I would like to move my mother from a nursing home back to her own home with in-home nursing care. She is now in a nursing home for rehab after a hip fracture. Prior to her fall she was independent, living alone, cooking, bill-paying, etc. She used a walker for balance but got around pretty well. Unfortunately, since the fall she has not regained any mobility after a lot of PT and cannot stand. The PT itself has worn her out. She is now incontinent and has one bad bedsore causing much pain since she cannot move herself in bed. She takes several meds. From what I am finding out, she has not received the best of care and is not always treated with dignity in the NH. She had to go back to the hospital due to low hemoglobin. They will discharge her back to the NH but it weighs heavy on my heart and I want to bring her home. I have 2 siblings that would be able to share in taking shifts with me. We would most likely need CNA and Skilled nursing levels of care. She cannot stand, the NH was using hoists. She has other issues including diabetes, heart issues, etc. All were completely under control before the fall and still are OK. Eventually, this will probably become Hospice. She is now very weak and barely eating. We do not have the funds for long-term nursing unless/until she becomes eligible for Medicaid after all assets (not much) are spent down and they would put a lean on the house. How long would it take to move from NH back home, aligning nursing services, hospital bed, etc? Does anyone have advice on how/where to start? Experiences with this?
If the person that has Medical or Health POA has placed her there or her Husband then you probably have a Court fight on your hands.
The placement was (most likely) made in her best interest and for her safety and continued care.
In order to release her you would have to obtain Guardianship.
If she agreed to the Nursing Home, (she has no cognitive decline making her not competent) she can asked to be released as long as she has a SAFE place to go.
The Nursing Home can arrange transport if she needs medical transport otherwise she can get into a car when she is released.
You need to have all the equipment that you will need in place before, or at least the day she is discharged.
I would suggest that you contact Hospice NOW they can arrange to have the equipment in the house, they can arrange transport and they will start caring for her right away. It would be so much easier with their help to co-ordinate the move.
Based on my recent experience, hospice will need to review her records and make assessment. My mother is now almost 4 years in MC, has little or no hearing, has been in a wheelchair for MANY months now and after a stroke early Oct, hospice came and denied. Mom is now a 2 person assist (they resorted to PT to see if they could strengthen her right side, to aid in transitioning and eating.) Their big reason? She hasn't lost weight in 6 months... Seriously? She didn't have a stroke 6 months ago!
The nurse recently demanded they come back. Mom has trouble eating and taking her meds. They managed to get weight on her and she has lost some (under normal circumstances, this would be good! she gained at least 20# the first year in MC, who knows how much over the next 3, mainly because she sits and reads.) So, she was approved and hospital bed arrived within a day or 2.
I wouldn't rule hospice out, as it can help with a bed, hoist, supplies and perhaps wound care - who knows what else... But, start with her doc, to get the ball rolling. Even if denied, I believe if doc orders the bed, hoist, etc, Medicare covers these items. They *might* cover a little (stress on little) assistance if she agrees (when mom was assessed for dementia, the nurse said Medicare covers the cost for her time and if mom agreed to have personal help, like showering, Medicare would cover the cost of the aide for that activity. We'd still have to pay for any regular aides who came.)
I read your profile. Your mom is so young to be going through so much. My mom did rehab in her 90’s.
Has she completed her rehab stint? Have you had a meeting with the social worker and occupational and physical therapist? Have they assessed your mom’s care needs?
After my meeting with the social worker for mom, I was told that mom would benefit from staying a bit longer. I agreed and that portion was paid out of pocket.
This will be a huge responsibility to take on if you bring her home. When my mom returned home she continued with home health that her doctor ordered. Home health provides occupational therapy, physical therapy, a nurse and an aide to help with bathing.
My mom has Parkinson’s disease. Your mom has a different situation.
Is your mom reluctant to sell her home to help pay for care? Does she oppose being on Medicaid?
She needs extensive care and it may become overwhelming for you and your siblings.
Can she go into another nursing home that she would receive better care? If so, move her.
Do speak to both the director of nursing and the social worker to get her wounds treated. They are bothersome. My mom had one too.
Hospice is wonderful. Do take advantage of utilizing their services.
Wishing you and your family all the best. Take care and keep us posted. Other posters will offer feedback on your situation. Hopefully you will find useful information to help you.
What specifically has the nursing home told you about her future care needs?
Good luck!
I'm wondering why The PT she received there seemed so inadequate. A good rehab program should have produced better results (unless she had deteriorating general health. Diabetes and heart problems may have played a part.). And a bedsore? That sounds like a problem with nursing care. But you will have, I think, more difficulty than you anticipate if you try to provide care in her own home.
An existing bedsore is difficult to treat. It takes scrupulous attention by care givers! And that my require more supervision than you can give or more skilled care than you can afford. And if she cannot stand, she must at least be out of bed for some periods of upright positioning and physical therapy. Will you require a lift? And can you afford home physical therapy?
Speak with her physician about her medical problems and her prognosis. Can she withstand active rehabilitation? Perhaps a social worker at the hospital can help you find a place other than the NH where she has already been, a place with a reputation for good nursing care, especially, and rehabilitation if she is a candidate for more active rehabilitation..
It’s so sad watching a parent decline. Mom’s roommate ended up being a permanent resident at the home.
Home health care provided by Medicare is extremely basic. It's physical therapy 2x a week for an hour each time. It is someone coming out 2x a week to bathe her. A nurse will come maybe one time a week just to check vitals.
I don't know what state you live in, there are various programs, different rules, regarding the state paying/sending in help. You must be prepared to do the bulk of the work yourself or pay for it with your mom's money. It is not cheap, and you have to worry
about no shows.
We brought our mom home from the nursing home needing 24/7 care, until all her assets were exhausted.
She had some compression fractures, probably not as severe as hip fracture like your mom. You can also be assured she is no being neglected under your care.
Talk to the social worker at the rehab to line things up - in home health, pt, etc. Then get phone numbers for everyone/everything they say they lined up for you and CALL YOURSELF to confirm. Start finding medical equipment that you'll need - potty chairs, walker, wheelchair. Medicare has to have the 'medical need' verification before they approve certain things like the bed, wheelchair or walker, so NH doctor or her own doctor is going to be completing those forms. Once you have a release date, you call all of these providers to make sure the equipment and her arrival home match. If you need to pay a few days for the bed, do so to get it there on time.
My Husband was over 6 foot. He was over 250 at one point during the time I was caring for him.
I managed by myself with first a Gait Belt then we went to a Sit To Stand and lastly a Hoyer Lift.
It is recommended that a Hoyer Lift be used with 2 people assisting One person the push the other to guide the sling so that the person being moved is not swaying or getting bumped into things.
But we managed. And when I had caregivers here they were also able to manage with just 1 person.
I just wanted to let you know that it is not impossible.
With the help and support that I got from Hospice I think we did very well.
The important thing for me in ALL the caregiving that I did was SAFETY.
If it was not safe for HIM for me to care for him at home I would have had to place him in a Memory Care Facility.
If it became unsafe for ME to care for him at home I would have had to place him in MC.
Again contact Hospice.
Talk with the SW at the Facility. She should be the one to line everything up for your mom to transfer back to her home. It shouldn't take long to get everything in place. A week, maybe.
I am glad you are able to take your mom home and that you have siblings that can help.
We only have one chance at this thing called life. For you wanting to take your mom home and you and your siblings take care of her, that is a blessing. If you can't, that is understandable.
I've witnessed time and time again what goes on in these facilities and I'm not pleased either.
It may be hard but you can do it. Your mom will be appreciative.
You know as well as I, no one will love your mom the way you do.
I had absolutely no idea how hard it would be to care for an elderly person in my home.
We get so emotionally caught up in our love for our parents that we truly aren’t looking at reality.
Of course problems exists in facilities and it’s important to face issues as soon as they happen but situations arise at home as well even if we are doing all that we can.
We catch ourselves saying, ‘Where there’s a will there’s a way!’ Yes, maybe for awhile but in some cases we are only buying a bit of time and causing ourselves a lot of heartache in the process. We aren’t trained professionals that automatically know what to do during extremely challenging times.
Of course you love your mom and placing her in the best facility that you can find is providing love and care. Also enlist the help of hospice.
I feel your pain and I so wish that I could take it away from you. Please don’t jump into this out of feeling obligated or guilt.
You will be biting off more than you can chew and live to regret it.
Once you start being a caregiver you will lose a part of yourself. You also lose being a daughter. You become a full time caregiver. It’s simply too much!
In retrospect, I would have done many, many things differently.
Start reviewing other care facilities now.
The very first thing you stated is "You have a heavy heart." That lets me know, you are not happy with your mom being in a Nursing Facility. Can I tell you something? I do not blame you. If it was my mother, I would fight with every breath I had within me to keep her from having to go into one.
Your mom is very young to have to live in a facility. She is probaly not happy there either.
I can not tell you about anyone else's experiences with Nursing Facilities but I can tell you about mine. I will tell you, they were not good ones.
When visiting Nursing Facilities,( Mostly are Memory Care Units) I like to observe. What I observe is the Nurses/Administrators greeting you with a smile like everything is all good in their world. However, when I look at the residents, there is another story.
You can just look at the countenances on the residents faces and tell they are not happy there. They appear to be just somebody back up against a wall, sitting very quietly, looking sad and lonely.
Have you ever heard the saying, "There is no place like home?" Couldn't be a truer statement. I can ensure you, your mom will not receive the same love and care that you can give to her. We are living in times where there is not much LOVE for people any more and it's all about self gain and materialistic.
The facilities want you to think it is all lovely and that your loved ones are receiving the love and care they need. From what I've seen, that's not true. (There may be a good one somewhere but they are few and far in between).
I've witnessed residents being mistreated and disrespected by staff. I can tell you about both of my grandmother's who had alz.
My dad would have to go to the Nursing Home (Memory Care) every evening at dinner to feed his mother, otherwise, his mother would never get to eat. The nurses don't have the time.
My other grandmother ended up in the hospital with pneumonia. Guess what was found on her chest? Handprints YES, I said handprints.
I'm sorry. I know I have rambled but stuff like this gets to my heart. I've shared what I know about facilities and it is in no way to make you feel guilty. It is your mother and your choice. You know what's best for your mom.
Hope things work out the best for you mom.
SN: A dear lady down the road from my home was bedridden. Her only child, her son, cared for her. Never once did he complain. Of course he had cousins to bathe her but the rest he did.
Blessings to you.
Her profile says 60. That is young! But in an earlier response to me she says that her mom is 91. So, maybe the OP is 60. Regardless, it’s a typo. Her situation is very sad.
Just because caregiving at home is right for some people doesn’t mean it is right for everyone. Don’t allow anyone to cause you to feel guilty. It is your choice to make, so do what is best for you and your family.
It is very sad that your mom ended up in a less than par nursing home. Don’t let that deter you from finding a home that she will receive good care.
In a non judgmental way, don’t hesitate to let the facility know that you plan on monitoring her care very closely.
Please remember that placing her in a nursing home is best for her, you and your siblings. Her care requires more than can be given at home. She has very serious issues.
This has absolutely nothing to do with a lack of love. In fact, it shows enormous love by allowing her to be cared for by a professional staff that you and your siblings can keep a close eye on.
Contact hospice. Hospice nurses are angels. They also provide a social worker and clergy.
Your first step is to get her better rehab and then have her discharged into your care. Get a hospital bed through Medicare’s durable medical equipment program and immediately apply for hospice. Research Medicare rules and apply for everything your mother is eligible for. Apply for a meal delivery program to get some of her meals delivered. See if you can get a lift supplement from Medicare. Call your area wide agency on aging representative and asl for help navigating your local resources. Above all, do your homework about Medicare and Medicaid services on line. Immediately get involved with the hospital social worker to help you make plans to send her home or to another facility, Hospital social workers know the rules and local resources.