How can I make my mom go into skilled care?

You are not going to get hospice without agreeing to have someone with her 24/7. Been there, they insist the patient is never left alone. When the nurse comes out, ask about a bed in a hospice facility and how to get her there. It may take a court order for emergency guardianship.

Tami, your Mom needs a higher level of care and that is something you just cannot do... and Mom cannot stay home by herself. Your Mom will need to dig into her savings to hire a caregiver to be with her while you work, she is at a point where she no longer has choices.

Whatever you do, try not to quit. Guess you could use all of your vacation days and sick days, but then what? If your company has FMLA [family & medical leave act] then you could take 3 months non-paid leave and your company would need to hold your job for you. But then what after the 3 months?

Most elders do not want to go into a nursing home especially if the elder is over 80 years old... back when their parents and grandparents had to leave home for higher care, the places were asylums, pretty scary places. Elders don't realize that today's nursing homes are so much better. But if she want to spend her final days at home, then you need to follow her wishes. But she needs to hire people.

If she's competent and wants to die at home, I would respect her wishes. Many people want to die in the comfort of home and I don't blame them

Your mother needs care 24/7 -- either at home or in a care center. If she wants to stay at home and can afford it try to help her liquidate her assets or whatever it will take and hire in-home care.

Other than mobility what are the other issues? When up and out of bed what can she do? Your description sounds like she needs skilled care. You state hospice is stopping in...what do they do? And yes, her financial resources should be used . Any apartment friends or church "family" to help out or talk with her? Are you able to get her to at least tour a facility? I hope you can find some help in addressing this concern you have for your mother.

Tamiame,
First, God bless you. Your question peaked my attention and so did the answers. What a wonderful website this is.
My husband (10 years of Alzheimer's) should also be in a nursing home. He refuses to budge. He had his 3 month check-up last week and this is what his doctor advised. 1. Contact social services. All hospitals have social service counselors that can advise proper steps and procedures for dementia and Alzheimer patients. In many cases, they can also provide contacts for in-home care. 2. The best alternative if nursing homes can be avoided, is keeping your loved one at home as long as possible. The cost is much more economical and the patient much more comfortable in familiar surroundings. 3. The Department on Aging is a wonderful resource for guidance. A day care center is great for temporary respite for the caregiver, however, your mother's condition would not be an option since she is bedridden. Also, call Medicare, your health insurance provider, even your church to see if they provide some type of pastoral care to watch your mom for a few hours a week. Unfortunately Tamiame, as caregivers, we must reach out for help which involves countless hours of time and resources. It's much more difficult than mere words and suggestions. Be persistent and don't give up. Be good to yourself and never feel self-centered or preoccupied when asking for help. That's a killer. I know. It almost put me in my grave. It still may. The doctor told me, even though I am in excellent physical health, I will, in all probability backed by statistical reports, die before my husband. Why? Stress and worry kill most caregivers. Learn to unwrap the bondage paper and tape caring for your mom 24/7. Learn to accept the fact that you have a life, you are meaningful with purpose, walk away and take breaks whether that is at work, long walks, talking to a friend, shopping---whatever you enjoy doing to remove yourself mentally and physically from the situation. Caregivers are the most under-valued and least appreciated of anyone I know---a hidden and forgotten group that saves the health industry millions of dollars annually caring for those no one can, or will help. It's up to us to assume responsibility for our own well-being. And, Tamiame, there will probably come a time when the only remaining decision will be to put your mom in a place cared for by professionals. Never look back. It's God telling you...it's time to walk away...you did all you could.

You didn't say what your mothers illness was and what her long term health situation will be. If this is going to be lengthy and your mother has deteriorated to this point, you have to enlist her physician in this process. There are rules regarding admission to skilled nursing for Medicare. You may be able to get inpatient hospice admission or long term care bed without a 3 day qualifying stay in an acute care facility. I have been going through this same situation for almost 3 months so I know how difficult this is. My mother was in her own apartment as well up until August 3rd when she had a really bad episode and it has left her almost completely bedridden and requiring 24 hour care. Neither her nor I were ready for this step. She is now in long term care and that was no choice situation much like yours. My best advice, meet with doctor, make a plan, use your FMLA benefits for a month and get her into the care situation her condition requires. Do the POA on Legal Zoom, get her to sign it and move forward. Ask more questions and get help. God bless you, your gonna need it.

While in theory one is supposed to be able to received 24/7 care, I have not found one singe HHA service willing to supply personnel for 24/7 care. From what I have heard, the client is not allowed to use two or more HHA agencies at one time. More loop holes...

testing 1 2 3

I took care of my Father his Last Two years of Life. I'm his Only Son. Mother Died Decades ago, of Cancer, in her Late Fifties, and he Never remarried. At the time I was grateful that I didn't have a "Wicked Stepmother." On Dad's Bad Days he would say that he wouldn't go to a Nursing Home or Assisted Living. But-sometimes he was Sweet-and said he'd go for My sake. I'm an Old Bachelor and it was Difficult to have a Life and care for him. I finally drove him to Assisted Living early last November. It almost felt like kidnapping at that point. He was put into Memory Care (which is like a nursing home) there, because he was deemed so Weak and Lethargic. He had one hospitalization in December, and then Hospice sweet-talked me into using their services. I actually needed them so he could have a bed with rails that he wouldn't tumble out of. He had his Ninetieth Birthday there-actually a Group cake and ice cream deal with other residents who had birthdays that month. He cried that he didn't Want a party. I am forever haunted that I didn't take him out to a restaurant, but he often fell on his head. He did so earlier when we went out for my own birthday. Hospice called me in Mid-December that he was "Starting to Decline a Little" and wanted to be put to bed in the daytime. I rushed over. He said a few words to me, and then fell into a Deep Sleep. I fed him fluids through a sponge thing, and stayed at his side for most of the next week. He began Kussmauling (Rapid Breathing) during the night of his Last Day, and then passed away at 10 AM. I know I can't complain to God or the World that he lasted all the way to Age Ninety, but I wonder if I'd done things different, if he would have lived more months or years. The head of Assisted Living offered to "Cancel the whole Hospice thing and send him across the street to the Hospital" if that's what I wanted. Maybe with supportive care he could possibly have improved. He was moving only one side of his body in spasms, so I'm haunted by the fact that he may have had some kind of Stroke. I guess, Realistically, he was at the End of the Line.

God help us all... Money is the issue in most cases when keeping our parents in their own home / surroundings. Most cannot afford 24/7 care for very long. I am the youngest daughter of 12 children.. My Mom at near 98 years old, has outlived 6 of my siblings and her 4 husbands..; the last one being 9 years her younger. She is a survivor ...even in the midst of arterial dementia... It started with a heel spur, eventually causing her stride to be off balance and eventually falling... Breaking her hip / surgery.. I've been able to keep her in her home for just over a Year since her hospital release.. It's been extremely expensive... I am married...not retired... I spent time with my Mom whuch helped some financially ..but often hired Caretakers leave or want more money etc. Leaving us with Super diffucult choices. I made a decision to move my Mom into an Assisted Living (Very Nice ) mini apartment... It cost $2,500 per month... Plus, you must furnish laundry detergent ..toilet paper & toiletries... Which is around $200. The staff aids in Bathing...helps in dressing... Keeps apartment clean ... provides all meals & administers medicine. This takes all of her SS check of $1,500...$500 from rental income and the remainder comes from her Savings..whuch will last approximately 2 years... After that, my brother & I will have to make up the difference. So the bottom line is " Money " that is desparately needed to CARINGLY make the best out of their last years... We, that are Still in the Work force and Married MUST ALSO take Time to Visit with our Parents... They Love us and depend on our Love

I must add that my Mom is monitored Very closely by a very well trained & caring staff ...that Attends to her every Need...

Good suggestions, everyone. Drpoundsign, please do not second guess yourself on anything you did. You were a hero for your dad. There is always something else that we think we should have/should not have done. It's all about intention, and clearly your intentions were nothing but doing the best for your dad. Hugs to all of us!!

Thank You,Tornadojan. I wish I had married an had a Family so they could have helped out, or that Dad had remarried or "shacked up." He DID have a Female Friend. He was a Bronze Star WW2 Veteran. My Maternal Grandmother lost a LONG Battle with Lymphoma in 1980. My Mother was out of State with her the last month, and for several months after that, selling her house and caring for my Grandfather (who moved in with us until he passed away at 92 later that same year.) My Mother was Diagnosed with Cancer in the Late Eighties, and lived about a year and a half with it. She Died in inpatient Hospice. Dad was Devastated, of course, although the outcome was expected. I'm in the Medical Profession myself, and had not passed my test for Residency at the time. I had not "made it" yet the day she closed her eyes.

She definitely needs care that can be provided by more qualified people. We got in in a carer, but she needed her time off and couldn't be there 24/7. So we asked dad to try out a nursing home for a few days and he stayed. I would suggest that you check her medication if she is moved and make sure it works without too many side-effects.

I feel when the patient has dementia and starts declining, is sleeping much more, and is very old, oncoming death is inevitable and a BLESSING. My mother was in a nursing home for two years at the end of her life and though she received good care, it was an unpleasant way, an unpleasant place, to live. If you could call it living! It was just existing. I wouldn't have wanted her roused and treated and kept on going no matter what. She just went to bed and slept for a day or two, she had a slight fever, and labored breathing, going downhill. They gave her a little morphine, and she died peacefully in her sleep. Death was, is, a blessing when we reach that point.

My mother will not die in in a year or two, she looks like with 24 hour waiting on her hand and foot that her organs will survive many years. She doesn't have Alzheimer's or cancer. She has come back to life 20 times in 18 years. I am dying from her living. She won't die, I guess, till I'm dead.

You aren't eqiipped to handle this. Even if you were a trained medical professional, you wouldn't perhaps be "on top of it." Think trained doctors and nurses. They have to update their skill set routinely.

I am sorry your mom is fighting you. I tell my daughter I hope I don't put her in this predicament. It may happen, I hope I remember not to do this to her...I hope I have arrangements put in order to help her make that move if I am too stubborn....Supposedly Home is where the heart is, but your heart is always with you..my friend mom stayed in her home until the end..basically until 911 took her to hospital.

What difference does it make? If she gets the care here or there, it shouldn't matter, a few pictures, a few belongings, and loved ones to visit.... There are options, I pulled my mom out of the house, ,took her to a board and care, dropped her off...it was hard, but I had no choice.....I would take her out and I love her...But she was not happy in my house, and I wasn't sleeping at her house, and that would not have ended up well for any of us or my daughter....so....life takes another path....she is silent now, doesn't talk which is really sad, and I see her every other day... and other days I see my aunt who is in the same situation but another board and care....

You know what makes it the hardest? A husband who has perfect parents at 87 years old and 3 doting, rich brothers and sisters in the town where his parents live. My husband has been a non -sympathetic human being to his wife who has lost every family member and is left with the sole responsibility of loving and caring for a parent while still being expected to love his family and his children and grandchildren while I have nothing left. I have one child, a daughter who at 27 has not gotten her own life right where I can feel something positive, good. I have one blood relative, that is it and I am her mother. I want to be here in this life for her, like I have been for my mother who was never there for me since I was 17. I wish that I adored my mother. It would make this hell so much more bearable.

My Mother will be 99 this month. She was forced into Personal Care from Independent Living. It was on a pre-text. Background: Mother was injured in a forced "Care Program" when she was having a medical problem against my stated wishes and her Doctors advice. The first thing that happened, she was injured in physical therapy. She passed out at night, went to the Emergency Room in a nearby hospital, fell out of bed in the Observation Room, broke her nose and was bruised. Mother returned to the facility and was placed in the Health Care Unit. She had been walking hundreds of yards a day with only a cane before she was injured and otherwise could do everything for herself. She couldn't walk on her own after the injuries were sustained. She was given P.T. and ordered a wheel chair. She got sick and was refused medical treatment in the health care center where developed pnemonia. We called 911 to get her out of there. From the Hospital she was sent back to her I.L. apartment. I stayed with Mom 24 x 7 and nursed her back to health. After a few months Mother could walk around the apartment with her cane, 200 yards in her walker and we used the wheel chair for longer distances.
We finally arranged for a nurses aid to watch her while I went to a Dr.'s appointment. Mother's bed was dry when I left. I found out 1 month later that it was dry when the first Nurses Aid left. The second Nurses Aid assigned that morning and the supervisor reported that I left Mother in a wet bed. Mother did not have an incontinence problem. It was a lie to give an excuse to tell me to take Mother to the Emergency Room at the nearby hospital or to the facility Health Care Center or the facility would call the police on me. The Emergency Room Dr was angry and put it in the report that there was no reason to send Mother to the Emergency Room or to put her in the Health Care Center and no reason why Mother could not go back to her Independent Living Apartment. My brother and cousin who have little to no communication with my Mother backed the facility that Mother should be in Personal Care. I did not sign the admission contract when the facility refused to give me a copy to review by myself or to take to an attorney. The facility Administrator sent it to my brother who signed it against my advice. I am the Health Care Power of Attorney and still cannot get a copy of the contract. It is 2 1/2 months later, Mother has not got back to 200 yards in the walker. She gets 50 yards, She would sleep most of the day every day if she could. When she sleeps most of the time she looses muscle tone. There are certain things that motivate her to get out of bed. She likes to sing gospel songs and sing old time songs from a song book, ea at once a week planned activity. She likes being with the ladies in the dining room for meals but often wants to leave without eating. The food is often pretty bad. When this happens, we bring in food or go out to eat which is several times a week. She likes to go for rides listening to Frank Sinatra tapes or to go to the pet groomers or vets with the cat. I am there every day. The facility snaps out at the height of Mother's exurberance and brings her down to where she wants to get back in bed and she quits eating time and again. Each time this happens it is harder and longer until we can get her up and active again. For example, a male friend of hers in Independent Living asked her and myself for dinner. It is in the resident handbook that this is permitted. Mother and I had been to dinner with him the previous month and mother paid for herself and myself. As she was getting dressed, excited, the I.L. Activities Director and the Nurses Aid supervisor who made the false accusation that I left Mother in a wet bed, pounded on Mother's door and they were both yelling at us that the director of Personal Care called them that we were not permitted to go to dinner with Mother's friend in I.L., that we were living it up to much, going out to much, etc., etc., and they accused us of mooching off of this gentlemen. That our activities were going to be curtailed. The facility wants her lying in bed, available for their convenience and they have even yelled at her when she and I have gone out of her apartment in the walker. When I was taking with her Physical Therapist at an outside facility and they suggested it. To sum it up, in my experience and from contacts whose parents are in different facilities, these facilities have nothing to loose when your parent dies, they just fill their space with the"next." They don't feel your loss. To the above, answer, don't feel guilty. I have seen that no matter how much a loved one protects and cares for their parent, spouse, child,or any loved one there is often that creeping guilt that you could have done more when they pass. Grief counseling or group can help one get over that. You did your best.

To every caregiver who thinks you could have or should have done more for your parent, spouse, or whoever the elderly patient in your life is: They may not wish you would do more than you can for them. I'm 85 and have been a caregiver to my mother and my three husbands who predeceased me. (My father died suddenly.) When my time comes, I don't want any of my children to "do more." Right now I'm living comfortably in an independent living facility of my choice, grateful that my mind is intact, and that I can enjoy my memories of a life well lived.

Tell your Mom that right now she needs a bit more help than you can give her at home.
Tell her that you want someone to help care for her that will do a good job and that the best place for her would be in a"Care Center" (maybe don't call it a nursing home since she has what I consider outdated feeling about many of them).
But when she is better and you can care for her she can come home.
Not an out and out lie since I am sure if she got better you would bring her home.
Hospice Nurse and Social Worker can help explain this to her.
Your other option.....
The funds that would be used to care for her in a facility is it possible that they could be used to get her care in the house for the hours you can not care for her. Either over nights if that is when she needs and you need more help or during the day. YOu could get a good caregiver for less than the cost of a Nursing Home. And she will feel more comfortable.
There is a trade off...you have a "stranger" in your house and you do need to make sure that you do background checks if you hire privately. Going through an agency is easier but a bit more expensive.

I agree with Pam, get her into a hospice hospital for her final days.

IMHO my mother would be a LOT happier living in an ALF. She flat out refuses. She lives with my brother's family. She is relatively independent, other than being unable to clean at all, or do much more than dress herself and do her laundry (with help). She NEEDS a cleaning service, but won't pay for one and won't allow me to clean any longer ( I throw EVERYTHING away, she says.) She has had many falls and we are just kind of waiting for the one that does her in. She can't go many places. can't walk more than a few feet and lives for her 2 Bingo days. In an ALF she'd be so much more likely to make friends and have more activities (and she'd be safer!) but even though it is completely financially doable---she refuses. Frustrating, to say the least. I do what I can, nag the 3 vacant sibs to PLEASE at least call her once a month and let it go.
I really hope I don't live past my sell by date, or I am cognizant enough of my own infirmities to place MYSELF somewhere.
End of the day--you CAN'T make your mom do anything. You'll drive yourself crazy trying and harm the relationship in the process.

Good suggestions by many. Instead of a large facility, you might want to check into a small care home. Hard decision, but I found a small residential home with only 6 residents and 24/7 care. They are licensed by the State. More individualized care and more if a home like atmosphere. Thus iPhone has two residents in Hospice and they come in regularly.

Drpoundsign, please know that letting your dad go on hospice was one of the kindest things you could do for him. If you had taken him to the hospital and off hospice, they would have been obligated to do things to him to try to keep him alive. Even with my elder pets, I always try to make the distinction between doing something medical for them or to them. If your dad was falling, weak and lethargic after a progressive illness, then hospice was doing things for him to keep him comfortable instead of the invasive procedures medicine would have to do to keep him alive, but not be able to reverse his dying process, merely prolong it.

I wrote a long monologue above. The point is skilled nursing can be just as unresponsive as any senior care section of any fcility. My friend and her sister home hospiced their Father with the help of an agency. He wanted to die surrounded by family in a home setting. She is glad she and her sister did this for him and sorry for the elderly who go through the trauma of not having a loving family surrounding them at the time of their passing. It isn't possible for everyone but the ideal of knowing of God's love for them through their families loving them has to be a great comfort.

drpoundsign: Ignore that. I meant to say "testing 123?" Who do you think you're talking to?