Hi friends,
I am getting near the fork in the road whereas I must make a decision in the coming months. Mom is quickly drawing to the point where she can’t be left alone. All of you that are care giving for loved ones already know the drills. My wife and I can’t leave home for long cause she is constantly crying because she is afraid of something. Her stove has been disconnected for sometime, but now she is burning up everything in the microwave. So now I am at a point of whats next? I nor my wife cant afford to come off our jobs to stay with her, home health care workers are expensive besides the normal cost of living. Therefore my thoughts are to start looking for a Alzheimer Nursing Facility.
My question to all of you who may be able to guide me is, what should I be looking for in a nursing home? What are the questions I should be asking? How do I prepare her for possible transition? How did your loved one accept it when you and your family decided it was time? Any and all information is greatly appreciated.
Bless Your Spirit!
RevYarb
Most nursing homes show you what they want you to see if you go in to have someone placed. I would say go in to just visit (don't set an appt.). Ask to see the different wards. Check to see if they are clean, if clients are up or still in bed. Also check out the activity areas. If your mom can be active with people her own age she will be happier. I am fortunate that in our area their is an adult day care for day time working hours. But, you have to think of you and your wifes health/sanity. Plus, your moms safety. I have had friends who have good luck with the council on ageing. They will give referals and assistance. Last but not least your local hospital may have a eldercare ward for dementia clients,or a social worker that can assist in this choice. Good luck and God Bless
I wouldn't write off home care assistance so quickly Rev. There are MANY companies out there with affordable and flexible price plans. I am sure your mom would enjoy living out the rest of her life in a familiar environment as opposed to a strange nursing home. Check out "home care" in google and see what you find.
Check with your state's health and senior services department for a list of inspected long term care facilities. In Missouri, the link is http://www.dhss.mo.gov/showmelongtermcare/ so you can see an example. Also DHSS has loads of info on how to choose a nursing facility, options for in-home care, etc. You may also want to consider contacting the local Area Agency on Aging. They sometimes offer an in-home inspection on what can be modified so your mother can stay home longer or what services are available for her.
For you and your family, I have found information at http://www.pbs.org/wgbh/caringforyourparents/ and http://thefamilycaregiver.org/ to be very helpful.

Hello, your courage and patience are in for quite a ride!
We based our decision on my mother in law's ability to help us physically. Of course, there was always one person from our family able to be at home with her prior to the change. We also, couldnt afford any out of pocket at home care expense. Her transistion came when a short hospital stay turned into doctors orders for therapy directly from the hospital to the nursing home. This turned out to be a blessing in disguise because with whatever reasoning ability she has left we could tell her the doctors said it was necessary. I saw some patients there who were content to make it home, then there are those who always want to get out of there. We are the latter, but we know it is exactly what is best for her situation. So we just have to lovingly and patiently direct her attention to other things when we visit. Regular visits help you and the staff make sure her needs are met. I asked the director once, how do the handle all the challenges...she said, 'we change shifts every 7 hours!!'
We kind of eased her into the atmosphere when we had to go out of town for a couple of weekends before the big change. We called and asked if the nursing home had repite capability. Her SS income was enough to afford 2 or 3 days. That helped us both to test the waters. She still resisted, but, I did notice when she was back home, she was bored to death. So at least, they have the many distractions to occupy her time better.
I must say, Caring.com helped us tremendously when we had her at home, and actually still does. We just didnt know what Dementia was all about or how to handle different situations and changes. What's important is that she feels loved thru it all. Someone told me once, even if she doesnt understand being there, you know that you are still showing your love and care with the visits, and all the little things that go along with taking care of her while she is at the nursing home. The side benefit that I also noticed is, the family is physically and mentally able to enjoy her more when we are not so frustrated and exhausted.
I appreciated the last comments and can relate to this discussion thread. My mom is still at home with dad and through a Wisconsin program called IRIS we are able to get about 40 hours a week home care. This is ok for now but I know that eventually she will need to go to a nursing home. I went and visited several times & took my dad once and my sister once. We looked around asked questions & feel that when the time comes we have a safe, healthy place for mom. It's nice to think we can or should keep them at home but I agree with the last response, nursing homes can keep our loved ones engaged and they have around the clock care from trained individuals. That is something I can not give my mom. Everyone's situation is different & it takes time to find the answers.
A nursing home provides 24 hour skilled nursing services. These are very expensive and range from $6000 - 8000 a month. Does you mother have medical conditions that require 24 skilled nursing?
If not, investigate memory care communities within Assisted Living Homes. They provide assistance with grooming, care, medications, etc. and are much more reasonable in cost. Look at several. Spend some time visiting them. Many have respite programs that allow you to have your loved one stay there for 3 - 30 days. This is a service to provide families a way to take a break, a vacation, a business trip, have a medical procedure, etc., but it also lets you 'trial' the care and see how it goes. There is a fee, of course, but there is no commitment or contract.
Another alternative is an Adult Family Home. These usually have around 6 people living there and have 24 hour custodial care. Costs vary widely, as do the services provided, so it is good to do a lot of investigation.
Each state has it's own licensing regulations and rules - these are usually available on-line through your state government website. Also, most nursing homes have a lot of information about both kinds of facilities, as they discharge people to them. They can be a good resource, as well. The key is doing the research, making visits, looking at the quality of the activity program, and finding the right fit for your loved one, and you! Changes are hard for a person with dementia, so you want to make a good choice the first time!
Good luck.
I have just gone through the very painful decision to place my husband in Alzheimer's care. He is at an assisted living facility with a special Alzheimer's unit. I had him stay there several months ago, so he was familiar with it. He has also been going to adult day care at another facility, so he is used to being in that sort of environment. Both of us talked to his doctor, and his doctor told him that I could no longer care for him at home, and that she recommended he go to a place where they could care for him. He accepted this pretty well, and for a few days before the actual transfer, I would bring up that the facility was really a nice place, etc. Have close family or friends with you when you actually make the transition. His two sons flew in from the east and west coasts, and this helped me tremendously. One thing for sure, you can't go it alone with this disease. I also got a lot of help from the facility with suggestions about how to approach it. We told him that we were going to "try this for awhile to see how it goes." He accepted that, and when I went to visit today for the first time, he asked "how did you know where to find me?"
Please check with your Office of Regulatory Services to see if the nursing home you are considering has any complaints or investigations for problems. My Mother was only in a nursing home for 90 days while my Father was dying but she was verbally and physically abused. The day I gave thirty days notice and returned she had a head injury and was bleeding profusely while the staff was standing around getting their story together on what happened. I understand that it is difficult to care for someone after I have been in the role for 27 months without a day off but please check in often and at different times. You will be shocked at what goes on in these places when the staff doe not realize you are paying attention. Everything from sedating the patients to ignoring their basic needs. It is a crying shame how the elderly and helpless are treated in some of these facilities.
Because of a bad first time experience, I have the questions that can help you determine which facility is best for your mom. Keep in mind, these questions were developed for an ALF ( Assisted Living Facility).
Rates:
1. How much do they charge?
2. Would mom's income of $XXX plus Medicaid waiver suffice?
3. Do they take Medicaid Waiver to help pay for services?
4. Do they help with the filing for Medicaid Waiver?
5. Are they registered with Social Security office?
6. How would payments be handled?
Medical Attention:
1. Is there an in-house attending physician or do we choose a primary doctor?
2. Do they work with specialists (Cardiologist, Dermatologist, Podiatrist, etc) that come to the home or does the family pick and transport patient?
3. Psychiatry – Do they have a preferred attending physician, or does the family pick?
- We currently have one; can we keep him if we choose too?
Medical Records
1. Do we have access to view medical & drug documentation of the patient when requested?
2. May we get copies of such records when needed?
Behavior
1. How does the facility handle difficult behavior, like wandering or the patient going through drawers?
2. Constant requests to go home?
3. Are the caregivers prepared to handle the demanding behavior of dementia?
4. At what point will the patient be evicted from the home due to behavior?
Stimulation
1. Are there Spanish speakers in the home?
2. What activities take place for mind stimulation?
Visitation & Family Outings
1. What are the visitation & phone call hours/rules of the home?
To Cheryldavis-
When we found out that mom was being sang to that she was "crazy" in the head, I almost lost it. My sister and I requested to have mom "stay over the weekend". We gathered her things in large bags, and it was pretty obvious that we didn't have plans for her coming back. We gave a 30 day notice in writing to comply with contract, we even offered to give them the next month free, but mom will not step foot in there ever again.
Needless to say, their pride didn't allow them to keep the free money, they just accepted the letter and denied all allegations. Always visit without making an appt nor letting them know before hand by phone. Just show up.
I think mom was being picked on, because we were micro-managing the owner of the facility. We requested to see records, and asked to speak to the home attending physician. I think we overwhelmed her and brought to light, she was never prepared and didn't want to share records. We decided to micro manage her because there was no trust established. And so I think that is why they were emotionally disturbing our mother.