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marymember Asked March 2015

What to do when an aunt (99) wants to change to a different NH; but doesn't realize the present one is best?

We moved my aunt from her unsafe home in another city about two and a half years ago. We brought her to our town and placed her in an excellent, clean, and wonderfully staffed nursing home in our town, as she had fallen and could no longer walk. During the two and a half years she has had excellent care and is treated with dignity and respect. But now she wants me to move her to a different nursing home because she thinks one of her medicines is not the one the doctor ordered. (but it is)..and she doesn't like it because a therapist is observing how she eats. (she has been losing weight) and another physical therapist is observing how she gets to the bathroom unassisted. My aunt won't ask for help because she thinks it is too much trouble for the staff to wait on her. So she manages by using her wheelchair and holding on to the hand supports.

How hard is it to transfer her to another nursing home as she is Medicaid? How much paperwork is that? And the nursing home where she is now takes her all the way to the city for all of her serious eye exams, laser surgeries, catatact surgeries, etc. (for free, and the driver is wonderful. I go along). She gets frequent baths, good food, television, proper medications, etc. How can we be assured she will get good care elsewhere? She is very much loved where she is, but she is a stubborn old lady, can't hear well, and thinks she is always correct.She was independent all her life; drove a jeep to Alaska, camped out, got a job there, etc. How much paper work will I have to deal with? I am her P.O.A.....I take care of an Alzheimer husband and just had cancer surgery and vein surgery and I am afraid she'll not have the care she is getting now. But she is insistant and angry. Says she doesn't have enough time for herself. She is almost 99. Everyone knows how to handle her, but if a different nursing home doesn't please her...then what? marymember

endofrope Mar 2015
she uses a cell phone and is 99?!!! I can not even imagine that, you are one lucky duck if that is what is in your genetic soup!!! Don't sweat the weight loss, my mom did the same thing. Their bodies just aren't as active and they don't need to eat as many calories. Nature is an amazing lady, why don't the professionals just let her handle things? Noooo, we have to "fix" the problem and force someone who is obviously doing just fine into a rigid "normal" Thank your lucky stars that your aunt is as savvy as you say and don't listen to the pros or us amateurs who probably are dealing with an entirely different situation. We all tend to put every situation into our personal "hell in a box" that we are in at the moment. Like I
advised before, do what feels right and it will all work out. (but then I'm caring for a BSC old woman who's main goal in life is zipping zippers and moving pillows. ;P

marymember Mar 2015
Hello everyone......I will let my aunt know that it isn't possible to move her due to Medicaid's strict rules. I have already experienced a problem this month when a mistake was made with Texas Health and Human Services Commission. I received a letter stating she was no longer Medicaid due to her receiving royalties from her unfit home near Houston. But she doesn't receive royalties and the mistake was fixed. So I do not want to even attempt changing her. The problem originated because she was receiving additional physical therapy and speech therapy. She had a very light fall in the bathroom, and didn't injure herself at all. She had lost several pounds and thus the speech therapist was seeing if she was eating enough, or having trouble with chewing. All this extra therapy angered my aunt. She complained about not having enough private time. Those extra therapies have been discontinued, and she gets the ordinary therapy as she did before all this happened. So actually, she was receiving super care and attention. This home has a reputation of excellence and therefore I won't remove her. Her mind is good. But if she believes differently it is hard to convince her otherwise. But the answer of Medicaid's strict rules will convince her that this is a bad idea. She is very smart; a geneologist; but due to poor eyesight she is unable to read as she used to, and unable to write letters as she used to. I have seen to it that she had laser surgery, cataract surgery, and follow ups. But the Macular Degeneration causes a problem in reading. I have purchased her a magnifier that costs almost a thousand dollars and enables her to read, but it isn't one of those big readers that looks like a television set. Her room is very very small. (half a room)...I have offered her more but due to her age and space there isn'tmuch more. She uses a cell phone, and it is small...but she handles it very well.....She'll be 99 in June. Her sister just turned 101 and lives in her home still.
This aunt has never married and has always been really independent. She and a friend drove a jeep to Alaska in 1944 or thereabout...rugged and tough and persistant....She can recall it all......Marymember

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endofrope Mar 2015
I've just accepted that my mother will not be happy no matter what I do. Put that
#1 in your mind and all the decisions get easy. Do what is best for them and treat whatever they say as just annoying buzzing, it is what they do with anything you say to them, so turn around is fair play!

sandwich42plus Mar 2015
My mother did this. She was unhappy in town so she moved to the country. Six months in, all the same problems cropped up. Fast forward 15 years. We move her 1800 miles into independent living. Same problems cropped up. Literally. Verbatim. Mom wanted to move to a different place. The answer was just no. No mom. Plus six months and mom was put into the care center wing. All the same problems started happening again. Verbatim. Again. No mom, you can't move. Plus a few more months, and mom was put in the memory care unit and guess what - surprise, surprise, surprise, she wants to move. Nope. I don't even entertain it at all anymore. A move is not possible so there's no point talking about it. If you want me to sit here and visit, we need to talk about something else.

She lobbied and fought and was ugly and mean about it every single time. The place is not the problem. The problem is inside the person and will follow them everywhere they go.

Cognitive decline will definitely cause this. Antianxiety meds are a great solution.
Don't let someone else's confusion make you second guess anything. That is a huge head game nobody should play.

ladylee1115 Mar 2015
Sorry but I agree. I would not move my loves one either. She will just have the same or new issues at the new place. It sounds like she is experiencing some Cognitive Decline.

Windyridge Mar 2015
She's 99?! There's absolutely no reason to move ths women if she's getting good care. Tell her anything you have to but don't fix it if it ain't broke.

Chicago1954 Mar 2015
I tell Mother "There is the telephone make your calls." It doesn't happen.

surprise Mar 2015
What your mom wants is not doable. You can be totally honest: no other medicaid place offers this level of service within driving distance for you being able to visit. "Sorry mom, this is IT. I know you are not happy, but neither of us have enough money to buy you what you want."

Her statements are about her not being happy in her skin, not about the home, and not about you. It's about her unhappiness. You might want to ask doc for an anti depressant next time. .

freqflyer Mar 2015
Mary, whatever your do DON'T move your Aunt. Your Aunt might find the new place isn't what she thought she was getting and starts insisting to be moved back to her previous location.... and what if there are no openings?

Tell your Aunt that the other nursing home don't accept any *new* Medicaid residents but that you will put her on a waiting list [I know it's a fib, but sometimes we need to stretch the truth so that our elders will settle down].... and that you will review the waiting list in 6 months.

Hopefully your Aunt won't call the other nursing home herself :0

BarbBrooklyn Mar 2015
Just tell her that it's not possible; that Medicaid doesn't allow her to change. Has she been seen by a geriatric psychiatrist? It sounds like it may be time for meds for anxiety and agitation.

Rocknrobin Mar 2015
Your aunt isn't thinking clearly. The staff are doing their job and the staff at another NH will do the same. (you hope) Reassure her they are observing her because they care about her and want to make sure she is safe.
About moving to another NH, don't. Especially since she is Medicaid. More and more NH are not taking Medicaid patients unless they start out as private pay. This is for sure not worth the trouble. Why would you move her from a home where she receives super care to a home where you aren't sure. You need to do what's best. And what's best is her staying put. Good luck. You can do this.

Countrymouse Mar 2015
You're not seriously thinking of going along with this idea, are you?!!

How do you know she'll get equally good care at this new place she fancies? Never mind that - how does SHE know? What makes her think it's so great?

I hate to say it, but if your aunt is beginning to "lose it" a bit - suspicions about her medicines, reluctance to use the help available - it might be time for you to start wielding your POA more forcefully. You don't have to hit her over the head with it; you explain the insuperable logistical difficulties to her, to win time, indefinitely; and otherwise engage in masterly inactivity, secure in the knowledge that you are in fact acting correctly and in her best interests.

If she becomes increasingly angry and starts really playing up, perhaps ask for a cognitive assessment? But I think it's reasonable to hope this will simmer down and she'll settle again. Now that you've found her somewhere that's working, the last thing you want to do is move her. I'm sorry she's having a rough patch.

One other thing: her not wanting to bother the staff for help? My mother drove me to drink over that, until the penny dropped: it wasn't that she didn't want to bother me. It was that she didn't want ME bothering HER! Maybe ask the staff if there's any way they can find to keep a lower profile and be less in her face all day? It sounds as if she's aching for more privacy.

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