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She is 87. Has been with us for 7 years. Health is definitely deteriorating. We are concerned we will not be able to provide the best care for her when she gets out. May be a good idea for her to go to SNF. Maybe just until she can get back to where she was before the hospital stay. She wasn’t able to do anything then either. We are not up to wiping and porta potty chores. How do I make her see that she is still pretty sick and needs round the clock care? Tough conversations to have. My husband and I are both in our mid sixties, I have medical issues myself and my husband does also. We cannot be lifting, etc. PLEASE HELP! Also we would need to provide a soft, if not liquid diet. Dieticians we are not. Help!

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You aren’t qualified to care for her. She is an unsafe discharge and will go to SNF. I don’t think you need to discuss it with her or get her opinion.
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anonymous1732518 Jun 2023
Yes they do. Give her an incentive to feel better so she can go home.
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Perhaps get SW or doctor explain to Mom that she needs more care than you can provide.
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Ask for the hospital social worker and meet with her privately at first. Tell her your mother’s caregiving needs now exceed your abilities to provide for her in your home. We always found the social workers had a great network and knew a lot about what nursing facilities had good reputations and open space both. The social worker is also part of discharge planning and can be the one to discuss this with your mom, to be the so called “bad guy” It may help to present it as going for rehab after a hospitalization as that is common for elderly patients. Then the rehab becomes long term care on site when she cannot progress to a level where in home care is doable. Rely on the medical team and hospital staff, even clergy if that’s appropriate to your family, to discuss this with mom. It’s going to be hard for her, you be the understanding and loving family member, not the bearer of bad news
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anonymous1732518 Jun 2023
What hospital is this? A hospital social worker set up my discharge to SNF for rehab, but she did not stress or even mention much the good and the bad. She mentioned to pick 5 from a list she had printed out and she'd call to see if there was a bed a available.
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Enlist the discharge staff to tell mom she’s going to SNF so she can regain strength. (Don’t count on that, though.)

Your plan should be that she never comes back to your home. You and your husband must take care of yourselves now.
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anonymous1732518 Jun 2023
Why not?
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So sorry for your family going through this . It’s probably best for all if Mom goes to SNF . It sounds as if you have been struggling to take care of Mom even before this hospitalization . Maybe it’s time to have Mom start out in rehab while you look for permanent placement for her .
Before rehab is finished , have the doctor tell your Mom that she needs more care than you can provide at home .
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And make sure it is HER money paying the SNF! Don’t rob your own retirement savings, whatever you do. She could hang on another 20 years, the way modern medical “miracles” are propping up the old folks these days, for what reason I can’t fathom, but so it is.
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tothebeach23 Jun 2023
Emma, I agree with you wholeheartedly. during covid, there was so much emphasis put on protecting the elderly that didn't have much quality of life anyway, but we never heard anything about the fact the shutdown was sacrificing a generation of children. If my 90 year old mother with severe dementia, had known she would end up completely incontinent and sitting and staring and not knowing anything at all or recognizing any of us, she would not have wanted to live this way. I know I don't.
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It's time now to call on Social Services in the Hospital to tell them that you have reached the end with caregiving in the home. Ask their help and intervention for in facility placement.
If Mom is moved to SNF that may be temporary, as is rehab, but those facilities should have social services as well, and do know that this is the ideal time to make this move; it is much more difficult from a home situation.

Your Mom may never understand, but you must gently explain that you are sorry, but can no longer provide for her the care she needs. Do not expect there to be no tears; there will likely be great grief in this for all of you, and it is worth grieving, but no one is at fault. No one caused all of this and no one can fix it.

I am so sorry.
Ask to speak to Social Services as soon as possible.
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This is your golden ticket to freedom. She goes straight to the nursing home from the hospital, easy peasy. Do not pass go, do not collect $200.

Do not ever entertain the idea of her returning to your home for any reason.

It will suck for both of you in the short term, but it it what it is.
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babsjvd Jun 2023
Absolute!
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From your profile: "I am caring for my mother Eleanor, who is 87 years old, living in my home with age-related decline, anxiety, arthritis, depression, hearing loss, and mobility problems."

I don't see any mention of decreased cognitive ability. I'm concerned that your mother still makes the decisions, and if she wants to leave the hospital, that is what the discharge planner will facilitate.

SO...you must state that you and your H are unable to provide her care any longer; that it would be unsafe discharge.

You are 66, and presumably your H is around the same age. Enough is enough. You've given her 7 years of care, and from your past posts it hasn't been easy and she's been selfish.

What is her financial situation? You wrote that she has SS. Does she have any assets that could be used to finance a facility? It is NOT your financial responsibility to pay for her facility.

Please keep us updated. We can become your cheerleaders along the way as you take the necessary steps to have your mother placed instead of coming home and subjecting you to continued 24/7/365 caregiving slavery.
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Find the discharge planning office in the hospital. Find out what plans they have been making with your mother. Is she being encouraged to go to rehab? Support that, and find a nice one where she can seamlessly transition to being a long term care patient.

Play hardball with both discharge planning AND your mother. If they and she insist on her being discharged to your home, state firmly state that you will NOT be providing transportation nor will you provide care at home, that you are leaving for several weeks. Mom will need someone to arrange in home care and she will need to figure out how to pay for it.

You are not responsible for your Mother’s care. Keep telling tge hospital that this is an "unsafe discharge" (keep using those exact words) and that mother needs more care than can be SAFELY handled at home.

Drop the guilt. It is blinding you to your mom's REAL needs.
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It sounds like her needs will be better served in a SNF. It’s very sad when it has to come to this.

My family recently had to place my father in a SNF. It is sad that it became necessary for us to do this.

None of this is easy. I wish you a good outcome.
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anonymous1732518 Jun 2023
You're so right about this
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Move her into a SNF and don't allow her to come home. Don't allow them to discharge until you have a SNF ready to accept her. If you feel you can't care for her 24 hours with her high level of care needs, don't. I guarntee you it will be harder than you think and could continue for years and years.

At the SNF she will get the care, including nutrtional, she needs. If she improves you can take her home and if not, she is in a safe place that can provide the care she needs.
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anonymous1732518 Jun 2023
Nutritional 😆. Not all SNF. I asked for nutritional. Guess what? Still getting things I don't want or can't have like white bread, sausage , lemonade, fruit punch, to name a few.
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First, you need to see if she will be going to Rehab. Medicare will pay 100% for the first 20 days, 21st to100 50%. The 100days are not guaranteed. She can be discharged at any time. You should be signing papers with admitting. Do not sign anywhere that you will be responsible for payment. If ur POA, then sign with POA following ur signature. That means ur Moms representative.

You make Admitting aware that Mom will not be coming home. Her care is now beyond what you can handle. Once she is done with Rehab, she will need to be transitioned to SNF. Where I live Rehab and SN are in the same building so easy transition. She may not even realize she has gone from one to the other. If she has no money, you start the Medicaid process. You can allow the facility to help you but you will need to keep on top of things. Once the ball gets rolling, you personally may want to keep in touch with Moms caseworker so your sure they are getting all the information needed. My State only allows 90 days to spend down and get info need to them or you start all over.
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lovelyliz Jun 2023
good advice, you cannot transfer a patient from home and it is easier from a hospital and that is where people make a mistake.
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Talk to someone at the hospital today about not discharging mom home. She has WAAAAY too much going on for you to handle at home. I would say something like that she needs a lot of help right now and needs to go to a nursing home. Someone else here often says a good answer is "Oh, I couldn't possibly do that". That is a good answer to your current situation. You can let your mom think that if she gets better, then maybe she'll be able to come home. I had strict rules as to when my mom could come home from the hospital and rehab from her knee replacements. For example: she needed to be able to get into the house independently (3 steps with a railing) and walk independently from her bedroom to the bathroom. Once her dementia progressed more, I placed her in AL because her care became too much to do at home, even with a few caregivers. I needed my life back. You will still have things to do for her when she is in a facility. And then you can visit more like a daughter instead of a caregiver which is so much better.
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You have to talk to her doctors. Make sure they are FULLY aware that she can not care for herself AND that her care is more than you can SAFELY do at home.

You talk to the Social Worker at the hospital and or the discharge planner. Make sure they are FULLY aware that she can not care for herself and that her care is more than you can SAFELY manage at home.

Do not allow them to discharge her to your home,.

And maybe the first conversation you need to have is with your mom.
Tell her that her care is getting to be more than you can SAFELY handle at home.
Tell her that she can not continue to lie with you and expect you to care for her.
If there is an option for her to hire caregivers to come in and care for her you could leave that option open to her.
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Good Morning,

Meet with a hospital Social Worker. Go on the portal for all of the hospitalizations and doctors/specialists.

One possibility would be that your loved one would need a short-term rehab facility. Check them out online. They "the hospital" will suggest (3). Do your homework on the places then the doc at the facility takes over.

If you don't like the first choice of placement, if there are no rooms at other facilities, you are allowed in least in my State to move your loved one to another.
Get all of this cleared up before a placement is made. Know which one's you are interested in and don't let others decide for you.

If it's too far along your loved one may not be able to return home with services because "skilled" care would require 24/7 availability.

You can do a lot online these days. Make your presence known so that the facility knows there is family around. A store-bought NOT homemade box of goodies are always a big hit at the nurses station.

Label all clothing, read about all prescriptions especially antipsychotics. Have the Church people visit. In other words put your loved one's name on the "visit" list from the local Church.

Things will happen gradually and you will have to make decisions along the way. If you don't like something you can change it. I will pray for you. You sound like wonderful people...vet all doctors online by your local State Medical Board.
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Meet with the hospital social worker, and her doctor(s) be clear that you cannot take her back to your home and that she cannot care for herself.

Do not take her back to your house under any circumstances as she needs to be in SNF, refuse to take her, believe me the hospital will find a place for her.

You have dedicated enough of your life to her, now it's time to dedicate time to you and your husband.

Sending support your way!
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Lostmysparkle Jun 2023
My situation too!
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Like my clients daughter did was she told her mom if you won’t take RC care you’ll have to go to a nursing home ! We can’t do this ourselves! I was hired and moms happy you just Nd to hire one your mom will love
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My mom has dementia, lived alone, forgot how to use the phone, forgot how to cook, drive etc. She is insulin diabetic with a difficult course on when to inject etc.
As an only child who works full time, I am unable to be with her all the time. Nurses sometimes were unable to be there as planned, with their busy schedules. The companion is not allowed to give meds.
With all that, mom, one day almost dies with a sugar level of 46.
I took her to the er and they admitted her.
The hospital had wonderful assistance with placing her in rehab, since she should not be home alone.
Rehab could not keep her since she had dementia but was mobile and could walk and possibly walk out the door.
again, the elder care services kicked in and I found a wonderful SNC .
She was transported to the SNC and has been there since.
This made an easy transition without her having to go home and then not wanting to leave.
It’s sad but working with the elder care experts at the hospital and listening to their advice was a godsend.
I hope this helps.
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have a dr. talk to her.
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Let the discharge coordinator and doctors be the heavy on the kind of care she needs, you can talk to them first to clue them in. Then as they are telling her what she needs to be safe you can say you don’t feel you can do all of that safely and well. You want her to have the best care possible and hard as it is for you to admit you know you can’t provide it. Ask what the options are and go from there. That’s the way I think I will handle it when the time comes.
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Provide a Reality Check from a doctor or Hospice Nurse.
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If the doctor thinks she can regain function to "where she was before," maybe he could prescribe Rehab for whatever time Medicae allows.

It sounds like she is exceeding your ability to help, You need to find her a facility that can provide the level of care she needs. You do not need to "make her see" that need. Were you hoping to cnovince her to agree? If you cannot manage her care, she may not have a choice about where she is going to live.

If you want to keep her in your home, you may need to hire 24/7 home care.
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When my MIL fell in February, there was no question of her going back to the way she was living before. The discharge planner basically told her where she was going. As others have said, let the social worker bear the heat. They're used to it. If she continues to need dietician-organized meals, she will probably need assisted living. So do you have a way to find one while she is in rehabilitation?
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Aspens04: State to the discharge planner at the hospital that it would be an unsafe discharge to home. You CANNOT take care of your mother since you and your DH (Dear Husband) have health issues of your own.
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