Certainly not an easy decision. As a matter of fact it was one of the hardest decisions I’ve ever had to make. I moved my mom in with my me and my husband about one year ago. Mom’s condition has been steadily declining and it has put a terrible strain on my marriage. I found a good skilled nursing home called Gurwin on Long Island for her.

I realize the Covid crisis will make it very hard to see her and my sister is now in panic mode because she may not be able to visit her. She NOW wants her to live with her and have round the clock nurses aides come to her home. I have spent months getting mom Medicaid eligible for nursing home placement . I saw the writing on the wall. I have kept all my siblings up to date with all the decisions I have made and now that mom can go into a good home my one sister who is a single mom with a 15 year old son wants to take her in. Honestly, she can barely take care of herself. Her emotions are dictating her decision to fight me on this. I love my mom too and to place her now during a pandemic was not a decision made lightly. Mom needs attention and care round the clock. She can do a few things like feeding herself and toileting at times but now she’s incontinent of urine most of time. The stress over the last year as her caregivers put a terrible strain on our marriage. My husband refuses to have help at home and I have to respect that even though I disagree. Any advice?

Am I wrong to place mom during all the Covid visiting restrictions and at times NO visitors. My sister is very close to my mom and she’ll not do well if she can’t visit her.

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Has your sister spent any extended period of time caring for your mother? Perhaps sending your mother for a few of weeks "vacation" time at her home would be a reality check.
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You are not wrong. Yes Covid is a fact of life at this time. Many facilities have been able to get a better handle on it than in the beginning. I'm thinking she would have a lesser chance of getting it at a facility than in a home with a teenager. Going into the facility on Medicaid means there aren't any funds to pay for in home care, unless baby sister thinks you will foot the bill. With mom's dementia worsening the kind thing to do is to get her settled in a facility while she can still make the adjustment to her new home. She very well may enjoy interacting with others and activities that are offered, sometimes they seem to improve a little bit or not decline as swiftly because of meds being more regulated and more stimulating environments. Do what's best for mom, little sister may have issues, she may stop talking to you, her problem not yours. You stated sis can't take care of herself, how in the world is she going to be responsible for mom's wellbeing? Let's face it, you are not doing this because you want to, you came to this decision because you need to do this FOR mom. Prayers for you and your family as you make these stressful choices. Know you are doing the right thing for all concerned.
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Barbrany3 Sep 2020
Thank you for your advice and encouragement!
Covid cases in NYC are dramatically declined and staff are way more savvy about how to deal with it now. FYI I'm in MN and my 85-yr old MIL was in LTC and got covid in May. She was really sick for 4 weeks, then had a full recovery. It's not a death sentence for every senior. Your marriage is more important. Your sister's 15-yr old is more important. My opinion is No to her caring for her in her home. Seasonal flu is nearing and with a teenager in the home, this is a double risk if worried about her catching something nasty. This past June our MN legislators passed an Essential Caregivers bill so that now 1 or more vetted caregivers (by the facility) will be allowed inside no matter what. You should find out if this has happened yet in NY. If not, you should have this discussion with your mom's facility admin. I wish you peace in your hearts that there is really no perfect solution.
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I see you have decided to go ahead with placing your mom. In the big scheme of things, this is probably for the best.

If the placement won't be happening immediately, is it possible for your sister to come to your house (rather than uprooting mom and sending her to her house) and be responsible for mom for a week while you and your husband take a much-needed vacation (even if it is only nearby) in order to safeguard your own marriage? That might be just the thing she needs to see that moving mom to a care facility is the best option.
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How does your sister think she is going to hire aides if Mom has no money. Are you the POA? If so, its your decision to make. And if NY is like NJ, you only have 90days from date of application to get Mom placed.
Your marriage is #1 here. Moms decline will continue to the point ur sister cannot care for her. And she should be enjoying her childs teen years. Shortly he will be on his own. I assume she works.

Do what you need to do. At this point Mom probably has no idea what is going on. Tell her she is going to a new apartment and will have new friends. It worked with my Mom.
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You are not wrong. Sister just doesn't understand the situation.
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So if Mom is qualified for Medicaid who is going to pay for all these at-home caregivers? Just wrangling these people can be a full time job. And how is your sister going to ensure they are safe from Covid? Who monitors them or their testing? Your duty is to do what is best for your Mom. Your sister has no idea how much work caring for an elderly infirm person can be.
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rovana Sep 2020
Excellent points. At home caregivers are very expensive - has sis any idea about this or has she not really looked into it yet? Also, even if you can afford 3 shifts, it DOES NOT mean you are home free. You have to coordinate, be willing to fill in when a caregiver cannot show up, to say nothing of the COVID issues. The nursing home is better able to police COVID testing/exposure.
Send mom for two weeks for a “trial” run and I am sure your sister will get how hard it is. My 91-year-old mother has been with me for three months which I do routinely now for three years. My sister has the other months of the year. Her dementia is getting worse all the time and my marriage has been greatly affected this time. We are both exhausted....It is a constant questionnaire and disagrees with absolutely everything that we say’s frustrating. Living with someone who has dementia is debilitating, frustrating, stressful, and exhausting. Sometimes no matter how hard you try your loved one will not appreciate it… Gets upset that you have taken over their life when their needs have to be met and they can no longer do for themself, so they take it out on you. My mother needs to be with others her own age so she can tell the same four (made-up) stories over and over and over again and no one will mind because they won’t remember. If you are the health care surrogate and have POA do what you think is best!
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Mrsrubee Sep 2020
I laughed at “the same four (made up) stories.” OMG, isn’t that the truth!
Gurwin is excellent. My Grandma was there in her last months of life & passed away there in 1998. My mother & my Aunt went there regularly. Now my mother, 93 has dementia & is very abusive every day to me. I’m taking care of her at home in Queens ...discharged her from SNF nearby 3.5 years ago. The Nurses, CNAs & Social Worker all warned me that she will get worse...they were right...She’s incontinent& immobile. We use a machine to transfer her. I have a paid private pay caregiver for 25 hrs a week. Not many caregivers would want to take care of her...she gets very abusive & violent. Please listen to me & leave her at Gurwin. It’s the best place on LI Hugs 🤗
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Combination of several factors would lead me to say no, you are not wrong to do this and sister probably has NO clue how difficult it is. As primary care-giver, do you have all the "authority" or is it shared with her? If not shared, welcome her input, but ultimately it is your decision.

The huge surge in NY has mostly passed - yes there still are cases, but there are cases everywhere. As someone else pointed out, with onset of winter, flu, colds, etc will become more prevalent as well. Your mother would just as likely catch this virus or any other virus going around staying with you or your sister, as you have tasks to do outside the home, just like anyone else. Your homes are less likely to have strict sanitizing like a facility would as well. (sure there are lax places, but this doesn't appear to be one of them!)

Having a 15yo in the home might make it even more risky, as many under 18 can catch and spread the virus (and other illnesses) without any symptoms. Also, if she has a 15yo at home, is she currently working? If so, who will take care of your mother? Aides? It is very expensive to hire 24/7, or even enough to cover a working day (8 hr + commute, etc.) If there's no money, how will the aides be paid? If she hasn't done any of the care mom gets now, then she also has no idea how hard it is and how much harder it will become, even if she isn't working!

I did look up the place you mentioned, sounds like a great place. For worries about the virus, see:

On that page, there is a link Visitation Update. Check that too. It does say that as restrictions are loosening, limited outdoor visits are about to start (as of today, it says Oct 7). If they do get a case, it resets the clock and stops visits, but still, it isn't like she would never see her! They also appear to have "drive through" visits. Granted this is more difficult, because the person stays inside and you stay in your car, but you still get to see each other! I had one outdoor visit with mom a few weeks ago. Between dementia, the masks, 6' distancing AND mom's lack of hearing, it was mostly a waste of time, but it is what it is.

If possible, perhaps they can also set up video visits. Most likely it would require help from staff, depending on how much your mother can understand/do, but at the least you both would be able to see and talk to her, just not in person.

After all the time and effort you've put into it (did she balk last minute?), you really don't want to miss this opportunity just to soothe your sister. If things didn't work out for sister doing the care, how long and difficult would it be to start over and find a place? On the flip side, if it *really* didn't pan out, and you both agreed it wasn't the right fit, you could take her out and let sister try, but I doubt that would happen!

Go for it!
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