Should we keep Mom in a nursing home or move her home?

Trying to make the decision between nursing home care and in-home care can be agonizing. There are many factors to consider. One of the major factors is how much time See also:
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See all 660 questions about Alzheimer's and Other Dementias and energy you have, and how long that will last. If an illness lasts several months and the patient either recovers or dies, either way, the illness is over. that is one thing. If the illness is projected to last for years and get progressively worse, that is entirely a different matter.

If the mass in your mother's lung leads to a terminal diagnosis with a limited life time, you may want to consider taking a leave of absence from your job and staying at home to provide care. Even then, there are more factors to consider. Do you have space in the home for a hospital bed on the first floor, can you meet both her physical needs and the emotional ones? Do you have energy to stay up nights and still function during the day? Is there extended family nearby that can provide respite for you? Since she has dementia, do you have the patience to answer the same question hundreds of times every day, to reassure her constantly?

For many caregivers, the honest answer to the questions above is no. When that is the case, as it is in most situations, the best solution is to let the nursing home provide for her physical and medical needs while you meet her emotional needs and improve the quality of her life.

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I can say from first hand experience that having a family member with dementia at home is extremely stressful not only for the caregivers in the home but for any family members that live nearby and are involved with care.

My mom tried to keep my dad at home after he had a major seizure that caused a quick decline in his mental abilities. I did as much as I could, but after three years of dad's continually declining health both she and I were pretty much burned out, even with having additional help in the house (in-home care). Unfortunately it took an overnight visit in the ER and a mild heart attack for my mom to realize how burned out she really was. Mom often told me when she was younger "we kept our old people at home". I think this was a contribution source of her uneasiness about placing dad.

We placed dad in an assisted living facility about 6 months ago, which has really been a good decision. Mom is now able to get out of the house some without worrying about whose going to watch and care for dad as well as not having to physically do all the things he needs done for him every minute of the day. She visits him often (3-4 times a week) and he has other residents to talk to and interact with. At home there were no visitors; the neighbors didn't seem to understand dementia and how people with this problem interact (or don't, as the case may be).

Not that mom and I don't still worry about him and keep a close eye on his care, but the day to day chores (bathing, feeding, incontinence care) are no longer stressful for her or me. Daily incontinence care on a wheelchair bound person is stressful enough, add in the dementia aspect too and any medication management you may have to do and....

I can understand that on the one hand you want to have your mom near and be able to spend time with her, but keep in mind that the nursing home has skilled personnel that understand exactly what has to be done with every situation that arises. You'll still be able to go see your mom and spend time with her; many facilities will even allow you to take her for an outing if she's capable. We do still do that with my dad every couple of weeks or so.

This is a very hard decision to make and the answer we found for us isn't necessarily the answer for anyone else. Perhaps your mom's doctors could give you some feedback about nursing home vs. home care. They understand how dementia and other diseases progress and the impacts on a person and the care levels required.

Above all be sure to care for yourself because if you're stressed out, burned out, whatever you won't be able to take care of anyone else. Hugs to you, Lisa.

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Nursing homes will not give your mother one to one care that she needs. They don't have the staff and they don't care. It is a job. If there is any way possible to keep her at home, do it. I understand there are times that is impossible to keep a loved one home. Nursing should be the last resort. We had a aunt that had great care at home for five years. No bedsores, no abuse only the best of care. The money ran out and she was placed in a very nice looking nursing home. One of the best in town. She was there for 15 days before she died. On the 13th day, we came to visit her, my cousin was trying to feed her and she could not swallow. She seemed to had another stroke. We demanded to see the charge nurse. While they were putting her to bed, we saw brusing all the right side of her. We demanded that she was taken to the hospital. It the hospital, we were told that she had been dropped ten to twelve days before and has laid in the nursing home with a broken hip. She had been dropped and had another stroke either the first or second day there and we were not told nor she was treated.

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While it's very true what you say "Nursing homes will not give your mother one to one care that she needs." I don't think it's fair to categorize all nursing homes with the statement: "They don't have the staff and they don't care. It is a job." Many facilities do have very caring staff. As far as keeping a loved one at home, not everyone is equipped to handle the day-to-day stress of caring for an aging relative.

I can't say that my dad's stay in assisted living has been wonderful. We moved him from one facility to another after just five months because of unexplained bruises, improper sanitation procedures, and finding medications on the floor of his room among other things.

ANY facility is going to have problems, whether they are "very nice looking" or "one of the best in town".

The family of the resident in the facility must be vigilant to ensure proper care, proper reporting, and proper treatment of the resident. Should any problems arise then reporting procedures for the facility should be followed first. After that most states have regulatory agencies that have additional procedures for correcting problems.

If you find response to the problems to be unsatisfactory at any level you need to seriously consider moving to another facility.

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this isn't an all-or-nothing choice, if that helps at all. you actually have 3 choices -- nursing home, your home and small care home that might offer the care your mother needs.

also, should you have your mother home, let Hospice be part of the picture. you would get great help from them, including actual people help. i believe, just by her health conditions, your mother would be eligible.

find out whether her Medicare plan allows paid help (contact your local senior services), or whether your state pays family members. then you can also hire in helpers -- and you should. your mother's care is not a one-person job.

if you choose nursing or care home, read the inspection reports (they must show you, by law) and you'll get to know their issues and strengths.

You can still have your mother home for visits even if you choose nursing home care. or you can choose respite relief care in a nursing home when you need a break.

my own favorite choice for dementia care is the small care home with up to 6 residents. check those out in your area. it's the best and most supportive care, if other major medical issues don't need nursing. nursing homes are never the best choice for people with dementia. they don't need nursing for dementia, they need companion care. small care home welcome family visitors.

so talk it over with senior services, go to one or two support groups and get mutual help, support and information. Then decide.

please don't dismiss care staff. i've worked in the field for 20 years and it's amazing the love and caring among them. when it isn't, it's usually because they're underpaid, over-worked and not being appreciated. don't make any assumptions -- do your homework, think it through and you'll know what you want. and don't forget the mix-and-match approach.

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Thank you everyone for your advice and ideas. It is so good to hear from people that have already been through this. My emotions go from secure in my decsions to completely doubting myself. I suppose that depends on the kind of day my mom is having. I visit her every day at lunch and usually have a nice visit. She is making friends and seems to have quite a social life. She was isolated at home with only a home health aide and the TV for company. We had just started going to an adult day care two days a week when she got sick. I think that is good alternative too. But now I realize that my husband and myself can not do it all by ourselves. I am still weighing my options and understand that I can change my mind whenever i think it may be necessary.

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This is really a difficult decision to make but please understand that when you're dealing with someone with dementia if you can't be easy going and relaxed it will take its toll on you. It is a really difficult disease to deal with. I love my Mom dearly and told my Dad when he passed away 20 years ago at 71 that I would look after Mom. Well Mom is now 97 and was doing quite well until the dementia hit her. I need to pray for patience every day. My Mom doesn't want to eat (she drinks her food) I try to make smoothies for her 2x daily and vary what I put in them. I try sometimes for over and hour to get her to drink one glass. It is so stressful for me when she won't drink. I'm a single 66 yr. old and a diabetic and have atrial fibrillation and other heart arthymias and sometimes I feel like I'm going to collapse! I don't know if Mom even knows me anymore - I think she might as she tells me how very much she loves me and I tell her the same. I work full time but have a Personal Support Worker come in and stay with Mom all day although I still do most of the work, after I come home from work. I don't have any family support and get extremely tired. My social life is zilch! I don't have an out except for work.
I guess what I'm trying to say is that it is wonderful if the person can be at home and you know what's going on with them. When they are in the nursing home it's entirely different than being with their loved ones - but you need to have the patience to deal with the dementia and you need to have a life as well with family support. God bless and I hope you make the right decision.

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Although there are exceptions, placing a dementia patient into a GOOD, reputable nursing facility is the best decision for everybody involved. The reason is that, in a GOOD home, the people to care for your loved one gets to go home and rest after their shift and rested people take over. They get time off and they aren't alone. At home often times there is but one person that provides the majority of care around the clock day after day, month after month.

It is often the case that, when a spouse cares for their husband or wife with dementia, they get physically and emotionally drained and, sadly, they pass away before the dementia patient.

This happened with my mom. She passed away while caring for my dad, who has dementia. She wouldn't let us put him into a home and didn't take any respite. My dad is still alive and physically healthy. He's actually in much better shape now because of the care he is getting. At home with my mom, well, she couldn't tell him what to do; what he could or could not eat, when to take a shower or brush his teeth... Now he's clean and he's slimmed down nicely. Also, he's happy.

I miss my mom terribly, and wish she had let me put him into a proper facility before it was too late for her.

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my mum was diagnosed with vascular dementia in jan of last year she must have had it for years as now she is so bad that she needs 24 hr care we looked for care homes that were offering what we needed and we found a wonderful one who really care about the people who are in there we did try to care for her at home but dad has mild dementia as well and it go to a point where we couldnt look after her for the amount of time she needed she is at end stage dementia now so we just have to be there for her at least now we do have the energy to visit them and just be their children my dads dementia has worsened and they have managed to get him into the same place with mum its so sweet to see them holding hands sat in day room the staff think its fantastic they are still in love after all this time so all i can say is go look at as many homes as you can and make an informed desision from there xx good luck hun xx

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