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Thank you so much for your insight....He is currently in a setting as you describe. He had wanted to go to a acute care rehab and the daughters did not like it....So, when he got there nearly 3 weeks ago, he decided NOT to participate in therapy. His meds had not been adjusted properly (he is on vascular dementia related drugs now, responding well) After the 3rd attempt by therapists to rehabilitate him, they had to quit asking....I just found out yesterday that his daughter has made plans for him to be transfered to a nearby swing bed on Thursday...I can not talk to him about this because he is in a very delicate mental state and I do not want to upset him...They are using his stroke, paranoia, dementia attack against me to make themselves justified making the decisions...My husband loved and adored me, when he attacked me and thought I had built a "movie theater" with his money, he began thinking I was the enemy! I hear this feeling of paranoia against the caregiver is common, but it HURTS...He is now very sweet to me and told me he is sorry for having scared me, and doesn't want me to leave him (which I NEVER said I was going to)...but, the daughter is still the most trusted one....so..

I am just hopeful that IF he comes back into OUR home, I am treated with respect and not expected to have to take care of his needs. They are going to set everything up (CNA wise) but your point about letting the CNAs see in advance what he needs is a very valid one! They may go out of the house running! There are a lot of emotions his daughters are feeling, they haven't been part of his life in years due to "issues" they have had with my husband. He had a heart attack and breast cancer last year and only ONE of the 3 even called or seemed to care....the family dynamics are crazy...very very disfunctional.....But perhaps they are trying to take care of him for guilt or whatever....

Thank you for listening....ultimately I want the best for my husband....I just want to make sure their actions are taken for that same interest! I am 14 years younger than my husband, but feel 1000 !!!!!!

Bless you for your time and help! I will re read and re read your answer....! Bless all of us undertaking the stress and large task of helping our loved ones!
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I think FIRST they better let the CNAs see what they are getting into and whether it is realistic for them. If you have already been told that it will take two people to operate the lift, it does not make sense to plan for only one. Hiring non-agency people may or may not work out. They can quit, they can provide poor care, or they could be just wonderful.

Given the stroke diagnosis, he could concieveably be tried in a subacute or even acute rehab program - we used a HealthSouth facility for my mom. You could let the daughters explain their goal of caring for him at home, and therapists could try to get him to require less than total assistance for everything, plus most rehabs can do a "rooming-in" trial where the caregivers practice doing everything for a few days while still in the hospital. If it came from someone besides you that the plan was not practical, it might help. His daughters are probably grieving and in some degree of denial too, they are not thinking as realistically and a really good rehab social worker or discharge planner could help them with that. Do the daughters think things are much less severe than they really are? Do they understand about the loss of judgement and problem solving in vascular dementia, even though the person may recognize loved ones and have decent long-term memory? And that the antipsychotics may be helpful but also pose a risk of drug-induced Parkinsonism that may require modifications to treatment? They just may not really grasp all that, even though they are nurses, because after all, it is their dad and they think home is better for him and may even have hopes it will make him better again.

The other reality factor to consider is that especially with holidays and weather changes coming up, no one is guaranteed that every shift is even going to be covered.

Don't let anyone try to talk you into agreeing to do something you really can't do! You could hurt yourself trying, and your husband could suffer terribly in the process as well if he can't be cleaned and mobilized at all during times you are again stuck with trying to fend for yourself and him without help. There are times when facility care makes more sense and this my be one of them.
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Thank you for your help...Unfortunately my husband is 450 lbs with no way of assisting. He has vascular dementia, has had strokes, is on a .catheter and is 6'2" tall. He has psychosis as well.

I have been told by several rental agencies that the size hoist he would need would need at least 2 people to use if he falls. We do not know if he will be able to stand for transfers yet and how to get him back into bed after transfer has been done in a local hospital setting with 4 people and hoist, which hurts and makes him uncomfortable. I am concerned for his safety and comfort. He has had bladder spasms, infections and other problems since being in his current skilled hospital setting. His meds have been changed, he is cared for so well there.

I am being pushed to have him back in home by his daughters..They are both nurses. Before his move to a hospital for diagnosis (which they did not want to do, they wanted to medicate in home in his horrible condition) They chose to use a doctor my husband had never seen for the psychosis! They had free range of meds, haldol shots, etc.....after 3 days, the one daughter gave up and ran out of the house....

They are suggesting setting up ONE CNA per 12 hour shift, (unbonded) and using grandchildren to sit and I am seeing nothing but bad for my husband.....I can not have a part in the lifting, cleaning of him...I am not in good enough shape physically (I have been his caregiver for 12 years....in the past months I did it alone, cleaning him etc, but he could walk then...at least to the bathroom for BMs where I would lean him and clean him against the sink) I am no longer able to lift his 100 lb legs or scoot him)

I am trying to find what the legal aspect of this is...inotherwords, who sets the guidelines for his safety and health??

I do hope your mother is better...and if you are still caring for her in home, God bless you and keep you sane and safe!

Any info about laws, guidelines, saftey issues, liability issues using non agency professionals would be helpful....Can you guide me further??

Thank you so much for your insight and speedy reply....I am so frustrated and also grieving for the man that was and now is no longer....I miss him!
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I learned to help turn and clean up my mom (5'1" and 265 lbs) in one of the hospital settigns where they actually wanted to have family help (I was in one where they did not want that at all - I was told I was in the way and they had their own way of doing things!) But I never got to where it was a one-person job to scoot her back up in bed with a draw sheet and do the whole change start to finish. A few of the nurses or aides could actually do it solo. They organized the basin and supplies and linens and turned her on one side, clenaed her and rolled up the dirty stuff and tucked it under, then rolled her back over to the other side over clean linens and chux and diaper. There is a program here in Arkansas, http://arcaregiving.org/faqs/ to teach techniques for it also. Still, you may or may not be able to do it alone. Bathing will require special equipment unless the immobility is temporary and bed bathing would suffice. Most lifting equipment is unwieldy and may not even work in smaller spaces, but it is generally covered by insurers, and may be the only way to mobilize out of bed. Do check weight limits on equipment before buying or rentng though; you might have to go with a speciali bariatric equipment company for some items. This is not easy, but unfortunately is gong to be more and more common!
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