She is currently in a rehab facility and we were told that she needs 24/7care - she has dementia does not really have any physicall ailements except her balance if off - she is constantly crying to come home although at home she gets anxiety - we are thinking of admitting my Mother into a nursing care facility but the guilt is killing us and we feel would it kill my Mother

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Teena you're facing an impossible choice: impossible because there IS no choice which can guarantee high quality of life and peace of mind for your mother. I feel desperately sorry for your situation, it is one which we would all dread.

There is no pretending that, at 99, your mother is not extremely old and probably frail; if she has dementia as well, then it is likely that she will feel out of place whether she is living in your home or in a skilled nursing facility, and she will continue to have the constant urge to 'go home' - which means only that she is seeking the kind of familiarity and security that are no longer accessible to her.

Unless you are able to provide an extraordinary range of services at home, the facilities at the SNF are likely to be superior. In addition, especially if she recovers well in rehab in the short term, she will benefit from the variety of social contact available in the SNF. The trade off, of course, is that she won't be the sole focus of attention, and she won't have the constant company of her child/children; but you can compensate for that with frequent visiting and close working relationships with her professional caregivers.

The guilt, the guilt, the guilt… oh dear. This is the 'what if' question that no one can answer. You and your sister are afraid, are you, that if she became extremely distressed on transfer from rehab to the SNF then the emotional trauma would result in her rapid physical decline?

Well now. Let's assume you've chosen your SNF carefully: in that case its staff will be skilled in dementia care, and experienced in helping frightened dementia sufferers to settle well in their new surroundings. I.e. they know their stuff, and you can trust them to do it to the best of their ability.

Now, unfortunately that can't be a guarantee that your mother will take to her new home like a duck to water. And unfortunately at 99 any hïatus in her care could lead to a set back (the same goes, mind you, for her transfer from rehab to home, if your home has become unfamiliar to her), which could be dangerous.

The one thing that you and your sister must take to heart is that you are both making the best choice you can for your mother, and you must not blame yourselves for being unable to magic a perfect answer out of thin air.

Your mother will be safer in the SNF; she will have many more, and better qualified, people contributing to her care and wellbeing; and her being placed there will still allow you and your sister to spend as much time as you can spare in her company. The transition may be painful, but that will not mean you've made the wrong choice: it means that your mother's dementia makes change hard for her.

Have you found a facility that you both rate highly? Or are you still searching? You could make the discussion of your anxieties one way of gauging how good the SNF is: they shouldn't laugh it off, or glibly tell you "oh she'll be fine"; they should take your concerns seriously and be prepared to explain their approach to settling a new resident in. I hope you find somewhere you're happy with, and that it helps to set your minds at rest.
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Thank you for you quick and helpful answer - there is only me and my sister we are able to get 24/7 care for our Mother but the question is will she be getting any stimulation out of this - she use to go to a senior center but is unable to now - we were told that the dementia unit always keeps there seniors active with things to do. We are not sure about my Mother she always seems to unhappy.....
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Eyerishlass is absolutely correct!
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The question of whether or not to admit an elderly parent to a skilled nursing facility always causes guilt. In everyone. When I was faced with the same decision the guilt of it made me sick and my dad was only 78 (but with numerous serious ailments).

Providing around-the-clock care yourself would be impossible. Caring for someone around-the-clock who has dementia is impossible, even with help (well intentioned family members). I don't know if you have siblings but if you do I'm sure you've all discussed this. No one wants to make the decision to place mom is a nursing home. You all may have come up with ways that work if your brought your mom home. It all might look good on paper. But I think others would agree with me that it can't work unless you can hire around-the-clock help. If your mom is in a position financially to hire 24/7 caregivers this would be an option.

If she isn't, the only other option is a nursing home. You've been told by professionals that your mom needs 24/7 care. You can split the 24 hours up according to how many siblings you have but never count on siblings to help. One person will end up doing 95% of the work. That's the way it is. And if you do have siblings I'm sure you all have jobs and maybe families of your own to care for.

It is a gut-wrenching decision to make but it's necessary. Guilt just goes with the territory.
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