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Should mom come home or go to assisted living?


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Old 03-02-2015, 10:10 AM   #1
rab19551
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Should mom come home or go to assisted living?

My mom has alzheimer's since 2009. She lives alone, close to 3 daughters. She doesn't take her meds, doesn't cook just eats pizza and drinks cokes. She went to the hospital last week by ambulance. Very confused, was very cold, didn't make sense when she talked. It took her several hours to come out of this. She is in rehab to get her meds straight and to eat right. She will be discharged tomorrow. She is now eating, making friends, taking her meds. She is happier than she has been in a long time. The sister who has POA wants her to come home with a caregiver that will come in for 2 hrs. in the morning and 2 hrs. in the evening. She will only be there for companionship, nothing else. No fixing of meals, no dispensing meds, etc. My sisters and I think this is the perfect time for assisted living. There are 2 places near us where she could go. They are very nice. Before the hospital visit last week, mom was very depressed, wasn't sleeping, and was very lonely. We don't know why our sister wants her to go home. It will be the same thing all over again with mom. This breaks our heart, we love mom so much.

 
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Old 03-02-2015, 02:06 PM   #2
cejayb
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Re: Should mom come home or go to assisted living?

I certainly cannot understand why you POA sister thinks that your mom should remain at home, especially when there are suitable places close by. Your mom needs company and full time care to ensure that she remains stable and you need the peace of mind of knowing that she is in a safe environment. Far better to take this step now than later when there is no option.

 
Old 03-02-2015, 11:41 PM   #3
Gabriel
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Re: Should mom come home or go to assisted living?

rab, there could be many reasons why your POA sister does not want Mom to go to assisted living. Have you ask her why? Is it because she thinks that Mom would be better at home? It is her own fear of denial that the disease has progressed to the point it has? Is it monetary concerns? Each has a different rebuttal. If you know why your POA sister thinks the way she does, you will then know what arguments to use to persuade her.

Problem is, with her having the POA, she is the one in control. I do agree with you. Since Mom has already had a difficult time at home alone and is doing so well in a facility, it would be a good time to make that change.

A few things that might help. Four hours a day sounds like a lot of assistance but that leaves 20 hours a day when Mom is on her own. Mom will not remember what she has been told in the rehab. They are feeding her prepared meals. There will be no one at home to prepare her meals. The problem is not with her ability to eat but with her ability to prepare her own meals. She was not taking her meds correctly before she went into the hospital. Since then somebody else has given her the meds. When she goes home she will again take the meds incorrectly. Yes, the chances of Mom ended up back in the hospital are great.

Socialization is very important. Four hours a day is not enough. Left on her own for 20 hours a day she will become lonely and depressed again. Mom will find it impossible to "entertain" herself. Wandering is a big problem. She will say that Mom doesn't wander. In fact Mom has just not wandered YET! If she is confused, scared, or looking for something or somebody she can easily leave the house and become lost. One of the reasons Mom may be so happy in the rehab is that she is no longer responsible for the house, cleaning, laundry, taking care of herself, cooking, and all those other task that she finds so very difficult at this time. I wonder what Mom would say if you ask her where she would rather be?

Time is not a tangible concept. It is spacial and those with dementia lose the ability to grasp time quickly. Telling them to take meds to 8 AM does not work. They eat when they are hungry. Sleep when they are sleepy. The brain also controls our feeling of hunger. If she is not feeling hunger and has no idea what time it is, when does she eat. If she is not sleepy, but agitated or scared in the even because of sun downing, she will not know to go to bed. Late evening and night time sun downing can cause the confusion to be worse. It is also a time of shadows, people on TV that may seem real instead of a fantasy, and strangers in the mirror. Beyond that the natural melatonin that we produce which created our sleep cycle is greatly reduced in the elderly. Those with dementia have very little so they tend to get days and nights confused. They often will wander the house all night and take cat naps in a chair from time to time during the day. Along with this the task of bathing, toileting, and other personal hygiene becomes difficult. Those task with many parts become confusing so they just don't do them. Along with that they lose the ability to small urine, feces, and body odor so they are not cued by smell that it is necessary.

My biggest fear is an emergency situation. Mom may know how to putter around the house and fix a pizza. What if that pizza starts a fire in the oven because Mom mistakenly turns it to broil and forgets it. What if there is an electrical fire because mom cuts a cord or a fire because she puts a cloth over a lamp shade. The house fills with smoke and, believe me because I have seen it happen, Mom will wander around the house trying to figure out what is going on, not call 911, and have no clue she should get out of the house. Take sister to the house and set off the smoke detector. See what Mom does. My bet is that she will not leave the house and call 911! Beyond that the "danger" smells go away early in the disease. She would not smell the smoke and know to get out or even get the pizza out of the oven. She would also not be able to smell spoiled foods. It is these situations that are the most dangerous.

I would call a family meeting and talk to the sister. Find out her reasons for thinking the way she does. Give her the alternative that you believe is better and why. Pull the fire alarm or burn something on the stove to see if Mom can rationalize well enough to do what is appropriate. Instead giving her the bottles of medication, give her the medications in a weekly dosage container. Then check it regularly (daily is best) to see if she is taking the medication. Get a web cam/nanny cam and install it in the house so you can watch what she is doing when she is not there. Sister might be surprised. Learn all you can about dementia and it's affect on the brain. Know that it is not just a memory problem but a disease that affects every function we have... everything we do is controlled by the brain.

Good luck and I hope your family can come to a good decision for your Mom

Love, deb

 
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Old 05-24-2015, 12:12 PM   #4
Gidget1000
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Re: Should mom come home or go to assisted living?

I have my mothers poa but i include my siblings in the decisions...we talk it out and decide together...if your sister insists on bringing her home, then sis should be willing to be caregiver as i have chosen to do...we put mom in a nursing home for a month but mom was so miserable i talked it over with my siblings and told them i wanted to bring her home and i have their support...now is the time to pull together as a family......and caregiving is a full time job...mom has a feeding tube and i tube feed every four hours around the clock...i cant say anything negative about the nursing home because they were good to her, but each family must decide whats best for their loved one...mom is 80 with alzheimers and congestive heart failure...she has fallen and broken both hips and have replacements on both sides...she doesnt get around very well, but i have no regrets about this decision and mom is so happy....having the poa shouldnt close the rest of the family out....

 
Old 11-16-2016, 04:53 PM   #5
everams
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Re: Should mom come home or go to assisted living?

Rab, I think you may be on to something. It sounds like your mom just isn't living very healthily at home. Malnutrition and weight loss is more common in seniors with dementia that live alone compared to those who live with others. If she is eating more healthily at the rehab facility, it sounds like she's open to change, she just needs it to be provided. I don't know your situation well enough to say what the best solution is - it may be assisted living, there may be other options. Companion care might help motivate her to eat better, but it still sounds like she needs help with her medicine. Home health care could help, but you still might need a nurse or another certified health care worker to come into the home to help her manage medicines. It's also possible to get home health for more than four hours a day if you are interested in going that route. The most recent study I read showed that about half of seniors with dementia living at home used home health services, so there's certainly precedent! I wonder if there's a meals on wheels program near you that could also provide better food if she does stay at home?

If there's one nearby, adult day centers are another in between option that would allow your mom to stay at home and only go to a facility during the day. These programs have structured activities to keep things familiar for the older adults that attend and would also provide those healthful meals that your mom would benefit from. Some provide medical services, so once again she could get support with her medicines.

Whatever you decide on, I hope that your mom continues to do well!

 
Old 11-22-2016, 07:49 PM   #6
LeeAnneK
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Re: Should mom come home or go to assisted living?

I can totally relate. My grandmother had Alzheimer's. It's a tough situation. I hope you find the best solution that works for all especially your mom. Good luck!

 
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