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Trying to see if anyone can help us understand it is possible to move mom in with family because nursing facility says she's a 2-person lift. Someone else says there are people who care for a parent by themselves at home even with this issue. When she's helped to the toilet, we've seen that one person alone helps, but they lift and hold her by the back of her pants because she can barely help with transfer from wheelchair. The caregiver has been bigger than she is though and from what I've read that helps.


She also needs to be weighed daily to check for fluid retention.


Can anyone share their experience with this?

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It's natural to want to see your mother happy, and to fix what seems to cause her distress. Numerous commenters have suggested questions to ask, ways to get more information, and shared their own experiences. The idea of spending 2 weeks of daylong visits so you can have a very accurate idea of what your mom needs for physical care, how her mood and thinking vary over time, how much time she does spend interacting, how much she is able to 'help' when CGs ask her to do things like hold tight to a railing or stand up on count of 3, etc. She will not regain lost strength, so as time passes she will need more help transferring than she does now. And that change can happen quickly.
The idea of finding ways to enrich her life in the SNF are good ones. Talk to the social worker and activities director of the SNF to see how they view your mom and what suggestions they have for enrichment. If there are local programs that provide visiting volunteers, they will know about.There may be activities that your mom doesn't realize are available or staff don't know she would enjoy them.
If she is religious, is there a church in the area that could provide a friendly visitor or a pastoral care visit on a regular basis? If she is clinically eligible for hospice care, all hospice programs provide volunteers for visits, pet therapy, reading aloud, etc. Hospice does not mean she will die in 6 months for sure. Find out about hospice services, as your mom will be appropriate at some point.

As a nurse caring for elders at home and helping families take care of elders at home, I would strongly encourage you not to bring your mom back to your facility. If she has declined to the point of qualifying clinically to be in a SNF, it means she needs 24 hour assistance and access to skilled nursing oversight around the clock. So, medically unstable. Skilled health care at home is a weekly visit by. nurse, and only continues when she is acutely ill. When stable, no more nurse, PT/OT, home blood draw, etc.
Her funds will run out eventually, and then the SNF must help you apply for Medicaid.
Your mom is blessed to have such a caring daughter.
Getting a SNF bed in a facility that is 'good enough' and close enough for you to visit (and brother, too!) is hard to find. Don't let the perfect be the enemy of the 'good enough'.
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The plain and simple answer to your question would be a resounding NO!
What in the world would make you for one second think that that would even be a possibility? I mean really. Do you have a death wish or something, as that would surely kill you before it will her?
Time to face reality and have mom placed in the appropriate facility where lots of folks are 2 person assists.
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please don’t put yourself through this. A caring facility has skills and equipment to take good care of her.
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Please do not attempt to move her alone.
If they say she is a two person lift - they aren't kidding.

It's not always about the weight of a person; it's also about the balancing act required and any resistance the person provides.

The last thing you want is to 'drop her' or cause her to fall; or even worse; you lose your balance and injure yourself at the same time.

My FIL barely weighs 110 lbs now and is still a two person lift. I have watched even two people struggle to move him from wheelchair to toilet; easy chair; etc.

My FIL has severe dementia; and is in a MC unit now. He gets excellent care; they feed him when he doesn't want to do it himself (he's on hospice now): they take him to the bathroom; get him in/out of bed, wheelchair, table seating and recliners. They provide activities twice/day to keep everyone's mind active and best of all; our access is unlimited. We can see him whenever we want; visit for as long as we want; take him to the garden and even visit with extended family in a 'Coca Cola Room' in the facility.
When we decided that we wanted to be 'family'; not caregivers; when we visit we can devote our time to telling him how much we love him and share memories. We don't have the added stress of caring for his daily needs.
I can't say it strongly enough - the stress of just handling the day to day needs of your Mom will cause you to resent her and will damage your own family relationships.
Please don't take this on yourself - spend your energy finding the best care for your Mom, Visit as often as possible (hardly anyone does visit - it's so sad); and know that you will be loving her by giving her the best care possible.
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PeggySue2020 Aug 2022
I can’t second you enough.
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There is no way you can do this alone. It isn’t safe for you, or for her. Think about what happens if she falls during a transfer. How will you get her off the floor? Think about how your own body will be damaged by the constant lifting. My husband passed from ALS. When he could no longer walk and needed almost 24/7 care it took a team of three people to care for him. One solution was we had a hoyer lift that was battery operated. So we could strap him in and the machine would do the lifting. It was too wide for the bathroom door so we would transfer him onto a rolling commode chair and then wheel that chair with him on it over the toilet. One person can do the lifting with a lift like that but my husband was fully mentally competent. I think with an ALZ patient it would take two people.
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I think when someone we love is suffering we want to make it better, so we look for ways to do that. The problem with the kind of physical and mental decline so many of us are facing/have faced is that there IS no way to fix it, every solution is imperfect and just a bandaid covering the hard and messy and terrifying truth that things are only going to get worse and then we die. Sometimes we say on the forum that there are no perfect solutions, just a choice between bad ones, no matter what you decide there are going to be moments when you berate yourself for not doing the other thing.
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"I think the real question is why would you want to?" as sp19690 asked.

Ask WHY then REALLY unpack those reasons.
Can alternative means meet those wants/wishes intead?

Eg
Q. Because it is right to care for one's parent?
Unpack: What is 'right'? What is 'care'? Is it physical care or emotional support? Must 100% care be provided by your own two hands? Is arranging the care, being the co-ordinator or advocate still caring?
A. Setting up a realistic & safe care plan with adequate caregivers IS care.

Q. Mom wants to live with family?
Unpack: the expectation of living with family can be a sweet idea... Nanna rocking on the porch.. The reality can be a stress-out, burning out solo caregiver, injuring themself while the elder is still unhappy/bored/wants to go home.
A. appropriate care to enable needs to be met + located close to family to enable frequent family visits.

Q. Because generations before cared for their folks?
Unpack: Compare apples with apples. Caring for fully mobile slightly older folk with low health needs is very different to caring for folk with mobility, behavioural, emotional, physical health needs.
A. While the past DOES shape our values, it cannot decide the future. Decisions today must be based on what resources are available today.

I am but one person. It is ok to say so.
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robandjane Aug 2022
Well stated.
Thanks for the reminders
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I would just like to add that at the end of the day after you've cared for your mom all day long, you'll be tired. Then you have to take care of her all night long.
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peanut56: An Alzheimer's patient should not be cared for at home.
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I cared for my Husband and he was at least 70 to 80 pounds more than I was. He was also about 6 inches taller than I.
I was able to transfer him using a Sit to Stand for a while, as he lost strength in his arms and legs I used a Hoyer lift.
I was able to get the equipment when he was on Hospice but you/her doctor can order necessary equipment.
In most areas facilities can no longer use equipment to transfer someone that is reserved for a Skilled Nursing facility.
The Hoyer lift can have a scale attachment to it so weighing is pretty easy.
Can you do all the care necessary? That depends on how determined you are in learning what needs to be done and how to do it. It also depends on how cooperative your mom is. If she struggles neither piece of equipment will be safe for you to use especially if you are trying to use it yourself.
You really should have caregivers lined up to help you, trying to do this all yourself is difficult
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Is the nursing home attached to a memory care or assisted living facility?

Perhaps she can be wheeled to those areas for activities.

I would speak with the DON and try to get her matched with others that are there because of the body.

I would also find out how well she sleeps at night. This could be devastating for you and your husband if she requires lots of night time attention.

Personally, I would try to enrich her life where she is before taking on home care. You can visit frequently, bring activities, hire a companion to visit a couple days a week and bring food, just to name a few things.

I think caregiving looks doable when someone else is cooking, cleaning, doing the laundry, managing meds, giving showers and changing diapers.

I was burned out quickly with the added laundry. Not to mention all the appointments and shopping and entertaining my dad expected, on top of my already busy life. I would never have been able to hold down and do a good job for a full-time employer. Thankfully we were just starting a new project and I didn't need to be ever present.

I hope this works for you if you decide to do it.
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Peanut,
If this were not your Mom, would you be thinking that this caregiving for an Alzheimer's patient heavier than you was a job you could be doing?

It is not sustainable.
This level of care cannot be done by one person without further stressing the caregiver who is healthy, let alone someone who has any back problems.

Will you have caregiving help to cover 24/7 care for 3 shifts per day? How many "shifts" do you feel one person can take on?

I hope you will make good decisions for your Mom to get the care she needs.
But am more concerned about your health right now.
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I have ruptured a disk in my back. Trust me, you don't want to go there. It pushed childbirth WAY down the list on The Worst Pain I've Ever Experienced. (To be fair, pancreatitis pushed a blown disk way down that list, too.)

I think you can find better options to deal with the food issue than bringing her home. Sometimes there is no ideal situation, but the best possible situation for the moment. What would happen to her when you blow out your back the second week she was home?
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No, you should not do this! It’s much more difficult, physically and mentally, than you can imagine. Let professionals take care of her.
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I just noticed a comment about being told the Hoyer lift requires 2 people to be used safely (and presumably that advice applies to every other mechanical lift).

That advice applies to facilities and to maybe paid certified caregivers in the home but most people don't have access to that and still use lifts safely in their homes. When the choice is between one person attempting a transfer without a device and one person attempting a transfer with a lift the unaided transfer has as many if not more safety concerns for the patient and especially for the caregiver.

Someone else recommended spending time learning the ins and outs of caring for your mother while she's still living in the nursing home, observing and learning how lifts work would be a valuable lesson.
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peanut56 Aug 2022
Good to know. I will continue to ask. An RN at the hospital (not the nursing home) also showed how to help from bed to toilet and had me assist. I used to help, but that has changed now. I've never thought caregiving was easy, but all the "No's" from people dealing with for years speaks volumes. Her mind is still at MC activity level, but her body needs NH and in no way do is this to disrespect the activities in NH. This disease is an equal opportunity thief, and noone knows exactly when.
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No you will not be able to care for her at home. My father tried to care for my mother who needed two people and had never ending issues including many falls. It is dangerous, especially if you aren't trained.
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No. And why would you want to take this on? What will you do with her when you injure yourself?
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Another thing to consider is transportation to medical care.

In my mom’s facility, her docs come to visit her.

How will you get your mom to medical care, if she is a two person assist? That’s in and out of the car, twice, at a minimum.
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peanut56 Aug 2022
We've used non-emergent medical transport in a wheelchair van, and it's been great. You have a good point, because not all areas have this service, so need to check that too. Home health has all kinds of help coming in for another person, even for bloodwork which minimizes trips out for the family and patient.
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Your mother is in a NH for a reason. She needs 24/7 care. A MC is limited to what they are capable of. I am sure if Mom became a 2 person assist, they would have told you she needs more care than they can give. IMO MC is just a step up from AL the difference, its locked down and may have more aides.

My Mom was the same weight I am and I could not lift her if she fell its dead weight if they can't help. Many a time I tried to help her out of her chair and she pulled back and I let her go back into the recliner. I was not putting my back out.

I agree willey about interaction. My mom had no socialization, it was just me. She no longer could read, she nor I did puzzles or like to play games. She sat and watched TV. At the AL, she had freedom to walk the building. She was in the Common area most of the day so she had socialization and entertainment. Lots better than living with me. Even at the NH they knew she was happier among people even if she could not always participate in activities.
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I think the real question is why would you want to?

And to answer your question i would say no. You have a hoid chance of injuring yourself changing and cleaning feces 1, 2 or 3 times a day. Especially since the person cannot move.

She has heart failure but what other issues does she have that make it so she cant move? Does it really matter at this point what she eats?
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If the nursing facility says she is a two-person transfer, take their word for it on that.
I was an in-home caregiver for almost 25 years and worked for all kinds of people. Having to move and transfer any sized adult on your own when they are dead weight is going to wreck your body after a while. It makes zero difference what size the caregiver is.
I've cared for more client than I can remember over the years. I can count on one hand how many had family members in the house who would assist with transfers and toileting.
Sure, it's possible to care for a person ailing with Alzheimer's who has to also be lifted and transferred from point 'A' to point 'B' and toileted several times a day the same way on your own.
The first thing that will go on you will be your hands. The pain will start off small at first. Then you'll maybe start putting on hand braces like I did when it's time to move them or reposition. Then it's wrists. Then your shoulders (usually a worn out rotor cuffs). Then your knees from your legs taking all the weight. And of course, no matter how careful you are or how good your practice of body mechanics is, your back goes.
I couldn't do hands-on care anymore even if I wanted to which I most emphatically do not.
Do not move your mother into your house. Maybe in the nursing home she can be toileted with an assist of one. That will change. Be a good advocate for her instead if hr hands-on caregiver.
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sp19690 Aug 2022
Burnt I am counting the days until you are out of your mother's house, being her caretaker and are finally free.
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No.
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When my mom reached the point where I began to consider buying a lift was also when I realized that I couldn't possibly add another level of care to the already high burden I was under. Rather than tackle this I'm going to suggest you figure out a way to make your mother's care in the nursing home more acceptable.
Consider that her mental stimulation will likely be even lower in your home than in the nursing home simply because she will be exposed to less people, plus all possibility of attending even the limited entertainment available in NH will be lost.
Her primary caregiver (you) will need to perform no matter how tired, angry, sad, ill, burned out without the possibility of relief - in a facility there are multiple hands available in 3 shifts so even when someone is having a bad day (or is less than competent) you can be assured it's not forever, someone new will be available to take over.
Meals are always a problem in congregate settings, in order to make food suitable for the majority they please no one. "Healthier" food isn't really a consideration at this point in life, nothing she eats is going to significantly change her underlying health in the few years remaining to her. If she would enjoy certain special foods that aren't available in her NH you can always prep them at home and share them with her there.
Plus as loving and careful as you are you can never replace the 24/7 availability of nurses who know and understand geriatric care and can spot and treat problems a layperson would miss. You won't be able to provide things like a real bath (the spa tub was a very popular feature at my mom's nursing home). You won't have a dietitian to evaluate her meals, or a doctor to make house calls. You will be the one cleaning up urine, feces, and blood - can you handle that?
And one more thing - it seems like we always go into this thinking the end is near, but I know first hand that people can live much longer than you might imagine with extreme physical and cognitive limitations - think in terms of years, not months.
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are u close enough to visit daily and bring her at least one home cooked meal?
My mom did this with her mom, who also needed to be fed because she was unable to hold utensils.
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peanut56 Aug 2022
Not close enough to do regularly, but she loves it when we do. So good of your mom to do that.
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You are planning to pay for hours of outside help? What happens when she declines and needs more and more help?

Who else is in your home (you write "we")? And what do they think about it?

There is no way I'd risk my physical health so mom has more mental stimulation and gets better cooking.

What happens when you injure yourself lifting her?

Are you the only one making this decision? Do you have siblings?
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peanut56 Aug 2022
Yes, I was planning on hiring a caregiver for her bathing and doing exercises prescribed, and so I could even leave for errands, groceries, appointments. Her quality of life is very important to me. She's always prioritized healthier food, and says she wants to be at home with family. She's told me many times she had her mom living with her for years. She could still walk though.

The toileting 24/7 along with that inability to stand is the biggest hurdle and as you questioned about what happens when you injure your back. I've started looking at transfer devices and was hoping someone honestly could say which if any are effective, since reviews online can be bogus. The hoyer lift the doctor already said needs 2 people to operate safely, so it's not an option.

My brother is content with where she is. It's very expensive though, and he let an opening at a less expensive facility near him pass by because she was finally adapting to where she was.
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Im assuming that “change in your work schedule” means that you are quitting the paid workforce entirely. Even if you do, you are contemplating being only one person spending 168 hours a week doing what departments of folks now do.

My suggestion. For two weeks, spend a dedicated 12 to 16 hour shift with mom in the snf after preparing a picnic lunch for you two in the cooler plus whatever else you think she needs.

Observe how they turn her, toilet her, bathe her, feed her and transfer her. To the extent permitted, assist. Take note of every diaper, wipe, chux, equipment used. Did you remember to pack everything? Do you have all the equipment, the hospital bed, the Hoyer or mechanical lift, that they have? Would there be clearance in her room at home for all that stuff?

Investigate the activities the snf offers with mom. If she refuses, what did you bring in your go bag in terms of entertainment?

Immerse yourself without having the experience first.
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You could try seeing if you can do this at the facility… I think you will find it quite difficult… not worth ruining your back health.. things do not get better
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Guess I question why you would consider doing this? If she is in a nursing facility with trained staff members and proper equipment what is the reason you are even considering this?

There is no way in the world I would consider this, I would leave her where she needs to be. Certainly not in my home or anyone else's. She requires way too much care for a lay person and she will continue to get worse, there is no better.
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peanut56 Aug 2022
Thank you for your reply. The dietary food quality isn't great for a person with heart failure, and they don't provide as much mental stimulation as she was getting in memory care; she is still the stage where she is more engaged than most of the other residents in this skilled care facility. Also looking for another place too.

My change in work schedule would now allow home care, and she enjoys my cooking which is healthier.
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