My mother in law has become ill and has been in & out of hospitals/nursing homes since January. How do I get her to permanently stay there?

Ideally, MIL will show some spark of interest that she understands living alone is getting difficult. Please talk to her and find out what her concerns are. She may be afraid of what life in a facility would be like. Another family member had our Mom convinced that all nursing homes are neglectful, abusive, you name it. That was a big problem with our Mom, but she's currently doing VERY well there. The other concern Mom had turned out to be what would happen to her accumulated possessions. Can't take all of it to a facility - even if it's a private room. You will need to address that as a family & everyone's different when it comes to their belongings. She had limited money & knew she'd be on Medicaid so she wasn't too worried about paying for the nursing home, but did have some home equity - which she kept asking us to somehow "hide" or "transfer" so Medicaid would not "take it." I think she was having visions of being actively tossed out of her house by "someone from Medicaid" and it scared her. The house did have to be sold for Medicaid eligibility, but it's not like a monster comes in and "takes" it. If she wanted it transferred to someone else, she would have had to had done that 5 years earlier and my understanding is that Medicaid would not have looked at it. She did not do that. Talk to MIL and see what's on her mind.

In the meantime, make a list of your concerns - it will come in handy the next time she's in the hospital. I presented my list to the facility's social worker (when Mom was about to get discharged from rehab) and bluntly but politely explained that Mom had nowhere to go where she could get help with her extensive list of needs and I'd like Mom to stay at the facility where she would be SAFE. The place she was at had both rehab beds and nursing home beds, so they started working on getting her a nursing home bed. Caring for her at home had been a disaster. I was the primary caregiver, but I needed more helpers - which weren't available and/or did not come forward. Bringing Mom home again was not something I could commit to.

On that note, be careful how much care you yourself attempt to provide. I still have not recovered from caring for Mom at home. Her needs kept increasing and she got more and more demanding. I'd be getting her food & she'd be yelling from her chair about where her water was?? I know it sounds cold, but be very careful when getting involved in a caregiving situation in someone's home - especially when the person doesn't have a lot of motivation and drive to do better & would just as soon get waited on hand and foot.

When MIL is in the NH for rehab, who talks to the discharge department when it's time for her to be released?

Does she sign for her own release? Do the discharge planners know she lives alone? Do they send someone to her home to make sure it's a safe discharge?

Apparently your MIL is coherent enough to be able to make her own healthcare decisions? Have you and your husband (her son) talked to your MIL and discussed your concerns with her? Is your MIL worried about how she is going to pay for the nursing home and is that why she doesn't want to stay in one? Is your MIL willing to have a family conference to discuss your concerns about her health?

Since she doesn't seem to want to stay in a nursing home at this time, maybe you can get her to accept Home Health assistance? That might be the first step to getting her into a nursing home permanently. Who knows?

When you have a "frequent flyer" [Yes, they are called that by the hospital and nursing home staff;) ] like your Mom who is in and out of the hospitals/nursing homes repeatedly, something eventually happens that results in them having to stay in the nursing home permanently. Unfortunately, as long as your MIL is able to make her own healthcare decisions, then you are just going to have to wait until that day of reckoning comes.

FYI: Medicare and Medicaid frown on patients who are repeatedly admitted to the hospitals and/or nursing homes resulting in the hospital/nursing home being fined for having these type of patients.

I don't know if talking with your MIL's doctor or with the hospital or nursing home social service department will help, especially if your MIL doesn't want their help. I am sorry that you and your husband are in such a tough spot right now. All you can do is ask a lot of questions and maybe someone will have the right answer for your MIL's situation. Good Luck.

Dear sunnydays,

I'm sorry to hear of everything your mother in law has been through. Are you able to talk to her family doctor or a social worker? Maybe Adult Protective Services? It's really tough.

It sounds like she might have had a mini stroke, or its a combination of her uncontrolled diabetes, high blood pressure, cholesterol and congestive heart failure combined. It would be better if she could be monitored full time and have proper food and liquids.

I hope you can find her the help she needs.