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Mom had been losing her ability to walk and was sitting for most of the day, either in her recliner or the bed. We had caregiver coming 3x week for 5 hrs. Mostly to give me a break. Last week, she was showing signs of a UTI and we called the doctor to get antibiotic and filled that prescription. When she started running a fever I took her to the hospital. It took about 20 minutes just to get her in the car and the nurse had to come help her out of it. She did indeed have a bad UTI but they ran COVID test and she came back positive. No normal symptoms, no cough, no shortness of breath and other than great weakness, she was fine. She has been there for a little over a week and the hospital wants to discharge her to SNF for rehab to get a little strength back. I am doubtful that much strength will return as she is 94 now. I know that Medicare will cover 20 days there and she has additional insurance. My concern is what to do after the stay in rehab has finished and she still cannot do much? Right now, she can't even sit up in bed by herself. If strength does not return, at least enough to sit on the side of the bed, she is going to need full time care. I am doubting my ability to care for her as I cannot lift her and I am 65 myself. I have not been able to see her for this entire time and she is just now coherent enough to talk to me on the phone. She does have some funds and land we could sell to help with expenses but not knowing how long this will be for concerns me. She may have enough to last her a couple of years and no telling how much longer she will live. I will not be able to visit in her nursing home either and she is becoming distressed that she cannot see us. Should I keep her in SNF and sell all her assets or bring her home and have full time care? I know if she comes home, much of the care will still fall to me. She has been living with us for 14 years already and I am exhausted. I want what is best for her. What to do?

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Thank you all for answers. She is coming home with hospice care. I have arranged for caregiver from 8 to 5 and I will do evenings and my brother has agreed to do weekends. My daughter, who lives close will also help if needed. She is not able to move herself much and is in a great deal of pain. Hospice will come 3x week to check on her. Hospice is better at pain management. It is actually easier if she isn't getting out of bed than having to try to move her. I think she will be happier at home and I will worry less. If I find I cannot do it, I will hire more help. After being mobile and doing for herself for so long, this will be a huge adjustment for her. I am not sure she will last long after this.
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Your mom can't manage her activities of daily living, so she needs nursing home level care. You may have to use up her assets (spend down) until she qualifies for Medicaid. I've been in your shoes: caretaker for 18 years, now mom is 97 and I'm 71, and now I have a heart problem I never planned on. I hope this won't be your fate in 5 years!

Good thing I got mom into a nursing & rehab center last year! If you keep your mom at home, besides the physical demands, you will have to stay there even more and be on alert 24x7. You could injure her or yourself, leaving you both in a jam. I find it hard to imagine that "full time care" at home will give you the relief you need or think will be enough. It's only going to get harder as she ages. Please get your mom to a NH where she gets what she needs and you monitor from a distance. And save your health.

She wants to see you? You can see each other on video calls with Zoom or Google Duo; get her a cheap tablet with a big enough screen to see the caller's face. (My mom's NH has activities people who help with these calls, but it's more limited if you're stuck using the NH's tablet or smartphone.)

Here's what tipped the scales for me. She's more likely to fall or otherwise get hurt if she's home. That might kill her, or worse: she might spend weeks, months, or years in a lot of pain. If I can prevent that, I have to do it. Mom may not like some things about the NH, but even she can't imagine a life of daily pain that becomes more possible every day that she's dependent on me.

I think you've seen a warning flag. I hope you heed it. Good luck!
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Facility placement is always easier from SNF than from home.

Have you done any research on facilities? I encourage you to have her sent to a rehab (SNF) that she could transition to their long term care.

This will simplify your leg work and give you a chance to work with the staff before she "moves" in. That way you can change your mind if you are unhappy with the facility.

The management really sets the tone for the entire environment, if they are miserable sobs to work for, everyone will be affected and you will see that attitude no matter what wing of the facility she lives in, if the management cares and has the interest of creating a great working environment and a safe happy place for the residents you will again see that attitude no matter what wing she is in.

Of course she is not going to be happy about changing anything, but you matter as much as she does and you need a break. Right now you will probably not get a caregiver to come in to a covid positive house. So you should plan on having her stay at the facility for a while. Even if it ends up just being respite for a month or two or???

Remember that your life matters and you are not a little girl that has to do what her mommy tells her regardless of how it effects you. You are a grown woman and you get to decide what you can do. No guilt, no shame and no remorse for taking care of you.

Scary changes for all, great big warm hug filled with strength for you.
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My dad recently went through a hospitalization, followed by rehab to regain strength as he had done a number of times before. This time in rehab though, progress wasn’t happening, the walking wasn’t returning, he was alternating between cooperating and trying one day, and telling the therapists he just couldn’t on another day. We came to believe he had no more “trying” in him, he simply couldn’t anymore. There was no documented progress and he was soon going to be kicked out for lack of progress. He chose to come home with hospice services. I also couldn’t lift him, the fall risk was high, I had to hire extra caregivers, and it quickly turned into an around the clock job to provide the care he needed. There is no perfect world in this, you’ll have to weigh the costs, not just financially, of having your mom home and providing a high level of care vs having her cared for by people much better equipped for her care in a place you likely can’t visit. I’m sorry you’re going through this, a hard road for sure
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You say you are exhausted. Now is time to prepare for mom to go to an appropriate facility from rehab. As you know her care will only become more difficult. Get out and go facility shopping for a continuum of care home where as her needs increase, the care can be adjusted.

Check into care homes, my experience was the care was better, fewer residents, enough carers to develop relationships with residents that allow them to know them better and understand their needs. Care Homes often can adjust care that will be necessary as you begin this journey.

You need to take care of you too, so you can continue to be mom's advocate.
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I would work on the assumption that she is going to need to stay in the NH has an LTC patient after rehab.

Do you have power of attorney?

You should see how rehab goes, but be aware that Medicare will only pay for those 20 days if the patient is making progress. If mom refuses PT sessions (says she's too tired or whatever) you are looking at a very short time in which to make some big decisions.

Also, ask about getting a Hospice evaluation.
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derochka Jul 2020
I do have POA. Hospice will not take her on unless she is terminal. If I could just plan on a year of care, she has assets for that long. Those assets will either go to a facility or nursing care at home.
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