Mom is 98 and has had Alzheimer's since age 84. She is in amazingly good health other than this, and has certainly outlived our expectations. Mom has a sunny disposition, which is unusual considering her disease. Mom had lived at home with my husband and me since her diagnosis and was content. She did need help with all ADLs. It was a lot of work taking care of her. But I work from home and my husband is retired. Between the two of us, we were able to take good care of her, without needing much outside help. It was exhausting though.
However, we started to worry about her being a fall risk at home. She was unsteady on her feet and would not always remember how to use her cane or walker properly. We considered getting consistent help in the house, but we thought we'd still have the worry about Mom being a fall risk here.
So we got her into a Medicare 5 star rating SNF very close to home, nearly a year ago. Mom was approved for Institutional Medicaid. Honestly, this is probably as good as it gets with nursing homes, given the high rating of the place and the distance to our house. Mom is content there. She is no longer a fall risk because they keep their residents in wheelchairs there. (I'm not sure that's such a good thing though, because she CAN walk and now gets very little exercise).
The bottom line is that my husband and I are not that pleased with the care or the cleanliness of the facility. We do realize it is probably a lot worse in the lower rated nursing homes.
Therefore, we are considering getting her discharged back to us, and having her live at home again. I am Mom's POA, so I think I would be able to do this. In our state of NY, she can get Medicaid home care. As long as we have consistent help at home, this time around, I believe it would be very manageable to have Mom back in the house. I would feel more at ease knowing I could oversee her care. I believe Mom would be happier here as well. I am not sure how we would handle the fall risk situation though. I may need to keep her in a wheelchair at home now, although I'd rather she walk if she can - at least some of the time.
Any thoughts on all of this? Are we crazy to even consider bringing Mom back home? TIA!
Consistent help is hard to accomplish with NY medicaid home care. I live in NY and can attest to medicaid home care is very sporatic and staff revolves in and out of agencies. So many short staff agencies can not handle the work load. You will be scrambling to find help or you will need to cover shifts.
Wishing you peace and strength for you.
"It was a lot of work taking care of her... It was exhausting though."
"As long as we have consistent help at home, this time around, I believe it would be very manageable to have Mom back in the house."
You believe wrong. There is an ongoing labor shortage in the US, partly due to the large Boomer population and the significantly smaller following generations; many workers in facilities are not US citizens and we will be seeing a shrinkage in workers willing and able to be hired in facilities especially now that the government if focused on immigration issues; Medicaid aids are not paid that well so it will be a revolving door of helpers on possibly a weekly level; what you gain in a "cleanliness" standard you will lose ground in having the headache of worrying whether a qualified aid will show up on any given day. FYI it's not easy to find aids who are willing to work weekends (been there, done that).
Instead, consider having constructive conversations with the admins at the facility about the cleanliness and give them the chance to improve. You can discuss ongoing unsatisfactory standards with an ombudsman. Or, maybe consider that you have an unrealistic standard for any given facility. Would you rather the staff spent more time on mopping the floors? Or tending to your Mom?
In regards to falling... my very elderly Aunt with advanced dementia fell 3x in her own home in the presence of family caregivers (and broke bones each time). My own Mom (age 96 and healthy) has fallen and broken bones 3x times now (once in my presence, all other times in her own home). There is no way to prevent this from happening except to keep the highest risk people in wheelchairs.
Please resist bringing her home. Your home is the sanctuary for you and your husband -- and you are each other's priority, not your Mom. She got to live her life and now you live yours. With your good oversight she will do as well as possible given the circumstances. May you receive peace in your heart about this.
The fact that she's now in a wheelchair means that her legs have gotten much weaker and is now more than ever a fall risk. Can you pick her up when she falls, and can you pick her up out of her wheelchair to put her in a chair or bed without hurting yourself? I highly doubt it.
Plus any time you disrupt a dementia patients routine(in this case by moving her again)they always take a turn for the worse in their mental decline.
If you want to "feel more at ease" knowing you could oversee her care, perhaps you just need to spend more time with her at the facility she's in. That way you can make sure that she's getting the proper care that you prefer.
Leave her where she is.
She is still a fall risk and maybe even more than before will you be able to monitor her? Do you have a plan for when she falls? how to get her up safely? And what will your options be when that fall results in a broken hip? Surgery? Rehab?
Will you be able to manage when you have to puree her food and feed her?
Will you be able to manage when you ...you get the idea. this is no easy task you are taking on. You have been there/done that.
I don't know if you are looking for people to agree with you or for those that think this is a crazy idea.
If you are going to tally votes put me in the Leave mom where she is group.
Simply the moving her may cause a decline you do not expect.
If you do decide to move her back you m ight want to get her evaluated for Hospice. If she is eligible for Hospice they can arrange all the equipment to be in the home before she arrives and they can arrange transport. you will have the help and support of Hospice. A CNA at least 2 times a week, a Nurse at least 1 time a week and all her personal and medical supplies will be delivered. All covered by Medicare/Medicaid