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I am a caregiver for both of my parents who still live in their own home. My mom had a stroke last year that affected her memory. She has gotten worse and I know it’s time to get her into a nursing home it’s the hardest thing for me to do. My parents both can’t get around very well and my mom is now lashing out at my dad and accusing him of sleeping with other women in the neighborhood, mind you he is 91 and can barely go to the bathroom. They have been married for 69 years and it makes me sad to see what is happening. I have a brother who lives here and will help if I ask but doesn’t see things like I do. My sister lives 7 hrs away and doesn’t come home very often. I worry about my parents 24/7 and I’m getting frustrated and resentful. It’s not fair to my husband that I come home from there and am always crying. I feel like I have no outlet and feel so guilty. I hate when people tell me how lucky I am to still have both my parents but I think, am I? This is not my parents anymore. They rarely get out and do nothing but sleep or watch tv all day. They both are hard of hearing and with my mom being so mean to my dad she won’t eat anything he gets her and she doesn’t take her medication unless my brother or I make sure she takes it. She is also diabetic and she doesn’t regulate that like she should. I try to go over there every day but sometimes I just can’t handle it. She has a nurse come once a week and I’m going there in the morning while she is there to talk to my mom about the next step and I’m dreading more than I can say but I know it can’t go on this way. Sorry to go on and on but I know some of you might be able to relate. I just think she won’t understand what we are saying and meaning as she is in a fog most of the time. It would be so much easier if she would say I agree it’s best for me to be somewhere where I can be on a schedule. But to be honest I think she will just give up in a nursing home.

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Many good answers and suggestions have been offered.
My take on the high points:
Don't discuss with her.
Take her to the home. Tell her the doctor is going to check her health out for two weeks so she has to stay.
Visit often at first and be prepared to stay overnight the first night.
Thank God for the many good suggestions from forum members.

Grace + Peace,

Bob
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Caltink, you tell them that you're taking them to lunch.

You arrange with the facility to arrive at lunch time. One person sits and eats when them while someone else sets up their new living space.

Most facilities will help you make a plan for this transition.
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Your mom's personality changes do sound like dementia--- the accusations especially.
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I saw a beautiful post on Facebook about a tired out old 30 year old horse that had once done a lot of rodeos that now just wanted to be left to enjoy his old pasture. It's a true story that nearly brought a tear to my eyes. I know what it's like to suddenly not recognize a parent. I get what you're saying too that she may give up in a nursing home.

Do your parents qualify for free in home support services through the county? Or an 8 hour per day, 5 day per week caregiver via insurance?

Can they be moved together into an assisted living arrangement? So much of it all depends on money. What you can't pay for falls on you. It's exhausting physically, mentally, emotionally and spiritually, and just when things are better, there's a shock of some kind.

If your father is lucid, can he make the decision for both of them? I get the feeling sometimes the elderly turn vicious on people they think want to remove them from their independence and into a nursing home. I don't know if they realize when they experience what seems to be psychosis. I also don't know if they can be dangerous. Im asking those questions myself about my 86 year old mother. I'm 55 and am toast.
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This is so hard on each one of us has who has gone through this. It's best that you visit the facility under the premise of meeting a friend there for lunch. Ergo, if the friend can't make it, you can still say how lovely the place is. But the move is critical for your LO's well being and safety.
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First of all, I know you love your parents - you love them for what they used to be. They are no longer your parents as you once knew them and this is horribly difficult to see but to have guilt over your feelings is absolutely insane. You are a human being and you are hurt, frustrated, angry and scared. Who would not be when this happens? You must face the fact that you cannot care for them any longer without you and your family being destroyed and having bad consequences. If she is losing it as much as you say she is, then she must be put somewhere where she can be cared for. And as to her negative behavior, I don't care if she is old, sick, has mental problems, whatever - it is unacceptable under any circumstances for any reason and if it can't be stopped, then the line has to be drawn immediately. I don't think it is possible for you to explain to her why things have to be different. She cannot comprehend this and she will in turn attack you and those around her. I would arrange to take her out for the day, like to lunch, and then bring her to her new home. Have it as comfortable as possible while you are out with her. She will be confused and perhaps rant and rave but let the medical staff handle that with her. As to giving up, that comes along with the aging process and nothing can change that. You just be with her and sweet and nice and then go home and lead a normal life. You cannot be surrounded with negative people. You are worth far too much more.
Good luck and peace to you.
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Like others have said, talking about moving with her will be of little use at her stage of decline. Once you pick out a place, go for lunch there with her under the guise of meeting an old friend. Take her back home afterwards., On moving day, be sure her room is set up and go for lunch again but this time you leave afterwards and say, “I love you, I’ll see you next time”. Leave and follow the advice of the facility on contact at the beginning. Try and make her room a familiar place with pictures, bedding, towels, shower curtain, and a dresser from their house, and things that are familiar to her vs getting “ all new stuff”. That way she may feel more comfortable in her surroundings. We had two parents who resisted moving and after we placed them, my dad accepted it and adjusted but my mom never did. She still hasn’t but that’s because she wants to “go home” to her house in 1960 and be with all her friends and family. Her wish is an impossibility. I solved her anxiety by still taking her away every afternoon and spending time with her. My dad has since passed and I am able to once again take her away daily. ( I’d had major surgery and was homebound for 6 weeks). My mom is back to still being sad she can’t “ go home” but her spark is back because she gets to see me again. Some people adjust and a few never do. You will learn that you need to do what’s best for you to be there for her. If you go down, it’s no good for anyone. That I can tell you from first hand experience. Good luck.
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I recently lost both my parents at 94 & 92 - the first line in my autobiography will be "at the age of 69, I became an orphan" - so I fully understand where you are at

You will be knocking your head against a brick wall if you think your mom is going to say 'well that's a good idea dear' - no she won't understand nor will any preparations do any good rather she may retain enough to be hard to manage - pack a small suitcase for her without her seeing & take it only 3 changes of clothes & toiletries because you can bring the rest later - if she likes tv buy a small one for $150.00 & put it up before she gets there

I fostered the idea with my mom that it was temporary & she was happy - indeed she took it as she was back in a nice rehab place that allows some personal items - I bought some small balls [dog & kid stuff from the dollar store] for hand exercises so that when she asked how long she was going to be there I'd say 'as soon as your hand improves & how are your exercises going?' then hand her a ball & we'd start doing squeezes but after 4 she'd forget what she was doing then stop 

After you settle mom then you'll have to settle dad so now do you want them at the same place? in the same room? - think that through as it seems dad may soon need help too - my dad also went into a NH but it was years afterwards & not the same one as he was mentally with it & wanted a different one

Good luck - Been there & Done That
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Step back a little. It will be hard, but you have to protect your own health and, frankly, your marriage. Cut your visits back to a few times a week. Your brother is there and, even though he's not as diligent as you, if there's a crisis, let him handle it or call you.
Skilled Nursing Facilities are extremely expensive, the lifestyle in them caters to the MOST frail of frail elderly, and your description doesn't sound like your mom necessarily needs one. Go look at assisted living communities that have memory care units. Pick one that you are comfortable with and that your parents can afford. Just the act of making the selection will give you a better outlook on a situation that must feel bleak.
It's very, very unlikely that your mom will have some epiphany about her ability to care for herself. You have to take control. Get your siblings on as allies. It won't help to have them interfering in a way that will take mom off the path to a move. Present the move as something that is happening, not as a decision your mom has to make. Doctors orders, necessary due to a change in yours or your brother's ability to help....use whatever you think will be most compelling and don't entertain objections. One tactic that often works is to frame it as a trial stay.
Would your dad move with her?
Good luck!
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Hold the phone. Your mom is a diabetic. Okay. She lashes out at your father. Alrighty then. A nurse comes to see her ONCE A WEEK?!? REALLY??? Girl, the only thing you can do now is put both of them in either a NH.....or AL. Don't say anything to them, just do it. For all of your sakes, just do it. They need this and so do you. Also, please call the Alzheimer's Association. They'll be a HUGE help. I know bc I use them.
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caltink Mar 2019
How do you get them into the car to go to the AL or NH?
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All of the above is great advice. It comes down to safety. A comprehensive memory evaluation would help in hr treatment plan and the physician, with you, would determine what steps to follow to create a better outcome. It is not easy, but you have to do what is best for all of you.
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In some way it's easier when people can't comprehend where they are or what's going on. The family members may feel at odds, but the family members also see and know the change in that person. Know that this won't be easy for you, but for your mother it will likely be the continuation of her confusion and lashing out. Old age and mental decline is for the birds!
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If you see that Mom is in a Fog, Then you Know it is Not safe for her to Be in her Own Home and it is Time to Go down a New Line. Talk to the Nurse who is Monitoring Her, Together it is Time to Make the Decision, Being Mom is not able to.
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I agree with 97yroldmom's comments. It doesn't sound like a "discussion" with your mom will be productive. At some point, we have to take on the "mom" (or dad) role and make the decisions for our elders. I would start looking for a good place for her and if/when the time comes, you come up with a plausible destination/excuse and take her there.

It is good that dad is okay with this. Reassure him that he can visit often, if he so chooses. Caring for her is hard enough for him, but to have to put up with the verbal abuse, which he likely cannot understand why mom does this, will wear him down even more!

Doc is in agreement and suggests NH, so that's a plus. Some NH also have MC units, which she may need - if she isn't really mobile, perhaps regular NH would be okay.

Absolutely recommend you find an Elder Care attorney (preferable with good Medicaid skills!) and consult with him/her. Usually a first visit (~hour) is free, so draw up and/all questions beforehand! There are many questions and issues to deal with. If either parent is beyond capability to sign contracts, hopefully someone already has POA (medical and financial.) If they own their home, that will have to be dealt with (EC atty should know all the Medicaid rules and can explain what needs to be done. Medicaid won't take their house, car, any/all assets or force dad to move - but best to get the real scoop from EC atty.)

Moving dad can likely wait for a while - let the dust settle in dealing with mom first. If need be, have brother do a trial visit, a week or two, and see how it goes. He might improve some when not under verbal assault!
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MoBryan
Thanks for coming back and giving us more information.

Your question was how to talk to someone who can’t comprehend about the NH.
I still think that’s not a good idea. Especially until you get everything in order. It’s no longer up to mom. Any discussion with her would only upset you both.

Good that dad is onboard.
I would make an appointment with a certified elder attorney well versed in Medicaid. My understanding is that when there are two parents to place, you have to file for Medicaid in a way as to not jeopardize the “community” spouses ability to support himself.
Ask for a free consultation with the attorney. You might want to visit with more than one.

It will fall into place after you get clear direction on what data you need to provide the attorney. You may be able to work with the NH directly but since you need to protect dad’s assets, try to find an attorney.

Since dad doesn’t have the same health issues as mom, he probably wouldn’t qualify at this time for placement with her.

Good luck with it all. Come back and let us know how it all goes. Hugs
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Are you in an area that has multiple levels of caring in one complex? Maybe your dad would feel more connected to mom if he was in a lower level of care in the same complex?
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You are getting excellent advice here, please take it!

alz.org will provide you with a world I’d info, and if you call your local chapter a real human will speak with you!
I found the Support groups to be especially helpful, I attend 3. I feel understood and validated in those communities, and have learned so much from these new friendships.

Take care of yourself first! We’re rooting for you!
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I really don't understand it when folks say "oh, my parent/loved one will die if they go to a nursing home.

That has not been my experience. The elders I've known who've gone to NH NEEDED that level of care.

My mom gained weight and learned to walk with a walker; eventually, she progressed to needing a wheelchair, but she was able to paddle herself around in that.

My mentally ill, demented WWII uncle, who had terrorized his wife and adult children while living at home was finally transferred to a MC care facility and eventually a Veteran's NH. He was the life of the party! Properly medicated, he became somewhat mellow and stopped threatening to kill my cousins.

I think you need to follow grandma's list above and just get it done, before YOU crash and burn. ((((((hugs)))))))
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anonymous763470 Feb 2019
I’ve had the same experience with my mom. She is thriving in memory care and loves it. And I have my life back.
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Have you and brother talked to your dad about wanting to move your mom?
You might find that the separation will be hard on him. It’s a catch 22 sometimes.
I wouldn’t talk to mom about it. If she has dementia she will only hear that you are taking her away from her home.
I think you are overwhelmed and not thinking too clearly yourself. Very understandable.
She’s not going to switch from dementia to clarity just because you have a nurse there with you.
Can your parents afford to private pay for care? If not, are they already on community Medicaid?
Has her doctor indicated that she is medically eligible for a nursing home or will she need to go to an AL facility?
its hard to make suggestions without knowing where you are in the process. You talking to the nurse might be helpful but if your mom has dementia, I’m not sure what good will come of it. Talk to her doctor to see where she is medically.
A certified elder attorney can help you figure out the financials.
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MoBryan Feb 2019
My dad has been mentioning about nursing home for awhile so I think he will be ok with it as he is frustrated and upset to see mom like this. I’m sure it’ll be hard on him to be separated but he can no longer help her.
I did talk to the dr about it and she thinks nursing home is where she needs to be and maybe if mom gets her meds and regular meals it will help. I know I can’t keep this pace and be well myself.
They are not on Medicaid and their finances are not great and that is my concern. I know I need to look into all this and really don’t know where to start but will find out. Thanks for the concern and suggestions.
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Sounds like there is not much to "discuss"
They both need help.
You can not do it all.
the discussion should be with your siblings to get their input. The Where will we place them. The when should we move them.
Who is POA for health and finances?
Is this something they can afford?
Will you have to apply for Medicaid for both of them?
Will you be placing both of them in Assisted Living or both in Memory Care?
Lots of questions.
Bottom line is you can not take this all on yourself. So to begin the discussion with your siblings tell them that you can no longer continue the way that you have. It is not fair to you or your family. So they have an option they can step up and take over what you have been doing or you find a place that will take your parents. Either Memory Care or Assisted Living. The employees are trained to get people to take meds, they can diffuse a situation so if your Mom starts lashing out at Dad they can handle it.
Your other option might be to have a paid caregiver come in and so some of what you have been doing. That would give you a break but still keep them in their home. (as long as they are safe in their home)
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MoBryan Feb 2019
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Or she will thrive because she is on a schedule and getting proper food.

Not to be cruel but would it be better if you died from a stroke or a heart attack trying to care for someone that needs 24/7 care?

It has to be stressful on your dad as well.

Unfortunatly some people need facility care and that is just a fact of life.

Find a place they can move together and have loads of help but make sure they can be separated if the level of care or aggression becomes more difficult.
Getting an assessment for placement will help tremendously, mom might even end up in a psychiatric hospital to get her stabilized.

We can only do our best, no guilt. She needs more care than she can get at home.
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