moment, she may not remember not to get out of bed or become distressed that she can't; they should be dealing with this capably too.

If she's being looked after well, she should soon be sitting up, eating and drinking as normal, and generally taking notice. Mobility and pressure sore risks will be well attended to. Her medical status and mental health status will have been thoroughly assessed and appropriate support will be in place. One really important point: what caused her to fall? A good NH will concentrate on identifying the cause or causes and dealing with it/them: in my great aunt's case, it turned out that in addition to other factors she'd become anaemic and needed a blood transfusion.

I can't recall offhand how long it took before my great aunt was walking (with a frame), partly because the rehab ward she was on to begin with was atrocious - rehab my foot! I'm amazed anyone survived it - and I had to get her transferred to a private hospital instead (I know things are very different in the US), so there was a hïatus in her care; but I remember being seriously impressed at how quickly she recovered once she was in good hands.

Now for the bit your mother doesn't need to hear about. My great aunt wanted to go home to her flat; but because she didn't want live-in care (money wasn't a problem, she was worried about living with a stranger 24/7) and we lived too far away to support her day to day, we arranged for her "ongoing convalescence" at a residential care home nearby. This arrangement was politely termed "temporary" and remained so for the rest of her life. I can't see you getting that one past your mother, somehow; and anyway I still feel bad we couldn't do better. But, the one thing that did cheer me up was hearing after she'd passed away from a close, old friend of hers that she had been very happy and comfortable at the home once she'd settled in.

So, there you have it: 6-8 weeks sounds about right, and given good quality care she should be right as rain afterwards. And then you can decide what next. Whose daughter is the granddaughter, where does she fit in? Unless you're unhappy with the arrangement for other reasons, I wouldn't rule out this option on the grounds of one fall at her "safe home" if your mother and niece (?) are both eager to try again. I.e. don't blame the granddaughter for the fall. The only way to prevent 100% of falls is a strait jacket and bed restraints: it's hard to accept, but you have to get used to living with risk that's as small as it can realistically be made. I say that as one who's hair is already turning white with worry about it, so I do truly sympathise.

Good luck, hope you see progress very soon.
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mistermet, do not take her out of the NH again. She needs 24/7 care and walking is far far away, more than 8 weeks, and balance will always be an issue. Nobody wants to stay in a nursing home, but it is much safer than living with relatives, good intentions or not. Ignore your sister's complaints.
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Just an update - Nov 4th 2013 the courts say my mother can go live with her granddaughter. Nov 6th 2013 she gets out of the nursing home. TEN DAYS later Nov 15th 2013 she falls at her safe home and now is back at a different nursing home with a fractured pelvis. She as of right now can not walk. At least 6 to 8 weeks of rehab. Can anyone give me any insight as to what we are in for?
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Why are you letting your sister manipulate you with guilt? Your sister is angry because she did not get her share of the pie and feels it is your responsibility to continue to care for your mother in the home she lost out on. If she was really concerned about your mother, she would take her in and care for her. Your sister's motives are nothing more than resentment for not being able to get a future inheritence. Let go of the guilt! You have done your part in caring for your mother.
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Hm. Two things seem to be troubling you. 1. Your mother's apparent unhappiness. 2. Your sister's somewhat vague accusations.

Have you talked to your mother's case worker, yourself? You say your sister says she says - oh-oh, Chinese whispers at work here - your mother should come home; but what has anyone said to you about that? Could be your sister's got hold of the wrong end of the stick. Could be that your mother's care needs are not quite as onerous as you fear; although, having said that, if they're not now they probably will become so. Talk to your mother's main caregivers at the home, see how they think she's getting on there. It could also be there are things she's not happy with that could be changed to improve her quality of life.

Eight months in, you'd have expected her to settle; but then again there have been other, ongoing changes for her to adjust to as well, haven't there? I'm thinking of your burnout. It reminds me of my brother. My sister-in-law tells me that my brother finds it depressing to see our mother in her diminishing state, and gives this as one reason for his making really very little effort to visit. I always tell myself I must not think sarcastic and unkind thoughts about him, but honestly..? HE finds it depressing? Really, what can I say? You say that half of your current visits are spent dealing with your mother's wanting to come home. I expect that is wearing for you (no, I'm not being sarcastic) and makes you even less inclined to spend more time with her; but what you've got there is a vicious circle. You're reducing the visits; she gets unhappier; you find it more stressful, so you reduce the visits…

Your mother is missing you, she is lonely, she is sad. If you can't or quite legitimately don't want to go to see her more often, work with her caregivers to deal with this. Call every day and make sure they give her the message. Delegate to a relative or friend, perhaps a neighbour your mother knows well, or a pastor. Just make sure someone's there for her. Feeling guilty about it is futile for you and useless to your mother. Don't visit more than you can manage, but don't do nothing.

Is your furious sister planning to contribute in any way to your mother's practical care? No? Thought not. Ignore her.

I wish you and your mother all the best.
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You made a deal with mom, when she was competent. The house is yours, legally and morally.

You have take care of mom and she needs 24 hour assistance, best provided in a facility. This too is the best decision for both of you.

Your sister is envious. Perhaps of the fact she is not getting 1/2 a house, or on a deeper level, maybe she is jealous of the obviously closer relationship you have with mom. Her opinions are irrelevant to the case worker and anyone else.

Shake off the guilt and try to have a nice Holiday.
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Your mom signed the house over to you NOT because you were taking care of her. She signed it over because they had outstanding bills of about 20 years. She knew she was unable to pay it off and that you can. Therefore, while she was still in her right mind, she signed over the house because paid off their debts. PERIOD.

Different scenario. Mom did not sign over the house 10 years ago, and you paid for it. In the meantime, you and your wife took care of your mom. I still don't see why she should not have signed over the house to you if she wanted to. You and your wife were there for her, took care of her and her bills. So, why shouldn't you get the house?

Do you know what sucks? When I started helping my father caregive mom 24 years ago, my father told me several times that the house/land will be going to my 2 brothers in the states. If I wanted land, I need to marry a man with land. All these years, I have struggled and stayed here, used my money to help pay for the house bills, the repairs, mom's supplies - Knowing that this house/land will go to my brothers. 23 years later, both parents are bedridden and still NO help from siblings. Mom has passed away. My siblings voted that the bereavement money would be split among mosf of us siblingsand father. I thought that sucks because I spent 24 years putting up with father's verbal, physical abuses (and my siblings knew this) and yet, we split the money. In actuality, I wanted the money to go to father as the surviving spouse. Why? Mom's medical expenses will be trickling in. Father has limited income and his cost is expensive -pampers, wipes, etc..

Mistermet - I wouldn't give a darn about what your sister thinks about the house. You got it straight and honest from your mom 10 years ago. Where was she when your parents needed her?

As for feeling guilty about putting your mother in NH, you will always have guilt. The most important question is: can you honestly handle your mother's care 24/7 as she progresses into her disease at home? Is she being mistreated in NH? Is she 100% miserable? Have you completely abandoned her to NH and stopped being her advocate at the NH?.... Of course not. Therefore, you and your wife did the right thing. Hopefully, your mother will stop asking to go home. Hopefully.

When mom was dying, my siblings flew from the states to come home and say their goodbyes to mom. I have been changing pampers for 20 years. My older brother was watching me change father's pampers. Brother had the nerve to tell me how to do it "correctly". I got pissed off, stopped, turned to brother and snapped, "Do you want to take over?" And I stood there waiting for him to answer. He shook his head. After that, he never ever offered advice when it came to caregiving. Sometimes, our siblings who is not in the here and now of caregiving, think they know the "right" way of doing things. Only way for them to really learn - is let them experience it. So, sis will never learn this first hand and will continue to harp on and on about the house, your mother in NH, etc.... If she gets too irritating, set boundaries with sis, and limit your family interaction with her. Then her harping won't keep igniting that guilty conscience of yours.
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Everyone sees things from their own point of view. I think you and all sibs need to sit down together and talk things out.
So objectively -- you are visiting 3x week. You are no longer your Mother's primary caregiver, the NH is.
Imagine you were in Sis's shoes.. you might very well be furious too (Bro live rent-free 20 years, takes the house, then "dumps" Mom in a NH where she is miserable - I'd be livid!)
It sounds like you feel like you "earned" the house by living there with your Mom & caring for her. How much is the house worth ? If it's $1.5 mil you have in effect been paid $ 70k a year to care for Mom (pretty excessive). If it's only worth $200k you've only been paid $10k /year (not excessive). You did live rent-free for 20 years --you''d have had to pay utility bills anywhere. Property tax is a pittance compared to rent & mortgages. I'm not saying that you took advantage of your Mom, but if the house is valuable you can understand why your sis thinks you took advantage of the situation.

You probably are right about Mom being better in a NH, but how is that getting paid for? If it costs more than she has, are you the one chipping in extra? Is her care suffering for lack of funds?
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I hope the venting helped.

Neither your sister nor anyone else can force you to take in your mother. If your sister wants to take Mother home to live with her, that might become an issue. But to get her released to have her return to the home you legally own? Ain't gonna happen. All you have to do is say No. Fighting about it is no doubt distressing to you, but at least you don't have to worry about having Mom back with you.

Those of us who are or have been caregivers to persons with dementia understand that it isn't always possible to provide the best care at home. The fact that she is having some really good days is evidence that the structure of that environment agrees with her.

Feeling guilty goes with being a caregiver. If you had Mom at home you would be feeling guilty about not giving her the opportunity to benefit from around-the-clock professional care. With her getting the care she needs you're feeling guilty that you are not providing it personally. Push the guilt to the background and continue making decisions in your mother's best interests.
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