My Mom (96) is in a Senior Living Facility for 3 years and now needs skilled nursing. What would be best for her?

Since your question was “What would be best for her?”, a couple of alternative concerns might be helpful while planning for her future.

If she does have “short term memory loss” and/or dementia, what indicators are you getting from her that her desire to be “home” is actually the place where she lived previously with her husband?

Many very elderly people in residential care talk about going “home” without necessarily meaning the last place they’d lived, or even any specific place in their pasts.

My own grandmother had come from another country at the age of 14, and never lived anywhere besides there and the “home” she entered the day she married my grandfather, yet poignantly pleaded to be taken home for several months during her seemingly endless cognitive loss.

When my mother became a victim of dementia, she too sought frantically to go home, and one day I took her past the home she left after 45 years when her hip had been broken. I regretted that outdoor visit for the rest of her life, because it jogged an uncertain but also longed for recollection that I couldn’t fulfill.

Do you have any way to determine what your mother’s specific expectations of “home” actually are?

If you know that her husband can “….no way…..take care of” her, will it be possible for you to access all of the support survives they’ll BOTH NEED?

If there’s any risk of any kind that circumstances could go from bad to worse for your mother OR her husband you will most likely be more comfortable yourself by considering BEFORE you make such a major change in all of your lives.

One of the hardest issues that hit us as caregivers is sometimes the fact that there is NO good or fair or kind or comfortable choice available for our LO, and when that happens we wind up having to make the choice that is the LEAST NEGATIVE.

If that’s where you are, make your choice based on alternatives that are the safest for her, least disruptive for all of you concerned, and least time consuming as possible potential decision making criteria, in addition to your thoughts about her needs.

Ultimately it comes down to doing the best you can.

My present LO used to say -

“When in Life You Do Your Best,
God, with Love, Will Do the Rest”.

Are they saying skilled nursing because she is non ambulatory?

I would find out exactly why she needs skilled nursing and start from there. One on one home care might be enough with a hospice nurse coming in. Someone, maybe her husband will have to give her meds, aides are not allowed to give them.

When my dad was in skilled nursing care, he was given his meds by a nurse or Med tech and everything else was done by a CNA. The NP came in daily for about 60 seconds to ask "how ya doing?"

One thing to consider, if she doesn't sleep well at night, will you be able to manage your life with minimal sleep?

I think that you should follow your heart and use your head to make certain it is doable for everyone involved.

You say ‘It breaks my heart when I go see her. .. I know my Mom is declining fast’. Perhaps your mother is another person who would like to die at her own home with her own rules. It might be quicker than with more care – in fact it might be very quick - but perhaps it would be what she wants. Perhaps you could check with hospice about how long they think she has, including at home. If it’s just a couple of weeks, it might be the best thing. You might be able to manage the costs of 24/7 care for a short time. If not immediately, a promise for a week or two’s time. It’s worth a thought? Or a frank discussion with your step-father?

Hello...her Husband, (my stepdad) lives at home. When I take him to see her it always turns into an argument. She tells him she wants to come home and he points to me cause I have POA on her.

I was in he same situation a year ago with my mother. I was very stressed over it and my wife suggested we bring her home. My mother never asked to come live with me and told me that I have been a wonderful son, so she was preparing herself for death. She was down to 70 pounds (she's always been petite) but her normal weight is 110.
I called her Doctor of 30 years and she told me to bring her home.
We brought her home and the first 3 months were very difficult.
We hired help and she had a nurse visit every week and physical therapy for 3 months.
But she started to gain weight and get stronger.
Today she is up to 105 pounds and exercising by walking around our house with her walker and spending 30 minutes per day on a recumbent exercise bike.
Sometimes they can come back and get much better.
She was 93.5 when I brought her home.
It might have been a miracle. IDK
My point is that there is still a chance for you mom.
She is also back to bossing me around, so that's a good sign.

She misses her husband? Isn't he in the same place? Can't he see her there?

If she can see him there, leave her there. Moving her now will cause additional rapid decline. It will be hard for you to care for her there.