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Mom has landed herself back in the hospital again with a UTI and likely sepsis. I am predicting a three day stay, which will lead to a 30 day stay in a rehab facility. They will most likely ask me where I would like Mom to go.


My choices are:


1) A facility about 5-10 minutes from my house. The care is adequate, but not spectacular. The décor is dreary, but the place is clean, food is horrible, really horrible, but mom doesn't eat anyway. Mom won't participate in any activities anyway, but the offerings are lame.


2) A facility 30-35 minutes away. I have not seen it, but I have heard good things.


On a website that rates rehab facilities and nursing homes, #1 has a 78% rating and #2 has a 90% rating.


If Mom goes to facility #1 I will visit her 5-6 days a week, usually short visits, but I have been known to stay longer or visit more than once a day. My kids will visit some.


If Mom goes to Facility #2, I will only visit her once, maybe twice a week because I have a 12 and 14 year old, work full-time and part-time as a Disney Travel Agent, hold a position on the HOA board and have a husband who travels a lot.


Either way, I will keep Carol, one of her caregivers, on the schedule for a few hours a day. Carol lives minutes from falicity #2.


So, would you put your mother in a lesser place but with more company or a better place with little company? As of right now, it would be for 30-40 days but I won't rule out that it could become permanent.

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I'm kind of having to make a similar decision for my parents.. closer for me or a slightly better facility.

If I were you I would visit facility number 2 before making any decisions. Have a meal there and see what the ambiance is like. Would it make a difference for your mom?

I think I would choose the facility with the superior care and the less dreary facility... even if it were a little farther to drive. You have to think about yourself as well. would you want to go to a dreary facility every day?

Maybe if you have a superior facility you may only need to go twice a week or so?
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So, I ran into our county's Chief Medical Director in the hall so I asked him about the two facilities and, oh, the face he made at the mention of facility #1... He basically said only put her there if you are going to visit every day to keep an eye on them.

BTW, I forgot to mention in my earlier post that Mom had two stays in #1 two years ago and it wasn't a bad place but it has changed management and her last stay there in January of this year was vastly different from her other stays. The place ahs gone down hill.

I am sure that right now, Mom is not in a position to weigh in on the issue so I am trying to go by how I would feel if I were the one who was going to be in-patient. While I think visits are important to her, I am leaning toward the better place.
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Take the better place and visit less often. We put mthr up in a memory care which has a great reputation for care, but is further. The other one is more expensive and beside a very fancy country club, so it's the "in" place to use but simply has too few employees to take care of all those seniors. Go for the better place and maintain your identity!
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Will you feel guilty about not visiting? Will you feel guilty for not having her in the better place? To me, the answer to those questions should help control your decision. If the place that is closer is not providing substandard care, than that is a perfectly reasonable choice. Don't go for "better" if you are to be guilt stricken by not visiting.
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I'm in a similar situation except my dad is currently in a facility which was recommended by his long time social worker which isn't horrible but the care is subpar just because the place is severely understaffed. I have a rapport with most of them and I visit every day, mainly because of what I just mentioned and, my dad has early on-set dementia and with the care concerns I feel better being as visible as possible. I've thought about moving him, but have no idea where to begin but also know it will be further and will definitely put stress on me and limit my visits (my mom has colon cancer and I help her at home even though she's very active for her age & considering the cancer).

I agree, visit place #2, have a meal and talk to some families if you can (maybe visit on a wknd so you can catch more ppl). If the care is that much more superior and it will make a difference to your mom then it's worth considering. Good luck!
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Please, please choose #2. It will allow you to not think about her care 24/7. When you are questioning, the care, she would be getting this thought that will leave your mind. That will drive you crazy. I chose a nursing home 4 hours away. Why.....far better employees, food, activities and a happy group of residents. Residents feelings are very important. They reflect how the home treats them. Being surrounded by happy employees and residents your reduced visits will not be missed.
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I had to make the same decision. Won't bore you with the details but tried place #1 and then moved her to #2.

It is a long drive for me every day but nicer her for her.
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I was faced with this dilemma as well. I spoke with several doctors who told me to place her in the BEST facility she could afford because she would be taken care of in the best possible manner. If it meant I would visit her less, that would be fine because I would know she was getting the very best. I went with their advice and am so glad that I did. Mom thrived there before her passing. I was able to see her once/week and take her out for the day. She had so many stories to tell me about the place. She loved it there.
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Put her where YOU feel most comfortable. Your mom will not care so much as long as she gets to see you and the kids. That's the best thing for her. Besides a 78% rating is pretty good as these things go. If she doesn't like the food then bring her a BurgerKing when you visit. My mom loves those things.☺
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Put you mother in the facility that is best for her. What if something happens to you, or another family member; you won't be visiting mom will you? Why haven't you visited place number 2? If it has good ratings you may be surprised at what you see. Staff may provide opportunities for mom to have plenty of interaction.

I placed my mom in a AL facility one hour from my home. It was the best place I could find within her income limits. It's very nice, in the country, they don't have a large turn-over with staff, the food is good, it clean and the facility and grounds are well cared for. Sometimes I wish she was closer, but I know she is in the best place possible.
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I'd say visit both. Then think about if you had no say about it. If someone else was going to put you in a facility. Which one would you hope they were going to pick?
You really only know others opinions if you don't check it out for yourself.
Peace of mind goes along way.
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I am feeling under the gun to make a decision because if Mom follows her usual pattern, she will spend just long enough in the hospital (3 days) for them to qualify her for the rehab facility. She just spend night #2 in the hospital. I have a feeling that tomorrow or Thursday will be decision day.

Although I like the idea of really checking out the place and even trying the food, I work full time and live 30+ minutes away. I send Mom's caregiver to check out two places and she felt that the one we are considering is much better than where Mom usually goes. I did stop by there last night and I didn't find the facility itself to be much different from the other one so it must be the care and staffing that are the big difference.

The not so good/close to home has one person per room in what used to be a two person room so lots of space and privacy. The better/but far away place is all shared rooms and they are really cramped.

I am very on the fence but I am thinking that it is most likely only for a month or so, so maybe I shouldn't overthink it.
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"Better" is in the eye of the beholder. I wouldn't want to share a room so I vote for the single room, not the shared room. If mom isn't likely to participate in any activities, then that doesn't matter. And you can always bring food in. If I understand correctly, this is for a relatively short term anyway, but even if it were longer I think closer is better so you can visit more. My mom is 15 minutes away and I've needed to go over more often recently to be with her when she's anxious and confused. So I'm glad she's nearby.
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M2M, my rule of thumb is asking doctor what would they do for their loved one or if the diagnosis was their own family. You got a face from medical professional on #1 facility. Right there... Caregiver that you like is closer to #2 which means likelier to make shifts, hopefully not call in at the last minute, maybe stay a few minutes longer. Facility #2 might mean fewer visits from you - sometimes the universe tells us that we need a respite break. If they are not completely incompetent, and you already know problems with food and staffing at #1, a private room in a pit is still a pit. Cramped room if you are not walking, or social flutterby, is less important. My MIL went to non-profit run by Good Samaritans and it was cramped, but staffed well by happy employees. Less money on grounds and top-level management, a little shabby, but they had activities, decent food, focused PT and OT. The fact that they were closer to MIL's church meant NOTHING - none of her "buddies" visited. Ya gotta give yourself a break and let rehab do its job. Part of that job is respite for you...
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You know your mom best - I have recently helped a number of online friends start giving "boosted smoothies" to their parents and it's having good results. If your mother won't eat, it might be better to choose the closer one where you can arrive with a smoothie to brighten her day!

What is in your heart? When I ask a question like you have asked, I usually know what I want to do - I'm just looking for approval. So, really, what is it you are wanting to do?
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My mom was in a nicer facility but about the same distance away from my sister as your possible #2. It's true she didn't visit as often but the quality of care and variety of activities made up for that. As to the food in #1: even if she doesn't eat much, she will still complain, they all do. So a better quality/variety/chef goes a long way to resident satisfaction.
But, if she will miss being visited by you and your kids, then #1 may work out better, especially if your kids can visit on their own as they grow up, and are willing to do that. That is priceless.
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Visit both. But, I'd advise to go for the closer one. The fact that you'll be handy to oversee things could more than make up for the additional fancy-ness of the other.
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Honestly RayLinStephens, I go back and forth. mom is currently I the hospital near where the far away facility is. Last night after making the hour round trip just to have my mother ignore me for 15 minutes and then act like I was abandoning her when I went to leave, I was thinking that I really hate the drive. It makes it impossible to do the drop in and takes up a lot of my family time for so little reward.

And the single room is a big part of the decision. Mom seems to be a magnet for crappy roommates and to have, not only a roommate, but a roommate three feet from you is claustrophobic to me. It would be different if the roommate would be company for Mom - I would not feel the need to visit so much but I know she will get a bad one.

So, just when I decide to keep mom at the closer place, I get this overwhelming feeling that I DESERVE for her to be farther away so that I can limit my visits to once a week and make it respite care for me.
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M2M, I know just what you're feeling. My sister thought the farther away place would mean fewer but higher quality visits but it didn't work out that way. Often she would have to stand up to mom, "just say no," she couldn't drop everything and drive the hour+ round trip. That produced tension, feelings of abandonment (mom), resentment (sis), not good for either of them.

Now my mother-in-law is in a place quite close to me. The convenience, for all of us, more than outweighs the perceived lack of amenities. It is an older, smaller facility, but she has a private room, and there is relatively low staff turnover. Yes she complains about the food (but then they all do ;) Comes with the territory. My late mom (in the nicer but farther facility with the better food) eventually complained about the food too - and it was perfectly fine!!! Their worldview becomes smaller, magnifying their "issues." We will get there ourselves one day, so I try to take it with a grain of salt.
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mom2mom, that was a great idea having your Mom's caregiver visit the places. The caregiver can see things that look out of place where the rest of us wouldn't even notice.

I know my Dad's 2 regular caregivers were highly protective of him. And if something wasn't quite right, they would find the right person to speak with at the senior facility.

Do you plan to keep on with Mom's caregiver? I did with my Dad, but we agreed he didn't need them a full day, only in the mornings so he would have the same smiling face when he woke up.
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Surely there are more than 2 places - go to other places - the driving does become a real barrier - maybe #3, or #4 won't put you in this problem - your instinct is neither is right - go with that - it will take some more time to look but could solve that issue
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I vote for facility 2.
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Moecam,

We are in a rural area. We have one place (the not great one) 5-10 minutes from my house; the good one 30-35 minutes away and another one that I know nothing about right next to that one. Everything else is an hour or so away and I have no reason to believe that they would be any better than the second place.
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ff, I hired Mom's caregiver back when she only needed companion care and, although she has become family (my children want to know if we can keep her after my mother is gone), she is physically unable to provide 40 hours a week at mom's current level of need. She is 79 years old and retired.

I have brought in two other caregivers and "promoted her" to Chief of Staff. She has Mom alone for few hours a day but she is also responsible for scheduling, covering shifts, running errands, shopping for Mom, filling pill packs etc.

My plan is to temporarily lay off the other two caregivers while mom is in rehab and hope that I still have them when she is released.

Carol will stay on (as she did last time Mom was in rehab) and visit with Mom and such (and bring her laundry either home or to my house).

Rehab #1 is near my house. Carol can see rehab #2 from her house. That would be one good thing about rehab #2. Carol could pop in often.
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Go for the better one. We had that choice with our Dad, we went with the one closer to home, was easier to take Mom to visit as she needed to nap during the day. He ended up getting MERSA and was diagnosis with Pneumonia the day after being released from there, he passed away within a month. Good luck.
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Not trying to be rude here but with your schedule I don't know how u think you'd see Mom if she was close by. I am retired and have gotten to the point I see Mom 4 or 5xs a week and she is 5 min away. Mom has Dementia and really has no idea that I'm not there every day. I would take the nicer facility and think about it being permanent. With ongoing UTIs and diabetes, she will only get worse. I think having her aide go to visit is a nice thing but check with the facility to see if it would be OK.
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Why must mom leave her home? She is familiar with the environment for most of her life, why traumatize her by placing her into a an alien environment at the peak of her problems? She should stay in her home, care at her home and enjoy life to its fullest. There are numerous programs that let mom stay in her home with one-on-one care at no monthly fee like a $6,000 a month she would pay at a care home.
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JoAnn,

I didn't take that as rude at all. It is a legitimate question. Mom has had previous stays at the facility near me. The first two times were a couple of years ago when she had been in my brother's custody. I don't know how the place near me was chosen since she lived 40 minutes away but it worked out. The rehab center was literally on my commute home so I just popped in ever day.

I have since switched jobs and homes so it is not on my commute but when she was there for five weeks this past January and early February, I did find time in my schedule to stop in 5-6 days a week. in fact, on weekends, if she was napping when I came to visit, I didn't mind popping back later in the day because it was so close.

I agree that Mom will only get worse and I am contemplating where she will be in the long term. I think if it is a long term placement I would even consider placing her near my brothers rather than near me. They won't visit her there either but at least it won't be my fault.

I can't imaging the rehab center having a problem with Carol visiting but not a bad idea to ask what the policy is.
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Hopefully you can get her into #2.
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Chris,

The plan is to keep her in my home, where she has resided for the past two years. What is being discussed is a 30-60 stint at rehab following a brief hospital stay. She is on day two of the hospital stay and I anticipate that rehab will follow.

She has a festering UTI which has caused leg weakness and confusion. She vomited and her wet lung sounds cause the doctors to suspect aspiration and maybe the onset of aspiration pneumonia.

There really are no programs that will help Mom stay in her home based on her assets and income bracket. She is self pay. She pays for 44 hours a week care (while I work) and I provide the rest of the care for free. We can manage right now but I may have to consider a higher lever of care eventually.

And, BTW, she does not enjoy "life to the fullest" despite our best efforts. I don't know if she has given up or finds it too demanding but her days are mostly moving from bed to toilet to TV chair, lather rinse repeat. We all try to engage her, get her out, get her to have conversations. Honestly, how different is life at home different from life in a facility if she is no longer interested in participating?
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