Last Sunday, after my 89yo mom attempted to kill dad with a butcher knife, he called 911 for the third time, she was sent to the ER and he refused to pick her up. (For details, see my thread, "How do we get the hospital to keep mom." Bascially, all this started with what I suspected was a UTI infection.) She was sent to a behavioral health facility, had a choking episode the first morning there, was sent to the hospital across the street, returned a few hours later to the facility, had another choking episode the next morning, was sent to the hospital again, and never returned to the facility. (They never sent her belongings with her and her POA, me, is supposedly the only person that can retrieve those belongings. I am three hours away with a husband with dementia. Going there to retrieve her walker and clothing is not an option. Why they can't just take them across the street and give them to her?) We don't know if the psych eval was ever done since she actually spent so little awake time there.
Three weeks before she went to the ER last Sunday (when what I suspected was UTI symptoms started), at home she was walking, talking (but with expressive aphasia), eating anything she wanted, cooking meals, doing laundry and light housecleaning. Now she is NPO (her directive says no feeding tubes or IVs or any other measures to prolong her life), unable to move from bed to wheelchair, speaking more clearly but her words indicate she is not aware of reality, and has been diagnosed with "dementia with psychosis." Oh, and the UTI, finally confirmed by a culture last Friday, was treated one time with IV Rocephin in the ER Friday and one tablet at home Saturday. Since she went back to the ER Sunday, no antibiotic has been given. I suspect this is why she deteriorated so quickly.
Now they are talking about her leaving the hospital. A week ago, we were all on the same page -- nursing home. A bed was found and is being held until July 1 (tomorrow). I'm amazed we found a bed in these days of the virus. Sunday my sister (has a doctorate in nursing), bil, and my husband began singing a different tune -- they want her to go home with 24/7 care. I am POA and it is up to me to make the decision. My choice is still nursing home. This morning my husband informs me that he never felt she should go home, so his fight with me Sunday declaring that mom should go home and I needed to respect his authority is now not even in his memory (or he is gaslighting me again).
Anyway, I now feel myself between a rock and a hard place. If I decide nursing home, then my sister will probably cut off all relationship with me for a while (it has happened in the past). She has already sent me guilt-tripping texts messages. "If the nursing home is going to quarantine mom for 14 days, she's going to get very little attention there until she dies a lonely death in an unfamiliar place." One home care agency turned dad down yesterday, said mom would be better off in a nursing home. Another agency failed to return my phone call until 8:00 p.m. last night, and then failed to send the email that was supposed to be sent at the conclusion of the phone call. And she said she couldn't have 24/7 care in place until next Monday at the earliest.
So obvious to all (except my educated sister and bil) is that mom needs to go to a nursing home. We are told that she should be allowed pleasure foods such as chocolate pudding, always knowing there is a risk of aspiration. In that case, she may not survive long at home or in a nursing home. The question I am wrestling with is, do I honor my father's expressed desire as well as my gut feeling that she should go to a nursing home and risk the future relationship with my sister, or do I take my sister's advice and bring mom back to her home?