When did you feel that it was best for parent to go to skilled nursing facility?

Casey1150: I understand.

When my mother fell many times, my husband and I were not able to lift get to get her back up. I would call the non-emergency number of the police department for a Lift Assist and they would come and access her and get her back into bed.

Hi Llamalover47. I'd like to explain what I meant by a 'coincidence'. I haven't been a member for very long and don't frequent this site too often. Recently the topic came up between my sibling and I about how we were going to approach the subject of mom staying in the skilled nursing home. I told him I belonged to an online support page and would put the question out there. The day I did so, the question appeared on this forum. It was only a 'coincidence' since it was there the day I needed to see it rather than searching through previous questions and answers. It is my belief if I keep my mind open and receptive, the answer may appear, which it did.

When I was given POA for two friends of mine who had no children and no close relatives, i got put on their checking account right away so I could monitor their finances and step in when necessary. When their conditions worsened and required a memory care apartment, I was shocked at the cost for the two of them to be there together, some $11,000 a month. They each had social security, they each had work pensions in addition, they each had long term care insurance and the wife had IRAs and investments. That still didn't cover it all, but came close and their savings could cover the rest for a while. The wife died after only 5 months there and half of her retirement pension now comes to her husband, plus all her IRA money and investments. His costs are around $3,000 a month and we can sustain this for 2-3 years. I will be selling their condo and adding that money to their savings account to tap over time. When he gets poor enough, he is eligible for veteran's benefits to help out. So, that's one person's story of how to manage this. The facility has agreed to take public financing once he's been there 18 months. He will easily pay his own way for that length of time.

Casey1150: I don't understand why you would say "coincidence I should come across this post? I think not!" This is a elder caregiving forum so, yes, this is the norm, e.g. what to do with our aging parents, who are sometimes living longer. In turn, we are then, quite possibly, in our 70's. A 70 year old then has health problems of their own, unless they have suddenly found the elusive "fountain of youth," which never existed in the first place.

Coincidence I should come across this post? I think not! My 88 year old mother has dementia and recently broke her hip. I left my home in another state to care for her over a year and a half ago. My son is maintaining my home for me until my return. Since I've been here, she has fallen numerous times and we have been to the emergency room within the last 5 months at least once a month. She is now in a rehab and we are planning on letting her stay at the facility after her rehab is done. It was a difficult decision to make and included a truck full of guilt, but it was also a necessity. My health has declined dramatically since I've been here and I can no longer lift her when she falls. My one sibling who lives close to mom needs to continue to work and the other sibling lives up north and basically does nothing to contribute to her care. The one who lives close by and myself would talk about wishing for an easy solution to our problem. Such as, what if she on her next trip to the ER they decided to keep her for a few days so we could get some rest? Ha, be careful what you wish for! We never wanted her to be in the pain she was in, just out of the house for a couple days. So, are we bad people? I don't think so, I'm pretty sure there are others out there who may have wished the same. Well, as it stands now, she will be staying and eventually I will be going home. We also hired a Medicaid attorney since she makes too much on one hand and not enough on the other. With the attorney's help, we hope to untangle all the legal mumbo jumbo called Medicaid. Lastly I will say this, it isn't wrong to put yourself first.. They say on the planes in the event of an emergency to put the oxygen mask on yourself first, then on the child. Only in this way can you help them. Take care of yourself, be strong and best of luck, we all need it!

Pardon me, I am wrong to assume that everyone is desperately poor like my late Mother. So sorry.

$12,000 - my mother, and my friend's mother in the board and care home each get easily over $1000 a month between social security and a pension. I realize not everyone gets a pension, though. It seems you have to be independently wealthy or dirt poor (Medicaid) in your old age.

Why does anyone think that $12K is a lot of money???

Does anyone live in their own home for that???

Here's my response to, '. . . that's going to equate to $12,000/yr. What elder has that kind of money stashed away for the proverbial rainy day?" Now 85, I recently moved to an independent living facility offering services similar to those at the board and care home that was mentioned. I don't have money stashed away, but receive -- in addition to Social Security -- pensions from two previous employers whose plans I joined when working.

cmagnum: Okay then. You hadn't shared that information before. That's wonderful! My husband and I worked for what we own and we did inherit a piece of change from my late Mother's house sale (I have one sib). Our investment advisor is an aggresive investor. We are glad that we're not emotional people, because that doesn't work with investing. (One such person is related to the family.)

Pinklifelines,

The doctor is NOT going to tell you it is time. That is not how it works. The doctor will look at her, see if she needs this or that medication, and --until you complain loudly and even if you do--send her home. The doctor doesn't live with her and therefore doesn't know how she REALLY is.

Here is the thing: you actually have to pull up your big girl panties, assess the situation, and make decisions. Not necessarily alone... Get true professionals into the house to give you a recommendation. But in the end, you have to decide what is best for everyone--including your poor husband.

In our case, the Area Agency on Aging came to the home. Funnily enough, my mother organized this herself by calling them to complain about me. They offered to come and she accepted. Amazingly, the woman spent three hours in the home with my mother alone. During that time, my mom left a burner on and invited stranger into the home, and told the stranger all about herself. The nice woman form the AAOA recommended that my mom be "placed."

But it needn't always be such a large step. See if it is possible for your mom to go for respite care for a weekend once a month, or have someone come into the home to stay with her once a month so that you and your husband can take a breather.

Whichever way it goes, I can assure you of this: nothing will happen if you don't make it happen. I couldn't fathom that I would have to make decisions over my mother's head but that is what was needed. She was incapable--and I just had to step up.

Good luck and hugs!

Sorry, but I do for I have some sizable investments apart from my retirement money that I will focus one day on paying the premium on the long term care insurance. The combination of my retirement with social security will be enough to live on. I can thus focus my other investments to pay the monthly premium. Like my dad did, I've prepared for this day since I first went to work. My divorced mother never made the income that my dad did, but what she inherited from her mother enabled her to invest in long term care insurance which helped a lot with her nursing home care. She got more money in support of her care than she ever spent in paying for the coverage. This enabled a great part of her mother's inheritance to pass to me. My wife is one of two who will receive an inheritance from her mother and she is very, very well off.

My husband and l have already put into our investment portfolio long-term care. Plus we have already prepaid for both our funerals including burial plots and caskets. My late mother struggled her entire life....from The Great Depression until she widowed early at 46 and never chose to remarry. You said "so does my wife and I (have enough money for a rainy day)," but actually you haven't because you have yet to buy long-term care insurance.

$1,000 a month is much less than assisted living costs.

My dad, my mother, and my grandmother all had enough money for such a rainy day and so does my wife and I. The biggest thing that helped my mom and helps my dad is having had and having long term care insurance which my wife and I plan to get one day.

Good grief, Lassie, that's going to equate to $12,000/yr. What elder has that kind of money stashed away for the the proverbial "rainy day?"

There is a board and care home here, in a beautiful old house. There are half a dozen residents, each has their own room. It costs basic about $1000 a month with communal meals. There is someone on the premises at all times, including overnight in case of emergency, but they do NO caregiving or driving them anywhere, the resident's family must arrange for those things separately. The residents must be able to walk and come to the dining room for meals. If they start falling, have serious medical conditions, or dementia, they can't continue to live there as the staff can't take responsibility. My friend's mother is 94, sharp as a razor though she now needs Depends and a walker, and quite enjoys it there. (She had, however, lived in various apartments for many years. She sold her house long ago, a year after her husband died, and was glad to unload it!)

While our parents certainly want to remain in their homes (and who can blame them, really?), sometimes it's just not possible due to a number of reasons: #1 they live in another state than us, #2 many of us are not trained medical professionals, #3 their needs outweigh the dangers of staying in their own home, et al.

When the MD, the FD and the SW tell you it's time, listen to them. They are a little more objective than a daughter racked with guilt.

I would only say to be careful in the process that you don't loose your marriage and end up all alone after your mom dies. Your marriage vows need to come first.

Wow, I can see myself in every one of these comments. I know that it's getting close to "that time" but I just can't bring myself to think of a nursing home. Mum has been with us for almost 5 years. I retired early from a job I loved to care for her, my marriage has suffered from the stress. My husband and I have no privacy and no time together. Yet I still can't bring myself to make that decision. I think it will have to be made for me by a Dr. or the fact that I physically can't do it any longer. I'm close to that point now. I've lost myself in all of this. I don't remember what it's like to be me. This website has been a Godsend though. It somehow helps just knowing I'm not crazy feeling the things that I do! Thanks everyone. xo

You may want to consider an adult family home, also called board and care homes depending on state.My mom needed more care but not nursing care so we found a wonderful home with 6 residents. The family lives there and run an amazing home like assisted living. We are so happy with this type of care. I would be very happy to share more info with anyone who wants to know about them. They have 2 caregivers there all the time so the staff to resident ratio is unheard of in larger facilities. The price is also less than half the cost of nursing homes. They are a wonderful option for many.

I knew my mother needed assisted living care when she kept forgetting I visited a few hours earlier.
It took about 6 months to find the right place and I had to hire a senior care consultant to find the right place that met our financial, location, and quality limits..
We tried moving her to independent living at the facility (it was so sweet! 4th floor overlooking a lake and sunset), but, over the course of the next few days, she wasn't remembering where she lived and wasn't making sense with who she met.. She was getting lost wasn't going to the dining rooms at the community. She too started burning pans.. So the director recommended Assisted Living...primarily cause they can't recommend her living alone if she can't find her way home, as well as her neighbor saying she repeats herself and forgets who they are.
God bless!

My mother was in AL and was very unsteady. She had fallen several times but fortunately had not injured herself badly. Finally she had a fall that required her to spend the night in the hospital. The AL management took us aside and told us it was time for Mom to go to a NH because they did not have the staff to accommodate Mom's growing need for 24/7 monitoring for her safety. We moved her directly to the NH from the hospital. There she was under constant surveylance with a large staff that made sure she was assisted every time she went to the bathroom, with dressing, etc. Toward the end, she was moved from bed to a special wheelchair with a hoist.
Assisted living has 24/7 staff, trained nurses, etc. The point I'm making is that, if assisted living cannot safely care for and monitor a person who is unsteady enough to fall on a regular basis then it is 10x harder and dangerous for a single person to deal with those issues in a home environment.

I just thought of a few more things after giving this a little more thought and digging a little deeper her. I must agree with the idea of physical therapy. Yes, physical therapy will help strengthen the patient's body by building muscle structure. However, they can also work on balance to prevent future falls as mentioned here. Another thing they should also teach in physical therapy is how to pick yourself up if you do fall. That way, you won't be laying on the floor for hours or even days in some cases where no help is available when people live alone. Having vital skills to get yourself up will really help a lot, especially when you most need those skills. Physical therapy can teach a patient how to use surrounding furniture to their advantage, and they can even teach patients how to get up when no furniture is around and they are caught out in the open should they fall. Proper PT can really help prevent falls if not at least minimize the chances, but sometimes people do trip, which is why I think PT should also teach patients how to pick themselves up so that skill is there when no one else is. Even with others around, not everyone is going to be able to pick you up when you're down, which is why PT should be teaching patients how to pick themselves up and not rely so much on others.

Here's another scenario because you often hear cases where a patient wanders off:

Let's say your loved one wanders off in the night while you're sleeping. Let's say they wander down a lonely road and maybe worse yet into the woods. Just like the story about a young boy who was found alone in the forest, switch roles, putting your loved one in the boy's shoes. Instead of someone sending your love one into the forest, imagine if your loved one wandered off from your home and into the forest. If your loved one got lost in the forest, remember no one is there to help if they fall. This is why PT should teach patients with fall issues how to pick themselves up if they ever tripped over something and fall. That can happen to anyone at any age, and knowing how to pick yourself up is a very important skill that comes in handy when you most need it. It sounds to me like as people age they forget this is very important skill, and they may need help remembering how to help themselves.

If you can recall the date this happened, you may want to start with alerting the Fire Chief. You may want to show up in person especially if you had any witnesses. Another route you could go is to alert your states safety department and make a complaint. No offense, but to a point I can see where they're coming from because they can't be taken away from other serious matters. However, they are there to help and they shouldn't be rude to people who need them. Being rude is very unprofessional, I agree there. Remember that they are human and not perfect. EMTs have bad days just like the rest of us, so try not to take it personally if at all possible. If this was a personal attack, then yes, it should be addressed to the proper channels. Another place you may also alert is your state's civil rights commission because this may turn out to be a civil matter. Anytime a patient situation is mishandled, you may be told that it's a civil matter if you go to even make a police report. However, the surprise may come later down the road when someone tells you the real truth that you were just told this just because they didn't want to touch the matter. People will come up with all kinds of excuses when they just don't want to be involved at a time you must make a report to people who are supposed to be there to help. It's very devastating to hear that authorities you're supposed to trust won't help at your greatest time of need. Had you not called 911, the patient may have laid there for quite some time just because you couldn't pick them up when no help was around. Had you left the patient laying on the floor til help arrived, you could've gotten trouble for neglect, so you really did the right thing. I recall a time my elderly friend fell off the edge of his bed and sustained a minor injury. I knew I couldn't pick him up and he had an emergency call box installed. The only choice I had was to use that call box that calls for help. As long as I knew him he only had one fall where EMTs had to come and pick him up because I just couldn't. However, I can't count how many other calls were made for other issues he could've clearly taken care of on his own. He neglected his physical needs and really screwed his body up pretty bad over time. Toward the end of his life, he was in terrible shape getting numerous illnesses and infections. I mean, it was terrible and he could've lived so much longer had he only taken far better care of himself. When he started frequently calling the squad about once or twice a week, I realize he probably should've been in a nursing home or he should've had a live in in-home healthcare aid. This may be the very reason he tried to get me to move in with him when I already had my own life and home. He tried to get me to give up everything for nothing and I wouldn't fall for it. He then tried another trick to get me to spend all of my free time with him and never have a life outside of him. I kind of felt a little smothered to be honest, and numerous times I felt better getting away from him. When he realized I was pulling away, he used pleasant things to dangle in front of me to draw me back

Richard thank you for your comment. Many of us needed to hear from someone like you to reassure us these services are there for us. Truly appreciate your input

Hugemom and all, I have worked in EMS for years and retired as a Captain. I would have never tolerated behavior like Kellydb experienced if I knew about it. Calls for lifting assistance are everyday emergency services business and usually done and handled in short order. No one should be hesitant about calling for help if it is needed. Woe betide the provider who would be surly with me if I had to call for help.

I am sorry the fire fighter was rude. Very few are going to act like that. Understand there are calls to 911 for lifting assistance fairly frequently and most times they are happy to help out. It's the people who abuse the system that cause reactions like you experienced. If she falls again, don't try to lift her yourself for fear of getting an attitude if you call 911. You could end up being the second patient.

Snow quail - in many states strapping a person into their wheelchair is considered a restraint and is illegal - the same hold true for trays attached. If you are seeing this please check your state laws regarding restraints and/or report it to the nursing homes ombudsman.