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I am a 30 year old only child of two only children. My parents have both passed away as well as my other grandparents. My 88 year old paternal grandmother is my only remaining family and I am hers, so her care has fallen to me. Since this August she has had 3 back to back UTIs. She has been in the hospitals for falls with utis 4 times in the past 12 months. After the most recent episode in which her neighbors had to come get me because they could hear her inside her house but she couldn't get to the door. I went and she had her phone right beside her but wouldn't call for help (was also an issue when she had a medical alert button she wouldn't push it when needed). The dr at the hospital does not think she can safely return home. They sent her to the nursing home for skilled care. With the most recent UTI she had major incontinence issues and massive confusion. Usually once she is on antibiotics for a few days the confusion improves, but this time it hasn't. The PT at the nursing home says she has no safety awareness and if she starts to fall she just falls and doesn't try to steady or catch herself. We don't have a close relationship to begin with, and she is fiercely independent. Today she called me and told me she needed to call a bank in a town she hasn't lived near in 15+ years because she had been robbed and they had taken all of her checkbooks. She never had any checkbooks with her in the facility, but was adamant that someone had taken them. It's frustrating to not have anyone to bounce ideas off of, because no one around me has dealt with this. I'm also exhausted after being my mom's primary caregiver during her final months of stage 4 cancer and am still dealing with selling my parent's homes and belongings. Any advice appreciated.

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Long Term Care best option in my opinion right from rehab. Tell rehab you are unable to care for her. You can help your grandmother by making sure she gets into a decent facility and she receives good care. The best to both of you.
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She clearly does need long term care now. The BEST WAY to get it now is while she is in rehab. See the Social Worker at once. Tell them that you have been advised now she have LTC. They will be able to help you get together what her assets are, and what LTC facility best matches her needs, and will be so much easier for THEM to find placement in Covid-19 times, than for you. You are 30 and need to live a life; please don't consider taking her home in your own care. If paperwork is not done for POA and etc. The Social Worker can help you with application for emergency guardianship the easy way. So sorry, you are very overwhelmed just now.
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hfry15 Oct 2020
Taking her into our home is not an option. We don't have the relationship for it nor would our lifestyles be compatible. We have pets that she wouldn't like and my husband and I tend to be night owls. It was hard enough for us having my mom (who I had a great relationship with) live with us for 4 months during her cancer treatments. Fortunately the POA paperwork is already in order and the facility she is at would be able to transfer her into their LTC. I feel like it's even harder being a grandchild making decisions than it was making the decisions for my mom. I don't think my grandmother really sees me as an adult and constantly judges my decisions, even though I'm trying to do what is best for her.
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The doctor and PT have advised that grandmother’s needs have shifted and she requires a higher level of care now. She may not like it but she’s no longer safe living on her own. Do you have POA for her financial and healthcare decisions? I hope you or someone reliable does as this is the time she needs a responsible person to act for her. Can she afford full time help in her home? If not, she’ll need to be moved to a place where she can get the care she requires, likely memory care or nursing home care. Talk to the hospital or rehab social worker, they usually have good advice on where to look for your next steps.
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hfry15 Oct 2020
I do have POA. I have considered in home care, but I'm not sure if that would be better or worse than staying where she is. She is very much a loner and doesn't like people in her space. I fell like she might be more resistant/ belligerent if someone was in her space as opposed to her being in a facility, if that makes sense.
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It definitely sounds like your grandmother belongs in Skilled Nursing permanently, as she's not capable of living alone. Even if she's not suffering from permanent dementia, the falls alone and the lack of safety awareness make her a very high risk person to live alone. There comes a time when independent living becomes impossible, especially when the elder is relying on a family member to do 90% of everything FOR her and calling it 'independent' living. It's not. It's at the expense of someone else and with another person doing almost EVERYTHING for the elder!

Definitely consider leaving her where she's at, where she can get proper care and live safely. If you send her back home, it's just a matter of time before some crisis hits and then the decision to go into the nursing home is taken AWAY from her. Having something done under crisis conditions is never optimal. That's what happened with my folks (I'm an only child too); my dad fell and broke his hip while living independently with my mom. Rehab refused to release him back to IL and he had a choice of either staying there in their long term care section, or finding an Assisted Living residence that would accept him (and my mother). So I had to scramble like crazy to find them an ALF, move them............ugh, it was too much, in reality.

Make the wisest decision you can NOW, while cool heads prevail, and while choices still exist. Don't wait for a catastrophe to strike before getting her into long term care.

Good luck!
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