How Do You Know When It's Time...?
I'm looking for answers/advice for what is the most human and loving thing to do for my mother.
My almost 90-year-old mother has Alzheimer's, but it's progression has been slowed by medication. It's affected her short term memory (can't remember to take medication, for example) and now seems to be affecting her motor skills (frequent falls, FEAR of falling/pain, and near inability to stand from a seated position). She also has problems with hygiene, incontinence and depression. Although she can walk, using her walker...she whimpers and moans with each and every step...although she claims to feel no pain while walking. She does admit to extreme pain upon rising from a seated position. (Yes, she was hospitalized recently and thoroughly checked for any broken bones or fractures, and has none.)
My sister is Mom's primary care giver. They live practically next door to one another. I live 45 minutes away and visit weekly for overnight stays.
I worry about Mom living "alone", even though my sister stops in at least once per day. I am worried about my mother's safety and well-being. My sister is adamant about Mother staying in her own home as long as possible, and has begun to enlist help from home-care professionals. I think what my sister has done is commendable, and I know she loves Mom and believes she is doing what is best. But I believe that Mother truly needs 24 hour care, for her safety....and for her mental stimulation. (Her life is now basically just sitting in one chair all day long, with occasional...and traumatic...trips to the bathroom or "potty chair".)
Here is the problem: My sister's plan was for her family (husband, child and her) to sell their home, buy a bigger home, and move our mother in with them. Great plan...but it should have been implemented a couple of years ago. Now, in my opinion, time is running out for that to be a viable option. My sister does NOT think that Mom needs 24 hour care. I don't know if that is denial on my sister's part...or an unwillingness to move in with Mom (which I completely understand.)
I am NOT criticizing my sister's care-taking, as she has done much more for mom than have I (or our brother, who lives outside of the U.S.)I do NOT expect my sister to assume the responsibility of Mom's care, even though she already pretty much has. I want to participate...and I am. But it is not feasible for me to move in with Mom. (Or, even if I did...I could not be there 24 hours a day, due to my work and my own family.)
I am starting to believe that the safest thing (and possibly the best thing for her mental stimulation) would be for Mom to move into a GOOD nursing-care facility. One that is close to my sister, so she could visit daily, if she wants...and so that I could visit frequently. Mom doesn't like that idea, when I've glossed over it in conversation...but Mom also thinks she can pay all her own bills, etc., which she absolutely cannot.
So...how do I know what to do? And how do I deal with my sister, who is starting to think that I am the enemy, for even entertaining the idea that Mom would be better served in a facility that could care for her properly?
For those of you kind enough to answer my question, please keep in mind these things that worry me: Mom's loneliness and depression, Mom's hygiene and constant urinary tract infections, Mom's frequent falling, Mom's pain, and Mom's mental confusion. Also, please note that Mom is VERY social (normally}. Also, please note that we have tried an emergency alert bracelet, and Mom either doesn't "get it" or refuses to use it...because she "doesn't want to bother anyone" (so, she sometimes has laid on the floor for hours, before someone has found her).
Does my mother sound like someone who can be left alone overnight or for several hours during the day? Is it really possible that Mom could improve significantly with home health care? Or does it sound like Mom is a good candidate for a nursing care facility?
And, aside from all of these concerns....could my sister and I actually be held responsible for some sort of "elder abuse", if we fail to move Mom to a safer environment?
Since my Mom and sister have a MUCH closer relationship than my Mom and I (although I do love and respect her)...I feel it is up to me to have the level head and do the hard thing (while my sister thinks I am evil incarnate for even suggesting that we "dump mother somewhere"). >sigh<
Thanks in advance for any responses.