fairfarmhand Posted June 25, 2015 Share Posted June 25, 2015 My mom was sick for the last 12 years of her life. My dad, a strong healthy man, cared for her for years at home. However, toward the end, she was in such bad shape she had to go to a nursing home. I got it. Had the situation been reversed though, I really do think that he would have been in a home for years because she wouldn't have been able to lift him and move him around and care for him properly. There is a health crisis with an older family person we are close to. I was talking to someone involved; this person was saying stuff like, "Well, you know nursing homes are not an option. They will just have to move in with one of us." I think this person believes that nursing homes are just places where uncaring relatives park older folks when they are "inconvenient." I don't think that they fully understand the challenges that caring for an infirm, immobile person brings. This person was absolutely not judging my family for our choices. They were just stating that they were going to refuse to put this older person in a nursing home no matter what. I listened. But I hated to tell this person that it's much more nuanced than just adult children being too busy with their own lives to bother with an older person's health needs. It's older people having complex medical situations that need full time nursing care. It's people who can barely roll over in bed. How does the average person help that infirm person maintain the dignity of not lying in their own waste, bathing, and doing "normal" things? I mean, I am stronger than the average person from farming. I cannot lift 150 pounds of dead weight. It's family members who have teens at home who also need a mom and a dad to parent them adequately. I see this assumption a lot and it makes me sad. Mostly it is younger people (in their 20s and 30s) who just haven't been faced with the realities of how these situations play out. It makes me sad that older people live so long in poor health and their families cant take care of them. It makes me sad that others judge the caretakers harshly for their decisions. It makes me sad that older people often lose all sense of dignity and self before passing. Aging is so hard. 10 Quote Link to comment Share on other sites More sharing options...
catz Posted June 25, 2015 Share Posted June 25, 2015 :grouphug: I agree with you 100%. Not everyone can financially, emotionally, and mentally do full time health care for a family member. I also think while I'm parenting minor kids (and even into early adulthood for some kids), that is my FIRST responsibility. 1 Quote Link to comment Share on other sites More sharing options...
momacacia Posted June 25, 2015 Share Posted June 25, 2015 I think that's fine. If your relative wants to take this other family member in, more power to them, let them at it! They'll figure it out soon enough. Experience is a wonderful teacher. 16 Quote Link to comment Share on other sites More sharing options...
J-rap Posted June 25, 2015 Share Posted June 25, 2015 I think you summed it up very well. It's not so cut and dry as people think. Everyone's situation is different, and different decisions can be reached while still based on a great love and caring responsibility of the elderly parent. 3 Quote Link to comment Share on other sites More sharing options...
BrittanyM Posted June 25, 2015 Share Posted June 25, 2015 Yes, I completely agree. The person you are describing sounds like my sister in law. We had a conversation on this topic years ago and had very differing opinions. At the time she had never closely walked through someone dying whereas I had on two occasions and that made a huge difference in how I viewed the situations. Quote Link to comment Share on other sites More sharing options...
fairfarmhand Posted June 25, 2015 Author Share Posted June 25, 2015 :grouphug: I agree with you 100%. Not everyone can financially, emotionally, and mentally do full time health care for a family member. I also think while I'm parenting minor kids (and even into early adulthood for some kids), that is my FIRST responsibility. And really, most normal older folks would understand that, even if they didn't want to go into a nursing home. Honestly, it seems like advances in medical have been a double edged sword. Yes, medicine has helped so many people heal and live wonderful longer lives. However, it also means that many people can spend years in a nursing home, many of them with very poor quality of life. Nursing homes are not all just depressing places, and many people there have good lives. But just as many are miserable. It's sad. I think I'll do what our old barn cats do when they die. They crawl off into a quiet place and fall asleep. 3 Quote Link to comment Share on other sites More sharing options...
G5052 Posted June 25, 2015 Share Posted June 25, 2015 My mother battled mental illness her whole life. She was also a violent person towards her husband and children. When dementia arrived, it got ten times worse. I was so glad that she was in a facility where they were trained professionals. They nearly put her into the state mental hospital at one point, it got so bad. No way could I take her. No way. People gave me a hard time about that, and I didn't even bother explaining. Timely to think about though. I've got yet another out-of-state crises with an elderly relative that I'm working now. I don't think he'll want to move. That's another factor. 1 Quote Link to comment Share on other sites More sharing options...
NoPlaceLikeHome Posted June 25, 2015 Share Posted June 25, 2015 :grouphug: I have cared for those in acute and long term care. Ideally I wish everyone can be at home but it is not always feasible. I am glad that medicare and medicaid may be looking at alternatives to long term care to allow some folks to stay at home with assistance such as day care, visiting nurses and aides, as well as other supports which may be less expensive and more palatable for the patient. 4 Quote Link to comment Share on other sites More sharing options...
Guest Posted June 25, 2015 Share Posted June 25, 2015 Totally agree and I'll add that my Great Grandmother was so much happier in a nursing home with bingo and other activities than she was being shuttled between families, watching TV all day. 1 Quote Link to comment Share on other sites More sharing options...
redsquirrel Posted June 25, 2015 Share Posted June 25, 2015 It is so much more difficult. My mom was a geriatric nurse and at some point even she had to make the decision to move my grandfather into a nursing home. He lived with us for years, longer than he really should have, because of family pressure that of course she could take care of him. But, it finally got to be not safe for him and not safe for us. I am certain that some in the family thought she was just 'sick of taking care of him' but, for pete's sake, it was her job and she knew that he needed more care than she could provide when she was home. He almost burned the house down a couple times. I am so sorry. It is easy to say things like "never" or "won't" or "must" or "always" when you haven't actually had to face any of those situations. And things like that are always nuanced! My friend moved her mom into a home at a relatively young age. Her mom has early onset Alzheimer's disease. What a relief it was to her mom! She loves it there and her stress level has dropped considerably. Plus, my friend knows her mom is safe. To much of the world her mom looked ok, but she knew and my friend knew that it was really, really hard for her mom to function. 3 Quote Link to comment Share on other sites More sharing options...
Garga Posted June 25, 2015 Share Posted June 25, 2015 They just don't know. They think they know, but they don't. In an ideal world, their way would be wonderful. But real life often steps in and messes up our ideal world. The older I get the more I realize that the things I think I know now are always subject to change. There's always more to the story, there's always more to learn. 10 Quote Link to comment Share on other sites More sharing options...
EmseB Posted June 25, 2015 Share Posted June 25, 2015 I think a big part of the problem is that living with a family member is great, until it isn't tenable anymore. Then you end up with a crisis situation where the person has to be moved quickly, possibly against their will, and maybe against the will of someone who is doing their very best to be the primary caretaker. And if the person had moved to assisted living/nursing care 10 or even 5 years ago, the situation wouldn't suck nearly as much as it does now that it's become acute. Hindsight can really suck sometimes. 5 Quote Link to comment Share on other sites More sharing options...
elegantlion Posted June 25, 2015 Share Posted June 25, 2015 My mom is currently caring for my aging father. He has the very beginning of Alzheimers and some physical issues that require aid but not constant care. She has a line in her mind of when the time for alternate arrangements need to be made. Part of the discussion is financial as well. My dad enjoys being in his own home and generally just watches TV anyway even before these issues began. He's not social and likes the privacy of being in his own home. I think the nursing home discussion can be colored by perception and family culture. I also think it's a part of the pre-grieving stage. Some people take time to recognize that their loved one is no longer the capable person they once were. My mom takes this on as part of the vow she made in "for better or for worse," and she's not doing anything she is not physically capable of doing. She would never assume I'd take on the role as caregiver if something happened to her, however. 2 Quote Link to comment Share on other sites More sharing options...
solascriptura Posted June 25, 2015 Share Posted June 25, 2015 I am worried about this as well. My husband's side has a history of poor health and I just know that I cannot care for my husband if he becomes bed ridden. He is over a foot taller and weighs 80 lbs more than me. How could I ever expect to lift him or physically care for him? Aging sucks and people continue to live longer and not often with excellent health. Is that a good quality of life? 1 Quote Link to comment Share on other sites More sharing options...
fairfarmhand Posted June 25, 2015 Author Share Posted June 25, 2015 I just hope that people who use the words "never" and "unthinkable" don't say these things to their elderly relatives. It would be quite a betrayal when the person HAS to put them in a home. 6 Quote Link to comment Share on other sites More sharing options...
fairfarmhand Posted June 25, 2015 Author Share Posted June 25, 2015 It is so much more difficult. My mom was a geriatric nurse and at some point even she had to make the decision to move my grandfather into a nursing home. He lived with us for years, longer than he really should have, because of family pressure that of course she could take care of him. But, it finally got to be not safe for him and not safe for us. I am certain that some in the family thought she was just 'sick of taking care of him' but, for pete's sake, it was her job and she knew that he needed more care than she could provide when she was home. He almost burned the house down a couple times. And you know what? "I'm tired" is a valid reason. You can't do 24/7 for years on end and not be tired. It's utterly draining. I mean, no life, no help, not even the ability to stay in bed and rest when you have a cold. And there's nothing wrong with saying, "I'm not emotionally strong enough to handle this." Everyone has a limit. Different people have different strengths. 9 Quote Link to comment Share on other sites More sharing options...
idnib Posted June 25, 2015 Share Posted June 25, 2015 I come from a culture in which nursing homes don't even exist, but extended families live together and everyone takes care of the infirm. Plus labor is cheap so it's not expensive to have someone come in and take care of the house cleaning and cooking, which takes a huge load off. When my grandparents were dying, their care was divided over maybe 8-10 people, with people of the same sex doing the bathing, the women doing most of the cooking and sitting/keeping company, and the men doing the heavy lifting. Having one or two people in our society take it on is very difficult. :grouphug: 8 Quote Link to comment Share on other sites More sharing options...
Woodhaven Posted June 25, 2015 Share Posted June 25, 2015 I think it depends on circumstances. If I couldn't give the care my family member needed, I would, of course let them go to a nursing facility. A bed ridden person would be difficult to care for, without question. It's important for a person to receive the best care possible. But I would visit often and speak with doctors and staff very frequently, following up on everything. My family has had personal experience with very poor care in nursing homes, so that colors our decisions. Just one experience: My mom was in a nursing home while she was recovering from a medically induced coma she had been in for a month. She was mentally alert, but physically incapable of anything until after rehab. Her doctor said that even though she was in one of the best nursing homes it was very important to visit her often and make sure the staff know her family is checking on her. My brother was able to visit her every day and sometimes walked in on things that shouldn't have been happening. Because of his intervention and the support of one of her doctors, a few staff members were fired. (People taking care of her would mock her openly and use foul language while laughing at her state of helplessness!) She was badly bruised while in their care too! At present my MIL lives with us. FIL lived with us until his death a year and half ago. He died in the hospital with pneumonia. He was 90, she is now 87. She is still pretty independent, but just can't be left alone. That's different from someone who needs medical intervention around the clock, though. We know she is much happier here than she would be in a nursing home. 1 Quote Link to comment Share on other sites More sharing options...
Princess Ariel Posted June 25, 2015 Share Posted June 25, 2015 I also think people don't realize that sometimes there are waiting lists to get into facilities for the elderly. When a crisis arises, one cannot always get a place and that can be very difficult to deal with. And having someone in a nursing home doesn't mean everything is taken care of. There are still doctor's appointments at other locations and that can take quite a bit of coordination. It would also be nice if we would have these discussions with our children before we get to a certain point in our lives and see what would be realistic for the future, for both parents and children. I have talked to my children about what I would be okay with in the future and we understand where each one is coming from. 2 Quote Link to comment Share on other sites More sharing options...
eternalsummer Posted June 25, 2015 Share Posted June 25, 2015 Surely there are some circumstances where constant medical care is needed. Bathing someone is not medical care. CNAs bathe old people in nursing homes. They are not any stronger or more trained than you or me, and they are generally paid to be honest terrible wages for what is a very hard job. http://cnatraininghelp.com/cna-skills/giving-a-partial-bath/ (that's for the bathing situation) 1 Quote Link to comment Share on other sites More sharing options...
Storygirl Posted June 25, 2015 Share Posted June 25, 2015 These are hard decisions. My grandmother, who had Alzheimer's, lived with us for many years while I was a teenager. My mom worked, and my sister and I helped a lot with Grandma's care. She lived with us until the end and did not go into a nursing home, although my grandfather, who was paralyzed on one side from a stroke, was in a full-time facility. Now my mom, who has Alzheimer's, has been in a nursing home for three and a half years. She lived with me for most of a year right before she entered the nursing home, and it was extremely difficult. I didn't have family nearby to help or give me any respite relief. When I could no longer take her with me when I left the house, and hiring in-home help was not a good option, I resigned myself to placing her in the nursing home, even though it was not what I wanted for her. No one else in my family would take her, and my elderly father was not able to give her the care she needed. I think about what I want for myself in later years. Alzheimer's is a real possibility, given my family history. There are benefits and drawbacks to both in-home and nursing home care, and each family has to decide for themselves what the best options are. But no one can tell someone else that they must care for an elderly family member themselves. My brother was very upset that my dad did not do more to care for my mom. The truth is that Dad did not know how to look after someone else. My mom did 95% of the parenting when we were young, and he really only had to care for himself for most of his life. To ask him to change when he was almost eighty was expecting too much. Asking anyone to take on elder-care when they are not completely committed to the burdens involved is unfair. I know it is possible to care for some infirm family members at home, because we did do that. But it is extremely hard on many levels. People don't really understand what it is like until they are living it themselves. It is fine for someone to decide that they will take on the care of a family member themselves. It's not okay to tell others that they must do so. It's good and right for the primary caregiver to ask other family members to help in ways that they are able and to give the primary caretaker needed breaks. It is also okay to change directions and seek nursing home care if in-home care does not work the way that was planned. Honestly, I hate that my mom is in a nursing home. I wanted to keep her in my home. I would have continued to do so if I had had the support and help of nearby family members. I gave her good care and more attention than she gets in now, but it took a toll on me and my husband. I think it's good for family members who feel this way to explore the ways that they can make it work. But sometimes nursing care ends up being the choice that works best for the family as a whole. 8 Quote Link to comment Share on other sites More sharing options...
JumpyTheFrog Posted June 25, 2015 Share Posted June 25, 2015 Bathing someone is not medical care. CNAs bathe old people in nursing homes. They are not any stronger or more trained than you or me They are stronger than an elderly woman who needs a cane herself and can't help her overweight husband move around. It sounds like both child care and elder care are extra draining in our society because extended families don't live together. So then women (much more than men) wind up trying to care for their parents and in-laws, often while still working themselves and/or having minor kids of their own to take care of. And now that families are smaller, they may only have one sibling to help. 1 Quote Link to comment Share on other sites More sharing options...
dirty ethel rackham Posted June 25, 2015 Share Posted June 25, 2015 Oh, I hear you. With my mom, I would love to have had her come live with me, but our home is not really set up to have an elderly person living here - it is a split level and there are no bathrooms on the main level - must go up or down a half-flight of stairs. Plus, we don't have a spare bedroom and I needed our family room for my business as well as school. When she could no longer live on her own (even with help), she went to a senior living community that had apartments, assisted living in the apartments, and skilled nursing care in a separate unit in the building. Towards the end, she needed skilled nursing care. We are facing this with my FIL, who is 87 and has a failing heart. He can no longer be left alone as he is a serious fall risk (he has bruises and lacerations from his last fall in the middle of the night when dh was there.) They are looking into a procedure for his heart. If he is not eligible, he will have to move to a nursing home. In the meantime, we have home health care coming in daily for either nursing checks or PT. However, that is only for about an hour. Dh and his siblings, plus FIL's girlfriend have been alternating care so that he is never alone. DSIL is taking family leave in order to take care of him until we can get things worked out. 1 Quote Link to comment Share on other sites More sharing options...
MotherGoose Posted June 25, 2015 Share Posted June 25, 2015 It is very difficult. My dh grandmother was infirm for a number of years and manipulated MIL into promising never to put her in a home, partially because her own mother was never in a home and she didn't think it was right. Great grandmom had 10 living children, all of whom lived nearby. And she died at a much younger age than grandmom did. So MIL was, in her 50s with back trouble, lifting and bathing and doing all of that stuff alone. Her 2 siblings wouldn't help. She couldn't even leave her to go to the grocery store alone, and grandmom didn't want a sitter. Yes, you can't leave an infant alone either, but they are portable, and you know that eventually they will learn to walk, etc. Grandmom used the guilt of "I took care of you!!" You have hopes of things getting better. And you can bathe/ lift/ feed them without undue strain on your own body. I do not want to put an unfair burden on my own children when I am aged, no matter how much I might dislike the idea of a nursing home. 2 Quote Link to comment Share on other sites More sharing options...
Guest Posted June 25, 2015 Share Posted June 25, 2015 My dad got to the point where my mom and sister could not take care of him. He was kind of *relieved* to be moved into a nursing home...they could get him the pain meds he needed; they could move him and help him to the bathroom; they could take care of the round-the-clock dosing schedules. About June 10, he fell, and my 92yo mother tried to help him get up, but he was too weak to help. In the process my mom injured her back and is now in pretty severe pain and has to go to physical therapy. My sister has a 9-5 job (and has to have that job) and could no longer keep getting up three times a night to help Dad. My dad went to the hospital for 5 days, and then to a skilled nursing facility until his death on June 22, shortly after Father'sDay. (Memory eternal.) There is no way he could have returned home...and I am darned sure he didn't want to. He knew he needed more than could be given at home, no matter how much his family loved him. It wasn't entirely about HIS care--some of it was about keeping care of my mom and sister. But ALL were definitely better off with the skilled nursing situation. For my sister and mom to keep him at home rather than "dumping him in a nursing home" would have been cruel to all involved. Quote Link to comment Share on other sites More sharing options...
TranquilMind Posted June 25, 2015 Share Posted June 25, 2015 I come from a culture in which nursing homes don't even exist, but extended families live together and everyone takes care of the infirm. Plus labor is cheap so it's not expensive to have someone come in and take care of the house cleaning and cooking, which takes a huge load off. When my grandparents were dying, their care was divided over maybe 8-10 people, with people of the same sex doing the bathing, the women doing most of the cooking and sitting/keeping company, and the men doing the heavy lifting. Having one or two people in our society take it on is very difficult. :grouphug: This is the way it should be. I had to do it mostly alone, but my husband helped. I'm glad I did this for her, and I would do it again, even though it wasn't easy with very young children. I do understand that there are times when it is dangerous to take care of someone, as when the person is violent. I can also see being physically unable to do some jobs, in the case where the person is large and/or immobile. But if families pulled together, a lot more could be done to take care of older people than is currently being done in this society, I believe. 4 Quote Link to comment Share on other sites More sharing options...
Catherine Posted June 26, 2015 Share Posted June 26, 2015 The real problem here is that people feel so entitled to judge the choices of others. What a different world we would have if people just minded their own business. 3 Quote Link to comment Share on other sites More sharing options...
Katy Posted June 27, 2015 Share Posted June 27, 2015 I mostly agree with you. After college the economy changed and I decided to go back to school for nursing. I mostly paid for that by working in nursing homes until I had enough education to work in hospitals. Some of that was temping, so I was at a lot of different facilities, with very different management philosophies at each. Some of them were in it for the money, and some for the love. It is complex, and even though I definitely have the skills to "lift 150 pounds of dead weight" and other things, even if you know how to do so it is not always the best choice to keep them at home. We've made it clear to our parents that they can live with us as they age if they want, UNLESS they have a serious medical condition or dementia, in which case they'll go to a 24/7 facility where they won't be in danger to themselves or anyone else. An actual, licensed facility with an RN on staff 24/7, licensed CNA's, and a locked dementia ward with access to a closed courtyard exterior, NOT an "assisted living facility" with no oversight. I will say that if you're in a good, stable facility without a lot of turnover (if the CNA's have generally worked there for 5-10 years without becoming nurses), those aides develop relationships with the residents and they really will do their very best to care for them well. And it's the aides who do most of the care. Unless it's a crisis of 15 call lights at once, or a death or the facility is understaffed, nurses are generally passing pills and doing paperwork, not caring for people one on one. An easy barometer of quality is asking the starting pay and the average pay of their CNA's. If they have an unusually high starting pay and the average pay is less than a dollar per hour more, it means it's a terrible facility and no one can stand to work there for long even IF they pay more. If they pay more overall and have a higher average, they attract quality people that stay there, and they pay to keep them. If staffing levels are low, or if you're in an area where there's only one or two nursing homes in the county and you don't like either of them and you really feel your family member is being neglected in some way, I have temped at a couple awful facilities where I learned that those residents whose family members show up at different, unpredictable times of the day, and who make a fuss if anything goes wrong get better care than those whose families don't show up, or who show up at predictable times. I think what can be ideal is either a VERY BIG facility that starts with assisted living condos with independent people and tons of activities, but which also has regular nursing care and a dementia ward on the same site (People will get exactly the balance of activities and care that they need) OR a tiny facility that only has three halls and everyone really becomes family to the staff, because they get more personal care. 2 Quote Link to comment Share on other sites More sharing options...
Halftime Hope Posted June 27, 2015 Share Posted June 27, 2015 I just hope that people who use the words "never" and "unthinkable" don't say these things to their elderly relatives. It would be quite a betrayal when the person HAS to put them in a home. This! I've had to caution a caregiver friend not to use going to a nursing home as a threat to elicit compliance from the elder. What will happen if the caregiver *does* need to seek out institutional care for the elder, how in the world could the elder see that as a positive thing if it has been used as a threat?!? Quote Link to comment Share on other sites More sharing options...
G5052 Posted June 27, 2015 Share Posted June 27, 2015 I will say that if you're in a good, stable facility without a lot of turnover (if the CNA's have generally worked there for 5-10 years without becoming nurses), those aides develop relationships with the residents and they really will do their very best to care for them well. And it's the aides who do most of the care. Unless it's a crisis of 15 call lights at once, or a death or the facility is understaffed, nurses are generally passing pills and doing paperwork, not caring for people one on one. An easy barometer of quality is asking the starting pay and the average pay of their CNA's. If they have an unusually high starting pay and the average pay is less than a dollar per hour more, it means it's a terrible facility and no one can stand to work there for long even IF they pay more. If they pay more overall and have a higher average, they attract quality people that stay there, and they pay to keep them. If staffing levels are low, or if you're in an area where there's only one or two nursing homes in the county and you don't like either of them and you really feel your family member is being neglected in some way, I have temped at a couple awful facilities where I learned that those residents whose family members show up at different, unpredictable times of the day, and who make a fuss if anything goes wrong get better care than those whose families don't show up, or who show up at predictable times. I think what can be ideal is either a VERY BIG facility that starts with assisted living condos with independent people and tons of activities, but which also has regular nursing care and a dementia ward on the same site (People will get exactly the balance of activities and care that they need) OR a tiny facility that only has three halls and everyone really becomes family to the staff, because they get more personal care. My mother was in a fairly small (50 residents) assisted living building with a dementia floor. Both of the directors we dealt with were very experienced and professional. They truly loved their work, and the staff loved them. My father was in the nursing home next door for several months (owned by the same people), and he also received excellent care. I still have older relatives in that area, and would look seriously at that faculty if they needed it, although they've told me that they want live-in care first. They have the property to do that and can afford it. The primary CNA that took care of my mother in in the dementia unit had been doing that type of work for 30 years. She figured out exactly how to handle her and taught the rest of the staff. I had a long conversation with her after my mother died and was in awe of her skills and attitude. 1 Quote Link to comment Share on other sites More sharing options...
Carrie12345 Posted June 27, 2015 Share Posted June 27, 2015 Personally, I hate that so many people won't discuss/plan these things in advance. My mother, currently just in her early 60s, won't think about, let alone talk about, what she wants in her later years. My sisters won't talk about what we can/will/hope to do when Mom's older. So I've pretty much told them all they can expect to keep quiet and go along with whatever *I* decide if they care so little. :001_cool: Quote Link to comment Share on other sites More sharing options...
TranquilMind Posted June 27, 2015 Share Posted June 27, 2015 I mostly agree with you. After college the economy changed and I decided to go back to school for nursing. I mostly paid for that by working in nursing homes until I had enough education to work in hospitals. Some of that was temping, so I was at a lot of different facilities, with very different management philosophies at each. Some of them were in it for the money, and some for the love. It is complex, and even though I definitely have the skills to "lift 150 pounds of dead weight" and other things, even if you know how to do so it is not always the best choice to keep them at home. We've made it clear to our parents that they can live with us as they age if they want, UNLESS they have a serious medical condition or dementia, in which case they'll go to a 24/7 facility where they won't be in danger to themselves or anyone else. An actual, licensed facility with an RN on staff 24/7, licensed CNA's, and a locked dementia ward with access to a closed courtyard exterior, NOT an "assisted living facility" with no oversight. I will say that if you're in a good, stable facility without a lot of turnover (if the CNA's have generally worked there for 5-10 years without becoming nurses), those aides develop relationships with the residents and they really will do their very best to care for them well. And it's the aides who do most of the care. Unless it's a crisis of 15 call lights at once, or a death or the facility is understaffed, nurses are generally passing pills and doing paperwork, not caring for people one on one. An easy barometer of quality is asking the starting pay and the average pay of their CNA's. If they have an unusually high starting pay and the average pay is less than a dollar per hour more, it means it's a terrible facility and no one can stand to work there for long even IF they pay more. If they pay more overall and have a higher average, they attract quality people that stay there, and they pay to keep them. If staffing levels are low, or if you're in an area where there's only one or two nursing homes in the county and you don't like either of them and you really feel your family member is being neglected in some way, I have temped at a couple awful facilities where I learned that those residents whose family members show up at different, unpredictable times of the day, and who make a fuss if anything goes wrong get better care than those whose families don't show up, or who show up at predictable times. I think what can be ideal is either a VERY BIG facility that starts with assisted living condos with independent people and tons of activities, but which also has regular nursing care and a dementia ward on the same site (People will get exactly the balance of activities and care that they need) OR a tiny facility that only has three halls and everyone really becomes family to the staff, because they get more personal care. I can see the bolded really hindering conversation with your mother. If you were my daughter, I'd never admit anything to you, under threat of being thrown in a locked dementia ward! Geez. My aging mom and her friends had a running joke with each other when one did something silly or forgetful, "Don't tell the kids!" I remember them saying this many times. It was just a joke, because they all had great relationships with their kids and a high level of trust, but they knew others who did not enjoy that position. All of them ended up staying in their own homes to the ends of their lives, but one moved briefly into a facilty, upon the doctor's erroneous declaration that she had Alzheimer's. She didn't. She moved back out and into a condo with her kids' help. Having already done this caregiver job myself, and with first-hand knowledge, I can tell you that I wouldn't have blamed myself a bit if something accidentally happened. I did the best I could and kept her in her longtime home where she wanted to be , with lovely older caregivers who were more like friends (after she lived with me for awhile with my full time care). My mom mentioned an uncle or someone long ago who used to wander away and they always just went to find him. My mom wasn't never a wanderer at all, but had she been, I still wouldn't have put her in a locked ward somewhere. Everyone is going to die somehow. If she had died by wandering instead of from being locked in a room in a facility, oh well. Quote Link to comment Share on other sites More sharing options...
TranquilMind Posted June 27, 2015 Share Posted June 27, 2015 Personally, I hate that so many people won't discuss/plan these things in advance. My mother, currently just in her early 60s, won't think about, let alone talk about, what she wants in her later years. My sisters won't talk about what we can/will/hope to do when Mom's older. So I've pretty much told them all they can expect to keep quiet and go along with whatever *I* decide if they care so little. :001_cool: Why does she have to talk about it before it is an issue? I would think one would know a parent well enough to know what her wishes would be. If you don't know, just ask in general, conversational terms, "Hey, mom.... (could start out about having seen this movie, or something) if you needed some help, would you let me hire a lady to come in here and help you out a bit, you know, when you are much older?" Would you prefer to live in your home, with one of us, or what? Just think it's a good idea if we all know." Gee, my kids already know what music I want at my funeral! I've lost my entire family, and been to dozens of funerals, so it's no big deal. They also know I WILL stay in my own home and anyone who tries to change that will have to do it by getting an order of guardianship against my will. Won't happen, unless I was unable to address it, in which case, it probably wouldn't become an issue. Quote Link to comment Share on other sites More sharing options...
Carrie12345 Posted June 27, 2015 Share Posted June 27, 2015 Why does she have to talk about it before it is an issue? I would think one would know a parent well enough to know what her wishes would be. If you don't know, just ask in general, conversational terms, "Hey, mom.... (could start out about having seen this movie, or something) if you needed some help, would you let me hire a lady to come in here and help you out a bit, you know, when you are much older?" Would you prefer to live in your home, with one of us, or what? Just think it's a good idea if we all know." Gee, my kids already know what music I want at my funeral! I've lost my entire family, and been to dozens of funerals, so it's no big deal. They also know I WILL stay in my own home and anyone who tries to change that will have to do it by getting an order of guardianship against my will. Won't happen, unless I was unable to address it, in which case, it probably wouldn't become an issue. Why? To avoid all the arguing people do when the time comes for people who haven't expressed wishes, made plans, and are now scared. I don't get your second paragraph. That would involve thinking about and talking about the issue. My family refuses to do that. That was, like, my entire point! Quote Link to comment Share on other sites More sharing options...
Katy Posted June 27, 2015 Share Posted June 27, 2015 I can see the bolded really hindering conversation with your mother. If you were my daughter, I'd never admit anything to you, under threat of being thrown in a locked dementia ward! Geez. ... Since my great grandmother nearly burned the house down three times by forgetting a pan on the stove when she'd had Alzheimer's, I think everyone in the family is realistic about when it's truly safer for everyone to be in a locked ward, where you can safely wander. Wandering is a stage of the dementia process. It would be nice if we could all do like that Dutch place that created a village for those with Alzheimer's, but that probably won't be availible everywhere in the next 30 years. http://www.theatlantic.com/health/archive/2014/11/the-dutch-village-where-everyone-has-dementia/382195/ ETA: Also, having seen plenty of people in the upper midwest who weren't in locked units, and who wandered, got lost, and then needlessly died of dehydration or exposure, there is NO WAY I think that is a humane way to "let someone die." It is needlessly cruel and horrible. 1 Quote Link to comment Share on other sites More sharing options...
Orthodox6 Posted June 27, 2015 Share Posted June 27, 2015 nm Quote Link to comment Share on other sites More sharing options...
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