Mom is 90, sharp as a tack, but needs help walking and using the toilet.

We've had good news: Mom is able to go back to her apartment at Independent Living! She had quite the turnaround after I talked her doctor into replacing the boot with an inflatable cast. Her walking then improved. I knew that big Frankenstein boot was throwing her off kilter. Her OT will be going back to her apartment with her for the next few days to watch her get around and make suggestions on how to do things a bit differently. She will have her companion coming in a couple of half days a week, and she'll have a Home Health Aide stopping in now and again. I knew this is temporary, but she's happy for now, which makes us happy. Thank you for all the suggestions and support. I am going to start researching private home health aides for when she needs more help.

You might want to get experienced in home help with references checked and who are in your area at the price you choose to pay. I don't blame you about the nursing home. The workers are very low paid and I have seen some horrible things in even expensive beautiful ones. We were able to receive a nursing assistant to help bathe and do other things daily with my grandmother in my home and a registered nurse visit once a week through Medicare payment. Tell the social worker that a realistic choice needs to be made and if necessary, get someone to help your mom so she can stay where she is happy.

My mom's IL was a tiered community (IL to AL to NH with hospice). Medicaid beds in NH, no Medicaid voucher for AL. I thought it was going to be the perfect solution as my mom & her funds & the other residents she knew could age along the system and she wouldn't have to move. When she started having issues with being competent enough for IL, the facility medical director would not place her in NH, she was AL and nothing was going to change his position. AL is totally private pay and the profit center for the facility. There was a full court push from admissions why AL was best; how it was all so worth the private pay cost, etc. I got my mom evaluated by her old gerontology group and she qualified for skilled nursing needed. It was all about continuing her private pay in their system, imho. If they have lots of assets, AL is fine. But most elderly if they live long enough will run out of $ and family should not be just expected to pay.

Fortunately, my mother is a member of a complex which has IL, AL and NH. Once you are living at the IL, you are guaranteed an apt/room at the AL and NH when needed.

While Mom and her friends at IL talk freely about the time when they will go to AL (after all, other friends have already moved there), they all talk about NH in hushed tones. They pretty much consider a nursing home to be a funeral home. It's a beautiful nursing home. . . .but they all know that it's the last stop of the train.

Realistically at 90, her overall situation is that she will need a higher level of care than IL within the near future even if her rehab goes well. Sounds like she will need 24/7 monitoring and actual hands-on help each day. That is what skilled nursing does. In many ways, the broken ankle will enable her to qualify for a NH as she was just too cognitive and ambulatory before this to get into a NH.

My mom was in IL & in her 90's and she went from IL to NH and bypassed AL phase. For her, this has been a great decision. She has Lewy Body Dementia is still ambulatory with a walker, can potty on her own and loves to do arts & crafts. Her current NH is her 2nd and a much better fit for what she likes to do. Not all NH are alike. Many have very good Activities departments and the residents can keep busy and do stuff. My mom's current NH activites director has them options to go on shopping trips, luncheons out, etc. There is a garden they can go out and mess with. They did a whole easter egg painting and hunt for the employees kids to participate in on Good Friday. These are some of the same things she did in her old IL. But now she has the higher level of medical oversight that she needs. The key is finding the type of NH that does this. It's good you are speaking with the social worker - I've found they are an incredible resource and if they don't have suggestions, they are going to know who to contact at another facility who might know. Rehab coverage from Medicare is limited, so if you need to find a NH the clock is ticking on finding one for her and getting her in before she gets discharged from rehab. Good luck.

I disagree with Social Worker. My mother-in-law was in Assisted Living, and she wore a button necklace that she would push whenever she needed help with something such as getting in her wheelchair, out of bed, to the bathroom, etc. or had an emergency. And my mother-in-law had Dementia, so she had mental difficulties to deal with too. It costs more in Assisted Living than Independent Living, but it was worth it (to both her and us) and gave her the freedom to live semi-alone. If I were you, I'd check with some in your area and see if they would fit your mom's needs.