Nursing Home - When to Know "It's Time"

I wish my mom had gone to nursing care much sooner but she refused and we couldn't force her until after many falls at assisted living landed her in the hospital and her doctor forced the issue b/c she needed at minimum physical therapy. she insisted on returning to assisted living as soon as she was deemed as rehabilitated as pt could do (and her insurance would have covered her continued stay)-and within 48 hours fell again, broke her hip and ended up back in the hospital then back in nursing care where she passed away 2 months later.

assisted living was fine when my mom could care for herself for the most part, but even the best does not provide round the clock monitoring (the one she was at when she had her final fall was excellent, but she was still on the floor unconscious for over 3 hours because it was in-between the times they would check on her). assisted living was fine for my mil when she was able to care for herself too-but the last year or 2 when she refused to go into nursing care she was spending more out of pocket for a private round the clock aide than she would have ever paid for nursing care (and while there are some EXCELLENT private companies that provide aides-some are horrendous and create nightmarish situations of neglect and financial/mental/physical abuse so family members have to be VERY careful researching and overseeing care). a few years after mom and mil passed I watched a pbs frontline documentary on assisted living that frightened me to the core, and confirmed to me that neither my mother nor my mil should have been permitted by the assisted living places to live there (my mother EVER, my mil within 6 months of moving in), both had needs that required trained nursing staff to monitor them continuously -not non nursing staff to just check in on them, remind them to take meds and come in twice a week to change their linens (the residents who had help bathing, getting to and from the dining room, handing them meds...those were all private contractors to the residents).


the nursing home my mom was in had residents who still went out. there was a van they could arrange with for travel to church and the senior center. there were weekly outings for those able to take advantage of them-sometimes it was the farmer's market, sometimes a meal at a local restaurant, maybe a local concert-or at Christmas, cruising around looking at the lights. lots of activities including a swimming pool. it was not the kind of nursing homes I remember visiting family members at in my youth.

I would say if your mom feels the need for nursing care then you should support her in her decision. if she finds that it's just too much care that's unnecessary she can always look at other options, but I think if it brings her the security she feels she needs that can go a long way.
 
My mom was in. Nursing home for two years and there is NO WAY your Mom sounds ready for it
Every single resident was in a wheelchair and many needed help to go to bathroom or wore diapers
You REaLLY need to visit and SEE what the difference between Nursing Home and ASSISTED living IS!!!

My mom was in a nursing home for a few years and not everyone was in a wheelchair, including her. She was capable of using the bathroom by herself as well but her medical condition required 24 hour care. She was quite independent otherwise. Many of the residents were not in wheelchairs, although many were. I agree that her mom probably isn't a candidate for a nursing home unless she chooses to pay out of pocket for one.
 
We went through this with my father. He had no choice but to go into assisted living after a fall where he laid on the floor for hours. So sad. Anyway, we (his kids) made him go into assisted living. He had the resources to pay for it. It was a nice place. However, his health continued to decline and after a year or so, he had to go to a nursing home, where he remains to this day (2 years so far). The nursing home, to me, is a depressing place (and it's a GOOD place...don't get me wrong), and NOTHING like the atmosphere of the assisted living facility he was in. But, he needs substantial care, and there is no choice. He is 84 years old now, and this all started when he was 81. 77 might be "young" relatively speaking, but it really depends on the health of the individual involved. My MIL is that age, and she lives very well independently....very active and in good health for a person her age (some normal age stuff). She's never fallen, etc. But, there are even younger people than her in my father's nursing home. Some in their 60's! (can't imagine).

Bottom line, if she's ASKING to go into skilled nursing care, I'd honor that request. It's time to start looking at what's available and consider the options. It's a blessing being able to look and consider it thoughtfully rather than having to find a place because of a need and have only a few days to do it. Visit places without an appointment. Drop in. You don't want them "prepared" but rather want to see what it's really like.

My FIL is also recently (within the last year) in a skilled nursing facility. HE just turned 80, but he has substantial health issues that leave him unable to walk (and now even talk). His place is very, very nice....just lovely. His room is many times larger than my Dad's room. Just the difference in the two facilities. Level of care provided is similar, just the design of the building.
 
It doesn't sound like she has medical conditions that would qualify her for Medicare/Medicaid nursing home coverage, so that may not be an option at this point even if you feel that she's right about it being time. But from what you've posted I don't think it is time, at least not for a full-on nursing home. They tend to cater to patients incapable of self-care, in diapers, wheelchair bound, requiring a secure facility, etc. not to older people who are having relatively minor issues like falls but who are still capable of cooking, cleaning, and caring for themselves.

Is selling her current residence and using the proceeds to get her an apartment in an assisted/independent living facility an option? My great-aunt did that when her husband passed and it was the best thing for her. She isn't alone and the residence she's in has craft and card-playing groups, a salon day, a walking club that encourages residents to stay active, 'happy hour' in the lounge every afternoon, and a generally lively social life. It is far better than the isolation of living alone IMO.

Otherwise, your best bet might be to hire a companion for her or to try to arrange more frequent visits from family and younger friends. That would be less costly than residential care and would serve the dual purposes of helping her with household tasks and having someone there regularly checking in on her.
 

We went through this with my father. He had no choice but to go into assisted living after a fall where he laid on the floor for hours. So sad. Anyway, we (his kids) made him go into assisted living. He had the resources to pay for it. It was a nice place. However, his health continued to decline and after a year or so, he had to go to a nursing home, where he remains to this day (2 years so far). The nursing home, to me, is a depressing place (and it's a GOOD place...don't get me wrong), and NOTHING like the atmosphere of the assisted living facility he was in. But, he needs substantial care, and there is no choice. He is 84 years old now, and this all started when he was 81. 77 might be "young" relatively speaking, but it really depends on the health of the individual involved. My MIL is that age, and she lives very well independently....very active and in good health for a person her age (some normal age stuff). She's never fallen, etc. But, there are even younger people than her in my father's nursing home. Some in their 60's! (can't imagine).

Bottom line, if she's ASKING to go into skilled nursing care, I'd honor that request. It's time to start looking at what's available and consider the options. It's a blessing being able to look and consider it thoughtfully rather than having to find a place because of a need and have only a few days to do it. Visit places without an appointment. Drop in. You don't want them "prepared" but rather want to see what it's really like.

My FIL is also recently (within the last year) in a skilled nursing facility. HE just turned 80, but he has substantial health issues that leave him unable to walk (and now even talk). His place is very, very nice....just lovely. His room is many times larger than my Dad's room. Just the difference in the two facilities. Level of care provided is similar, just the design of the building.

I know what you mean about it being depressing. My grandmother had dementia and she actually lived with us for as long as possible until it just became more than we, not being professional care givers, were able to handle. Our family was very diligent in that someone would pop in everyday to visit and sit with her, take her for walks, feed her lunch, or just watch tv with her. Its sad seeing a family member in declining health, but I think the most depressing part was seeing other residents who day in and day out didnt have any family or friends visiting to talk to and spend time with. I do understand not everyone has family that can do what we did everyday, but its sad how some are forgotten once theyre put in to a nursing home...


If your mom wants to go into a nursing home maybe you should let her try it out. I personally think that if shes still well enough to care for herself shes not going to like just having a room to herself. Atleast with assisted living she will still have an apartment to herself. Its hard to know whats better for her until you're in the situation.
 
We ran into the same situation financially with my father-in-law. He did not qualify for reduced assisted living accomodations because of his pension, the assisted living place raised their prices to more than his income, so he was placed into a nursing home (state takes all but $50 of his income).
He went downhill so quickly after being moved to a nursing home.

Explore the various programs. At that time, section 8 could apply toward assisted living.
Are there more programs through the state that your mom can use to remain at home?

Good luck to your family. It's such a hard stage.
 
I hear and listen to stories like yours everyday. I work for a non-medical home care company in PA called Home Helpers. There are franchises across the county. We have clients that range from 40s-90s. Our caregivers go into the clients home to help them with things they are unable to do 100% by themselves (bathing, cleaning, laundry, cooking, etc) There are numerous different companies out there these days. I would be happy to answer any questions you might have. Just drop me a message. Lots of luck.

Hi there--I can't seem to figure out how to send a PM (or maybe don't have access to) so I apologize for not communicating this to you privately. I tried googling "home helpers cost" (needless to say my parents are in need) and the google search results are ... not flattering. There seems to be more emphasis on "hey buy a franchise from us!" than anything, and some pretty bad stuff by page two of results. I am only mentioning this because if you get in touch with your marketing department, they may want to hire someone who specializes in google search optimization or something.
 
My dad was in a nursing home a couple of times after falling very ill. Two different places, and I agree with others who say your mom doesn't sound remotely there yet. Most nursing homes (though not all -- my grandmother was in a pretty upbeat, social one) are for people with extremely severe issues, like not being able to use a bathroom or walk. Falling doesn't count -- instead, you should get to the heart of the falling. We took my dad out of the nursing home and put him into assisted living. In Florida, we found one that was actually covered by his SS and small military pension. He did much better there.
 
While you're deciding, you might consider getting an order for home health care safety eval from her doctor (if you haven't already). Having so many falls, i'm sure she'd qualify for at least home health PT through medicare, and probably nursing for help with medications...
 
I really think you and your mom need to figure out why she is falling before making any move to a new place to live. Is there something physically wrong that can be assessed and attended to? Someone mentioned an ear infection as a possibility or perhaps she sits too long and doesn't realize her foot has fallen asleep or many other things, you know? Good Luck!
 
OP, it does sound as if your mother is ready for a different living situation, but full on nursing care at this point might be questionable. It's hard to say without input from her doctor -- and a thorough heart to heart with your mother to be sure she hasn't made this request because she's either holding some facts back from you or is simply frightened due to the recent falls.

I also wanted to comment about Meals on Wheels since it was mentioned upthread. It's a great program that is helpful to a lot of people. However, we've noticed quite a rise of cases in our probate court where a good portion of our seniors struggle with a steady dose of the Meals on Wheels. In this area, which I would guess to be fairly similar to most others in this regard, Meals on Wheels is largely a pasta heavy diet, which presents trouble for many of our seniors in regards to blood sugar and many notations of weight gain, both of which leads to other health complications. I urge anyone who knows or loves a senior who struggles with meal prep in order to remain in their home & relies on Meals on Wheels, devote a little time whenever you can to preparing fresh and nutritious meals for them. I know of two cases in particular where seniors not only were able to remain in their homes, but their overall health and mobility improved with a strong nutrition intervention by the families. Good nutrition and eating habits are so important at any age.
 
Unfortunately she doesn't have the funds for assisted living, and Medicare would not help pay for that.

Those of you who have family in their 90's who are ready to go to a nursing home, I understand that, but my Mom is 77 and I kind of feel that's a "little young" for
OP- I am not sure if Medicare pays for Nursing home in your Mom's case?
It sure didn't pay for my Mom and she was helpless and had to live in one
 
DMIL went to assisted living first. A facility was chosen that had the next steps there also, so she was in the same place and just changed apartments/rooms when the time came.

Assisted was an apartment. She could take her cats with her and was on her own, but they had people to help if needed.
They also had a communal dining room if she wanted to go have a meal there with others. They also had planned trips.
She really liked it there.
Then when her health failed more, she went to a different section of the place and someone was there more, administered her meds, helped her take baths, etc.
Now she is in the hospice section which is more like a "nursing home".

If she is ready, I would do it......but not the "nursing home" part yet. Finding a good fit for her is going to be the harder challenge.
 
Hi there--I can't seem to figure out how to send a PM (or maybe don't have access to) so I apologize for not communicating this to you privately. I tried googling "home helpers cost" (needless to say my parents are in need) and the google search results are ... not flattering. There seems to be more emphasis on "hey buy a franchise from us!" than anything, and some pretty bad stuff by page two of results. I am only mentioning this because if you get in touch with your marketing department, they may want to hire someone who specializes in google search optimization or something.

Googling what you did brought up the price to open a franchise, which is what the company is. I am not familiar with other Home Helpers across the country. The one I work for in PA is awesome and has been doing great business for 10 years. The cost for an in home caregiver really does range. Have you contacted your County Department of Aging? Your mom might qualify for some help that way. Even 2 hours a day for a couple days a week might be covered by the county. Paying out of pocket typically costs $19-$22/hr. You could always look into hiring a private duty person but then you run into having to do your own background checks, etc. This is my companies website. http://www.homehelpersphilly.com Like I said I don't know of any Home Helpers out of state but they do exist. I would start with the County and see what they have to see. http://www.michigan.gov/osa
 
OP- I would also have her checked for the 3 falls
My Mom has unexplained falls- we later realized they were mini strokes...and when she then had the BIG stroke- that was it...full time wheelchair the rest of her life
 
OP- I am not sure if Medicare pays for Nursing home in your Mom's case?
It sure didn't pay for my Mom and she was helpless and had to live in one
Just an FYI. Medicare pays for very limited amount of skilled nursing care (I want to say 30 days, but I could be wrong). After that, it's Medicaid which, depending on the financial resources of the patient. Medicaid will only pay once assets have been COMPLETELY exhausted(or within a few thousand dollars). So, if OP's mother has a home, this will need to be sold, and used to pay for care before Medicaid will pay. If that is the case, then OP should do as a PP recommends and use her home to pay for as much assisted living as possible before going into a nursing home. Assisted living is way nicer, and sounds like, more appropriate, to her mom's needs.
 
Just an FYI. Medicare pays for very limited amount of skilled nursing care (I want to say 30 days, but I could be wrong), and usually only for rehabilitative purposes following a hospital admission. After that, it's Medicaid which, depending on the financial resources of the patient, pays. Medicaid will only pay once assets have been COMPLETELY exhausted(or within a few thousand dollars). So, if OP's mother has a home, this will need to be sold, and used to pay for care before Medicaid will pay. If that is the case, then OP should do as a PP recommends and use her home to pay for as much assisted living as possible before going into a nursing home. Assisted living is way nicer, and sounds like, more appropriate, to her mom's needs.
 
My parents just moved into assisted living last week. I had made plans for my mom to move into a nursing home, but my brother made the decision to move them into assisted living. I am not sure how long it will last, but we will see.

I think many times our parents are scared when they make the decision to move. I have noticed as my health as gotten worse, its scary to worry about what is going to happen. They are in pain and aren't able to do the things they use to do and are afraid if something happens and they fall or become ill and nobody finds them for an extended period, its just lots of worry about.

I would take her at her word and start looking into nursing homes. She doesn't have to move now, but I would start looking and making plans for when the time does come.

Is she working with a senior agency? They can offer lots of help and have lots of information. I didn't think my mom would be able to move into a nursing home, but they worked with us and showed us how it could be done.
 
OP, hopefully I can be of some assistance. While I currently work in home health, I have worked as the director of nursing for various assisted livings in the past.

There is a lot of guilt that goes with placing a loved one in any type of facility. However, you are ahead of the curve in that your mother told you she is ready. While you hate to see her give up her independence, that may be a trade she is willing to make to be in a place where she feels safe and secure. I have spoken with lots of families who have told me the same thing only to have their loved one thrive. They are suddenly in a place where there are others their age they can talk to and who are going through the same thing they are. I have seen residents become the life of the building after their loved ones told me that all they would do all day is sit home watching TV. There is also something to be said about her not having to remember to take her meds, or cook, or clean.

With her falls and your fear of her breaking a hip, I would recommend looking into possibly getting her Hipsavers. They are briefs that have hip pads built in. They are not overtly noticeable under pants but your mother may not like them. I will tell you that their website is horrible but I have always been a huge fan. I've seen stats that say they prevent x % of hip fractures and I can't speak of that. I can tell you that I've had residents who fell quite often and none of them broke a hip when they had them on. It is a blessing that it sounds as though she wears her Lifeline. It can be a STRUGGLE to get some to wear them.

The above comment that Medicare pays for a very limited amount of skilled nursing care is correct. In Texas, Medicare will pay 100% for 20 days of rehab / skilled nursing. Day 21-100, Medicare will pay 80% with the remaining 20% being paid via private insurance or out of pocket. If the patient remains in rehab / skilled nursing past 100 days, the full cost falls on the patient. However, for Medicare to pay anything, the patient must have spent three midnights in the hospital.

My first step would be to schedule a meeting with your mother and her doctor. Her falls are a qualifying event for home health meaning Medicare would pay for PT to evaluate her and ensure she had a safe, trip free, home environment. I would also speak with the doctor regarding future plans such as independent living, assisted living, or nursing home.

Others have described independent living well so I won't touch it. While Medicare will not pay for assisted living, other things might such as any VA benefits or LTC insurance. If assisted living is an option, set down with your mother and really go over her finances. I would then go to various assisted livings and meet with them. Explain where you are with your mother and discuss the financial situation with them. They may be willing to help. I know when our census was down, we were always willing to admit residents who were paying below market rate. If that is something you are interested in doing, PM me and I can give you questions to ask and things to look for. While some assisted living communities do not have skilled staff in the building at all times, some do. I have worked in one that had a nurse in the building at all times and I have worked in one where I was the only nurse employed.

Another thing to consider is that a lot of the nicer nursing homes in the Dallas area are tied to independent livings / assisted livings. Like a previous poster stated, you step down until you move into the nursing home. They give first openings to those patients who are transferring from their independent living or assisted living and it's almost impossible to get admitted straight to their nursing home. If this is the case where you are, I would recommend identifying the nursing homes you like and then speak with them about their independent living / assisted living and their step down process.

The great thing is, we are in an age of amazing resources such as the internet, community senior care agencies, or even the DIS. Use them all to your advantage. I hope some of this information was useful and please feel free to PM me with any questions. Best of luck!!
 
Just an FYI. Medicare pays for very limited amount of skilled nursing care (I want to say 30 days, but I could be wrong). After that, it's Medicaid which, depending on the financial resources of the patient. Medicaid will only pay once assets have been COMPLETELY exhausted(or within a few thousand dollars). So, if OP's mother has a home, this will need to be sold, and used to pay for care before Medicaid will pay. If that is the case, then OP should do as a PP recommends and use her home to pay for as much assisted living as possible before going into a nursing home. Assisted living is way nicer, and sounds like, more appropriate, to her mom's needs.
I agree....I had forgotten Medicare paid for a period of time- she had to go from Hospital to Nursing home after 2 nd stroke

As for costs...Assisted living you have an apartment and it's in the $6k monthly range here
Nursing homes are in the $3k- $5 k a month here

So OP....if the funds aren't there, hiring a sitter to help a few hours a day could work and give her companionship
 


Disney Vacation Planning. Free. Done for You.
Our Authorized Disney Vacation Planners are here to provide personalized, expert advice, answer every question, and uncover the best discounts. Let Dreams Unlimited Travel take care of all the details, so you can sit back, relax, and enjoy a stress-free vacation.
Start Your Disney Vacation
Disney EarMarked Producer






DIS Facebook DIS youtube DIS Instagram DIS Pinterest DIS Tiktok DIS Twitter

Add as a preferred source on Google

Back
Top Bottom