Is a referral required for LTC at a nursing home? My mother Is ready to go and thinks I need to just take her.

There is really just no answer to this grief at the end of life, and I fear we fight it too much. Is there any better response to what we meet at the ends of our lives than depression and grief? It is loss upon loss upon loss. To me it is better to try to talk about it. To say "How are you. Is this hard? What is the worst part for you? Are there things I can do to make this easier for you? Do you know how much I love you?"
They get very tired. The patients I saw at the ends of their lives, I kept trying as a nurse to tell their families, desperate to help them, that they are tired. That they are ready to go. That they have lived long lives full of happiness and pain. That they are tired now. Many patients literally turned their faces to the wall to disengage with their loved ones, ready for their next and last journey in life. The families were often desperate to re-engage them. I came to so empathize with the elders. They were ready. WE the young, the middle aged, the late middle aged could not get it. But they were ready. And they had done this life. It is very difficult to explain. I can only say that I learned from them, and I will never fear the end of life. I fear the torture before it, but not the leaving. I believe it is the "trip of a lifetime".
We cannot get it. We may begin to as we come more near.
Those who live long are ready. I saw patients who lived so long that they curled speechless into a fetal position. I am an atheist. But if anything could ever make me a believer, that would have been it. It was the full circle. The full cycle. It is quite beyond our comprehension I suspect.

"Seems" is the word that I find most intriguing here. Have you asked her? I once asked my very quiet aunt who told me that she was tired, very content to sit looking out the window at clouds and birds, and that she thought about her life, all the things she had done, and was quite content with that.

Because there are no hard and fast rules about facilities and what they are called and what services they provide I would recommend going to facilities and talking with them about the services that they actually provide and how the pay scale works.

Have her doctor fill out the paperwork for submission for a facility. In AZ it is a list of health issues, help required for activity of daily living ie bathing, dressing, preparing food, etc. Mental status and overall health, with requirements for managing their status, like daily walks, activities etc.

Doing these steps while you are waiting for a needs assessment from the area on aging will put you a step ahead. You will know what facilities can meet her needs, how much it will cost and how to apply for public assistance if needed.

You could always try a month respite and see if she does better. However, if she is having separation anxiety, she may just want to stay in your home. If that is the case then you will need to decide what you are willing to do.

Best of luck. Such a difficult situation.

So, consider calling the local Area Agency on Aging and having a "needs assessment" done. That should tell you what level of care she needs.

That's heartbreaking :(
It sounds like she would probably qualify for both a nursing home and an assisted living. For AL, no referral needed, just research and money! For nursing home, you will need a doctors referral, this can be the PCP, or if all else fails, you can take her to ER for failure to thrive, and tell them you can't care for her, and the ER doctor can make referral. However, it's very hard to find a LTC nursing home bed (not sure if you have medicaid already), and once a MD writes order, they are only obligated to find you "a" bed, not necessarily a bed in your preferred facility, so you never know where she might end up. I know it's sad, but you can't sit with her all day, you also have a life and things to do. If you are willing to pay for an assisted living, maybe those funds can be used to hire a caregiver to sit with her?? I know, but it's not you. You'll have to allow yourself to maintain some boundaries. I'm sad for you, it's hard.

Most nursing homes have some kind of "criteria" that the person needs to be meet to be "eligible" to become a resident there. Every nursing home or assisted living I know of has waiting lists a mile long.

I agree that her quality of life would be better in some type of senior facility.

Consider state-subsidized Assisted Living unless she needs 24 hr nursing care. My mom is in the nicest AL home in the area and because it is subsidized the cost is only $1800. They offer assistance with bathing, require everyone to come to meals in a beautiful dining room, dispense meds, and go to their rooms to get them for daily activities. Laundry is done & rooms cleaned. Chapel services daily and a hairdresser weekly. This is in Alabama but check in your state. It’s awesome!

To begin with are you sure you mean Nursing Home vs. Assisted Living. What are her main and daily needs? What is she capable of?

We didn't need anything to place step-father and wife in AL, except $$$$.

I should have used a different word than seems. I have asked her and she says she loves it at my house. I question it because she cries or tells me she cries all night.

She wants me by her side every minute of the day and when I ask her to come to the living room with us she doesn’t want to. I sit in her room or outside with her when she smokes. She even wants me to sleep with her. She has separation anxiety and we just got meds for that today.

She has dementia and repeats the same thing and talks about nothing else. When I try changing the subject she doesn’t hear or listen and goes back to her topic of discussion.

I think I meant nursing home but maybe memory care is where she needs to go. She can’t function on her own. I do everything for her. She refuses to bathe, wash her hair or dress herself. I fix her meds and food. She can’t see very well so doesn’t drive. She feels lost. She not only lives in a strange city our house is unfamiliar to her. It breaks my heart to see her struggling with everything. She has always been very independent.