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We live in Orange County,CA and are considering board and care because she is on a fixed income and we can't supplement it anymore. Prior to moving in with us 7 months ago she lived in a great assisted living costing 5,000 a month. We paid about half of that. I am on disability, my husband is out of work ,we have one son in college, our daughter is a senior in high school and two other sons who, God bless them, help out as much as they can but they have their own problems, own lives to live.

I really need input from you about how to break the news to my mom, how to help her make the transition and also how to evaluate board and care facilities to try to avoid a nightmare in advance.
Thanks in advance for reading this. God bless each and everyone on this forum who struggles with senior care.
Kim

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caremom1,
Check out website medicare.gov. They can point you to NHs in your area and you can print out a handy NH checklist for evaluating each NH.
The info they have is varied and useful.
Also your local Area Agency on Aging. Very helpful.
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caremom1,

I'm so glad to read that you are going to see a counselor and it will be money well spent because right now you and your husband are strung out with so much stress I bet you feel at times that you are just going to snap into a thousand little pieces.
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ditto, put it on the doc. They're prepared for this, understand the family's position, know what to say, and, in my mom's case anyway, the doc is god! But she will continue to ask why she cna't go home with you so be prepared. We just keep saying she needs the care and rehab and we'll evaluate down the road. She has dementia so she has lost track of the time -- 5 yrs. now, but still asks. THe biggest surprise was that Mom became quite the social butterfly at the nursing home, whereas she had been so isolated living alone before "the fall." SHe was quite mobile in her wheelchair and never in her room, always at Bingo, poker, trivia, visiting others, etc. So watch for that silver lining in this dark cloud. God bless, keep us posted.
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After she's in the place where she will be staying......try to bring as much of her surroundings at home to the NH.
Decor and art are important. Her personal things will be more important to her than you may realize. You will have to limit the items, but bring in what you can. It will warm the sterile and stark environment.
Little treats help too if that is at all possible.
Family pics, favorite blanket, shawl, nic nacks etc.
Try & get her involved in the activities they have. The NH my mom was in had an ice cream social every afternoon. Even had sugar free for the diabetics.
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"Prayer helps alot" is surely true!! I hope he will adjust, my mom has still not quite adjusted, only because she is so quiet, and judgemental of people, that she just will not socialize! so while there, You try your best to push him even further into participating in some of the activities they offer! I so wish my mother would do that! She wont, and unfortunately I cannot do a thing about it..............It has to be her choice, everyone is too dumb or old for her to associate with.............cant understand how she can judge just by outter appearance alone! always been that way though........even with me, I learned way late in life that it is an inside job! thats when I realized the saying "dont judge a book by the cover came into play" Good Luck to u, and everyone else struggling with similar situations.........
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We will be facing the same delima in a minute.
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195austin-
Thanks for the additional details. My mom is currently in a skilled nursing/rehab after a 3 day hospital stay. I am supposed to meet with the social worker there before they discharge her. Is this who you are referring to?
I have told everyone there, repeatedly, why my mom can't be cared for in our home. The social worker said she knew "many resources and options". I sure hope she does because right now my husband and I are just short of being crushed with the multiple stresses and pressures in our lives.

I made an appointment with a counselor for myself even though we really can't afford it. Right now I think it will be money well spent.
Thanks again to you and everyone else who has shared , and continues to share, on this tough topic so many of us are struggling with.
Kim
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I would only add let a social worker help with medicaide if she gets in rehab after a three day hospital stay-and many docs will understand this-then it is easier to have her placed-first you need not to feel bad about this decision after you tell the social worker that you are not able to care for her at home you will be surprised how much help you will get-I waited a long time waiting for someone else to step forward and help me and my counsulor convinced me I needed to rescue myself and when I told the rehab facility I was not able to care for him myself at home everyone agreed as my husband did a few days later-even he did not at first-speaking up was the hardest part for me.
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Tweetie-
Well, it looks more and more each day that is where my mom will end up. Right now the nursing and rehab facility where she is doesn't offer long-term residency but I have to find a suitable place that does. Then I have to figure out how to pay for it. I'm sure she will be asking to go home just like your dad.

Have you taken the Savvy Caregiver workshop offered free by the Alzheimer's Association? It is fantastic and it is a national organization so classes, this and others, are offered all over the country. It is open to anyone who is a caregiver, with emphasis on the challenges related to dementia in all forms. I highly suggest all of us who haven't taken it do so. I have also met some wonderful people there.

Thanks for your support and info. My prayers are with you, your family and your dad. You're right, they do help.
Kim
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My dad was just placed in a nursing home because he wants to live by himself but has dementia and has absolutely no strength in his legs at all. He kept falling at home and I just told him he had to go to the hospital for his legs to see what was wrong. From there, I talked with his doctor who agreed that he needed longterm care in a nursing facility. It breaks my heart when he asks continuously when he is coming home but I have to keep telling him he needs a lot of therapy. I don't know how long that will go over for but I can see that he is feeling a lot more comfortable where he is and hopefully, he will stop asking. I understand, believe me, it is so hard for you and them to make that transition. Prayer helps a lot.
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Caremom - I just saw your comment about "equity in our home" and nearly had a panic attack. DO NOT use the equity in your home, at your age to help your mother!!! That equity is all you and your husband have to fall back on should YOU need assistance. Let medicaid help your mom - there is NO shame in it after all these years. It is a program to help people like her who've worked hard, taken care of others and done all they can for themselves. Medicaid IS intented to prevent financial ruin of families like yours. Given this economy, there is too great a risk that you will not get jobs that paid as much as you made a few years ago - the risk that you can't pay the equity loan or line of credit is too great. DO NOT LOOSE YOUR HOME to pay for a few years of care for Mom. That's the first rule of care giving - DO NOT put yourself at risk of financial ruin to help your parents - would your mom WANT that? Probably not. She probably loves you too much for that. You're a kind and loving daughter, and you have the right to think of the security of your husband and kids before your mom. It's a tough situation, we WANT to do so much for them but sometimes we can't do every thing.
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That is exacly what I did! I put in all on the doctor! The sad part is that the doctor really did say that moms condition was way too severe and needed too much skill than I could offer..............so thats a start, if that doesnt work, try talking to her, tell her there are beautiful places around close by where you can pop in and out to see her,and someone will always be around to take care of her, tell her u are worried about her safety, and want her to mingle with others in similar situations, and maybe meet some great friends, who are around her age, and they could relate better, than just the fam. It worked for me before we actually got a diagnosis for my mom, when we checked into places, we used our noses, and all of out senses, to see if we ourselves would mind being in a place that we went to see, after seeing about 7 places we decided on Emeritus, which was totally awesome! they let u bring anything u want from home to make it just like home! It was beautiful, they even had a smoking section out back for those who smoke, I guess they couldnt make them stop after years of doing it, even if they carried oxygen around...They did though have seminars about quitting often, and many many activities for them, like bingo, picnics, outtings, and many other fun stuff for them to do, oh and arts and crafts which my mother loved. Unfortunately now my mom cant be in an assisted living place anymore as there is too much freedom and has to be watched 24/7 with her diagnosis, she is constantly falling, on a special diet, all pureed, because of dysphasia, which can cause particles of food and drink to get trapped in the lungs and she would then be at risk for pnewmonia....My mom has a very rare desease that only affects one in a hundred million in the whole world, and she was the unlucky one to get it! but she is still ok, gets irritated at times and non-compliant which she will end up just hurting herself, I am there on a regular basis, daily, and spend alot of quality time with her now, as what she has is very progressive, This is not your fault! u have done all u are able, and she just needs more skill then u can offer, not to mention your own family to take care of on limited funds like me! sweetie u are not alone, and at first she may sqabble about it, but then come to the realization that u made the right choice for her safety and well being! GOod Luck and let us know! please!
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Crow-
I don't think she qualifies for medicaid yet but she will as she has no assets except a monthly teacher's retirement. I don't know how much control I want the government to have but I may have no choice. You are certainly right, we are at the breaking point in more ways than one. My husband has been without work for several months and we have exhausted all our "emergency" funds and resources. Luckily, we have a large equity in our home but selling and drastically downsizing means uprooting our daughter who will be a senior in h.s. this fall, a son who is a jr. in college and another adult son who lives with us, helps out with expenses and loves this house that is also within walking distance of his dream job. We have lived here for almost 12 years and my kids have grown up here.

My mom can be in assisted living or something else anywhere, so she is fast becoming the least of my worries in that regard. I will definitely follow the suggestions here to make the doctor the "messenger". I just have to fight my way through the maze of insurance and benefits and government regulations.

I really have found being the daughter who loves my mom and manages her care a much better role for both of us at this point than direct caregiver.
Thanks again for your support and input.
Kim
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Does your mother qualify for Medicaid?

I agree that the doctor needs to be the heavy, but you really don't need to have her in your home with everything else going on plus it sounds like your family budget is overtaxed already.
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We just went through this with my mother. I live 800 miles away from her assisted living but I wrote the doctor a 3-page letter outlining the horrors of her living at home alone after a stroke and multiple falls. My mother was demanding to go home and we put it on the doctor who told her "NEVER". He told her to be mad at him and not at her daughters. It's a hard thing and very stressful for the family, but making the doctor the 'bad guy' seemed to help our situation.
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Thanks so much for the input ! All of your comments are supportive and informative. Best of luck with your own struggles.
Kim
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... and... i've been blogging about my experiences related to my mom's move to assisted living and then to a nursing home. You can find the link on my profile page. It's not for profit, just to share my experiences and help others understand all of these details.
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I agree with HAP - put it all on the doctor. Tell her that the doctor thinks she can't get good care at home any longer. If necessary lie and tell her he's prescribed some therapy in a rehab center. for a few weeks until she's stronger and can come home.
First - find out of she qualifies for medicaide - state aid. There are financial criteria and look back periods to comply with, so understand those clearly. Look to your state dept of health and welfare to find out the criteria for CA.

Then, call her doctor and tell him that you just can't care for her any longer given your own physical health and needs of your family, don't make it a financial discussion. Tell him that you'd like him to prescribe some PT in a rehab center or nursing home. He might have a preference for a nursing home nearby or in your town. IF he'll do that, then your mom will qualify for UP TO 120 days there paid for by medicare. IF, during that time, they determine she will not improve, then medicare will stop paying. At this point, you want medicaid to kick in and begin paying. Getting her qualified NOW will help with that step.

To understand all that's involved, you can call any nursing home. Speak with their social services staff and find out all of these details. Don't be afraid to ask a lot of questions and don't let anyone make you feel stupid. This is a lot to wade through and it's complicated, so ask and ask until you're clear. There is no stupid question when your intent is only to help your mom and hold your own family together!! Best of luck.
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Kim_Can you possibly have your PCP or Neurologist suggest this to her-upon an evaluation of her condition. In this way, it get's you off the hook. That is how I worked it with my own Mom and it did work..

For addional support-you might want to contact your local chapter of The Alzsheimer's Association-or call them at there 24/7 hotline # which is 1-800-272-3900...They are a great orgaization to work with-and will respond to all types of dementia.
Best,
Steve
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