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My mother-in-law is a resident in a long-term care facility that is experiencing serious neglect issues and staff shortages. She was lucky enough to live in a semi-private room without a roommate for the last 10 months. Unfortunately, she now has a roommate, and we are frightened. Her immune system is compromised and her risk of exposure to Covid is heightened (the LTC is doing a poor job of monitoring Covid and keeping residents who test positive quarantined). The staff in her wing have gone from taking care of 14 residents to 30+.
We reported care concerns to the regulatory agency that manages NHs in our state. They are highly discouraging moving her to a different facility (they say it is bad everywhere). They say the number of neglect complaints has escalated so much that they cannot promise when they can get back to the person(s) filing complaints. Our next solution is to move her home so that we can ensure she is receiving the care she needs and is protected from re-occurring Covid outbreaks in the NH.
What is so frustrating is that the LTC has been increasing their effort to fill up every empty bed with Medicaid patients regardless of whether they have the staff to care for them. Staff shortages are so bad that last night we saw, and spoke with, nurses who were sobbing from the stress of not having enough staff to care for the residents. My heart goes out to them.
Care was never great before, but we could at least control her environment by providing the extra care she needed. She is depressed because she does not have the privacy she enjoyed before, says the care has gone even more downhill, and she can't sleep at night. She wants to come home. We wish we could afford private care but can't.
Thoughts?

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A female relative of mine died in summer of 202O from Covid. She was being taken care of at home for a physical disability. She had PT coming into her house and it’s assumed that one of those brought the virus into the home because they were isolating as much as possible. She began coughing one afternoon, her oxygen level quickly went down, and she went immediately by ambulance to the hospital where she died the next morning. Her husband had a mild case but never managed to shake the brain fog though he recovered quickly and was in excellent health prior to Covid. He probably has long Covid. Last week he
moved to assisted living. Just relating this because I believe we all should continue Covid precautions as much as possible. The attitude that we all have to get it sometime is not helpful. Be careful and maybe you won’t suffer like these good people did.
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You'd have to move the woman to the moon, alone, to insure she won't get Covid. Even in your home, do you not go out? You don't live in a bubble, so the chances that you'd bring Covid TO her at home are quite likely. Moving her to another SNF, same thing. You cannot protect her from Covid just like you can't protect yourself or anyone else! Nothing works, not masks or jabs or boosters or anything. We are all going to get it at some point, we have to assume now, and likely SURVIVE it, so that's the message to repeat to yourself at this juncture. We cannot live in fear of this virus any longer, and 2.5 years of doing so is enough!

My husband is immuno suppressed.....not compromised but suppressed. We still go out and live our lives because the alternative is hiding in our home 24/7 and sequestering ourselves away in fear, which we refuse to do. We avoid large indoor gatherings, thats about it. We've been in hospitals and medical faciities continuously for the past 2 years also, meaning we've definitely been exposed to the virus plenty of times. We've not caught it. We've had our 2 jabs and 1 booster and that's it, we're done. If and when we get it, we get it. Everyone has had a pretty mild case lately, it seems. My DH can't even take Paxlovid due to medication interference. Plus, the doctors are generally veering away from recommending it anyway.....a virus has to run it's course. And we have to allow it to. My DIL and her family all have Covid now and the doc gave thumbs down to them for the Paxlovid, saying it can cause more trouble than it cures. Look what it did to Fauci, after all.

If you're taking MIL home to keep her safe, you're fooling yourselves. If you want to take her home due to neglect at the SNF, thats another matter. If you think you can manage her 24/7 care alone at home, by all means do it. I wouldn't. My mother was 92-95 years old and lived in Memory Care Assisted Living thru the height of Covid, never caught it either, and died of dementia and heart issues in February. I was unable to care for her at home and never would've considered taking her out of her MC for Covid or any other reason. She needed a TON of care that required a team of people working 24/7 to accomplish. Idk what level of care your MIL requires?

You can go visit her more often and spend time with her, making sure her needs are being met at the SNF during this time of being short staffed. That's a consideration too.

Wishing you the best of luck.
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What care is MIL not recieving? Is it particular scheduled items like a bath or getting dressed? Or is it through the day items like bathroom help or help with her food?

Ssometimes you can find nurses in training (students) or retired nurses to assist for a couple of hours at a time. An extended family member hired a student nurse to come by each morning, help with a shower and getting their LO dressed and eating breakfast. A retired nurse came by at lunch and assisted with eating, midday toileting and got LO settled for an afternoon nap. The family member visited each night at supper time. The home felt the short staffing more at meal times than other parts of the day so the outside help at meal times made a difference.
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A few questions, there is not a lot of info in your profile so the answer to these questions might help.
Why is MIL in Long Term Care?
Do you have the capability to care for her SAFELY?
Do you have the room and equipment to care for her safely?
Will you need to hire caregivers in order to care for her? If so would there be nighttime caregivers? If so are you prepared for that?
If you can hire caregivers (just as in facilities caregivers are in short supply) there is still the risk of COVID.
Have you actually looked into other facilities or have you accepted the discouraging comment that you should not try moving her as it is "bad everywhere".
Is MIL a candidate for Assisted Living rather than LTC? If that is an option it opens other facilities for you to look at.
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Unfortunately, I don't think there's a great way to avoid COVID at this point. If she's been double-boosted, that's the best protection she can get, and I assume the NH at least has the sense to have their staff masked. That's probably the best you can hope for.

If she's getting skilled nursing, then honestly, you will not be able to replicate that at home yourselves. Ten months is a long time to be in a facility then go home again. The expenses of supplies alone may break your bank, and never mind how difficult the hands-on work will be. No one can do it alone, and that's why even a reduced staff in a LTC setting is better than family trying to care for someone in addition to working, sleeping, and caring for a household.

Who cares what the regulatory agency says about moving her? Move her if you think that'll be better, and it may well be. However, if she's on Medicaid and thinks she could have a single room to herself, I think that's not realistic no matter where she goes. Perhaps she just needs to have time to get accustomed to the roommate.

It stinks all the way around, but I don't know that bringing her home to avoid the chance of COVID will make her life better, and it certainly won't do that for you.
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The missing part in your decision making MAY need to take a look at how bad the level of infection is in your immediate area.

Many people who comment on COVID live in areas that are safer or not as safe as where you are.

I’ve lived in hot spot where the rate of infection has been high since the pandemic began. In situations like mine, “home” is NOT necessarily SAFER and may be even less so than you’re describing in her current residence.

My LO is 94. She has survived 2 COVID infections, but my husband and Iwere also infected by an unknown source while living in a totally isolated household.

All of us who are caregivers are feeling either “frustrated and hopeless” or are very naive.

My heart goes out to you.
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BlueEyedGirl94 Jul 2022
I completely agree with this. We have been exposed and then by definition exposed both my homebound FIL and homebound grandmother inadvertently. We have had a private pay caregiver expose FIL inadvertently. We have college-age daughters, we have multiple family members contributing to the caregiving for both homebound family members. With each subsequent caregiver you increase the chance of exposure.
Switch that up, while chances of exposure are probably higher in a skilled nursing facility and I can imagine your concerns are high... you don't mention that she is actually being neglected there just that you are concerned about her exposure. If you bring her home are you intending to put her in a room and isolate her? I'm not being sarcastic I'm being 100% serious. Unless you limit her visitors, wear masks, test everyone with a rapid test before they see her, change out the household ventilation, and don't allow her to leave that room (which all have their own problems) you really aren't gaining a lot of protection. You have to weigh that against how much will change for all of you.
I'm not saying it's the wrong thing to do. I'm just saying you need to consider ALL of the impacts.
When COVID first started and my town began lockdown, my mom, who MY family actually already shared a home with (when my dad passed away from terminal cancer, we sold our home and moved over with my mom, she loved to travel and that gave her both company AND someone in her home to take care of things when she was gone. We love being together and it gave her time to spend with her grands as well so we were all excited about it) was actually short term living with my grandmother and we decided to move them BOTH back here during the lockdown so that only one person had to go out of the house. My girls were doing online college classes, my daughter took a leave of absence from her nanny job, my husband and I were both working from home and we TRULY locked down.
It was eye opening to say the least. My grandmother did not do well. She was used to her solitude and the quiet of her home. She didn't want the "noise" of an active house (we weren't loud...we were just a normal active family but to her after years of just her and silence we were loud). She was chomping at the bit to get back to her domain. My mom LOVED being home. She craved the stimulation and "noise". She needed it.

So as much as protecting her from COVID is important...it is everywhere and it there is only so much you can do to protect her. There is no such thing as 100% safe anywhere. The question is...what will moving do to her? To you? To your family? Will it be beneficial for her? Will it create problems for her? For you? You might be eliminating one issue partially (COVID) but creating more without realizing it. So really consider all of the potentials before making a decision.
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COVID is here to stay. In the two plus years its been with us, we have never contracted it. We have our shots and a booster and we contracted it during out Cruise. Everyone boarding the ship had to be tested. So, MIL could get it at ur house.

I might just visit more. Maybe do some little things to lighten the staffs load.
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gladimhere Jul 2022
Have you or have you not contracted covid? Your answer says both.
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I'd hire a private CG to come in a couple times a week and help mom out before I would make the giant step of bringing her 'home'. That's a change she may not really enjoy. And trust me, your DH will not be taking up the slack, it will entirely on you.

Check with the NH and see if they have certain criteria you must follow to have outside help. Working WITH the system will be better than trying to create your own 'system'.

And once MIL has left NH care, it will be very hard to get her back in.

COVID is here to stay, we all have to deal with that.
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Even Fauci and Biden got covid, each with all their staff and all their protocols. My in laws got it again despite having no interaction outside medical staff and their caregivers. Keeping up to date on shots and getting pavloxid lowers the risk of death, and that’s all anyone can do.

As to the lack of privacy, this is what typically happens with Medicaid. And if she truly needs snf services on the government, she’s in a better place to get them than with one person, even family.
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I would either have hospice evacuation or hire private caregiver to help out until this caregiver shortage ends ..with hospice, she get extra help coming to facility just for her. Believe me, you won’t know what you’re in for if you take her home. Find a way to make it work where she is. Hugs 🤗
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dear OP,
:)

hug!!
you know, with such a question you’ll get answers on both sides of the spectrum: keep your MIL in a facility vs. keep her home.

you’ll hear from people who had awful experiences keeping their LOs home; and people who had great experiences.

only you can make the decision because: (1) only you know all the facts, and the consequences of either decision; (2) the consequences fall on you, and not on any of us giving advice.

anyway, my opinion:
keep her home. you said she’s miserable in the facility, and you’re worried about covid.

you said you can’t afford in-home private care: i wonder if there’s any way you can find some funds for it. i hope so. i hope your MIL has a house she can sell, or some assets. i hope you can hire in-home caregivers.

definitely you shouldn’t become a 24/7 caregiver; that’s slavery. and it’s your husband’s mother: he must help her.
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You don't share what level of care your MIL needs as you may not even be able to provide the level of care she needs. I would assume she needs significant care or she wouldn't be in a SNF. Before you make any decisions, you need to ensure you can provide that level of care and understand the impact it will have on you and your family.

My mother is in a SNF and I know we couldn't care for her at our home. We don't have the space nor are we equipped with all of the extra equipment needed for her level of care, including hospital bed, lift, etc.

It is a sad situation but if you can't pay for private care, you will need to either take her home, leave her where she is or try and find another place (which would probably have the same issues).

My solution has been to visit more frequently, get to know the staff really well to ensure they know I am invested in her care and I have hired someone to visit when I can't. I would explore what else you can do before moving her home as she may not get the level of care she needs or it could make your home life almost unbearable.
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I would find another home, just because the regulatory agency doesn't want to address the move doesn't mean you shouldn't research the options and move her.

I would never consider moving her into your home, she will not get better and unless you are wanting to give up your entire life and are clinically trained this would not be an option.

Read around this site, from the many others that have done this and are unable to cope and are basket cases to boot. Caretaking for an elderly person is not a walk in the park.
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