How do you know when it's time for a nursing home?

Are you aware that he can get Medicaid while you still live in the house? It would probably go to Medicaid at your death, but it will not count as an asset keeping him ineligible.

Also talk to your local Area Agency on Aging for lots of advice.
Division for Aging Services, Las Vegas
1860 E. Sahara Ave., Las Vegas, NV 89104
702-486-3545

Maryvee, have you spoken to an elder law attorney who is an expert in Medicaid?

I don't know enough about your situation or the law to give advice, but you should get legal advice even if it's expensive.

It's a horrible thought, but could you divorce him and turn him over to the state? That's an alternative to you dying from burnout. I sincerely hope you can find help. Please let us know about what you learn.

My husband urinates all over the house, will not go in a toilet, I keep a bucket in the laundry room, but sometimes when I am busy, he will urinate on the furniture. It is terrible, he also gets up in the middle of the night and urinates where ever he decides to. I cannot put him in a nh, because it is cost prohibitive. We are niether poor enough, not are we wealthy enough to afford the $7500.00 per month it costs in this area. Does anyone have any ideas for this situation? I am exhausted. Noni1

The fact that you are even asking the question says a lot. What is the right time and stage for one family many not be the same for another. Everyone's situation is different. If you are the primary caregiver then the decision for a nursing home needs to include your well-being as well. My mom is in a personal care home now. I took care of her after her stroke as long as I could. I was exhausted. It started to effect my relationship with my husband and my children. When my oldest daughter was about 12 she had enough and was leaving home. My blood pressure was up and I had chronic back pain from all the times I had to pick my mother off the floor. As Standing Alone said, they have had their life. Now it is our turn. It is hard to say and harder to do but it is true. My mother had her life and raised her family. Granted her productive years ended sooner than expected, but I have my own family and I need my chance to live my life, too. There are still some things she can do on her own but she is a huge fall risk and I can't be with her all the time. I can't say she took it well, but keeping her with me would have probably killed me before her.

If she has Dementia, the sooner the better. The earlier you get her into a memory care facility, the easier it will be for her to make the adjustment and for the staff to get her accustomed to care. Staff in memory care facilities are specifically trained to know how to deal with all of the behaviors associated with dementia, and for them it's all in a days work, where for you and your mom it's deeply personal.
As mentioned in many other comments, you need to take care of yourself. Cargiving a family member for a long period of time can actually shorten your life span due to the stresses it adds to you physically, emotionally, mentally and spiritually. Contact your local Alzheimer's Association to find an Alzheimer's/dementia caregiver support group. You can get group locations and contact info at alz.org Good luck and take good care of yourslef.

When 24/7 care is required and there is either no money for fulltime care at home or no willing caregiver. StandingAlone made a point. Her mother had a life and the daughter would like the same. No life has a higher value than the other. Nobody should have to be forced into a 24/7 caregiving choice.

It sounds to me like we are using the term "nursing home" to include assisted living facilities. There is a big difference. Most assisted living facilities can help with things like incontinence. They provide nourishing meals, laundry service, bed making, entertainment and some exercise programs, while providing constant oversight of the resident

Assisted living homes usually don't have a doctor on staff, and so your loved one can continue to use your family doctor. You will have control over what drugs can be administered to your mom, and the staff at the home will make sure that she takes the medication on the prescribed basis.

Taking care of an elderly person is certainly a drain on one's personal energy, and it is best to plan on the placement in a home while the loved one can be a part of that decision. Few people who are caregivers are young enough to have the energy for that sort of commitment.

Konacaregiver - I'm sure all of us struggle to some degree with putting our loved ones in a nursing home - it's an incredibly difficult decision and not one that any of us make lightly. If we did, we wouldn't be on this website. Please don't imply that if choose a nursing facility, we just don't care enough to manage the situation at home. For many people, a nursing home is the only real option. Maybe not for you, but for many of us it's the best we can do for someone we love.

awbuell - There are nursing homes that accept medicare or other senior group homes, etc. He may be eligible for Veteren's contribution (if he was a vet); etc. I suggest you visit some a senior center or senior resources agency in your area and meet with them to learn about options, financial assistance, medicare, etc. and what facilities may be an option. They will walk you through how the system works. The big question is "will Dad be open to moving to a facility vs. staying at home with the care he has?" Regardless, for his future prognosis, you both should understand and prepare for options for "when the time comes".

Hi all,
This is such a challenging topic...I am smack dab in the middle of it...got her in a nh now, after falling and breaking her hip, and after 6 weeks of rehab...still can't be alone due to serious risk of falling. Can walk with walker but very poor balance and so even with walker, at risk for falling and can't do things like ADLs alone. Still...she doesn't really seem like nh material and she wants to go home. I would like to care for her but can't be there 24/7 with full time jobs and two young, busy boys...so hard...we would have to move to take her in..need another bedroom, and I am so afraid that if we leave her she will fall. Medicaid pays for nh, but they take everything, all of your parents assets, to pay the huge bill, so it's a big commitment. I don't think there is a specific time that is right for someone to go into a nh...I think it depends on many factors and I think everyone has different levels of ability, tolerance, etc. for care taking. I have NO idea if I am doing the right thing or not. The indecision is the worst part.
Good luck.

If one can't see, walk much and doesn't have her mind, this is an oxymoron question. YES!

My husband has been in NH for 3 yrs. Parkinson's, stroke, "impulsivity" gave us no other choice. Could not walk or talk and it was not possible for me to care for him at home any longer. Difficult decision but the right one. He has no dementia so is aware of his body declining. Communication is very difficult. (Any suggestions?) Has use of only 1 hand but the PD has made his writing teeny tiny & not readable. Only 10 minutes away so I visit almost daily. The staff in this NH is wonderful!!! Continually doing everything they can to give him the best possible quality of life. Started with medicare and now on medicaid. His share is $68/month. Long process but worth it. I enlisted the help of our local Service Links which is a national org. that helps with senior issues. Helpful.

As a gerontologist, two things predict nursing home placement: Caregiver burden levels; and safety issues for the loved one. A doctor can answer the second one but so can you as a caregiver. As for the first, listen to those people around you. There may be signs of you as a caregiver being overly stressed to the point that your help is in jeopardy. Restlessness, sleeplessness, being overly depressed or cranky are signs of caregiver burden levels being over the top etc. Dr. J

If you feel you are not adequately providing GOOD care for her at home, then it's time to start the process. Incontinence aside, you have listed other VALID reasons she should be in a facility and you should not feel guilty about that. Talk to her doctor first, ask for referrals and start shopping around. First and foremost, if your mom isn't on medicaid (or medi-cal if in california) that process needs to be started a.s.a.p. if there aren't enough funds to cover a nursing home. Good luck.

Wow! It certainly sounds like Standing Alone waited too long. I think you need to go by whatever you can handle. If it is causing too much stress and health problems, you need to get some recommendations and check each facility out first. Your Mom would not want you to risk your health to take care of her. However, you need to do your best by her, just as she did for you when you were a child. Dementia is a difficult situation for the caregiver time and requires alot of patience. On the financial side, Title 19 cannot be used for a nursing home until assets are depleted to $2K.

It is a personal decision. You have no need to feel guilty whichever way you decide. I think sometimes the caregivers age and physical condition needs to be a big consideration. And their lifestyle and needs. Also the temperament of the elder. Someone who is milder and cooperative is much easier to care for than someone who fights you tooth and nail. Money is another consideration. What is the most effective way to use family assets. It would not be wise to invest excessively in an elder if there is a younger generation in need of education. Not all care facilities are the same and even the best have some employees that are below par. But for one person to provide 24/7 care is insane.

Kona, please. I had to literally BEG the damn doc at the nursing home that my mom is at to put her on some kind of chill pill. The NH my mom is in certainly isn't full of 'drug pushers'. And frankly, better my mom keel over at age almost 89 from a side effect of a drug, than ME keel over from cardiac arrest at age 48 from dealing with her 24/7 for years on end pretty much by myself. She's had her life. I'd like mine now, thanks.

When you get up in the morning feeling nothing but a sense of dread and gloom, it's time for a NH!

When your mom messes and pees on the floor more than the dog, it's time for a NH!

When strangling your parent suddenly seems like a good thing, it's time for a NH!

When you clean the kitchen, look back a few minutes later, do a double take and can't remember doing it because you're so exhausted from care giving, it's time for a NH!

When you're jekyll one minute and hyde the next, it's time for a NH!

If you start going outside and cussing like a sailor to relieve stress, praying the neighbors won't think you're nuts, it's time for a NH!

When YOU start to wonder if you're nuts, it's time for a NH!

When the doc says your blood pressure is through the roof and you're on your way to a stroke, it's time for a NH!

When AC is the only socializing you've done in years, it's time for a NH!

When you're wiping your elderly parents butt more than your own, it's time for a NH!

Yup.

I'm sorry that I don't have much to offer, but I want to follow this thread because I have this question, too. My dad is still at home, but has dementia and Parkinson's, has become incontinent and is a fall risk. He lives alone with help from a home care agency and myself and a concerned friend. I worry constantly and I would love for him to be taken care of in a facility. My question is, how does it get paid for? My dad has meager savings and Medicare does not cover a nursing facility, right?

Hello and Morning from Snowy St. Paul Minnesota.
My mother has Alzheimer I suspected it for some time but she was November of 2012...
At that time it was obvious and was told by the doctor she would need someone with her 24 hours. She was also a fall risk.
I was her her primary Caregiver and POA...
Between my two sisters, and Brother and a Home Care Agency we were able to keep her home until 8/10/2013.
In May 2013 she fell and fractured her back a set back physically but more so mentally.
In August 2013 she fell and fractured her hip once again not using the walker, this was a big set back...it really set her back mentally.
While she was in rehab my sister that was living with her decided to move, my brother who also lived there was driving over the road, my other sister had more health issues, the money was running out, and I was burnt out going out their daily.
While she was in rehab I spoke with the social worker and doctor about placing her in a Nursing Home hoping for the one my husband and I have been volunteers with for over 16 years, was 3 blocks from my house, and she was already in rehab at. It wasn't until minutes before the care conference that I was told she would could stay.
The Nursing Home has been wonderful on communicating with me and I speak with them on a daily basis. I am very happy were she is at and I don't have any regrets.
I hope this helps...

incontinence may not be a reason but being burned out and your own heath in danger besides having no life for yourself is and they take good care of my mom in the nursing home she is in, they cannot start any new meds without asking me first

By the way, my mom is incontinent and we use underpants on her all the time. She usually does pee during the night and the underpants keep the moisture away from her body until we get her up in the morning and take her to the toilet. During the day, we try to take her to pee in the toilet usually after each meal or more often depending on the amount of liquids we give her throughout the day. Incontinence does not need to be a reason for sending your mom off to a nursing home. IMO.

Nursing homes should be a LAST option when all other options including whether she can be cared for at her home or at the home of a caregiver or relative or child have been considered. Just so you know that when you do decide that the nursing home is where your mom belongs that she will be the victim of the doctor in charge and most doctors at nursing homes are full on drug pushers who keep prescribing drugs even though the side effects are obviously harming the patient. This is what we we experienced with our elderly mom for the 2 months that she was in a nursing home and this is why we knew that we had to take care of her at home. Good luck.

when you can no longer provide for his or her needs, it is time for a nursing home especially if your own health starts to fail which is what happened to me, been caring for her for 7 years, was burned out and going through divorce, he has mistress and my mom was subjected to watching me go through hell, so between caring for her and my mess, my health has suffered, got her into a nursing home, now to take care of him in court

i like your reply jinx. incontinent or bedfast would quickly require rotating shifts of help imo. my mom got to where i had to nap when she did to be available during her waken hours. quite comparable to a toddler. cant turn your back on them for a moment.

My mother said you can take care of them at home until they become incontinent. Some people soldier on past that point. If she is in danger of falling, she might be safer in a NH. Tell us more about what needs you can't care for. Also, are you getting any sleep? That was the limit for me with my father.

I just read your profile. It sounds like it might be time for you to let her go. She will be kept clean and will have more stimulation in an NH, and you will be happier to visit her and love her if you aren't having to live with her hygiene issues. Good luck.

It's time. Go to the MD and have him recommend placement.