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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 think further comments & opinions about the original question can only be helpful to others, however I'd like to inform posters that the Mom2Mom's mother had sepsis that didn't respond to treatment, wasn't able to go into a facility for long (or maybe at all, I don't recall exactly), went on hospice care, and has passed away. 

Many threads like this go on here on AC for years after the OP posted the question. I'm not trying to police the thread as much as I'm feeling sympathy for a member who lost their mother yesterday. ♡
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I think, ultimately, that the facility should be all about your mom and her care. Although the temptation is strong to make it more convenient for visits, I think that issue is secondary to mom's care and comfort. A good facility will provide her care and provide socialization and stimulating activities. Even if mom does not want to participate in scheduled activities, there should be regular room visits and opportunities for mom to interact with staff and residents. Also, in room activities should be available. If mom is provided these things, she will not miss the daily visits from you, or if she does, not as much. In my opinion, always go for the highest quality you can afford especially when it comes to the care of your loved ones.
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Mom2Mom,
Sorry for the loss of your Mom.
Feeling sad.
At the same time, you got your life returned to you.
You are a gracious person, deserving of all that is good.
Good for you for the escort of your Mom to the end.
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I couldn't go through all the postings however, I would go with the closer because you will be going regularly - what if 'good place but far' has a change of ownership? - if you are there 5 to 7 times a week then they will be on their toes always - I advise [from another person's & my own experience] that you change arrival times so that you come in morning/ mid afternoon/ evening etc - so they can't get mom 'up & pretty' for 3:00 tues because you come irregularly - worth taking a long lunch or have other family members help you with this effort

HOW OLD ARE YOU? - I don't ask this out of hand rather I know as someone about to be 68 & taking care of both mom & dad in separate facilities [they have the same name & chance of med files mix up is nil when they are apart] - if you are 35/45/55/65/ those answers are different as this makes a whale of a difference

I can't wait to have them closer - dad now 16 minutes not 3 1/2 hours has helped me so much however I am now doing more for him as he needs this but the percentage of time in travel has gone down so much - now I see him twice a week instead of once a month but actual time is slightly less - you have to weigh the pros & cons on YOUR OWN CIRCUMSTANCE - no other person wears your shoes - hope this helps - hugs to you from me
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Just checking in M2M to see how your mom is doing?
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Mom2Mom - Progress not perfection, and you have progress. This is better than where you were, and there is a light at the end of the tunnel even though you can't see how far away it is.

I'd get 24 hour care. You need a corner of your life back. Take all the help from hospice that is offered. And at work - it's a lot easier to deal with "mom's on hospice" than a person who has an aging parent for whom there could be 10 more years!

You will get through this well.
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M2M
Your care and support of your mom are amazing and I hope you can get things lined up without too much hassle

Let us know how her move home goes as we learn from each other

Now that the decision is made - will antibiotics be stopped and will the hospital discharge immediately?

You must be so tired
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I am so sorry. This is so hard. Get as much help as Mom can afford, if you can get 24 hours, do that. The time you have with her will be more quality time when you don't have to do the hands on physical stuff. Wish I had some words of comfort. Hospice does help the family as well as the patient.
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M2M, not burn leave but covering your behind if sudden crisis. You don't have to take it;) don't blame you a bit. If she can afford it I'd do 24 hrs. Leaves you able to organize all else and just be daughter. Take care.
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Thank you. I spoke to the hospice person a little bit ago and they are providing me with a list of caregiving companies. I am wondering if I need 16 hours a day or 24 since, before the hospitalization, Mom was sleeping through the night. I know her funds will cover that.

Non filing for FMLA because I have no intention of burning my leave or taking leave without pay to care for her myself just so that my brothers can inherit more. Bitter? Yes. Of course, the doctor won't make any specific predictions and he cushions everything with "she could improve" but he is thinking weeks.
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First just *hugs*.
Hospice does not cover 24 hour care in home. Your Mom will pay out of pocket. Hospice provides durable med equip and meds at no cost to you. No more doc payment. The hospice med folks see her no copay. Hospice will come to your home. Her supplemental may cover part of caregivers but I'm not sure of her policy. Call and ask.  If hospice offers help with anything say yes. Any help like volunteer sitter yes! Mattress yes! Anti anxiety yes! If there is a chaplain or social worker yes! Any materials for teens on transition yes! File for FMLA now. Take a breath and know we are all holding you in our arms as you take the steps. Your mom trusted you in this. You can do it.
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The PA has said that she will need 24 hour care when she gets home. Will hospice cover this or should I be calling agencies and expecting to pay out of pocket (she is on medicare and has supplemental insurance)?
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M2M, just hugs to you. Yes, hospice has done all this before and will help you organize what happens next.
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Mom has officially declared (to the PA) that she wishes to come home (to my house) and receive comfort care only. Now we have to figure out what insurance will cover, how to arrange for a hospital bed, caregiving coverage, oxygen etc. I am assuming that they have done this before and can help me with it all.
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I think you might be on a bit of a hiding to nothing waiting for your mother's decision. Isn't it asking rather a lot of her to be able to make one at this point? Perhaps the doctor would agree to see your mother when you're there to help her process the information.
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Pamstegma. I would respect her decision if I could actually get her to make one. She won't provide the hospital with an answer - just stating that she is still deciding. So, they are obligated to keep treating her and to keep conducting tests to see if they can find a solution. In the mean time, she keeps asking me to take her home. I told her that I am fine with that but she has to say it to the doctor when he is there.

They have explained to her several times that she is likely not to improve and they can just make her comfortable if she chooses and she can even go home and receive palliative or hospice care. She just can't bring herself to commit.

Ali,

I am guessing that your dad wanted to get better and still had some fight in him. My mother does not seem to have any fight left in her and hasn't wanted to do anything necessary for survival for quite a while.
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(((((Hugs))))) hope this works out in any way that's best for your family.
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Hang in there, M2M. I didn't realize that your mom was having such a health crisis, despite reading your post about the "palliative care" conversation.   My dad was in sepsis in Oct '14 and it took 2 weeks of IV and feeding tube, and another month of rehab, but he did recover fully.  This may not be in the cards for your mom.  I don't have any advice except that -- you're doing great, and you're there for her, and there's nothing more you can do.  You're doing all you can.  (((((hugs)))))  
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M2M
I'm so sorry

This agonizing for you both

Prayers to you
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so sorry mom2mom, it sounds like she wants to go home on Hospice protocol. As hard as that sounds, please respect her decision.
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The PA who has been working with her told me that she wants to go home. He explained to her that means home to die and then he asked her if she wanted treatment or comfort. She told him she was thinking about it and would let him know her decision.

She is not in a vent yet.

She's not talking to me at all. She is lying here with her eyes closed and won't speak until I try to leave and then she asks me to stay
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M2M, this is a very tough time for you. If she is intent on leaving the hospital with a ventilator, it is very difficult to find a LTC facility which can provide that kind of care. Have you talked with the hospice folks yet? They are good at facilitating the difficult conversations. That way you and she can make sure everyone understands what SHE wants.
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MsMadge,

They think they have the urinary infection under control and they don't seem to be concerned about sepsis. Part of the antibiotics were to stave off aspiration pneumonia. The precipitating event was her vomiting and then me not liking how wet her breath sounded. Her oxygen was in the 70's in the ER. They believe that she aspirated into her lungs. They have ruled out a stroke and clot in her lungs and they have her on high oxygen.

Mom vacillates between asking the doctors to continue testing and treatment to saying that she wants to go home despite being informed that going home would mean going home to die.
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Mom2mom
So sorry to hear the antibiotics are not clearing the infection - this is sepsis from the UTI?

Does the hospital have an infectious disease specialist overseeing the treatment?

Prayers for you and mom
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Definitely go with the better place! I went thru this with my mil. I wanted her in the better facility, but she wanted to be close to her friends and family. I said ok, but didn't agree. She was in there for about 3weeks and all I heard from her was complaints about the staff, the food, etc. I refrained from saying I told you so, but never again, if she ever has to go to rehab (she had a hip replacement) again. Hope that helps!
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I am starting to think that it might be a moot point. I have a feeling that Mom will not be coming out of the hospital. The PA on the hospitals team called me a few times yesterday and then we had a meeting in Mom's room for her to give me verbal consent to make decisions for her when she becomes unable.

There is a lot of discussion about the possibility of a ventilator and an lot of "we are not sure what is going on but we have suspicions". They have thrown antibiotic after antibiotic at her with no improvement.
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I had a similar choice with rehab for my mother and chose #2 and am very glad I did. She didn't like not having me visit every day, but I did call every day, and I knew that the staff would keep me posted.

And to be honest, I needed and enjoyed a bit of a break from caregiving. I think #2 was the best choice for both of us!
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Mom2Mom,
You've got Carol!
I agree with MsMadge and PhoenixDaughter, go for the best care.
Everybody likes Carol best anyway!
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How is she today ?
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