How do we decide the next steps for my 92-year-old MIL after hearing she cannot live alone out of state any longer?

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My 92 yr old MIL is living alone in NY now. We live in Fl. She recently fell and now has phys therapist, nurse, social work and personal care aide. Although she's improving, their observances and tests have determined that she should not live alone. What do we need to do to determine our options for future care? How do we decide if her moving to Florida to live with us is the right thing to do? My husband and I both work 30 plus hours per week.

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I live in the USA while my 92 y/o mom lives in the Caribbean by her choice as she refused to leave her house. In 2010 after a stoke, hospitalization and restricted mobility we moved her into a Christian facility affliated with her Assembly where she is well treated and comfortable. During my visit I took her for and Echo. After viewing the results the physican provided a letter stating "she needs 24 hour supervision for mobility". Since she lives alone we felt this is the best care for her. On my recent visit I discovered that her non clinical acquaintance had negative plans for her gain and convinced mom she is able to go home. Thus, mom refused to use her prescribed cane, held on to others and walked, bathed etc. and insisted her friend care for her. On her arrival she was unable to climb her house entrance. My family and me have agreed that the Christian Home provides 24 hour medical care, supervision in contrast to her staying alone and unprotected in the house. Thus, decided what is best for mom. As a social worker I applied my knowledge and skills with consultation to decide what is best for mom. You have to assess, evalutate, consult in the decision making process with other family. Good luck.
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I have heard that the care in a AL varies-sometimes it is a long walk down to the dining room and some only check on the resident once in 24 hrs and they can be very expensive with upfront cost and monthly cost of $3000.00 a month.
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Also, if you bring her to your home, check with schools in the area that train CNA's(Certified Nursing Assistants). They should be able to handle her needs and may be a bit more reasonable than agencies. I had the 2 adult sons of a CNA we knew who stayed with my husband (while I worked). He actually enjoyed their company. Just a word on AL facilities - most in CA have one charge for the unit itself and whatever else is needed has to be paid separately. Ask questions before you get surprises.
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Please give much thought about bringing her into your home-read some of the thousands of posts here and on other threads -yes there is one who was happy about but there are not a lot of Ps's like Linda's around. Look into other options like AL and nursing homes now while she is get help-that will not last long if it is medicare home care-see an elder lawyer with her money at once to get advice once she is somewhere she can always visit your home and you will still be very invilved in her care if she is in Fla near you-if she is in a NH the state of Fla will take care of selling her home without thinking twice they did for friends -while her husband was ill for 15 years he never put the house in the childrens' name and after the husband died she and two of the children lived in it until she was placed in a NH in Fla and the state evicted the adult children and sold the house while she was living. The above suggestion of having students work as caregivers is a good idea-maybe an internship could be created with medicial students or social work students doing the caregiving. Just think it over carefully-use your head not your heart.
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You can always move her to your state into an asst living close to you. win win.
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You do have options other than moving your MIL in with you. They have great Assisted Living Facilities in Fl. In my investigations, I found that they have ALF with different care levels and the cost of are not at all what they are up north. But if you do decide that moving your MIL in with you is best. You could sell her property and utilize the money to help you with in-home care as well as the services here in Florida. I have found that maid service and home health aides can be hired separately and you can do your own background checks. You can safeguard your own home as if you were safeguading it for a child. Their all kinds of locks for stoves, doors, cabinets. etc. But you do do have choices and I don't think I would leave her in NY when Florida is such a great place for the Elderly. Whatever you and your husband decide, my best to you. One more thing, there are alot of Medical schools here and the students need to work PT or FT to help pay for their education, esp. the private schools, a good place to find help, if you do in-home care. Also, in looking for ALF or NH, their are many that specialize in Dementia care or Alzeimers care that you could look into.
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It's a series of hard choices done by everybody. You really need to think about if you want to be a caregiver and your DH too as it will become all encompassing and not get any easier. I'm assuming she owns a home and my comments are based on that.

For us, I, as DPOA for my mom forced her to move from her home of 50 years into IL in 2007. No, it wasn't pretty but she had refused to even consider moving to my state in the 10 years before (even after visiting several and signing up for an senior community apt) and had done two last minute refusing to sell her house and move into IL anywhere. The last straw was driving in for a surprise visit in 2007, she was 90, and upon opening the door we got hit with gas fumes as the stovetop was on unlit for hours.She was sitting in her room, watching TV and unaware. And it was the stove's fault. When we went to open 1 of the 2 back doors to get the gas smell out, we couldn't as the awning had fallen blocking part of the door and the key was broken in the lock - again not her fault as someone had tried to break in and did it. From that point on she had as far as I was concerned no say in the decision making. I placed her on a couple of IL waiting lists that afternoon and arranged for home health to come in several times a week till there was an opening. Took a couple of months.

She likely has Lewy Body Dementia - so she appears to be highly functional and great at ADL's. We were lucky in that because of that she was able to get into a very good & highly supervised IL and was there for a couple of years, did well, participated in activities and could afford it. She had a fall in her apt, refused to use the pull chain to ask for help (yep, refusal is her middle name) and then felt bas for weeks, not eating much. Had a more than 10% weight loss so she went from IL to NH (on Medicaid). She still owns her home.

On retrospect, I would have forced her to sell the house years & years ago. As it would have given her more flexibility in where and how to live. If you wait till they need a NH and they have a home, then they are stuck in that state in order to be covered by Medicaid. So if you move your mom to FL, then her home in NY will no longer be considered a homestead, so likely will have to be sold unless you can rent it for enough to pay for property management and all the expenses on a non over 65 exemptions piece of real estate. One of the experts on this site is a FL based elder care attorney - perhaps talk with him about your options on if you move her to FL.

Not everybody is good at being a elderly caregiver, I know that neither myself or my DH would be good at it nor could we provide the level of services and socialization that our mom's got/get at their AL/NH. Good luck!
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