Should Mom go to a facility that is close to home or to a better facility?

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Should Mom go to a facility that is close to home or to a better facility?

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Hello, I would chose the better facility that is a bit further away. At least you won't have to worry about her care. Even if you are unable to not visit her as often b/c of the drive at least you'll have peace of mind. I was in that situation before and I went to look at the Rehab. closer to my house and it was so depressing I walked out after 10 minutes. The one a bit further was fantastic. My mother had a huge private room with her own bathroom and I knew she was safe and happy.

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Facility #2. I live in a town where 30 minutes is a quick trip anywhere you go. It's all relative.

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If you can continue to have her aid for a few hours a day then take the better facility - visiting once or twice a week should be okay

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Can't judge others about visiting. For me it is now my husband who has no idea who I am. I call to see how he is or if he needs anything. Once a week visit is all I can manage emotionally. When my mother was in assisted living I visited every day after work and helped bathe her etc. I was exhausted but she was unable to communicate, I was younger but it still took a toll on my health too. You just do what you can, no one should judge you.

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When I faced this question many years ago when my mother was required to go to a nursing home, I chose the better one which was ten miles away. I was able to visit every other day because I was still working and my time was limited. Anyone in a home needs an advocate. I was very pleased with the cleaner facility with better care.

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I think the closer option is best. Those patients who have more frequent visitors get better care. Plus, the one with a higher review could have slipped since the last reviews, and sometimes those reviews are written by employees to make the place look better. I had my mom put in a facility that had stellar reviews, and they ended up being horrible. I had to pay her aides to be with her 12 hours a day just so she wouldn't sit in her own filth, and so she could be fed. If the food is truly horrid at the facility, bring her some smoothies from home, or some other treats. Also, bananas are good because they are soft and easy to eat, plus packed with nutrition.

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It's a no brainer you choose the facility that will give your Mum the best care - ALWAYS

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How is she today ?

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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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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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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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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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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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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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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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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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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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M2M
I'm so sorry

This agonizing for you both

Prayers to you

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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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(((((Hugs))))) hope this works out in any way that's best for your family.

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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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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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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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M2M, just hugs to you. Yes, hospice has done all this before and will help you organize what happens next.

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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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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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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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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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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
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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Should Mom go to a facility that is close to home or to a better facility?

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