Any helpful info on visiting nurses?

Your mom is no longer safe living alone. She needs a full time caregiver or a nursing home

TM
The caregivers on this forum are scattered across the country, some even in other countries and have had many different experiences. Just know that we each answer based on our own experience or opinion.

I can tell you that traditional medicare Part B covers home health for patients who do not require 24/7 skilled nursing care but would benefit from less than 24/7 skilled nursing if they are considered home bound. Your mom would qualify if she has that insurance. Others may also offer it. I’m only familiar with original Medicare. The various agencies can be found listed on Medicare.gov or online. You will need a drs order. Usually it’s the primary who signs the order.

The nurses visit is about like going to the doctors office. They assess the patient, take vitals, set up pills, arrange for CNAs if needed for bathing, arrange physical therapy etc as needed, they will do wound care as needed. Can collect for UTI, do blood work. It is not for custodial care. They usually only come once a week but can come more often if the doctor orders it such as for wound care when a bandage needs changing more often.
The benefit is you have a regular medical check on mom without having to take her into the doctor for many services.
In the situation you are in, or mom is in, she may need someone to help her with her meds on a daily basis. I hired someone for two hours each day and they helped with meds, breakfast and lunch prep. This in addition to home health. We expanded the hours as needed. But my LO took all her meds each morning. Your mom may take hers as needed or throughout the day. Usually a non nurse will offer the meds or remind the patient it is time to take them etc. I had good luck with aunts daily aide. My mom was able to manage her own although HH set up her pill box etc.
I found home health very helpful with my mom and DH aunt. But again, they aren’t there to be a sitter or caregiver.

I personally would want my mom to have 24/7 access to pain meds with such a horrible disorder.

I was diagnosed with Trygeminal Neuralgia back in 2020 ~due to a symptoms of sharp stabbing pain and a C Reactive Protein reading of 28. Thankfully the diagnosis was wrong. I was terrified at the prospect of going through life with such a disorder as they explained it. I’m so sorry your mom is going through this. I was given morphine and steroids and put on gabapentin until they realized I didn’t need it. Hopefully your siblings realize how awful the pain is and don’t let her suffer.
Good luck finding her a good helper. Hopefully your DH will be better soon as well.

Would it be possible for you to convince your mom and sisters that while your husband recovers that spending a week or two in an Assisted Living apartment would help mom with more consistent care. Having activities around might help her as well.
Tell them that this would be a "Respite" stay.
I bet that once mom is getting regular contact, consistent medication administered she may feel better.
Even if after 2 weeks she still does not want to be in AL your sisters may find that they like not having to be doing all that they are doing for mom and they can once again focus on their own families.
Your mom should not be living alone.
When you say she is confused, she has her day and night mixed up, not taking medications properly and can not eat much this all says to me that she should not be alone.

That's a terrible type of pain and living by herself means she has nothing to distract her from it. Maybe consider a companion aid to do things with her and take her places.

Have you explored other treatments for her, like botox injections and stereotactic radio surgery (radiation)? Her age makes other, more invasive forms of treatment inappropriate for her... but her current medication may stop being effective, which is a common problem in treating this pain. If it were me or my Mom I'd overturn every rock to figure out how to find her relief. It's called The Suicide Pain for a reason.

Does your mom
live with you? Sounds like your mom should benefits hospice care. And on top of that, you should find a caregiving company to have continue come out and help her or you with the medications. That is SO IMPORTANT.
I didn’t realize it, until my friend said I needed a caregiver to help meet my husband. Doing this alone is so stressful. And now you are caring for 2 people.
You may want to get a man who can help you with your husband, and also help with your mom..
think about it. More people will respond. That added layer of caregiving helped me out a lot. I didn’t know I needdd it.
caregiving burnout. It is real. You may need just a break for a bit

Trigeminal neuralgia is horrible, and the meds for it may have bad or even dangerous side effects, depending on the meds. However, unless her doctor orders it, it's not usually a condition that requires hospitalization. If your mother is confused and has evidence of dementia, putting her in a strange environment could be very psychologically damaging. I agree with the other statements made about visiting nurses. If your mother can take her meds herself, as it appears to be the case, you might for now hire a home care agency that uses nursing assistants (not necessarily CNAs). They should be able to follow a medication schedule in terms of advising your mother as to what she is allowed to take; if she tries to take more, they will let their agency know. They should also be able to manage some of the other situations you've mentioned. Whether or not she needs 24-hour care at this point is unclear.

If there is a fire, can she get out independantly? Can she cook for herself or toilet by herself? Can she take her meds or dress independantly? What if she falls at night? I just mentioned a few ADLs that would qualify for AL. The most important question is about her safety when alone,

Honestly if you do not think mom is safe living at home a "visiting" nurse is not going to help much more than a "caregiver / companion" that would come a few hours a few days a week. (a caregiver or companion would be less expensive than a nurse and if there is no medical need for a nurse this would be an expensive out of pocket expense) A caregiver can give medications, they have to be physically taken by the client but the caregiver can put them in front of her and if mom would take them herself that would be acceptable to an agency. If you hire privately the caregiver can actually "give" medications.

If you think mom should go to the hospital though then she should go. At that point you can stress to the medical staff, the Social Worker that mom can not be discharged to home. That might make it a bit more "real" for mom and siblings.

In our experience, visiting nurses aren’t necessarily RN’s and aren’t always allowed to do medication management. When my adult son (medically complex all his life and left with a brain injury) was young, we had visiting nurses. They made me batty. I’ve never had medical training but I was much more confident in caring for him than they were. I’m not slamming on nurses, my daughter is one, I’m just not convinced about the home health ones in many instances. They can seem rushed and less sure of what to do. I ended up letting them go. If you know what’s coming, start that process now and stop expecting anything from siblings. That’s my two cents and experience.

I would echo what KNance said. Even after a hospitalization mom only had visiting nurse come about 3 times for 20 minutes or less, the first visit being a week after she was released. I believe the VN requires a doctor's order.

After mom's last hospitalization for double pneumonia and a collapsed lung, the visiting nurse came for "wound care". She kept asking mom to show her the wound and mom said she didn't have one. So the nurse wrote her up as "refusing care". I'm sure there are some wonderful visiting nurses out there, but our experience was not good.

Your mom needs a physician managing her care and potentially ordering home services (if you can get them to do that). But in the long run, she is going to need much more. I know how hard it is, and I wish you the best.

I was a secretary for a VNA. We were non-profit subsidized by the Township. We only went into homes of people where insurance and Medicare didn't cover something a Doctor wanted done, we needed an order from him. We did wound care, catheter care, filled pill planners, checked vitals, and even bathed a client when they had no one to help them.

Unless your Mom has a lot of money, she probably could not afford an RN. My DD is one and has made an average of 90/95k a year in the last few years. If your Moms main Caregiver than the decision to place her is yours. If she is not taking her medications correctly, then an AL is a good choice. It will also give u more time with ur DH.

I think she needs to get an evaluation by her PCP. She hasn’t had one in a year.

Thanks for your responses.

Welcome!

Does Mom have dementia?

It doesn't sound like she should be living alone.

If she JUST needed someone to manage her medications for a couple of weeks until her confusion (say post surgical) cleared up, the Home Health Care (what visiting nurses provide MIGHT be appropriate), but if her confusion is from dementia, that's only going to get worse.

Visiting Nurses come In for 10 minutes - 20 Minutes - They do the Vitals and check on medication . Sometimes even after the script Is written it can take them up to 10 days to arrive and then depending On whom you get They can be Late . They are a quick fix when someone leaves the Hospital .