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After a month of being in the hospital and rehab, mom will be discharged tomorrow. She has done well with her PT and her therapists have encouraged her with accolades as to how well she is doing. Problem is she is expecting to go home with the intent of running marathons. She honestly thinks she is in better shape than when she fell because she feels so much better. What she doesn’t realize is that she is under constant supervision and only does what she is told. At home she’ll do what she always does and forget all about the guidelines they set for her. Her dementia is well disguised because she wants to go home and will say and do anything to get her there. Once home, I’m sure she’ll go back to her old ways, not using her walker, bending and reaching and twisting which will only aggravate her condition (she has PMR and compression fractures, along with severe osteoporosis). Her rheumatologist thinks AL is the best place for her......but she refuses. Sister and I will share the brunt of this burden, as my dad is not capable of being a full time caregiver. I’m at a loss.
Do I just wait it out until the inevitable happens?

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Get the folks at the rehab on the horn today to set up home health coming out Friday at the latest.

If your parents call with an "emergency" call 911.

Look, your parents have the means to fund their own care. YOU are not a retirement plan. You have your own family to care for and you are not a spring chicken (and neither is your sister).

You need to say "I can't possibly do that".
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Reply to BarbBrooklyn
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Severe osteoporosis, not good. I’m sorry but regardless of where she goes, she is very fragile. Would your dad be willing to move with her?

Depending on how advanced the dementia is, you might discuss with her that she is 89. She might like to live to 100 but chances are she won’t.
She will more than likely live longer in ALF because she would be in an environment where she would be less likely to accidently harm herself and be better able to live pain free longer. Her mind is strong (therapeutic fib) but she has physical limitations that have to be considered.
If that seems too far afield then, yes, you probably have to wait for the fall.
Hopefully, you will arrange for her to continue to have therapy once she comes home.
But remember that you and sister need to be watchful that you don’t wear yourself too thin too soon.
Please, please set boundaries. Hire help. Don’t bring her home and start doing housework and running foolish errands. MANAGE her care. Don’t provide it. You have to pace yourself. Decide before she comes home the amount of time you will contribute. She’s had someone waiting on her 24/7 in the rehab. Why would she think she needs ALF if you provide all the help.
Good luck.
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Abby2018 Mar 28, 2019
Great advice....thank you. Yes, they would both move to AL together, which would certainly be the safest alternative. We have done a much as we can to make the home safe....but there are still obstacles that makes falling inevitable. She is very stubborn and places her love of her possessions above all else ( which in part makes the home unsafe). Therapy will continue and you are correct....she will expect the same level of attention when she’s home. I don’t think we can handle it.....she will drive my dad crazy.
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"Manage her care...don't provide it".

Please, Abby. Remember this.

Your parents are financially comfortable and can hire help. Help them find an agency.

Do not become your mom's personal servant.
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Abby2018 Mar 28, 2019
Thanks Barb.....Truth be told, my plate already runneth over with my own family commitments and this added burden will be short lived.....for both me and my sister. Especially since my brother is useless and refuses to commit himself. Sadly, my dad would never move without her.....that is until this has a negative impact on his own health.
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Carefully consider the answers here, Abby. DO NOT allow yourself and your sister to become your parents' stepandfetchits.
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Good for you, Abby!

We have a longtime poster here, Frequent Flyer. Her parents went to look at an AL ( because she couldn't do the home upkeep for them anymore). Parents said " maybe when we're old" ( they were 95 at the time)

The mom fell, hit her head, major brain bleed. She died. The dad then happily moved to IL and then memory care.

Sometimes, all you can do is wait.

Keep in touch. We care!
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Abby2018 Mar 28, 2019
I am so glad I found this site.....kind, caring people who pretty much understand the struggles and challenges we all face as our loved ones grow old. Great advice from kindred spirits. How fortunate we are. As always, thanks again Barb.
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Safety, comfort, contentment. You actually have (sort of) four choices.

You can choose to place her her and her spouse in the nicest AL you can find.

You can allow her to return to the life she was living before she fell, to fend for herself with her spouse’s help.

You can bring her home with full time live in help.

You can bring her home and plan to be her full time care giver.

The decision making? BRUTAL. But as painful as it is, when you consider her medical status and your father’s willingness to accompany her AND her medical provider’s input, the decision seems a bit clearer.

Of course, SHE REFUSES. EVERYONE with dementia refuses, because of the dreadful and undeniable effects of dementia. And while it is tragic in every case, her “refusal” however poignant, is the LAST consideration to be using to decide what can be done to help these dear people to a life that is “safe - comfortable - content”.
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So, Abby. She's not dealing with a full deck of cards, is she?

Do you have medical POA? I think not.

As damaged she is, it's your mom and dad's right to make poor decisions. And it's your right to say "no, that's a really stupid choice mom. Why have you saved for a rainy day if you're not going to use it to fund your care?".

Get the money question out in the open.

When we realized my mom needed facilty care and that it would cost 5k per month, my mom said " oh, I can't afford that". Fortunately my sil the MBA said " don't be silly. Of COURSE you can afford that".

You need to be very tough here, Abby. You need to let both of your parents know that you're not signing up for this gig.
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Abby2018 Mar 28, 2019
I even made arrangements for them to visit a lovely AL facility just 8 miles away. Very highly rated. Weren’t interested. My dad is digging in more and more to oblige mom. At this point, I can’t see getting through to them until something happens once again. I will continue to take her to drs. appointments because I feel the need to stay in the loop since I can’t trust her feedback. She lies and her perception is not reality. I will continue to fill her pill box once a week. Sister made arrangements for the home to be cleaned on a monthly basis ( not our idea....it should be done weekly). Short of that I will not do any more. If brother wants to fill in the gaps he’s welcome to it.
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Let her drive dad crazy. Make HIM want to move to AL. Move him there.

Mom will be alone and she'll need to make a choice. Home alone or AL with Dad.

Abby, don't see this as YOU needing to step in. Make it inevitable.
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She refuses to go to AL, which is understandable. I had two aunts who gladly went to AL before they 'needed' to, because they didn't want to be a burden to their families. My mother totally freaked out when I took her to AL, and I felt like a complete failure as a person and daughter, and yet, I had no other choice. My mom was in the AL apartment less than one day when she had to be moved to Memory Care, because that was really the stage she was in. The story is long, of course.

Back to your mom, refusing. Can you say to her, "we (her daughters) are not capable of providing the care you need now? We don't have the skills necessary to care for you on a 24 hour basis. Please let's consider AL so that you have what you need, we can continue working, etc, and we will enjoy our visits with you on a regular basis."

I know this is very difficult and perhaps seems impossible, but you cannot give up your life for someone else, even a parent.
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HI- My sister and I faced a similar situation with our parents. After firing 10 (yes, 10) home health aides-we had no choice but to help them move into an AL apartment. My mother expected my 88yr old Dad with Parkinsons Disease to help her and manage his own medications. (Was not happening) Year and a half later, they have been separated due to my mother's continuing fighting with everyone-my father, the nurses, the aides, my sister and now, me. There is no one left. She has demanded a night aide, in addition to living on the concierge floor-which is kind of a joke. If I told you how much it costs--oh my goodness!! But still the little tyrant makes constant demands and driving us all crazy. My piece of advice-as the others mentioned above, manage their care, get them in a safe and comfortable environment and go and visit once a week. Maybe then Mom will acclimate and find some others to complain to-I mean --talk to. I never thought our lives would turn out like this--theirs or ours. My mother expects me to be at her beck and call and actually told me that if I didn't have to worry about HIM (my husband of 37 years) I would have alot more time to care for her. What a peach! Don't let her go back home alone-something will eventually happen that will necessitate their going into AL. A good AL facility will work with you-I think they exist mostly for the daughters and sons who stress about doing the right thing for their sadly diminished parents. Good luck. Be strong. this is tough.
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Swc610 Mar 30, 2019
re-reading-my mother fired the 10 health aides. Most were lovely women who did not deserve to be treated poorly. Why I allowed myself to be treated that way for so long, I don't know.
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