My mom is 75 & has lived with my husband & I for 2 years. She has copd, emphysema & moderate alzheimer/dementia. Currently her health is stable, but she is frail. She has a visitation nurse once a week and bath aides twice a week. My husband & I both work full time and for now she can be home alone for a few hours at a time. She does NOTHING all day & night except watch a little tv & sleep. She is content with that. We have tried encouraging her to read, or knit or even fold laundry and she is just not interested. She has never been a very social person. The only place she ever wants to go to is the casino, which I take her a couple times a month. She depends on my husband & I for all her needs. He is very patient & loving toward her. I know I am very lucky. We do not have any family to help She has begged me to not ever put her in a nursing home and I know I have made promises I cannot keep. I am tired, stressed, I feel resentful & guilty. I don't feel like a daughter anymore. I love her and want what is best for her, but at the same time I want a life also. Is that selfish?

She is on medicaid and her choices may be limited. How do you prepare your parent for a different living arrangement?

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First of all, you have already honored the spirit of your promise to "never put her in a nursing home." You've done all you can, so don't feel guilty.

Your mom likely thinks of nursing homes as they were decades ago. Most have changed quite a bit, many have changed dramatically. They aren't the warehouses they once were (in most parts of the country).

As to what she needs - I'd say a nursing home. Assisted living is generally for a basically healthy elder who needs some help and increased safety. When a person can only be alone for a couple of hours and has COPD and other physical issues, plus dementia, she should qualify for a nursing home. Since she's already on Medicaid, a nursing home would be paid for, while assisted living may not.
You may have to put her name on a waiting list for a Medicaid bed, so I wouldn't put it off.
Good luck,
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In my town, here is the difference between Assisted Living and Nursing Home. In AL, you have your own apartment/room (some with a little kitchenette and some without) but you have to provide all your own furniture and essentials (i.e. toilet paper, toothpaste, toothbrush, towels, soap, etc.), usually 3 meals a day are provided to them in a cafeteria type setting, their medicine is controlled by the staff, and the rent is set by how much "help" you need. In a NH, you usually have to share a room with someone, all essentials are provided, their medicine is controlled by the staff and there is usually one set rent-rate due to you usually requiring more help be provided. A NH is usually higher than AL. Check with your Adult Services and see what Medicaid pays for. If she can get in one of these facilities, I would suggest it. She would be around people her age, but she doesn't have to be very social either. It's up to her. She can watch TV in her room or whereever and would have 24/7 care while you and your husband are at work. With Dementia, it will relieve a LOT of self-induced stress so you're not so worried about her (or your house) when you're not home. If you find one you like, maybe you could take a tour of the facility with your mother so she can see what it would be like. Just tell her you're just checking things out in case she becomes worse where she wouldn't be able to stay with you - that you'd like her input on it. But only you know when it is time to do something like this with your mom. Just do some research ahead of time so you know what Medicaid will pay for. Hope this helps. ((HUGS))
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