Should we move FIL to a nursing home closer to us?

Move him closer would be my suggestion. Then, you can see him often. If he is mentally competent, ask him what he wants to do.

Cheaper to live in SC than NJ..........and guessing the care facilities are cheaper too.

If it seems better, safer, kinder to FIL to leave him where he is, do that.

I can picture bubbles of ? guilt ? grief rising up to shape into reasons to want him closer.

It is natural to want people closer. That feeling to wrap them up & bring them home.. That somehow that will make the situation better. Maybe it would? You are weighing up a known situation against an unknown one.

What about a comprimise?

Stay where he is for now. For stability. See what 3 months from now looks like. If he has stabilised, is stronger, better medically able to be moved, re-visit the idea then.

I live South of you. I don't know what NHs are like in the Trenton area but here, especially since COVID, I heard not so great and short staffed. My Mom has been gone almost 6 years and out of the 3 near me, only one would I place Mom in.

I agree, keep him where he is. Between Hospice and longterm care he should be well taken care of. And Medicaid would be a factor when it comes to residency. Medicaid does not go over State borders.

Has there been financial planning in all this? & taken care of?
South Carolina is one of the handful of States that has the minimum allowed by the feds of a personal needs allowance of $30 a month for a NH resident on LTC Medicaid. By & large those that do run very narrow & tight eligibility social services programs, like Medicaid.

so that being said, markevans, what’s FIL finances like? Does he have enough in savings to add to his monthly income to 100% private pay for his care in a NH for at least 2 years? Avg Nh abt 9K a mo without any extra fees, abt 110K a yr for basic room&board. MediCARE does not pay for residential/ custodial care costs in a NH. MediCARE as his health insurance will still be billed by the NH for doctor visits and other traditional health insurance coverage - like PT - along with whatever secondary health insurance. But health insurance does not pay for room&board costs. MediCARE hospice benefit will cover a hospice company coming out to see him 2-3 times a week at the NH for 2-3 or maybe 4 hours but hospice is NOT going to cover his overall custodial care costs at the NH. Right now as he is on a post hospitalization rehab, his stay is a MediCARE benefit at 100% first 20-21 days.

So does FiL have enough $ to 100% private pay 2 - 2.5 years (avg stay in a NH) or will he need to file for So Carolina LTC Medicaid? Or will you & your spouse be paying for his care? Or will those nephews in SC be paying? And who is this group will be POA and signing off on NH admissions & responsibility paperwork?

If he is on Medicaid for health insurance, LTC Medicaid is a separate program that he will need to file for. It’s the program that will pay for custodial care for those “at need” medically for skilled nursing care and financially “at need” which basically means impoverished with 2K max nonexempt assets and their income less the State of SC Personal needs allowance of $30 must be a copay to the NH every month if the NH participates in the LTC Medicaid program. There will be required lookback on his financials to accompany his application which tend to be a 5 years overall period; any gifting places a penalty which is an ineligibility by # of days.

If the current NH / rehab facility he is in does not participate in LTC Medicaid program, then he will need to move to a Nh that does and file his application from that NH.

If he was on OSS program at his old Assisted Living, post an update…. It probably will be messy as he’s going to look like he has “income” as OSS paid him not the Assisted Living. OSS is not a LTC Medicaid “waiver” so it doesn’t necessarily show up in the Medicaid system.

It’s a tough decision to make but it doesn’t sound like he is well enough to move.

Has he expressed wanting to move closer to you? Or is it that you would like him to be closer to you so you can visit him more often.

I would wait to see what the doctor says. It’s possible that it isn’t feasible for him to be moved closer to you.

Wishing you peace while you’re in this difficult situation.

He has 2 nephews living nearby that are visiting him. He thinks he's moving back to the AC facility. He is very angry and wants us to move him immediately back to AC. He does not understand how weak he has become. It is very difficult to talk with him on the phone, his hearing (with hearing aids) is very poor.

My mother had congestive heart failure for 7+ years before it took her life, my cousin is going on 15 years now. It depends how advanced your FILs CHF really is to know whether or not he can or should be moved to a SNF closer to where you live. Being on oxygen is not enough of a reason to keep him living so far away where you can rarely see him.

Wait to see what the DOCTOR has to say about all of this before you make a decision about moving him. I personally would want my folks close by me at end of life so I could visit frequently, but not if it would kill them to move. Only the doctor or cardiologist could weigh in on that matter.

Good luck to you.

I wouldn't move anyone in such condition. The trip would be a hassle, and it would most likely have to be by medical transport. The stress of the trip would be major.

As for his overall health, you certainly do know about his overall health because you've outlined it in your post. He is in bad shape. And you don't mention mental health, which is a definite factor as people become more physically ill.

If you move him closer to you and as his health deteriorates more, you have a major problem in your own back yard.

I'm sorry you're going through this, and I wish you good luck.

CHF and on 02 with this level of debility and this diagnosis, my answer is no move.

You should instead be making a trip to see him, and know that it may be the last.

CHF is Congestive Heart Failure. The heart is failing. They will treat to try to keep fluid off the lungs and out of the tissues as well as they can, but there is no cure for this. He should very likely be on hospice.

It is important now to have a competent POA or next of kin following his progress. A 3 person move may mean obesity? A bad complication to have in all of this.

I would not attempt this move at end of life, and I think that may be where you are now. A good facility and Hospice is what I, as an old retired cardiac nurse would recommend to you for now.

A move of any kind with someone this dependent on 02 could cause flash pulmonary edema and death at worst, and would be very trying and difficult in many many ways at best. At least discuss this with his doctor, and get his recommendations for hospice as well. This will only aid in his placement where he is at now.

I am so sorry you are facing this.

Any other children and where are they? Do you want him to move closer? Why and why not? Is he toxic and you prefer some distance?

Yes, on the surface I think it would be better for everyone if he were closer to you.

That also depends on if YOU want him to be closer.