How do I choose between home care and nursing home care for my Mom?
My mom is 83 and in rehab recovering from a stroke. She was living alone, completely independent, and now she is completely dependent. She can't walk or use one of her arms. She's been in the rehab for about 60 days and has reached her "baseline" so it's time to think of the next step.
I am so torn about what to do, and it is really my decision, as I'm her only child. She is not demented, but in huge denial about her abilities. She wants to go back to her apartment, but without any care, which she needs 24/7. She insists she does not need care (many of you have heard this story before, so sorry for the repeat!) I spoke to her PT who was saying that in addition to thinking about what's best for her, I need to think about what's best for me. I guess a SNF would be better for me in a way. I think it would be so weird for her to go home and be there alone with this person all day/night (two people). Only one of my mother's friends is still alive, and other than my kids and me, she would have very few visitors.
I don't know how to make this decision! Her large one-bedroom apartment would have to be set up somehow with a bed for the night nurse, etc. Her rent is very low, which is great, so I'm thinking maybe she goes to her apt during the day and the SNF at night? The cost is comparable (i.e. outrageous) for home care and SNF.
Every day my mom tells me how miserable she is and how she wants to go home. She is not into the rehab place's little activities, like bingo and stuff, so I doubt she would participate in those types of things in a SNF. Maybe we should try home care and if that doesn't work, a SNF?
Honestly, I'm terrified to tell her she has two options, period: SNF or 24/7 care at home. She will say neither!
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As for my parents, I had to wait for a major crises. My Mom [97] has a major fall with head trauma, lived in long-term-care for her final 3 months. During those 3 months my Dad welcomed caregivers on day one as he couldn't manage on his own. The poor guy couldn't make himself a sandwich as my Mom use to do everything for him.
When my Mom passed, 2 weeks later Dad said he was ready for senior living as the house was too big for him to manage, plus he was scared of the stairs [even with a caregiver helping him]. Dad moved into Independent Living and loved his full size apartment, then 6 months later he needed to move into Memory Care, which he also likes. Now I can finally breathe after 7 years of catering to my parents :)
Anyway, nothing much has changed with my mom. She still needs 2 people to get her in and out of bed/wheelchair so going home is not an option. It's really sad because now that she is no longer a rehab patient, but now a longterm patient, she gets little to no PT/OT. It feels like they've given up on her. I think she is getting more confused and out of it now that she's been there for 3 most (is that possible?) We have started going to the corner restaurant for snacks and a drink (which she loves). Otherwise, she mostly just hangs out in her room, laughs and chats with the aides, and awaits visitors. She has a new woman on her floor who screams all day that she wants to die, or is calling the police, etc. What a nightmare. All I can think about is how do I avoid ending up like this??
If it comes to a point you need to find an SNF, you might want to use https://www.seniorary.com. You can compare lots of local SNFs there.
Best regards
In your Mom's mind she thinks she can do all these things. And that is normal for an elder to think that way. Both my parents [who were in their 90's] kept telling me "we can manage" and I had thought they could, too. The inside of their home always looked presentable on the main floor [I never snooped upstairs, I should of as that would have been a walk-up call for me]. I always thought my parents were clear minded, as that is how they presented themselves any time I brought over groceries and talked to them on the phone.
I suggest you tell the discharge planners that you will not be able to supervise your mother's care in her apartment, and that you get her name on the waiting list for the places that would be most suitable.
I think Babalou is probably right. If Mom goes home you may ultimately have to involve APS. I hope you can avoid all that and get her into a nice care center.
Your mom6life has changed. She neds to make peace with that. She may need some space to do that. Leaving her may force her back on her own resources, which she may begin to evaluate more realistically.
And again, let the discharge team meet with her. Let THEM tell her, specifically, what she needs.
And if she fires them after a week, you call APS and report her as a vulnerable adult.
I'm always in favor of a group setting over individual, at home care. More eyes to oversee the situation, fewer opportunities for bad things to happen, in my humble opinion.