Have you ever had to put a loved one in a nursing home?

[Alexandra]

Sometimes I wonder how folks arrive at the decision to put a loved one in a nursing home. It seems like a really hard decision because how really do you determine "now is the time"? It is not like it is a glucose test or a cholesterol screening and over such and such number you need to get help. What makes people decide to do this?

I would love to hear from people who have done this or who have some thoughts on this very difficult and painful subject. What event or behavior was the determing factor in your family member's case. At the time were you being proactive or reactive? Do you mind sharing?

I ask because I will be making this decision in 2008 (pretty sure).

Thank you.

[Doran]

We, my brothers and I, are grappling with the prospect of when and whether to move my 83 year old father into a home. He has Alzheimer's/dementia, COPD, and various other health issues. This is not a choice we will make easily nor take lightly, as I imagine is the case with many who walk this path. For us, what makes it especially difficult is that we know my father does not wish to go. He has a fear of nursing homes (his mother spent her last years in one) and has told us so many times in so many words.

 

Unfortunately, his mental and physical deterioration are such that my mother, who is his primary (though not his only) caregiver, is jeopardizing her own health trying to care for him. My parents cannot afford full time home nursing help, even though they have two women who *would* do that for them if they were able to go that route. Not to mention a lack of room space in their small condo to provide any sleeping quarters for said help. My brother and his wife, who live nearby and who are also very active in my father's (and mother's) care, are not willing to have my parents live with them - a position I fully respect inspite of the fact that I might make a different choice if I lived nearer. Opening your own home is a wonderful gift to offer a family member, but not everyone is willing or able to make the sacrifices needed to do so.

 

I think, for us, it will come down to determining at what point my father's wishes to stay home are in direct opposition to us needing to salvage my mother's health simultaneously, for she is not ready nor willing to move to a home herself. It will be a heart wrenching decision and one for which I may always feel guilty. It tears me up even to think of it now.

 

I'm so sorry you're having to face this.

 

Doran

[cin]

With my mother it was determined by her physical condtion...when she broke her hip. Then her heart failed and she needed IV meds so it was a no-brainer, thank goodness, because she would have fought it tooth and nail.

 

My MIL has Alzheimer's and we are moving her to assisted living in the fall. She is not really willing, but she knows that she HAS to do it; she knows what is to come, so she will go. We have come to this decision because there have been 2 'incidents' with the stove (the details are fuzzy) and over the summer she wrecked her car an amazing number of times (I've lost count). We have to set up her meds every week, and even still, it gets mis-taken. DH point blank told her that it is to be done, and part of it is for HIS peace of mind. Nurses to help with meds, sprinkler systems, 24 hr assistance for any problems, security, and transportation, just to name a few. An easy decision? Nope. Will we feel better when it's done? Oh yeah. And as DH has put it...she won't know the difference in another year or 2....Men!!!!:rolleyes:

[Whisperlily]

I don't have any personal experience, but I feel for you. I hope you get some good advice here.

[linders]

My dear FIL stayed in his house, down the street from us, as long as possible. In 2 short years he went from living independently to needing a little help (light housekeeping/cooking) to 24-hour care (dressing, bathing, incontinence). He went from being a gruff but fairly mannerly person to someone prone to abusive outbursts - I stopped taking my young DSs for our daily visits. At the end, he was violent whenever he needed bathing or medication, and he actually injured a caregiver. That pretty much necessitated a nursing home.

 

It is never, ever, an easy decision. My heart goes out to you.

 

Linders

[kalanamak]

and my mother just couldn't care for him any more. He had a choice of my sister's house with 24 hour nursing care, my house with 8 hour nursing care, or this place, which was near 2 sons he was very close to, and used to living around. He chose to stay near them, which was probably for the best, and had a wonderful time at a place that looked like a cruise ship inside, with "richer" meals than my mother cooked. He learned all the nice ladies names ("Beth, Beth with the hair clips" and "The twins"...both had Swedish names although one was blonde and the other straight from Africa), counted the number of step to the turn for the elevator, and had a muscly man bathe him, which he loved. He died in two months (stroke).

 

I would be realistic about finances, and start picking the best one they can afford NOW, so that when you NEED one, you won't be at the bottom of the waiting list. Bad places are awful, just awful.

[Amy in Orlando]

We've been in the situation with dh's grandmother. While she lived at home we were her pirmary helpers and that worked for several years. Finally, at 90, she was too frail (three strokes) to be home alone so much of the time. The ultimate decision was up to her grandkids (dh was a step grandchild) and they moved her to a nursing home in Georgia. It was absolutely heartbreaking, but her family really didn't see another choice.

 

I wish you luck in making a decision and finding peace with it.

[Sandy in Indy]

Our family came very close to having to put dad in a nursing home. (He died before we actually moved him from the hospital.) Dad was too ill for Mom to take care of alone and not sick enough to be hospitalized--and he had Alzheimers on top of his medical problems.

 

It was soooooooo hard to tour nursing homes with the idea that we were going to place Dad in one of them. It just wasn't something we wanted... My sister and I went with Mom to look at three places. We all thought one of them was much more suitable than the others, even though it would have been a longer drive for Mom.

 

I think some of us have the idea that family should take care of family. And that is true to an extent. I don't understand placing a loved one in a home for convenience. But I do believe that circumstances can dictate the **necessity** of a nursing home. And if you've come to that point, I think you have to ditch the guilt and see that this solution is the one that really is the best.

 

As someone else mentioned, love them. Visit often. Don't beat yourself up.

[Ellie]

My mil was in assisted living for the last 13 or 14 years of her life. She would have died otherwise because of her health issues. As it was, she really did like the place she lived and was content.

[sdWTMer]

Oh the idea of that just seems like a heart-wrenching one to make. My dad's health has recently been downgraded so I worry about him. My 3 other siblings all live in the same town, but they all work and have tremendously busy schedules; I am the only 1 who is home all day (but I do live in CA and they live in TX), except for running the boys around. The only glitch is if I bring my parents here, then I will be doing it on my own. That's a frightening concept.

 

I just can't imagine putting my parents in one, but sometimes I think that you really have no other alternative.

[Sugarfoot]

it's a terribly difficult decision. With my grandfather, we did assisted living first. His health issues were heavy enough to need full-time care, yet he could still enjoy social activities, meals in a dining room, field trips, etc. He lived in this situation for a couple of years and was right down the street from us. His health declined suddenly and rapidly, and was moved to a nursing home. He didn't live long there. I'm thankful for the "in-between" place that allowed him to have his own life, so to speak, while still having 24-hour, "low-tech" care. (not intensive medically-specialized care) Depending on your situation, I think it's helpful to look at the different levels of "assistance" available. Sometimes, you don't have to go "all the way" to the nursing home level right away.

[Amy loves Bud]

We had to make the decision to place my dad in a nursing home when he was 80. He had had several hemorrhagic strokes over the previous two years, was developing dementia as a result of the strokes, and was physically very weak. When my mom was diagnosed with lung cancer that year and required the removal of most of her left lung, we knew that she couldn't recover from surgery and go through chemo while caring for dad.

 

Really, my mom's illness made the decision an easy one to make (not that it was easy, but you know what I mean). I have wondered what we would have done had she not been ill. Dad was getting to be tough to care for anyway, but I'm sure it would have stretched out a lot longer had Mom not been sick.

 

I'm sorry you have to face this. It is not a happy thing to deal with.

[Laura Corin]

My parents-in-law were living together in an apartment and my FIL started to have falls and lose mobility (going to the bathroom, getting in and out of bed). He developed Parkinson's, which was not fully controlled by drugs, and a slew of other problems (on top of obesity and muscle weakness from no exercise in the last sixty years). My MIL kept trying to help him and hurting herself. For a while they had nursing care at home, but that still left the worry on my MIL - she was losing weight and damaging her health.

 

In the end, it was for my MIL's sake that my FIL was put into a nursing care room and my MIL into an apartment in the same complex. It's been very hard, but was the right decision.

 

Best wishes

 

Laura

[Nancy in MI]

He has Alzheimer's and my mil is a parapalegic. He was recently evaluated (something the doctors do at regular intervals) and has finally reached the point where he needs care around the clock. Unfortunately, my mil is not able to handle it because she has been in and out of the hospital with an infection and had to go again last night.

 

She said it was the hardest decision she has ever had to make. I know she feels bad because he took care of her so faithfully after her car accident 20+ years ago, and now she is unable to take care of him in return.

 

She has delayed making a decision, but this latest development forced her into making a decision. It may not be permanent, but it will be for quite some time until she can get well enough to go home and handle everything.

 

It's been very sad watching this all unfold. Fortunately, dh and his 2 sisters are level-headed and are all on the same page. However, they are not overly close so they don't really lean on each other for emotional support. But, hey, that's what I'm here for, right? ;)

 

Nancy

[Mrs. Readsalot]

My grandfather because of cancer of the throat, he need special care and my grandmother couldn't/wouldn't do it. When he went into the nursing home my grandmother wouldn't stay alone in the apartment so she went to live with my mother and brother (my brother had a terminal illness at the time although he was doing fairly well but was difficult to live with) My grandmother and brother did not get along well living under the same roof. Not long after grandmother went to live there she fell and broke her hip and ended up in the same nursing home with my grandfather. I was living 4 hours away at the time and received all details second hand. My grandfather died after being in the nursing home for 2 years. He was 95 years old and would have prefered to died when first diagnosed. He had had a wonderful and full life. It still breaks my heart to think about his last two years. Grandmother lived in the nursing home for 10 year in total and loved it. She made friends, which she had never done before. She didn't have to cook, which she hated to do. Considering the fight she put up against going in a nursing home it is amazing she loved it so much. It's just strange how things work out.

Then there was my brother. He fought going into a nursing home tooth and nail. He was angry about his illness the entire 10 years he had it. He made everyone around him miserable. I would get calls in the middle of the night from him saying our mother was trying to kill him. I even had to get the police involved once. I call this the nightmare period of my life. Don't get me wrong I had compassion for the fact that he was sick, but honestly he had a death mentality (I won't get into that here) The first nursing home we but him in he was so miserable to the staff they literally kicked him out (didn't know they could do that) He wanted to be at home. At times when we were in the middle of this I felt like I was living in a fog. I went up to help as much as I could. We finally found a nursing home he would accept being in ( we looked at over 10 with him) He was in the nusing home for 2 weeks before he died.

Over my years of visiting the nursing home (mainly to see my grandmother) I saw many lovely elderly patients with alzheimers. They family would visit and all said it was really for the best when they decided to place grandma/grandpa in the nursing home. They knew their loved one was safe and well cared for and they need their wfie of husband would maintain a quality of life not having to be the primary caregiver. I think they made a wonderful decision. I say this because my MIL cared for her ailing husband(he was ill for 7 years) until his last days (he spent his last 3 days in a hospice) The last year of my FIL care was especially draining (again lots of trips up they were 3 hours away in a different direction) lots of mental and physical stress But as we look back the biggest thing was that it ended up defining my MIL's life When my FIL was gone she didn't know what to do . It was as if she had forgotten how to live. It wasn't grief either because she didn't really like him very much. The situation with my FIL started near the end of my brothers life and contiuned for 7 years. Basically for the entire 18 years dh and I have been marriage we have had to deal with this type of thing in our families. It has been very difficult. My FIL has been gone for 2 years and we have been responsibile for MIL during that time. She lives near us and is dependent on us. She doesn't drive and has had 4 surgeries since she has lived near us. She has recently been diagnosed with diabeties and has broken a rib and sprained her knee. So once again we are starting to decide whether she should be living on her own. I will be honest I am so tired of having to think about these decisions. I know that sounds selfish but I am being honest. It has made my dh physically ill. I know this has gotten very long, I just wanted you to know that you at not the only one dealing with such difficult decisions. It is so hard on everyone involved and can make you emotionally and physically ill. I find prayer helpful and talking with others that are facing the same thing. I think the biggest hidden aspect of this is guilt over should I being caring for my loved one myself. People don't tend to talk about this. Your mom may be feeling it. How do you make her feel better without bringing it up. She support and love her and understand that she can't do it herself. Be very understanding with her. THis will help a lot.

Well not sure it I was of any help. Please feel free to PM me if you want to.

I really feel for you in this situation.

[Danestress]

My MIL just put her mother in a nursing home. Granny had refused to move away from her small, isolated town in order to live with either of her daughters (who were willing to have her). Eventually, MIL chose to pack all her belongings in long term storage and moved out there. A great sacrifice for her, and one she couldn't have made if she still had a living husband.

 

Now MIL has been there six years and Granny is 96 years old. She's very frail, has poor vision and poor hearing, and can not stand unassisted or walk. Her house was entirely unsuitable for a disabled person, but MIL "made due." She had a nurse to the home twice a week and a doctor who made house calls, and Granny was unable to leave the house for the last couple years. Very very frail. It was a terrible situation, and one we couldn't really help with because Granny lived a couple of thousand miles away.

 

So recently Granny had to go to the hospital with a foot sore that wouldn't heal, and MIL made the decision that that was the first step on the way to a nursing home. Granny had fallen twice and at MIL's age, she really didn't need to be trying to lift and care for her.

 

The thing that is so hard about it is that Granny really chose this. She had the chance to move close to her daughters (or in with either of them) years ago and refused. She was so stubbornly attached to where she was, which I understand, but she made, in my opinion, a dreadful mistake.

 

My parents started touring assisted living facilities a year or so ago. Neither of them at the time was in need of assisted living, but they were determined not to wait until they were helpless and then rely on me for care. So typical of them to be primarily worried about me.

[Harriet Vane]

My aunt has a brain tumor. She is in her early forties and is brain-damaged. Her husband was bound and determined to care for her AND their five children until the end, but his hand was forced when she started having frightening delusions. He couldn't get enough in-home care to cover all the hours needed, and with her delusions she represented a danger to all of them.

 

The decision to put her in care happened quickly because her situation had escalated so badly.

 

While it's not the best nursing home (it's a county home)--there are staff there who are caring individuals. My aunt has settled in well and actually really enjoys the variety of things there for her to do and the social life. There are volunteers who bring animals for the residents to cuddle. There are opportunities to take art classes or go out to Target. There are performances to watch.

 

The process was eye-opening for me, especially as it has been complicated by questions about my grandmother's care. She is senile, but still functioning. She refuses to go to a nursing home, and my relatives are in serious denial about her condition.

 

Another eye-opener has been the total contrast with dh's grandmother, who chose to go into a small private nursing home a number of years ago. It's a graduated living facility, and she *loves* it!!! The transition into the facility was peaceful--no stink of defeat, no resentments about "forcing" her there. Her experience reminds me in many ways of the fun I had living in a dorm in college! She enjoys eating with her friends in the dining room, which is set up to look and feel like a restaurant, and she really loves all the social activities. The home is near one of her daughters, who visits her several times a week.

 

I told dh I would eat beans for the rest of my life if it meant we could afford a better home than the one at which my aunt resides.

 

We are in the process of figuring out a way to save and/or set up our insurance so that we could have in-home care if needed. There is something in me that doesn't like the idea of "warehousing" the elderly. YET 24-hour care for someone who is in bad condition is SUCH a burden on the family. And, I cannot shake the sense that dh's grandmother doesn't feel "warehoused"--she genuinely enjoys her life at the nursing home. If either of us declines seriously (honestly, with my family history, I expect that I will!) then we want to be able to afford a graduated living facility near one of our children.

[T Baer]

(LTC or long term care) facility. Here are my thoughts.

 

A) Each facility is different, some offer specialized care as in a Dementia/Alzheimer's unit. There's the pro and con to this. There is a need for added security but does being in this type of unit increase their disease because they see and interact primarily with those that have the same disease?

 

B) Care is only as good as the staff that is giving the care. You can check this information by

1. Visit and observe with your eyes, ears and nose,

2. Ask about staff turnover rates, and regular staff training

3. Talk with other residents or their family member, and

look at their inspection record. The latter you should read about defiencies and not just look at the number of defiencies. This should be posted or available at the facility or you might be able to get a copy at the library.

4. Ask what is the ratio of CNA(Certified Nursing Assistance) to resident. The CNA is the one who see the resident and does most of the hands-on care. The federal or state requirements are minimum, but the facility that I worked out had more that what was required.

What is the "typical" routine for helping the resident getting up, dressed, bathing, giving their medication... for the week and the weekends. Staff is lower on the weekends.

 

C) How are non-nursing care treated? Is the facility favorable to including helping the residents to utilize:

1. Religious services and have the space, and ministers or lay people for this.

2. Out of the facility trips (social or medical) encouraged and/or provided. What about over night trips?

3. Activities programs with a variety to meet residents at different mental and physical levels

4. How are other medical needs handled (dental, mental health, vision care, physical or other theraphies)

D) Food Services, This a biggie! What does the food taste like esp if your loved one has special dietary needs. What is the menu on a weekly, monthly basis? The biggest complaint was food. I remember one lady telling me that, "if I eat another chicken, I will cackle". Granted some residents are on highly restricted diets and there isn't too much variety, but it's worth check on it. Also how often if at all can they have "special" meals on their birthday, Christmas and/or other Holidays.

 

5. How are Emergencies Handled? When would they call 911 and you?

 

6. Finances. Medicare and/or Medicaid available. Does the facility take care of this and if not will they help you? Also what services are provided in the Room and Board cost. What are the add-ons. What does the family need to provide toiletries, laundry care?

 

7. Private or Semi-private? Can personal items be used to decorate the rooms. How much space is available

 

I know there's more I could add here and there's lots of information out there. I think AARP might have information.

If you have specific questions, I might be able to answer. I have to say while it's been over 10 years since I worked there.

[Joanne]

Let's look at some realities.

 

People *are* living longer. In many ways, though, they are living longer with medical, physical and emotional challenges that don't kill them but do effect the level of care they need.

 

Life has gotten complex. Younger famlies are busier, geographically scattered, more likely to move for work.

 

The emerging need for adult day care, assisted living, and nursing homes is born of many complicated factors. The image of the oldest generation being in their own or a family home until they pass is nostalgic, but not realistic.

 

We made the decision to put my mom (now passed) into a nursing home as she was loosing her battle with lung cancer. The treatments and the disease combined made her need increasing care which my dad was unable to meet. The nursing home was, ostensibly, to provide therapy and build her strength but we all knew that it would be the end.

 

My dad did and still suffers tremendous guilt. We were fortunate that my BIL works (Dietary Manager) in the nursing home we put her into; we had insider info and on site accountability.

 

Since getting (re)married, we've struggled with aging parent issues. My FIL has been disabled for 30 years (with MS like symptoms) and in a wheelchair. He was ok until his wife died of lung cancer. The next 2 years in his home with a hired caregiver, things went downhill. The caregiver was "adequate" with him but did not care for the property, home and related issues (that were part of the contract). In east texas, we had limited pool of people to live on site and assist. We were 3 hours away; his other son was out of state and his grandchildren (who are all grown men) were scattered and in early adulthood, marriages, etc.

 

We moved him into what we thought was a good setting and were told, after an inperson evaluation, that they could help him at the independent living apartments. Turns out "they couldn't". We moved him into a nursing home for physical therapy, to build up the side that functions best. The physical therapy went great but the care and nursing side were a daily nightmare.

 

Finally, we found the assisted living he's in now. I'm alternately delighted and scared by it. Not so much the staff and facility (we are pleased) but by the situation in general.

 

We *could* have used the AL money to renovate my home to accomodate his needs (wheelchair bathroom, turn front room into his room, some other things) but decided not to.

 

We see him several times a week, the kids volunteer there. It's an imperfect solution to a very complex problem.

[Sunny]

It is a VERY hard decision.

My Grandmother broke her hip at 92. They would only release her to a "home" because she HAD to have someone available to help her because of her age. But, she hated it. It was very close to our home, we could walk there and so we did, daily, to visit. It was evident that once she was healed and walking, she didn't want to be there anymore, but in this time, all family realized she really wasn't capable of going back to her own home again. She had been functioning on routine and taking her out of that showed us how poor her memory really was.

I felt terrible and unable to deal with having her in a home. Big time. So, I moved her in with us. It was wonderful for our family for quite a while. She was helpful, and it was a blessing to have her around for our young children to see how we take care of the elderly.

But, by the year's end, she had lost her hearing and needed hearing aids, and everytime I attempted to help her get them in properly, I was sneared at, called names, and yelled at in front of my young children. She started demanding things, like being taken out daily to shop.

This caused me to decide that no longer was she a good example for my children, and that being antongonistic towards our family beliefs and practices was like having an enemy in the house.

It was still a hard decision, because I felt guilty, but it was the right decision. You can only help them to the extent they want to be helped.