My dogs are very spoiled and only used to us. I have 1 who likes people and will jump and kiss you a lot. The other is a bit grumpy and just wants to snuggle. I'm going to keep them separated from mom but with a gate so they can see what's going on. Should I take them outside and introduce mom to them in the wheelchair that way its not territorial?
Not sure the best way to introduce.
Any suggestions?
"I'm an EMT and my mother was living at home with my sister. My sister is no longer able to give mom the care she needs. So she is in a Skilled Nursing Facility after being discharged from the hospital a few days ago after MULTIPLE recent falls. We were all excited (mom too) about her moving into long term care after SNF. I have been there the past 2 days and the 1st day ( I was in street close) was AWFUL!! I wont go into details but I was ready to pick her up and take her home. I was tired and irritable so didn't fly off the handle but I did take notes for future reference if needed. Day 2 I went up there in my uniform and you would have thought The state inspectors walked in!!! EVERYBODY was coming back to moms room to see what they could do for her................
I am REALLY struggling because I KNOW that I can take MUCH better care of her at my home. But I'm concerned about care giver burnout. I take care of people at work for my career (EMS) so coming home to care for her concerns me. My other concern is my dogs. They are older and this would be a big change for them. And NO they will not be going anywhere!! I can separate them from Moms room/bathroom.
My thinking is that if I have to sit at this facility in my uniform when I am off all day anyway, she might as well be at home with me where we can both be comfortable.
With her income SSI I can put up cameras and hire a CNA and or Sitter to come when I am at work. I am also sure that her home health visits will continue with Nurse, OT, PT, and an Aid 3 times a week.
I'm afraid I may be making this decision out of my need to rescue ie: EMS. But I'm also looking forward to bonding with my Mother and having no regrets when she passes.
So this is where I'm at and I need to make my decision withing the next 10-20 days (length of time her insurance is covering nursing home SNF."
The dogs are the least of your worries. Think about the future. Your sister burned out for a reason.
Points to consider:
-Will you be quitting a job to take care of her? If so, what will you do for income?
-What will happen to your mom if you become ill, injured, or are no longer able to take care of her?
-Just because you're an EMT (a tough job, you have my respect!) doesn't mean you can provide all of your mother's medical needs. Taking care of other people all day is one thing, then switching gears to care for Mom is something else.
-If Mom starts wandering at night, how will you stop it? If mom needs you often during the night, how will you handle going to work in the morning? Being an EMT you're used to every bodily fluid there is, but are you okay with changing depends and/or sheets during the night if she becomes incontinent?
-If Mom can't be left alone, who will sit with her when you aren't there? When will you have time to do basics like grocery shopping, errands, and all the things to be done?
-Are you okay with no more vacations, dinners out, or even a weekend getaway as long as Mom lives with you?
-If you burn out (and it's 99% likely you will), what's the plan? Are you okay with placing her in SNF again? Will it be too hard on Mom for her to go through another adjustment of going from home to an SNF?
-You know caregiving is a lot of physical work... lifting, etc. What happens if you're no longer able to do this?
-How will you handle it if Mom develops mental issues, or gets dementia (if she's not already?), Mom may be a totally different person mentally over time. This is rough on adult children and family. Will she take any medication or treatment without an argument, or will she fuss? How will you handle that?
-You say you KNOW you could do a better job caring for her. While you may love her more than any staff person could, really stop to think why you think you can do it better. For months, or years, and do your day job well too? An EMT can't make mistakes.
-Are you wanting to take mom in because it makes you the good daughter? The one who didn't burn out and 'give up' (burnout is not giving up, just using the expression). The one who stepped in and 'saved' mom?
-If your dogs cannot handle Mom being there or she does not adjust to them, what will you do with your dogs? If you're forced to make a choice of Mom vs. dogs, this will break your heart.
First the 10-30 days of insurance coverage, well if she is there from a post hospital stay, the coverage is dependent on her being “at need” and that is determined by her ability & participation in rehab. If she’s all “it hurts, I’d rather not today”, that’s fine. Nobody will make her do rehab. But she will be written up as non-compliant for care and insurance will stop completely. She may not have 10-20 days….
So you are expecting her to “have in-home health of RN, OT, PT and an aide 3times a week”?
AND
you plan on continuing to work FT as EMT while mom lives in your home (by herself while you r at work) & w 2 50+ lbs “spoiled” dogs.
If she is right now in a NH on a MediCARE rehab benefit, that is time limited AND she must show in her chart that she is progressing sufficiently to whatever ICD-10 codes she was sent to rehab on in order to stay on this type of Medicare benefit. Most enter rehab after hospitalization from a fall or stroke and r in on 3 weeks of rehab, which MediCARE covers 100%. Should rehab be needed and approved to go beyond the first 20/21 days, MediCARE will continue coverage up to 100 days but she will have a coinsurance of $171 a day if she’s on Original MediCARE. ((If she’s on a Medicare advantage plan, it’s whatever they set & good luck on that.)). I’ve been on this site a long time, and by & large rehab rarely goes beyond 30 days for elderly on MediCARE rehab benefit. The 100 days max mediCARE benefit tends to be younger MediCARE who have bad accident and r in rehab for a TBI and in a long term rehab facility that specializes in brain injury & relearning for months & months. Not elderly mom who falls and breaks a hip, those are 2-3 maybe 4 weeks rehab and if not progressing they are totally off any rehab benefit, often off rehab by day 15 if they don’t participate in therapy. My point is, don’t expect mom to get the PT, OT, nursing services she has now at the NH to be automatically done for her in your home.
So does mom have a huge amount of savings, investments and monthly income to pay for inhome private pay caregivers for all times when you are at work? And do you have a set schedule for EMS so that mom can book caregivers in a set schedule for when you cannot be there for hands-on oversight? Like she has 300k in assets and 2k a mo in income? That’s ime what she’ll need to private pay for inhome CNA care & copays for speciality like OT, PT for a couple of years. Neither MediCARE or Medicaid will pay for 24/7 care unless you r in an extremely high cost of living city, like NYC.
Has your mom gotten an assessment? This IMO needs to be done, especially to determine if she is a continuous fall risk. If so, she needs 24/7 oversight. One good jump by 1 of those dogs will have her fall. One leash pull will have her fall. If your not there, how can you be assured that they will not be aggressive towards her? She is not part of the pack.
Your sister was right in telling mom and you that a NH was needed.
You may not have any regrets when mom passes, but your likely to have regrets when she has yet another fall at your home, or when one of the dogs snaps at her or your having to leave work early once again to deal with a mom emergency in your home.
Please pls pls get an assessment done so that you have on paper the information needed as to just how much oversight she needs BEFORE you move her. Should things go bad at your home, getting her back into a facility as a LTC resident (private pay or LTC Medicaid) will not be as easy as her entering a NH as a rehab patient (mediCARE benefit).
I would say that something you might want to consider is sitting down with the facility director and telling them what you observed, see what they say, and then make your decision. If your mom was excited to make that move initially, then maybe there's another facility that would be a better fit. But you work in health care, so you know--they can't fix it if they don't know about it. I think you could be at real risk for burnout as you will have no down time if you move your mom in. Unlike some posters here, you have a family member that's ready for as much of an independent life as they can handle. Sequestering your mom in your home if she's game to go live in a community might be doing her a disservice. It sounds like you're weighing the pros and cons--I wish you luck!
My mother lives in Memory Care Assisted Living and has fallen 78x. If she lived with me, that would have been seventy-eight calls to 911 to have someone like you and your team come to pick her up off of the floor; she weighs in the neighborhood of 200 lbs of dead weight and is wheelchair bound so won't assist in getting herself up.
The doctors and therapists and podiatrists and dermatologists and dentists all come into the MC to visit mom. If not, I'd have to figure out how to heft her into my car and to those appointments across town, with the wheelchair. Along with figuring out how to have 3 hot meals a day prepped for her, activities planned out, Depends changes and bathroom blow-outs figured out, showers, all the soiled laundry and bedding washes..........and on and on.
Just wanted to add my thoughts in to the already wonderful thoughts others have given you.
Please think long and hard about what you're about to take on here. Very long and very hard. And if you're so inclined to do it, think on it again.
Good luck.
There's a trap here. It's the "I see a problem and I jump in to fix it" trap; "I see an emergency, and I jump in to give hands-on assistance" trap; "I perceive something that might become an emergency and I jump in to prevent it from becoming so" trap.
Be careful. Be very, very careful. Thinking that you're the "only" person who can truly take care of mom is a slippery slope; while you are a professional, maintaining that professionalism is *extremely* difficult when it's involving your own loved one. Trust me. I struggled with that every single day that I took care of my mom. And having people - whether it's other members of your family or yourself - expecting you to be "the one" to do the caregiving because of what you do for a living is one of the pitfalls of being a first responder.
If you decide that this is the path you're going to travel, then make sure you "prepare for the worst and hope for the best"; have at least one (if not several) contingency plan(s) ready, that are realistic, doable and acceptable to everyone involved. Make sure that your own pride in what you do for a living won't prevent you from, down the road, admitting that this situation is too much for you to handle alone and make the necessary changes. Failure to do so won't be just unfair to you, but also to your mom.
Insofar as the dogs - I'm a dog lover. I have always had big dogs (over 50 pounds). A gate isn't going to hold a 50 pound dog back unless it's permanently attached to the walls...one of those spring loaded baby gates is NOT going to do the trick if your dogs really want over/through the gate. What sort of dogs are these? Are they generally calm and friendly (after the initial meeting, I mean)? I get the feeling if you're asking the question about introductions, you can already foresee a problem. I would trust that gut instinct. As Loopy Loo asked, what are you prepared to do with your dogs if it doesn't work out having your mom there? You need to have a plan in place for that possibility, too, because once you pull mom out of the nursing home and bring her to your house, if you need to find some other place for her is going to take time; equally finding another home for your dogs should you choose to give them up will take time as well.
Good luck.
The 1st day is always a bit of chaos, new routine for everyone, perhaps huge issues with other patients, staff called in sick or?
You should not make this decision based on 2 visits. Your heart is leading, not your head.
If your mom is/was looking forward to LTC she is probably lonely and wants the social interaction that a facility offers.
No one is going to do it like you would, it doesn't mean that it isn't just fine. It's like asking your spouse to mop and then being upset that they didn't mop like you but, the floor is still mopped.
Placing our parents in a care facility is probably one of the most difficult things most of us will ever do, learn to pick your battles and figure out what is really important for your mom and her well being.
My dad was a hoot with the staff, so he had lots of them checking on him. It actually made others jealous because he got so much attention. But the 1st few days, I actually wondered if they remembered he was there. They were getting their marching orders and then it was game on.
Edit: you have to remember that their job is very different then the emergency, critical types of things you deal with daily. By the way: Thank you for what you do.