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mhtmtree Asked September 2014

When do you call it quits and put your Mom in nursing home?

Currently living in our home with Alzheimer's. I have three siblings that agreed to take care of twelve hrs per day and my wife and I would give up our privacy, move her into our home and take care of her the second twelve hours per day. Two of the siblings bombed within 5 weeks, drinking and drugging. The third is on his way. My wife is at the point that it is affecting her health, physical and mental. It is also not doing me much good. Mom is physically in good health but needs 24hr supervision. Finances are getting low. Although we do not know how much more we can take, we are feeling guilty about looking into nursing homes.

skinonna Oct 2014
Even though my MIL was in a $7000+ a month AL we had to hire 24 hour care for her after she fell and damaged an eye requiring eyedrops every 2 hours. It would have been easier if she was with us and we could have hired care for let's say 15 hours a day. You can spend on a AL or just hire some help. Of course, if there are no funds available......

vstefans Oct 2014
PS - has her bone density been evaluated and treated? This can be done and is commonly overlooked.

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vstefans Oct 2014
7K a month seems steep - you might do better. And if you are determined to keep her home, look for any kind of community-based waiver programs that would give you soem in-home care. 7K a month would buy you some substantial respite and let you ignore the sibling's bad behavior.

gladimhere Oct 2014
Maggie, I do not think a trust will protect assets from paying expenses related to care for a spouse even if married later in life. My mom had a trust drawn up 15 years ago that instructed the assets were to be used for her care first, any remainder was inheritance. Then Mom married a high school beau eight years ago. They also have a prenuptial agreement. But, Medicaid does not consider prenuptials, one is responsible for the other unless other processes are followed.

Folks, encourage your folks to live together in sin. While my Mom's social security benefit will increase if he passes first, they have to be married for 10 years for that rule to go into effect. And when you marry at 80 what are the chances that both will live another 10 years?!

Countrymouse Oct 2014
I'm sorry you had a disappointing experience with your mother's AL - the costs are dizzying, especially when your mother doesn't seem to be getting what she's supposed to have paid for. Don't let it put you off all of them, though. They do vary, and you need to make allowances for 'teething troubles' too. Best of luck with the plans.

mhtmtree Sep 2014
Thanks for all of your answers. Here are a few more details on our situation. Until 11/13 my mother was living on her own. Then she fell and broke her hip. She had that fixed and went to a rehab. The first night, she tried to get out of bed to go to the bathroom. She had forgotten that she was not supposed to get up. She fell and broke her femur, just below the repair she had 3 days prior. Off to another hospital for special procedure. All went well and had her moved to a different rehab. Based on what we were told by the therapists, we expected her to be there for at least 3 months. All of a sudden, after 6 weeks, they told us she was ready to leave the following week. Since we were not prepared to bring her home, we opted to put her in AL for memory impaired, at a cost of almost $7000 per month. She was supposed to have daily activities but since they were under staffed, she rarely got to do anything except watch movies with the other 4 people in her ward. She was clearly not happy and called constantly begging us to get her home. My wife and I agreed to convert our garage into an apt for her with the proviso that my siblings would take care of the day shifts. Two of them were unemployed and the other was self employed with no work. We put all of the safeguards in place including cameras, alarms on doors, keyed entry and exit, etc.
As I said, two of my siblings decided to continue their lifestyle of drinking and drugging with in 5 weeks and the third is on his way back to drinking. My wife was not supposed to have to deal with any of this unless I could not be there at night. My mother is in good health, knows who everyone is but is sometimes confused on where she is, what she had for lunch 5 minutes prior and is a fall risk. Her dementia is getting worse however. The reason we wanted to move her back home was to give her the best quality of life possible for as long as we could before she slipped away, mentally. She is on medicare right now. I am going to see an elder law atty on Friday to start the ball rolling toward medicaid for when the time comes that she will have to go to a nursing home.

I know this is a long comment but I guess I'm just venting.

Countrymouse Sep 2014
You stop calling yourself a quitter, for a start.

If your mother has full-blown dementia but is in good physical health, the average family home is not a safe place for her to be: she is a serious accident waiting to happen. So not only is this situation not good for your wife, or for you, and sounds as if it's been the last straw for your siblings one by one, most important of all it's not right for your mother. The earlier your mother moves to a dementia care setting the better her chances are of doing well there. Start looking now.

Chicago1954 Sep 2014
The time to put a loved one in a "nursing home," is BEFORE you move them into your home, in my opinion. Most homes are not handicapped equipped, nor do they have ramps or doors for walkers and wheel chairs. (Mother is 95, my MIL is 91) Private care facilities have 3 shifts of registered care givers, to help your loved ones. (Even those workers get 2 days off per week.)

And I know I say this (because it happened in my family), what if the patient outlives you? Someone will move mom or dad, then. I say make it happen, now.

I don't think families should worry about cost, until they have checked it out. The nursing homes are full of people, that I know are not wealthy. Most everyone does need full-time care, at some point. I think that we need to plan on it.

Sunnygirl1 Sep 2014
Yes, some of the places I have looked at are very nice. This one particular Memory Care facility, looked like a vacation resort.

They are trained to focus on people with dementia. That is very important. I have heard that it might not be a good thing if the resident is not advanced in dementia, but I wish I had gone that route in the beginning, because a sharp decline can cause you to need to switch quickly. In hindsight, I would go with a Dementia Unit from the beginning.

sandwich42plus Sep 2014
Go tour some residential facilities and see for yourself. It's not the state home for mentally incompetent like it was in the 1970s. These places look like hotels with nice furnishings, carpet, lights, dining rooms that look like restaurants. The one my mom was in for a while was like a cruise ship that didn't go anywhere. Activities, housekeeping, laundry, 20 meals a month, wifi, 55 Dish channels, outings. They had a beauty shop, gift shop, PT room, visits from the post office, the library, pet therapy, musicians, theme nights for suppers, cocktail hours. I wanted to move in but was told I'm far too young. You could add on services like medication setup, reminders, help getting dressed.

My mom didn't setup her bank accounts ahead of time, so we are just paying cash out until it's all gone, selling a piece of property, and using up all her assets until there are none. Then it will be Medicaid.

jeannegibbs Sep 2014
Maddie4me2, the brutal truth is that a chronic serious illness in either husband or wife has a severe adverse impact on BOTH. A good attorney specializing in Elder Law can help avoid impoverishment for the well spouse. See such a specialist as early in the disease as you possibly can. You will still not be as well off as you would have been if neither of you were seriously ill, but it can help you avoid the worst case scenarios.

freqflyer Sep 2014
You're right about that, Maggie. And especially those who marry later in life, set up trusts so if one becomes quite ill, all the net worth of the other isn't wiped out. It's complicated but a good Elder Law attorney can make it clear.

MaggieMarshall Sep 2014
If it's your husband, you need to see an elder law attorney pronto.

And, actually, all marrieds in their 50's ought to see one so they can plan well in advance.

Maddie4me2 Sep 2014
What if its your husband and putting him in a care facility would bankrupt you.

BarbBrooklyn Sep 2014
In addition, please consult with your mom's doctor about what level of care is needed now (she might not need NH care yet, could do well in AL/Memory Care) but try to find a facility that has all levels of care so that you do not have to look again in a few months or a year down the line. Also, make sure that she is placed close to one of you. We had this strange idea that placing mom in her own town, about equadistannt from two of us was a good idea. It wasn't. First, her "friends" from the town never came to visit (in the same way that she seldom went to visit "friends" who were in placements; secondly, when she had a stroke, it took all of us hours to get to her, by which time several medical mistakes had been made based on my mother's answers to questions. Somehow, how matter how much medical information gets sent with the patient to the hospital, the docs always ask the patient. My mother is very agreeable; when they asked her about a variety of medical conditions, she nodded her head "yes" to almost everything. Including "do you have diabetes?" It took us a while to get all of that sorted out.

jeannegibbs Sep 2014
For someone with whom you have a long-term loving relationship, like a parent or a spouse, you never call it quits. You love and cherish and honor and do your best for that person until you are parted by death.

For someone with dementia you do this by asking consistently and answering sincerely, "What is in the best interests of my loved one and others involved at this point in the journey?"

That answer might be "Keep him in his home by providing support services," or "Bring her into our home," or "Bring her and some outside services into our home," or "Find a quality care center that can provide three shifts of caregivers." The answer may change in the course of the journey, or it may remain constant. It is critical to keep reassessing the situation.

Placing your mother in a care center, advocating for her, visiting her, shopping for her needs, and being there for her in crisis is NOT "calling it quits." It is acting out a new answer to "what is best for everyone concerned?"

If you ask the question sincerely, answer it honestly to the best of your ability, and then fail to follow through doing what is best at this point in time, then you might have cause for feeling a little guilty.

BarbBrooklyn Sep 2014
"affects" not "effects"

freqflyer Sep 2014
I agree 100% with what ba8alou said above. In fact, every now and then I will remind my parents [who still live on their own] that if anything happens to them health wise, to look for someone who is professionally trained and is certified to help them. I know Dad understand this, Mom on the other hand probably would dig her heels in.

BarbBrooklyn Sep 2014
I'm not sure I understand why people with no training think that they can care 24/7 for someone with a disease that causes mental degeneration. Why would one feel guilty about getting your parent professional care? It is one thing if your parent is a person cognizant of what they are doing and how it effects others. It is something altogether something else when dementia sets in. You have no reason to feel guilty, any more than you would if you gave your parent insulin for diabetes.

freqflyer Sep 2014
mhtmtree, the time to move a parent into a professional environment is the time that whomever is the main Caregiver is on a verge of collapsing. One out of every 3 Caregivers dies while caring for a loved one..... you don't want to make your wife one of those statistics.

Your Mom would probably prefer to live at someone's home, but in Assistant Living she would make a lot of new friends and be around people of her own generation. Once she settles into the routine at the AL, she might enjoy being there. Plus whenever you and your wife visit it would be quality time :)

pamstegma Sep 2014
You are all at that point where you need to hand her over to professional care. Do not feel guilty!!! Hey, when someone is ill you get them the best of care and save both their lives and yours.
You use the money from the sale of her home to get her into a nice private pay place that will take Medicaid when her money runs out.

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