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My mother is 94 and recently broke her back when she went to get back into her bed when she was at home. She is able to be somewhat mobile and use a walker. She is currently at a nursing home that gives her rehab for maybe a couple of hours 5 days a week. The rest of the time she basically sits by herself in her room. She is legally blind and mentally alert. She wants to go home. My brother currently stays at her house and could give her most of the care she needs. She owns her own home and could afford to have someone stay with her. She is not rich. She is highly independent at least in mind and spirit and doesn't know who or how to go about finding someone to take care of her needs. She wants to live the remainder of her life in her home and is petrified of being institutionalized. It seems the nursing home and the doctors are trying their best to keep her at their facility and are not helpful in any way of helping her manage on her own. How do I get my mother out of the nursing home?

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Larry, I can understand your Mom wanting to live in her own house.... the older generation has a false stereotypical idea what nursing homes are all about. One would think that your Mom would be delighted to be around people of her own generation, making new best friends, where she can eat with other people in the dining room, and enjoy the activities.

Does your brother understand all that is required to help with your Mom? Would he be able to do 168 hours a week [24 hours x 7 days] for months on end... even if your Mom hires someone for a few hours a day? There are no vacation days or sick days when caring for someone.

At a nursing home the Caregivers work 8 hour shifts, then they get to go home, have a good night/day sleep and return refreshed the next shift. When one is caring for someone 24/7, there is no such thing as returning refreshed. At the nursing home the Caregivers know CPR, they know how to take blood pressure readings, there is usually a RN or LPN available on staff if there is a medical issue. And if a Caregiver is under the weather and not at work, there are others to fill his/her shift.

There is a lot to think about before bringing Mom home.
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If she is 94, none of her children are young enough to care for her. Encourage her to achieve her PT goals and socialize with others. Without that she will simply go home into a downward spiral and need 24/7 in home care, from someone a LOT younger than your brother.
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I agree that it seems highly unrealistic to suppose that your brother would be able to provide most of your mother's care. I'm 51, I'm knackered looking after my 90 year old mother, and she hasn't even fractured her spine. I honestly can't recommend it.

Having said that. If your mother is competent, and understands her condition and its implications, and she wants to go home, then nobody can prevent her. Therefore, to quote one of my favourite ever fictional characters: "if you must do this d*mn silly thing, don't do it in this d*mn silly way." (I realise you don't plan to! - but you could tell her words to that effect.)

Speak, with your mother, to the person in charge of her care plan and tell them that the goal is your mother's return home. Your mother doesn't need their permission to discharge herself, so they can't outright oppose her, so they might as well help her. What you need from them is a realistic time frame and a realistic expectation of how far your mother can be expected to improve. If she fractured her spine getting into bed, she is very frail: what are her underlying diagnoses?

What you need to explain to your mother is that there are practical arrangements that must be put in place before you can agree to her return. Possibly this will make her a little more co-operative, seeing as she'll have a goal in mind, and possibly that will speed her recovery (depending on what led to the fracture, of course).

You then need to assess her home (or better yet, get an occupational therapist to do it) for safety and adaptations, think carefully about what activities of daily living she will need help with, and think again about who is going to provide that help. To be blunt, you and your brother will also need to think about how long you expect your mother to live, and how greatly her needs might increase in the future.

What I'm saying, I suppose, is that it can be done, but it is hard work and you cannot prepare too thoroughly. She can't rush it, and you shouldn't help her to.

Oh, and involve your brother closely in all this planning, by the way. If he begins to look nervous, bin the whole idea and start again.
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She really needs to complete her re-hab. Your brother can stay with her as many hours as he wants to, in her room. I am certain that she needs stimulation and ways to go out into the lobby and to the activities.

I suspect that the doctors and nurses know how brittle your mother's bones are and are hoping that she stays in 24/7 care.

My mother is 95. My mother in law is 92. Both are getting good care in ass't living and a nursing home. It isn't easy on family, but think what is best for your mom.
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