Mom, age 91, has been in assisted living 4 months. The head nurse told us today that she ought to go to a nursing home.
Mom cannot hear or see well. She has hand tremors. She doesn't walk well so increasingly needs a wheelchair. She is experiencing incontinence, depression, is overweight but no illness or disease.
Lately she's been sleeping a lot, like until mid-afternoon, and they have a hard time getting her out of bed, even though it's wet. Sometimes she will kick at them.
She has some dementia and confusion too.
She's getting to be too much for the staff at the assisted living to handle. They said they can't pick her up and that there's no way she could get out unassisted in an emergency.
My sisters and I are upset. For one thing, we picked that assisted living precisely because they said she'd never have to leave. She can die there, we were told.
I suspect they would just like an easier resident.
We need to discuss this with them, but odds are we'll have to move her,
MY impression of a nursing home is a place where people just lay there in a hospital bed. Yes, Mom is getting worse, but we don't want that for her. But I haven't visited one for years.
What's a nursing home LIKE these days? I know it will cost more money. She may need to share a room (don't know, but she has her own room in the ALF now, with her own bed, recliner, dresser etc. now.)
Any insight or suggestions? Thank you.
It sounds as though your mom, now in her 90s, is failing, and that she may be in a place where Hospice Care could be ordered if she doesn't wish to be treated any longer in hospitals, nor undergo a whole lot of hospital based testing, and if she is herself tired and understanding she is approaching end of life, and family agrees. I would discuss this with her if she is at all open to it and with her care providers. Hospice would give her extra support to be certain. The goal would be comfort and not "getting you back on your feet" which is something a Nursing Home is not there to do and will not do. Nursing Homes, as opposed to ALFs, do understand that they are the last station on the track.
These are things to discuss, think about, and ponder as you approach the end days.
I am sorry. Do go to visit facilities. I will hope you find a good one.
This is not cheap, of course – it runs a little over $9,000/month. The siblings are working out the financial piece but just wanted to write this quickly to let you know that there are some very good facilities out there.
The reason I say this is we went the hospice route in assisted living and was told if it became too difficult and my father in law needed more care than they could provide , that we would have to pay for aides to come in . The assisted living had a few agencies that they used for this purpose . They would schedule it but the bill was to be paid with my father in laws money . He went from still walking to dying within days , ( more quickly than we anticipated ) before any agency aides were scheduled .
Having agency help come in is sometimes how they allow people to stay there . They are not normally staffed for people who need as much help as your Mom . The nurse already told you that she’s too much for the staff at this level . Don’t be surprised if you need to hire agency help .
Hospice doesn’t send an aide everyday . They send one 2-3 days a week for a few hours for bathing , change bedding .
She needs her bedding and clothing changed every day because of her incontinence. She will go to meals (usually) but needs help getting there - but a lot of residents need help with mobility.
They can occasionally talk her into going to some activity. And she has good days.
Much of her problem I think is that she doesn't want to be alive any more. She will occasionally say that she wishes God would just take her.
My sister went to see her yesterday and said when she got there, Mom was just sitting in her chair, no lights on, no TV going, just "thinking about all the bad things that have happened to her."
And since she can't move, hear or see very well, it IS hard to interact with anyone.
Still, it's worth asking what the ALF staff would think of the idea of an aide. Thank you!
https://story.californiasunday.com/covid-life-care-center-kirkland-washington/
Keep in mind the story was written at the beginning of Covid, and they were the first nh to handle it. Look beyond that, and you’ll see that it was in most cases above par.
So you might want to get mom to the ER first to see what's going on?? Why has she declined so swiftly? A stroke perhaps causing her to be unable to move well, incontinence and some dementia as well? That is a distinct possibility. There can be a disease at play, like cancer or Parkinson's that's gone undiagnosed, too. CT scans and an MRI should tell the story.
The AL ACCEPTED mom 4 months ago and you are NOT agreeing to move her until you figure out what's going on first. Period. You'll need time and cooperation from them. Use your voice to advocate for mom now and insure she gets the best care possible. I fought hard to keep mom out of a nursing home and to extend her finances to stay in Memory Care Assisted Living until she died. Which is another possibility for your mom.....Memory Care Assisted Living if her dementia worsens. MC provides a higher level of care somewhere between AL and a nursing home, and keeps the resident till death.
So just see about getting your mom diagnosed and go from there.
GOOD LUCK!!!
My mom is 81 and in AL. She needs to be able to ambulate independently down to her meals. She uses a rollator. She's on the 2nd floor and needs to be able to get down 1 flight of stairs in the event of an emergency. I think she can do it, but it could be a stretch. And we'll all keep hoping there never is an emergency calling for evacuation.
So, from what I know of one ALF, your mom is really not a great fit for that level of care. It's unfortunate that you were misled. I think that they like to fill the beds as quickly as possible and may be hoping for the best when they sign up a new resident.
Maybe hiring an aide would be a way to keep her in AL?
My MIL is in her second nursing home (newer one is much closer to us). 95% of the rooms are doubles which kind of stinks. Who wants to live with a stranger??? They have activities and exercise classes, etc. They've come a long way from the gross and smelly places I remember visiting as a kid. But at this time of her life, the options become pretty limited and their time for being happy is pretty much over. I know my mom is not happy but there's not really anything I can do about it.
Have you talked to your mom's doc about any meds to deal with her combativeness? I wonder if memory care would be a better fit than a nursing home?
Best of luck.
Mom's taking anti-depressants.
We've been in communication with the doctor a LOT over the past few months. She's been in the hospital twice & had various scans (both due to falls, she wasn't hurt either time but it was standard procedure to send her.)
She saw an audiologist a couple of days ago; some hearing loss, yes, but normal for that age. And they agreed that she does better when you look at her, and the environment isn't noisy - some of it is mental processing.
I'm really curious to see how Mom responds to her doctor's visit today. She REALLY likes him. And he hasn't seen her in person for a few months, will hopefully help to see what HE says.
Thank you!