I’m 68 and retired living by myself and considering the possibility of moving my 92 yr old mother into my home vs putting her into an AL facility. What are some pros and cons? She is needing help with bathing, dressing, and walking. Just recently she is forgetting some things and I’m concerned for her health and well being. I have looked at some AL facilities close to me and they average $5500 a month; most amenities she would not be able to participate in and I think it may be wise first to try to have her live with me. What do you advise?
If you have a volatile relationship with Mom, where is is mean, spiteful, and thinks everything should revolve around her all the time...then AL would be worth it's weight in gold.
Sorry for anyone I have offended...but unless you have or are going through a live in situation with a Mom described in 2nd paragraph, you have NO IDEA.
I live in easy walking distance to my mom, but I will not co-habitate because I do need a piece of my life, and respite for my physical and mental health is critical.
Beyond that, my thoughts are:
1. You may be surprised by how moving your mom from her familiar routine will reveal deficits you didn't expect. If your mom is not able to relearn the stove, dishwasher, washing machine, thermostat... you will be doing all of it for her. She may perseverate on items that were not moved and talk endlessly about where they are. She may become depressed and dispondent.
2. How adapted is your home to accommodate her physical needs. Are there steps/stairs, area rugs, tubs to step over to get into the shower... all of these things are fall risks and need to be modified before she moves in with you.
3. What do you envision her life to be across the next few years, and how will you provide the expected care. This job only gets harder and more demanding. Do you have the physical strength to care for her? Do you have connections to bring in additional care for her needs? What is the plan to watch her 24/7/365? You will not be able to do this alone. For me, I want my own home so I can sleep while paid caregivers take over my job.
4. How hard will it be to move her a 2nd time from your home to assisted living when she is older and less able to adapt? If your home is not her last move, she will have to go through all of the learning of a new place again. Are you clear in your mind what point you make that 2nd move, and where she will move to?
I would strongly encourage you to live with your mother for at least a month to fully assess her skills in her own familiar home before you move her in with you. Go to all the hospital visits, and talk to her geriatric care specialist. Have a comprehensive geriatric evaluation done to help you identify her overall needs.
Then, have her come stay with you for a few weeks to see how she adapts to your home.
Involve her in the decisions, and have a plan for the full array of needs the two of you may encounter in the years to come before you do anything at all.
My final thought is that this is your mother, and you deserve to have healthy, positive emotions about her. I have made a commitment to my mom to keep her: healthy, safe, and (hopefully) happy - but I can't control happiness. If I am unable to keep her healthy and safe, I will place her where she can receive the care she needs. As she declines, I will bring in paid help so I am not run ragged and turned bitter.
There will be an end to this job. I hope I am spending it by her side sitting with her, holding her hand, and listening to her stories - not exhausted providing all the basic needs and unable to simply spend the time end of life deserves. Wherever you can do that, do it.
Why should you take her in to live with you
What effect will 24/7 care have on your health
Can you manage 24/7 care
What happens if /when her health deteriorates
Is it better she goes into AL whilst she is able to get to know people rather than have to move when she would find this harder
Are you cut out for being a 24/7 carer, dealing with all personal needs and mood swings
Do you have POAs for when they are needed
Can you keep her safe from falls, wandering etc.
If you can do all these things at 68 can you do them at 72 (assuming she lives 4 years).
What is your health deteriorates so you cannot look after her
If you can answer positively to all the above then have her to live with you - but if even one of the above is a negative then think very hard. You say that already she would not be able to participate in most amenities - that seems to suggest she needs more care that you alone can give. Think about one simple physical act - can you lift her off the floor on your own?
No one is assuming anything. Jlaroche clearly states in the post that the 92 year old mother needs help bathing, dressing, and walking. She is also forgetting (cognitive decline).
At 92 these things are not going to improve. They are going to get worse the longer she lives. This is fact. A person 68 years old themselves should not take this on.
You did and it worked out well for you. That's great, but your experience is unusual. No way should someone 68 take this and alone on top of it. No way. AL is the best choice here.
it will be important for you to be able to pay for an aide from an agency or private pay for several hours a week on a schedule that meets YOUR need. If you don’t have that you WILL burnout. With a solid support plan you may be able to make it work. COVID and what I saw during my mother’s stay at a “rehab” facility made it a necessity for me to take her into my home. But it has not been easy. I have good space in my house and a great agency caregiver but I am the only daughter and so I am the caregiver when the aide is not here. My brothers live out of town and can’t do the toileting assistance that I do. She is bedridden so I don’t have to worry about falls but I have to use a Hoyer lift to get her to a chair every day. I am married and it has been a hard adjustment for my husband but we are making it work. She has LTC insurance and pays for supplies and things not covered by Medicare and/or LTC out of HER money. Medicare paid for a hospital bed and the lift. I pay for comfort and safety things like reinstalling my home phone in case I need 911 - can’t risk using a cellphone. The inheritance thing mentioned by one poster is nonsense. As long as she stays with you snd you absolutely need to spend money to make home care at your residence possible, then it is for HER benefit not yours and has no bearing on anything when her estate is being settled - even if you have to renovate a bathroom to make it accessible. Remember that an AL may take her this week, and tell you that she needs skilled nursing the next. Factor that in to your financial planning. But also remember that 24/7 home care at $25 to $30 an hour(or more) is out of reach for most people. Conversely, 24/7 AL or skilled nursing actually costs less but is not one-on-one care and it comes with COVID and quality of care issues. But you do keep your freedom which is not to be undervalued. Since 24/7 home care by an aide is too expensive you likely will have to fill some big gaps yourself. Most of us love our parents - none of this decision making is easy. As I write this, it is 3 AM snd I am up because she could not get comfortable to sleep tonight. A little children’s liquid Tylenol and she is in dreamland. I am not.
First, I think it is wonderful that you are willing to have her live with you and you are concerned about her welfare. God bless you for that.
My mother lived with me and my kids in our current home for 11 years. She was fairly independent at first, but 5 years in health challenges and surgeries gradually diminished her abilities and wellness dramatically.
In retrospect, once it became clear she needed help with meals, fall prevention, bathing, etc. I wish I had looked into Assisted Living or a Nursing Facility as a long term option.
Why do you ask?
1. The Conversation Won't Get Any Easier
No one wants to leave "home" or be away from familiar surroundings and loved ones. The sooner you get your mother somewhere she can receive extra attention, the easier it will be on everyone. If you decide later that it isn't working out, you can always bring her home after the fact. And you can do so with a plan and home health, etc. in place because you'll know her needs beforehand.
2. Elder Care is 24/7
My mom used to say "it only takes a few minutes" to heat up leftovers, crush and mix her meds, etc., etc. In one sense she was right, but there's so much more to it than that. She got to the point she couldn't administer her meds herself (she had a PEG tube) so I was on a 6HR shift for that. Then there was the meals three times a day. Then time for emptying her trash (which had to be done twice a day due to her health issues), checking/changing her dressing, helping her change clothes, etc. Having all those tasks throughout the day really cuts into your day! You never really are at rest for more than a couple of hours.
3. Your mom *might* stay healthier in a facility.
Each situation is different, but I noticed with my mother when she was in a good facility with professional, trained people on a schedule making sure she actually took her medicine on time, had meals in her room regularly, had a bath, etc. she tended to look better and seemed to feel better also. She wasn't in pain from skipping her medicine, she wasn't worn out from trying to do things herself that she wasn't able to do, and she wasn't arguing with me about myriad matters as I tried to handle things for her. :-)
4. You may be better company for her if she's in a facility.
Again, each situation is different, but I had far more energy when I was not caring for my mother in the home by myself. Part of it was not having all those tasks to complete, but another part was having "space" to be myself and live my life.
You say you're retired. That means you can visit your mom frequently and then relax in your own home knowing she is safe.
5. In Home Care/Help May Not Solve Your Problem
I don't know if your mother has or is eligible for Medicaid or not. They pay for ongoing caregiving. Medicare will pay for a nurse and PT if there is a "qualifying event" like significant change in health, discharge from a facility, etc.
That being said, to get the true relief/assistance you need with her, you will need someone coming in 4 hours a day for several days. Even if that is cheaper than the AL facility, you have to coordinate schedules, let someone in your home, and you're still on the hook for the majority of the time.
6. Burnout is Real (and Dangerous).
Over time my mom became less and less able to do things and I went from being laser focused super-caregiver to barely getting by with the necessities and feeling drained all the time. I lost weight and energy and unknowingly began self-soothing with food and treats. I also developed high blood pressure and at one point leg pains and chest pains that sent me to the ER a few times.
In Conclusion...
If you become burned out, you won't give good care to your mother and you won't maintain your current health very long.
If the AL facility is affordable w/ the money your mother has coming in, I say go for it. It is good and right to help her find the best option for everyone involved. It has to work for you too, not j
The trial period surfaced the impacts to various aspects of my life and made it easier to decide whether it is a feasible long term arrangement (it is not).
You do all the work and get little appreciation for it while the rest of the family does nothing but free load off of your mom.
Besides which at your age your body is wearing down and you may not be able to take care of both her and yourself. It is difficult getting her in and out of the bathtub for her bath. She could fall very easily and hurt herself. If you are not trained in how to handle these situations you can easily hurt yourself and be laid up for a few months.
With her bad memory you would have to take precautions she does not get out of the house and wander. That can be deadly in the winter. I have encountered a few walking around lost in the snow wearing nothing but a house coat. They did not know where they were or where they lived. Thankfully I could figure out where they lived and got them home safely. We call them wanders. If that is the case sow contact information in the back of all of her clothes. That help tremendously if the police find her and take her to the hospital.
I hate to break it to you but most care givers I know regret being a care giver.
Thanks for asking!
Good Luck! If you have any questions, don’t hesitate to ask! :)
I honestly can not fathom how that would be.
Your mom is blessed to have you.
However, they are currently living in an IL facility and my mom gets AL services. The cost is nearly $7,000/month. Mom is too frail (Parkinson's) to attend book group or play bridge with others, as we imagined she would do. Dad is physically healthy but experiencing gradual dementia, gets lost around the facility, tries to help other old ladies get their food (thinking he's helping my mom).
So the facility isn't meeting their needs and they really need two different kinds of places - one with physical supports/transfers/bathing for otherwise healthy mom, and one with close supervision for otherwise healthy dad. We are actively considering renovating my home with an in-law addition and moving them in here. I would NOT be a full-time caretaker. I still work (teaching) and am out of the house 20 hours/week. I would hire caretakers (with their money - now we're saving $7k/mo) to help with physical care, maybe 3 hours every morning and 2 hours in evenings, plus coverage for times I'm away from home.
Reading through your comments, I pause over the one about what I'd do in an emergency. And I already anticipate the emotional issues - they were difficult parents and we have a more formal relationship now, but it works. I am their main caretaker/driver/interpreter for all medical appointments now.
My brothers are eager for me to take them in. Don't mind giving up a chunk of potential inheritance to have my parents pay for my house renovations. We've already talked about that. But my friends say I'm out of my mind!
If you move them in, consider if your parents and brothers will expect you to care-give without compensation?
Will you be paid for it? will they contribute to household bills? yes, your parents will pay for the outside care-givers but don't forget or discount how much you do.
Will your brothers offer YOU respite time and care for your parents?
She is not vey mobile and uses a walker. We built a custom house and tried to make it handicap assessable for our old age. The showers all had a small step-over to get into the shower and she could barley step over it. Now we look back and think we should have made one of the showers a roll in type.
Although the bathrooms are good size she could not get her walker in.
She fell in the bathroom and knocked the glass shower doors off the tracks. Luckily they did not break and cut her. I did have to call 911 and have firemen pick her up. My husband was not home and I could not do it myself,
I had to clean the restroom EVERYTIME she used it.
She could not get into any of our beds they were to high. I had to get step stool but I was afraid she would fall off. She would get up 4 times a night and I would listen to be sure to get up and help her.
We do not have any carpet or area rugs so no trip hazards but she still fell . No carpets leave hard tile to fall on and she fell three times,
incontinent issues LOTS of laundry.
I had very difficult time keeping up with everything and I had help.
These are just some of the logistical issues we faced and I have not discussed the personality difficulties brought on by the dementia. (They are mentioned in my other posts) She is now in a board and care facility. About $3,500 a month. That’s has its own issues to. This has been long and difficult journey.
I hope this info helps give you an idea of some problems you may encounter.
Am I physically able to lift, support, and safely handle a 100+ pound person multiple times per day? No. The likelihood is I would badly injure myself trying to do so (bad back, painful hips and knees), and would also end up with her injured as well. -This one is the deal-breaker, the other questions/answers really just confirmation.
Is my house so configured that neither of us would need to use stairs (already a problem for me at age 62)? Are my bathrooms handicap accessible? No.
Would I be happy with her in my favorite spot in the living room blasting the TV only on her shows? No. Would she accept staying in her room? No, she has been extremely critical of others she knows who have expected that of their live-in elderly parents. She would have to be at the center of the house and household, and entirely on her terms. My life as I prefer it now would vanish. She would be in charge. Does she like my cooking, and would she eat it without endless criticism? No.
Would she be happy isolated in my house never seeing any other people? Not seeing her friends or neighbors? No.
Did she offer to let me move into her house as an adult when I had a brief difficult time moving back to our home state? No. She refused to let me stay there even a couple nights, afraid it would become longer. While still at her best she absolutely rejected the idea of us sharing a home. Would it magically be better now? A huge “no.”
I could go on. The big one is the realistic physical expectation of the work load at your age and state of health. Can you take on a more than full time, heavily physical job, where you work all the shifts on-call around the clock?
A board and care home—something much smaller where residents are more closely monitored—was suggested to me. I visited one and it is what she needs ( but it has a shared bathroom which I know she will not like; nor would I.)
I am now having to decide between moving her there or a nursing home; taking her to my home out of state; or staying with her in the ALF as her caretaker.
Each choice has disadvantages. Tho it is hard, I do think you need to figure out what is best for you and then fit your mom around that rather than making what’s best for her the deciding factor. Because caretaking can swallow your life.
As for the cost, if your mom or her husband was in the military, she may qualify for aid and attendance. It is a VA benefit. Google it and see if she qualifies.
My mom is doing much better with me around. It grounds her mentally. But it is very hard and I don’t know how long I can hang on.
Good luck to both of us.
Please stop comparing a 90+ year old mother who is dead weight with dementia who is totally immobile, incontinent, gets violent…hits, punches, pulls hair, needs adult diapers, a lift machine, wheelchair with a 6 lb newborn who is portable & you can carry. ..who will get potty trained & go to daycare & then school. Sorry to be so blunt…You have no clue
They are more reasonably priced and they don't have all the amenities that create a big price tag.
I placed my dad in one because he wouldn't have utilized any of the activities or amenities offered and I thought, why waste money on something he will never use? Not to mention he couldn't afford the thousands of dollars monthly.
It is a good option for someone that just isn't into or able to do the activities offered.
If you do your research, you will find one that works for both of you and where mom can age out.
Doing the caregiving alone becomes to much quickly, especially if your mom isn't ambulatory.
Best of luck finding the best choice to meet her needs.
I come from a family of introverts. We are NOT shy but being around other people, even for short periods of time, is physically exhausting! The very idea of a group setting is the definition of HELL to both of us.
So, if you are an introvert and your mother is an extrovert, or vice versa, it will be awful for you both to live together.
The amount of mental flexibility needed is as important as the physical ability to take care of someone.But, consider that your life will NEVER be your own while you care for someone else....and it isn't all negative. Sometimes the rewards are profound enough to enable you to accept the incontinence issues and even laugh about it.
My Mom and I are both introverts. I have monitoring devices around the house to keep track of her. Even with dementia, my Mom prefers a great deal of time by herself and with her dog(that I take care of the daily needs for) or the backyard garden. I set up engagement activities for her and keep her mentally stimulated. She doesn't like watching TV or anything (which is nice).
I have an aid come twice a week....I get a break, mom gets a break.
So, far it is working for us.
Last but not least, be sure all her legal and financial documents are in place - and if they aren't, do it NOW before you make any decisions. An elder law attorney who is well versed in Medicaid will be invaluable to you if you decide to place her or have in-home care.
Which was good because when Mom developed vascular dementia, there was no stress in taking control.
In my experience, as the condition worsens of your loved one you may not be able to get them into assisted-living anymore. In other words, they may not be able to qualify and would have to go to the next level of care. My fathers orientation visit to the assisted living was the last time that he walked on his own. After that he needed a cart. They would not have taken him into the assisted-living had he not been ambulatory at the time. Since he was already a resident, they kept him a long time before other care was needed.
In my experience, the nursing home cost jumped over twice as much as the assisted living. Another thing that happened was that the facility agreed to keep my loved one even when he ran out of money. He was able to get a Medicaid position in the nursing home since he had been a resident in the assisted living. In other words he never would have been able to slot right into a Medicaid bed in the nursing home if he hadn’t been a resident in the attached assisted living area already. I am aware that not all places operate this way but this was true in our situation.
The other area of consideration that comes to mind is Covid. The nursing homes in my area actually shut the doors and would not let anyone in to visit. It is open now but anytime I am exposed to Covid starts another extended period that I am not able to visit. Whether you are vaccinated or not vaccinated… The rules are the same. They have kept the residents very safe but it has come at the cost of isolation.
Again, you have some very good answers here. Please take them to heart when considering your own ability to provide care. For me it was a very emotional time. Pray about it and then move on knowing that you are doing your best…….