How do you tell your mom that "it's time?"

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motown13
motown13 Posts: 688 Member
My wife ,my brother, and I are all coming to the conclusion that it is probably time for my mom to go to a home. She says she was recently tested for Alzheimer's, and was told that she shows no signs of it, but all I know is that she has almost no memory anymore, and she makes a lot of stuff up. She can barely walk, and falling down is pretty routine for her. A few weeks ago she fell in her apartment, and was laying on the floor when I got there. She said she couldn't get up. And I couldn't get her up, so I called 911. A local police officer helped me get her up.She said she had been on the ground for about 6 hours and couldn't even get to her phone. We bought her a cell phone years ago... she made 2 phone calls in about 4 years before losing the phone. And she said she doesn't want another phone.

Also, she loses control of her bowels occasionally. And she seems to have a constant UTI, that doesn't seem to be able to be controlled by drugs ( I know that she has seen the doctor more than once about this, and I know that I have picked up her drugs for this at Walmart )

Can you "make" someone go into an assisted living place? If she can't afford it, what then?

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  • kgb6days
    kgb6days Posts: 880 Member
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    Man oh man that's a tough one. Have you talked to her doctor? When my dad got older it was tough. He didn't want to go to a home, but he could hardly walk, had major health issues and his wife had dementia. He was frequently in the hospital for his health, and I got the doctor involved. My dad did start voicing suicidal thoughts (if I have to live like this I'd rather die) and the doc told him in was the nursing home or he would have him committed. Sort of forced his hand. After he was there he loved it. Good luck. These times are never easy. I just hope I don't put my daughter through it when I get older.
  • Ashleyambermfp
    Ashleyambermfp Posts: 15 Member
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    This is tough. I understand your situation.

    I believe that a doctor can force the situation and call social workers into the home to assess the person and recommend actions. I am in Canada and here we have what is called CCAC - Community Care Access Centre. They are a government based association that will help people with disabilities or the aging population. They can also give advice. You could also call your local Long Term Care (LTC) home and ask them for advice. They will more than likely have you speak with their on staff social worker.

    Good luck. I wish you the best
  • motown13
    motown13 Posts: 688 Member
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    Well, there is one small issue with "her" doctor.... Her doctor is leaving her practice in the next 10 days. So, I guess whe will just have another doctor at the same practice, but they won't really know her like her current doctor. I don't think my mom plans to use the same doctor as she is starting her own practice that is pretty far from my mom.
  • jenbit
    jenbit Posts: 4,289 Member
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    I work in the health care field and have help others through this situation... Its very difficult to convince an independent person that they are no longer able to live on their own.. If she is resistant to the idea you may want to hire a companion for her. Then she can stay home a while longer and you will have peice of mind. When hire a companion please make wure to do research in your area for a good company check references ect... Many companions are avlible for live in work and will make your mothers life and yours better.
  • lmc8774
    lmc8774 Posts: 129 Member
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    I work at a nursing home, so maybe I can help. Have you tried talking to her about it? Be up front about how you feel and that you are worried about her well being living alone with her health problems. You could try visiting some nursing homes or assisted living places with her. It could help, it could scare her. It is hard to say not knowing her. I saw that her doctor is leaving - do your best to make her new doctor aware of your concerns. Possibly have them bring up that it is time for her to think about living in a community setting.

    Second, I would recommend if she falls again, don't get her up. Call 911 and let an ambulance take her to the hospital. Once she is in the hospital you will have a team of professionals and doctors that can help you possibly transfer her to long term care. It can take the pressure off of you. That might sound kind of harsh, but it sounds like she is beyond the point of knowing what is in her best interest with her confusion. Sounds like she has dementia and the UTI's can cause a lot of confusion in the elderly. The UTI's are probably not clearing up because of the incontinence, or at least that is contributing to it coming back all the time.

    Does she have home health involved? If not, talk to the doctor about getting them involved. Having professionals in the home can help you with convincing her it is time for a change.

    As far as finances, if she has no resources talk to a Medicaid caseworker. Medicaid will pay for nursing homes and assisted living. If she has resources she will have to spend those down before getting Medicaid. If she has a home, you will most likely have to put it on the market for her to be eligible for Medicaid. The Medicaid people will explain all of that.

    Finally, there is nothing easy about this process, but you are not alone. I've dealt with a lot of families dealing with the same exact thing. I provided a brief answer to a complicated problem. Good luck to you and your family.
  • motown13
    motown13 Posts: 688 Member
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    Thank you all... this won't be easy, I know.
  • tayjenks08
    tayjenks08 Posts: 16 Member
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    I would recommend first having a home health care aides come to the house, that way she can still be home, but someone would be there if she needed help, also to help clean up and do things around the house for her. You can introduce it as a companion, maybe someone to just spend the day with her. I think thats what im going to do for my parents or grandparents, help them stay at home as long as possible with the help of home healthcare professionals. Im a nursing assistant myself so i used to work as a home health aide, now i work in a nursing home. I know and see how tough it is. Good luck.
  • CarlieeBear
    CarlieeBear Posts: 325 Member
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    This is soooo difficult! My mom had always said she never wanted to be in a nursing home. Then she had a massive stroke and was forced into one. Telling her she was going to a NH was extremely difficult because of that. What we (my sis and I) did to make the transition easier:

    1. Researched the NHs in her town.You can view inspection reports online. Do this! There are some very bad NHs where Mom lived and, fortunately, we knew about them. The inspection reports definitely confirmed our understanding. Finding a good place with openings can be more challenging, but we did and were reasonably happy with her general care and extremely happy with the therapy staff!

    2. Decorate as much as you're allowed to ... to her taste, of course.

    3. Visit frequently and at varied times of day. This helps her spirits and it ensures better quality care at all times of day. NH staff do not want to be caught giving poor care.

    4. Listen to her comments about her care. If she's like my mom, you may have to encourage her not to be too nice. My mom had very few complaints, but you can bet the NH heard about it when she did have them.

    These tips also apply to assisted living. Telling my mom we felt AL was the best option for her following the NH was even more difficult. She had worked incredibly hard with the goal of being able to go home and live with my sis again. In the end, it was close but not quite doable. It would have meant my sis and I being her nurses rather than her daughters. We gently explained that to her and she agreed that AL was probably best. Here are additional tips for AL:

    1. Tour the facilities. When Mom was moved to the NH, there wasn't time for this. When looking into AL, I visited the 4 options in her town that would take elder waiver patients (govt. assistance). Then I discussed the options with my sis. We then took Mom and Dad on a tour of our top choice. It was a beautiful place, they knew the director from church and one from when I was a kid, and there was a lot of space for Mom to walk safely indoors. The view from the windows was beautiful and it was quiet. Mom ended up with a room where she often saw deer and other wildlife out her window.

    2. She will need to have an assessment by the staff to see if she is a good fit for their level of care. This involvement of healthcare professionals can also reassure her that you're not pushing her off on a facility. My mom had no such concerns since she knew our character and had lived with my sister for several years.

    3. Once she's there, encourage her to get involved in activities she enjoys and to get out and meet people. My mom was one of the friendliest people ever and, despite the fact that she had aphasia to the point where my sis and I often needed to act as her interpreters and frequently didn't understand some things she said ourselves, she made some very close friends. She surprised us with some things, too, like how much she loved manicures (we had no clue).

    Paying for care...If your mom doesn't have long term care insurance or a lot of money, contact the government assistance office in your county. You shoul be assigned a social worker who is supposed to help you apply for programs like Elder Waiver and Medicare/Medicaid. It's a lot of work and a pain in the butt, but you can survive it :-) We were assigned to a SW we were told was one of the top SWs in our county. I'd hate to have worked with a crappy one, because this chick was hard enough to work with. They are overworked from what I understand. Here's some advice:

    1. If your mom has cash or investments, she may need to do a spend down. When the govt. helps you out, they like to clean you out first. She can give a certain amount away each month and/or spend a certain amount each month. She'll be allowed a house and car without penalty.

    2. Make copies of EVERYTHING!!!! If they lose your paperwork, you are the one responsible. This happened to me. I'd put it in the dropbox. After that, I handed everything in to a person and made sure they date stamped it.

    3. Govt. healthcare assistance covers 3 months back.

    4. Someone should get financial power of attorney, healthcare POA and the right to her healthcare information and to talk with her doc about her medical issues. You can find forms for Financial POA online for free that will work. Each healthcare place has paperwork for you to sign for permission for medical release.

    5. Expect hassles. You're dealing with the govt, which means red tape and overworked staff. My social worker was required to respond within 24 answers, but this didn't always happen. If you expect crappy service from cranky workers, you'll be ecstatic if you get decent service from bland workers :-)

    My sister or I visited Mom nearly every day for 4 1/2 years...usually to "tuck her in" at night. She had other visitors often. She loved her home at assisted living. The last part of her life, I did so from 1 1/2-2 hours away, driving straight to her AL after work with a boss who didn't like that I was driving that far every night 'cause I might have an accident (he was a real winner ... esp. when he fired me for a list of lies and exaggerations, then fought me getting unemployment and losing that battle).

    I hope all goes well with your mom! lmc8774 has some great advice, too. I might be wrong on the house and car, because my Dad was a "spouse in the community". With my dad in the community (living with my sis), they were also able to have money and investments in his name..