Do I need overnight care for mom?

There is a reason people are asking if you really want to do this. Hundreds of people on this board thought they could do home care too, and now they are exhausted, broken mentally (and physically) and wish someone had warned them. Your replies of "that's not what I asked" means people are saying something you don't want to hear. Consider why.

The fact that you're hoping you can skip the night diapers is but one indication that you don't see what is coming. She was placed in NH for a reason, and one of them was overnight care.

You will not be able to work from home AND take care of Mom at the same time. Your work or your mom will suffer. Again, multiple people on here thought they could do that too. Most have to handle several work interruptions daily to tend to their elder. Any sort of schedule you have now will be out the window.

Can you lift her every day?

You will need an aide, if not for this reason then another. Are you okay with workers (strangers) in your house overnight?

Can you handle multiple toilet visits, butt wiping, diarrhea, bed urine, and getting her undressed/dressed? Multiple times a day, and night too?

Are your toilets, bathtubs, etc handicap-ready? Will her bed have safety rails? Are meds stored safely?

There will be no more dinners out, no vacations. Friends and family will say to call if you need anything, but you'll find almost none will volunteer to stay with her if you want or need time out.

When do you plan to get things like errands and grocery shopping done?

If she worsens, how will you handle the medical needs? If she keeps you up at night, how do you plan to handle work the next day?

If you get sick, injured, or compromised, what plan do you have for her care?

Finally, consider she is set in a routine at NH. Taking her out of that and into a whole new one is a rough transition on an elder. If you end up having to place her again, that's another round of transition and newness she'll have to adjust to.

I've said before that people think they can "love their way" through caregiving. That love will be enough to sustain their energy and will. It isn't. Most on here loved their elder dearly and wanted to care for them. They had to place their elder to save both of their lives.

If you're bound and determined to move her to your house, certainly no one can stop you. Just go into this with open eyes and KNOW what you are taking on.

I think it might be instructive for the OP to spend 48 continuous hours in the NH to see what her mom's care needs are. And if she sleeps through the night. And what her level of "need" is over the course of those hours.

Look, I'm all for home care if it is the best thing for everyone involved. I just want the OP to be fully informed about what the issues that come up might be.

The great thing about having my mom in a NH was that the care came to her.

There was a geriatrician, Advanced practise nurses, medtech nurses, podiatrist, audiologist, dentist, psychiatrist, dermatologist and eye doctor. All of those services were available "in house". No need to shlep mom out to have her seen.

Our only foray into the medical community was for a biopsy of what we all thought might be a new melanoma (it wasn't). But it was a heavy lift to get mom to and from the dermatologist's office, up on the table, etc for the procedure. I can't imagine having had to take her out for ALL of her medical care.

For Five years my mom was changed each night before bed. Then first thing in the morning. I used Sam’s club depends with one Sam’s club pad inside. Mom’s crack on her bottom was coated each evening/ morning with Desitin. I bought the adult wipes from Sam’s club and used these to keep her bottom area clean and wiped down prior to using the Desitin, I also reapplied the Desitin when ever she used the bathroom or once she was bed ridden when I changed her. Every few days I applied the Desitin under mom’s breast and if needed in leg joint or anywhere else I thought might need it.

I borrowed a hospital bed from the Lion’s Club and I purchased a pressure mattress.
From Amazon I purchased washable bed pads, One was placed under the Sheet and one on top. I also purchased disposable pads to have as back up. Most nights mom did not leak. I used a washable pad on moms recliner and later on the wheelchair.

I never had to roll or reposition mom, mom never got bed sores. Desitin was my mom’s best friend along with the alternating air pressure pan. Later on when mom was having trouble standing I was able to get a Hoyer lift. This became my favorite device and my mom loved it. I used the split leg harness sometimes and other times a short full harness I purchased from Amazon. Mom was in a seated position in these harnesses vs the V position. I was able to move her. easily from bed to recliner or wheelchair very easily. We never used overnight care. I used a small camera that if I woke in the night I could check on mom easily.

Make sure mom is kept clean down there and use barrier cream. Try and get and alternating air bed pad for your mom to sleep on. Get her out of bed during the day. Wishing you the best. Get help for a few hours each week to give yourself a break, if mom is not ok the be left alone. My mom passed away at home in August.

Now my dad 97 needs a little help here and there bad knees. He is incontinent sometimes but not always. He keeps a urinal near him. He uses the Desitin also. More places on him for protection day and night. Mostly he coats himself. On bad days I do, we joke about greasing him down. Dad’s of sound mind which makes it easy. He is able to still live on his own. We live across the street. I go over a few times daily and always at night to make sure he is safe on stair lift transfers, because of his bad knees.

I wish you the best ask your doctor what durable medical equipment you may qualify for through medicare. If the nursing home has physical therapy they can possibly order a wheelchair if needed before she leaves. If you are in the US check with the Lion’s or Rotary club to see if they have a lending program. My mom had her hospital bed for 5 years from the Lion’s club.

I would change my Husband before he went to bed and I would change him at least 2 times during the night. Actually once was before I went to bed then the other was about 3 am.
You can get mattresses that are alternating pressure mattresses that reduce the need to change position as often but she should be repositioned fairly often (every 2 hours is standard)

Changing her every morning is obvious but bathing her every morning is not necessary and can sometimes lead to skin issues as well. Cleaning the areas that become soiled, wet is important but a bath or shower is not necessary.

You might want to contact Hospice and see if she would qualify for Hospice services. You would have a Nurse that would come see her weekly and a CNA that would come in 2 maybe 3 times a week to bathe her, order supplies and help you out for an hour or two. you would also get the proper equipment that you will need. A good Hospital bed, a Sit to Stand or Hoyer Lift if either are needed, or you will get them when they are necessary.

You should also start looking for caregivers, either an agency or if you are going to hire privately. Even if you do not need one over night having someone come in a few hours during the day several days a week can be a lifesaver (and sanity saver)

I did the same as you, kept mom at home, with just one shift of aid.  I put barrier crème on her and rotated her any time she woke up.  BTW, I REALLY doubt the NHs check anyone every 2 hours

I'm not a professional, but, if they say she needs to be turned on a regular basis, I'd think that is required. I'd discuss it with her doctor or hospice team, if she's on hospice.

My question is why are you taking her out of the NH? By the time people get to a NH home its because they need 24/7 care. Are you ready to give up your life. Hiring someone will be expensive. Was Mom private pay or Medicaid. If Medicaid, she might qualify for some in home care.

I posted on LoopyLoo's answer up above. She mentioned a lot of things I'm dealing with, in trying to take care of my wife at home. But in reading all of the answers I can see that no one answered your question. So I hope this helps. I use "always discreet underwear" overnight maximum on my wife. I buy them thru Amazon. I also put 2 "certainty under pads" down on the bed, one half way over the other. Then I put a heavy pliant plastic barrier cross ways over those and top that with 2 more pads. Otherwise I'm up to my ears in laundry. Even though the diaper manufacturers say they don't leak. Some do. You can get these items at Walgreens.

The problem is that you can not leave a soaked incontinence brief on without skin breaking down.

So, if she wets half hour after falling asleep then you have a good chance of skin problems.

You can check for the 1st week and see if 1 time a night would be sufficient and about what time it is needed. If she is completely bedridden she needs to have her position shifted every two hours as well.

I would not let the nursing home dictate what you need to do but, I would listen to their advice on how to keep her skin as healthy as possible. Once sores develop they are challenging to heal and can cause other issues.

Good luck with having her home.

The nursing home is absolutely correct. There will be a high risk, near certainty, of eventual skin issues without a regular check. There is no diaper that will substitute for it. But ask the question and you'll get misinformation all over the place like bladders can hold urine for 8 hrs, so and so gramma slept in urine and had no skin problems, 2 hrs is extreme (it isn't), limit fluids (worst idea ever), etc. We're talking old people here. Get a grip. Prevention is far easier than treatment.