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All family caregivers are over seventy. Elderly family member is extremely visually impaired, has hearing problems, is diabetic and has to use a walker or wheel chair at all times.

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I'd say the best time is when they can no longer do their ADL's well enough for one person to manage. My end point with my mother will be when she can no longer walk back and forth to the bathroom. I am not strong enough to lift her and don't want to do things like changing diapers. It is where I've drawn my personal line of when she needs to go into a facility. Other people can have lines drawn at different points, depending on how much they can tolerate.
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When the patient does not have caregivers under 60, it becomes very difficult to keep them at home. So now would be the time to look around at facilities and gather up five years of financial records for Medicaid.
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When the caregivers decide to say " no".
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Here are some guidelines that I found useful in my own situation with my late mother:

(Keep in mind, in my situation these were ALL in play, not just one or a couple...)

1) When the elder cannot function well enough to perform their own daily self-care, like bathing, toileting, taking meds, eating/cooking - and there are no funds or aid programs to hire help or family able to do it.

2) When the elder's medical situation becomes such that they would be better cared for in a place where their health can be constantly monitored by qualified staff (nurses, etc), and again - because there are no funds or programs available to provide care in the home.

3) When the elder refuses help from family, will not hire help (or can't afford it), and has become a danger to themselves because of the above reasons as well - they are unable/unwilling to provide care for themselves and are becoming dangerously ill or unclean and/or their living situation is dangerous to them due to their inability to stay safe in the home.
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So, for us, it was clear that mom needed care in a facility because she had dementia, and her reality was no longer shared reality. As a family, we agreed that, given her mental state, it was better that she be looked after by fo.ks with training, by more than one person, in a situation where there were professionals available in a crisis, and where medical care was easily accesible on site.

Had mom not developed dementia ( and the accompanying paranoia, delusions) and had she "just" had chronic medical conditions, she might have been able to stay at home with caregivers, or lived in my brother and SIL's home with care coming in. But when it was clear that she was an unreliable reporter of her circumstances, it was clear that the more eyes the better.
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This is a question that I think every caretaker asks themselves regardless of the circumstances they are dealing with. I am sometimes amazed at the early on decision some folks take in placing their elders in a care facility and have known of several who just decided on their own that they were ready to have a less stressful life And decided to move into a nursing home or assisted living because they wanted to. I always think those people are more intelligent than others. Wrong of me to think that. Just telling my true reaction. My goodness, if all of you are over 70 you might enjoy looking into the services offered for yourselves!
I've known 90 year olds in better shape than some much younger. But as has already been mentioned, when the ADL's aren't happening or the caretakers are unable then it's time to do what is necessary to take good care of our loved ones.
My parents would have never accepted it but thankfully not all feel this way and sometimes there is no other choice. I strongly believe that each person involved must be considered. Not just the oldest. I also believe that since we are all going to die and the elders have already lived a good long life that quality of life is more important than quantity and if living at home is what they want to do without undue hardship on others, why not? They might live 6 months longer in a nursing home but why should that be the deciding factor? With all the problems you mention, the patient must be pretty stressed. A move might be a huge relief if extra help is availabke for all the issues you mentioned. I think it is a case by case decision and All Memders of the family must he considered. Are there grandchildren being neglected? Are there spouses who need extra help. We love our parents but we are more than their children. Your personal circumstances must be inventoried. It's a problem of our times. I think it's best solved with input from all involved.
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I am at the same quandry as you. Mom who is now 96 is getting worse and worse. She babbles constantly and repeats everything over and over infinitem. She no longer seems to know when she needs to go to the bathroom. In other words, she depends upon her depends. I myself am 68, and have been caring for her now for ten years. I am an only child, so I have no choice. There is also the financial question. She does not qualify for medicaid, but there is not that much money. I like you, am confused as what to do. I think she is past the point of an assisted living facility. Yet around here, that is pretty much all that is available. Nursing homes being mainly for rehabilitation. I think the time, is simply when we are no longer able to care for them at home. Like someone else said, when the elder becomes a danger to themselves. When homecare is no longer practical.
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When they have dementia, don't even recognize their own homes, are incontinent, start FALLING DOWN, and spend their whole day shuffling between bed, the tv, and the toilet - their days of staying in their dear old home are over. They aren't going to be entertaining at home, or re-decorating, or working in the garden. They aren't going to be shopping for new linens or groceries or stocking up on Christmas presents to store in the closet. They don't even know where they are! Time to let those trained in senior care to take over.
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I just want to say...don't expect them to like where they will be placed. Mom is in an AL. The max amt of residents is 39 so her caregivers know her. Check out the longterm nursing facilities before placing someone there. Mom was just temporarily on the LT side. The room was for two and it was so tiny there was no room for a lounge chair. Just a bed and a side table. Maybe a small dresser? The closet was big enough for one person but two were expected to use it. Check out there activity room. Do they separate the very bad from those who aren't? Mom was sat right in front of a woman who was saying she wanted to die constantly.
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Medsister Dot is 89 years old, and She's got visually impaired eye sight, hearing loss and diabetes, but Her mind is perfect. A move to a Nursing Home now would Kill the por Woman. Why not apply for RESTBITE CARE,It's FREE, and get a two week break for You and all the other Carers, and organise Carers in rotation when Dot gets home. When an Elder Lives to 89 years, there can't be an awful lot of time left.
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As far as I know, Medicare does not pay for respite care unless on Hospice. Which is something that could be looked into. Hopice will provide an aide. A nurse checks in on the patient 2 or 3 times a week. People r still under the impression that you have to be terminal and have to pass in six months. Not true anymore.
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Hi JoAnn29. Here in the Republic of Ireland an Elder Patient Cared for at home is entitled to 30 days of FREE RESTBITE CARE in a 12 month period.
While RESTBITE CARE is of enormous Benifit to the Elder, it is essentially for the Carer, thus all Carers should apply for it.
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When you decide that you can not give her the care and attention that you want to.
When you want to become a daughter, son, wife, husband, sister, brother again and not a caregiver.
When it becomes dangerous for the person you are caring for.
When it becomes dangerous for you to continue giving care to your loved one.

Any of these can point to it is time to be placed where professional help can be given.
It is not a one size fits all reason.
I was lucky, I said I would care for my husband at home as long as I could safely do so. He was not resistant and it was very easy for me. I have a house that is accessible so it was easy for me to get him into the bathroom, easy to move around with a wheelchair, hoyer or sit to stand. I had the best help from Hospice.

I have said at my support groups that if you are asking this question then it might be time.
There is NO guilt that should come with this decision. It is a move that will allow the person you care for get the help they need when they need it. It will allow you to become a loving caring person that can spend enjoyable time not having to worry about a brief change, a soiled bed, making a meal, getting medications taken when necessary, and all the other little things that take up a day.
You will also begin to get your life back, use some of the time that you used for care giving and volunteer at a Hospice, at the facility where your loved one will be, volunteer at an animal shelter, take a vacation, pick up a book and read, go to a movie. See what it is like to be out at night or be able to leave the house without having to wait for someone to relieve you so you can go shopping. (I am having to learn how to do these things and it feels odd)
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Johnjoe, thanks for letting us know you live across the pond and how Ireland handles respite care. That is so great that your country gives 30 days per year free to caregivers. Wish we would have something like that here in the States.
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It is time for the elder to go to the NH when they no longer can live in place.
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Wow - we need to move to Ireland! I would say that when a person cannot get dressed or is not able to move around without falling - time for a nursing home. Caregivers over 60 might end up dying before the person they are caring for.
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Medsister: There comes a time in the elder's life where they can no longer "live in place," which means living in their own home. Ideally, it is good IF they can stay in their own home and here are a few ways they can do that---
#1 Reverse mortgage (assuming they own their own home)
#2 If reverse mortgage is accepted, then it pays for caregivers to come in and assist them.
#3 Visiting Nurse Assn
#4 Night-duty nurses
#5 Family member moves in for caregiving
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When the person who has been doing all the caregiving now feels they need their own caregiver themselves !!

I always feel that someone who is a senior citizen shouldn't be doing caregiving to much older seniors... when was the last time we saw the Aides in a nursing home being in their late 60's and early 70's? Seriously, there is a good reason... endurance.

I really believed my parents still viewed me as being 35 instead of 70 years old. Really now. When I was 35 I loved to drive all over God's creation. But at 70, I was now white knuckling it, and driving at night was a challenge for me :P
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