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Furachan Asked November 2014

My Mom (93) is incontinent, falls frequently, has congestive heart failure but wants to stay home. Any advice?

She cannot stand up by herself, requires 24 hour care. Would she be better off in a nursing home?

pamstegma Nov 2014
CHF is often accompanied by vascular dementia, so she may no longer be competent to decide what is safe for her. I would pursue Guardian status, that is the only way you can move her without her consent. See an attorney and file the petition soon.

Furachan Nov 2014
Thanks everyone for your advice. Much appreciated.

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Reoffthehook Nov 2014
Well my suggestion would be to put a diaper on her to start with and then see if she is capable of using a walker. If that's no good, how about a wheelchair? I had a hard time when my mom was falling frequently putting me in a constant state of anxiety when I had to leave the house to go to the store so I would wait until late at night when she was all tucked in before I left the house. I had to call paramedics to lift her off the floor because at 200 pounds I sure couldn't manage it. She had been on antidepressant meds for too long and stopping them really helped a lot. I didn't realize how much it affected her balance. I did go out and get her a fancy walker with a seat and wheels and brakes and all that. But some people are better off with the plain version until they get used to it.
Does she have a potty chair by her bed? Is she opposed to diapers? The new diapers are really more like thick underwear that easily pull on. I hope this helps you in some way to decide what's best all around.

Eyerishlass Nov 2014
If your mom continues to fall, and she most likely will, her choice to stay at home will be taken from her following one of these falls. She'll injure herself or lay on the floor too long and the subsequent hospitalization will turn into having to live in a nursing home. Only with around the clock care will she be able to stay in her home and in-home care around the clock is more expensive than a nursing home.

If your mom needs 24-hour care she can either get it in her home with around the clock aides or in a nursing home.

jeannegibbs Nov 2014
If Mother were on hospice, I'd say let her die in her home. But she could go another three or five or more years. Unless you have guardianship (which would be hard to get until/unless she is truly incompetent in the legal sense) you cannot force her into a safer environment.

Something may happen to force the issue. One of her falls may require hospitalization -- she'll be unconscious or in severe pain. That will change the game. Or one of her falls may be fatal. Or her memory loss may become so severe she'll forget where she is or that she wants to stay there.

How long could she afford three full (8 hour) shifts of care in her home? (I know that is very expensive.) After all of her assets are spent, Medicaid would cover her nursing home charges. They would cover some in-home care instead, but not 24 hours, because a nursing home at that point is more cost effective.

I sympathize with the poor dear wanting to die at home. I sympathize with your desire to keep her safe. This is a very difficult challenge.

Furachan Nov 2014
She is now confined to her bedroom. The three care shifts during the day are only about an hour long. When she gets up on her own, she risks falling, an increasingly frequent occurrence. Three days ago she fell and wouldn't or couldn't activate the emergency button on her wrists. Morning shift discovered her lying on the floor, called the emergency services, paramedics checked her out, offered to take her to hospital, she adamantly refused. Again, signed a form and was replaced on her bed. Thereafter and temporarily we instituted a very expensive "night watch" shift by her bed, all night. Incontinence, several trips (assisted) to the bathroom, cleaning of sheets, carpet, etc. She now requires 24 hour qualified nursing care according to all the professionals but "wants to die in my house". Terrible situation where she is not safe at all and requires tons of care. A high quality nursing home nearby is, everyone agrees, the only solution, but mother will not agree. Oh and she has some memory loss/early dementia.

jeannegibbs Nov 2014
Better off than what?
Living alone? Yes, she would be better off in a nursing home.

Living in her house with 3 shifts of caregivers? Not necessarily. With the right arrangements made she might be better off or at least as well off in her home than in a nursing home. Maybe, maybe not. Can she afford around-the-clock care?

Who takes care of her now?

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