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This sounds really horrible, but I don't want my mom to come home for hospice care. I know it's absolutely going to destroy me, seeing her hour after hour in her state. She has dementia and I don't even think she will be that aware of her surroundings at this point, but my siblings are pushing for this as of earlier today. Of course they're going to force the decision on me since it's my mother's house, but I am tapped out emotionally and physically from the 3 years that I cared for her before she had to go into long-term care. I also have trouble with having strangers in my house or even siblings coming by at whatever hours. I am an introvert and not being able to have any time to myself is going to take a drastic toll on my health. Has anybody else gone through this?

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From a post back in Jan 2020: "I am literally looking at applying for Section 8 housing because I don't know how much longer I can live in this situation."

Why didn't you end up doing this?

Where is your mother now?

You know your siblings are trying to bully you into at-home hospice. When your sister says there only needs to be someone there 12 hours/day, she is figuring on YOU being the caregiver for the other 12 hours. And, since you are always there, the other siblings will start missing their hours. And why not? YOU will be the backup caregiver, and I bet you will end up being the 24/7 caregiver before long. Believe it.

Keep us updated.
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yankeetooter Aug 2021
Yes, that was me back then. My mom was still at home but was very verbally abusive, and despite me knowing that it was the dementia speaking (and frequent UTI's, dehydration, etc.), she would get very personal, and it hurt a lot.

But then (maybe the next stage of dementia?), the verbal abuse pretty much stopped, and she became a lot more pliable. Maybe as she became physically weaker, she realized she did need my help? I don't know. And so I stopped thinking about moving out. Also, (and I verified this by researching it), my sister found out from the elder care lawyer that since I had been the caregiver for at least two years that Medicaid wouldn't be able to take the house, so that gave me more security.

My mom is now in long-term care, as she got so weak eventually that she couldn't even stand to get to the bathroom (or even for me to clean her up.) I have health issues, and I am simply not strong enough to hold her up and clean her up at the same time. (That would probably be hard for even a stronger person.) She also had a bedsore wound that wasn't healing due to her sitting most of the time. (She slept in her recliner chair, and had been for years.

I know (about the twelve hour thing), and after seeing a lot of responses on here, and doing some reading up elsewhere, I definitely am against this, and adamant that I am not going to care for her the other twelve hours. I plan to talk to the social worker at her place, but I am also waiting until we get the official assessment results from the doctor. I'm really hoping that they just recommend that she stay in the home, as it would prevent a lot of family friction, but I am prepared to make my case if it becomes necessary.
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Please consider this- I am currently the youngest local survivor of my generation. My mother was the first sister of seven children, with two older brothers.

They were stoic to the point that revealing illness was consider among them to be weakness just short of conspiracy.

Months into my Godmother’s illness, at the age of 82, the information was shared with me. I was in my fifties, with two HS aged children.

By then she was desperately ill, still at home, and was being cared for by my youngest aunt. Both were single.

Too sick to leave the toilet and wash basin, my Godmother REFUSED HELP. Her sister grew more and more frail, more and more distressed, begging for help, no one knowing what to do.

The day came when one family in-law marched in, took over, and physically pulled her out of the house and to a hospital, where she was quickly diagnosed with metastatic cancer of the pancreas and liver.

After a brief hospital stay, the hospital moved to send her home. They told the “caregiver” sister she would need a hospital bed to be set up in the living room, in a small house 100 years old, with NO SANITARY FACILITIES ON THE FIRST FLOOR.

To her CREDIT, my (perpetual) caregiver aunt, after caring for her mother (severe dementia), her brother (advanced Parkinson’s), and then her sister, FINALLY said NO.

My Godmother was then placed in a residential hospice, where she died a few weeks after she was admitted.

I am now POA for my youngest aunt, the survivor. SHE REALIZED that SHE could be “destroyed” if she “brought her sister home”. As it was, she quickly developed shingles almost immediately after the funeral and suffered for years with the aftermath.

Do you have ANYONE on your side? You certainly do have ME.
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yankeetooter Aug 2021
Thank you. I will be talking to the social worker, and my boss even suggested I talk to the pastor at my mom's church to see if he will be an advocate.
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A member of this forum came up with a terrific description for people in a situation like yours.

Don't let yourself be 'Voluntold' that you have take care of mom if she returns from the nursing home.
If you are done with being a caregiver, then let that be the end of it. Absolutely refuse to continue with it.
Why are your siblings so adamant about mom going back to her house if she is out-of-it with dementia and won't even know that she's in her house? If she's already in hospice care that's paid for by Medicare and her secondary insurance, so it can't be because they want to protect assets or potential inheritance.
Seriously, why don't you ask them why they want her to leave the facility she's getting 24 hour professional care in, to return home to a person who cannot provide this for her.
Who has your mom's POA? I hope that it's you since you were her caregiver. If you do have it then there's no discussion. It will be your decision to keep her where she is.
If you don't and your siblings want her to go home, explain your situation to the nursing home she's in and tell them that you will not be available to care for her if she returns home.
Your siblings cannot just throw you out either. There will have to be an eviction process and you are also one of the heirs to your mom's property. This will take a long time so don't be too afraid of them.
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yankeetooter Aug 2021
They want to bring her home because then they figure they can visit her anytime they want, as opposed to having to make an appointment first. I am under the same rules, but I don't want them coming in whenever either. And Mom seems hardly cognizant of when we visit.
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Your sister's level of cluelessness is astounding. Hospice doesn't replace full-time care, it's in addition to it.

Your mother is in full-time care because she needs it. Hospice simply takes care of the medical side of her care while she's in place, and they focus on the quality of her life. They don't change diapers and feed someone.

If your mother doesn't require anything like wound care, you'll see a hospice nurse once or twice a week at most until she begins to transition.

Tell your sister that taking your mother home at this point is abuse, not making her more comfortable. Make it VERY clear.
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yankeetooter Aug 2021
I think my sister intends to use an outside agency for 12 hours of care daily, so it wouldn't be as if it was just the hospice care, but I'm still concerned. My mom has been incontinent for a while, and I can't imagine her laying in her waste and/or urine for 12 hours until the aide comes the next day. I am not strong enough to lift or roll my mom, so my doing it meanwhile wouldn't be possible. My sister's response to that is that they're probably not changing her overnight at the nursing home. (I don't even want to contemplate that, but I certainly don't think that's an acceptable excuse!)

She does have a worsening wound (from her being bedridden most of the day), so hopefully the hospice nurse would come out more often than once a week, but even when she was at home they would only come out 2-3 times a week. I know things are different when you're in hospice care, but I still don't want my mom getting a horrible infection.

Finally, I have real concerns that if she's in a more familiar surrounding, she might try to get up in the middle of the night and then fall. She's very weak now, and maybe the hospital bed railings would prevent that (I hope), but I would still be worried.
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Whether your sister listens ot not is immaterial. You are putting the NH on notice that you are not doing this "job" and that your mom will be unattended for 12 hours a day.

If she is unable to get out of her home in a fire, that's an "unsafe discharge". Please use those words.
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Helenn Aug 2021
Totally agree .. nursing home has been her home for awhile .. your mother familiar with those surroundings … think that’s where she needs to be… bringing her home will be upsetting and traumatic for both of you… be firm with the nursing home and your siblings and your house will not provide a more peaceful ending … if anything will be chaotic.
it’s unbelievable how siblings on these posts who are drive-bys and bystanders suddenly wake up when end is near !!!! Be firm. Visit as often as you can !!! And feel confident you did as much as you could for her…
siblings cannot say same !!
take care
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You sister "is" clueless. My Mom was in LTC for Dementia. There was no way I would have brought her home for Hospice care. I would have been responsible for her 24/7. Hospice will provide an aide maybe 3x a week for bathing. The Nurse will show up about that many times. You will be shown how to administer the morphine and other medications. You will be changing Mom while she is in a bed. And like you said, she will have no idea where she is or who anyone is. She will not only have Hospice care in the facility but when they are not present, the aides and nurses that she has known will be there caring for her.

Do not allow this to happen. Tell your sister if she wants Mom home then she needs to do the care. You did your sgare, your not doing it again.
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yankeetooter Aug 2021
I thought I replied to this, but maybe not. Yeah, my sister plans to hire an aide for twelve hours daily, but I feel like that wouldn't be enough. And I can't (and won't) do all the physical things you're mentioning; I have a heart condition and don't have a lot of physical strength.

I just hope I can get my sister to listen to this.
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I cared for my dad in his home on hospice. It was much harder physically and definitely emotionally than I could have known. I still feel privileged to have done it, but there are some aspects of it that still trouble me. There is one inpatient hospice facility where we live, it’s like a high end hotel in looks and the care has a stellar reputation. Maybe we should have chosen it, it wouldn’t have been my dad’s preference but it likely would have been far easier on us. Perhaps there’s an option like that in your area. Don’t do anything because of feeling pressure, it’s a hard road and no one should be compelled by others to take it all on. Wishing you and your mother calm and peace
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yankeetooter Aug 2021
Thank you. It hurts to say it, but I know my mother is ready to go. My dad passed last February, at which point they had been married almost 61 years! They are Christians, as am I, and I know my mom can't wait to be with him again.

When I go to see her at the home, especially more recently, she has declined so much. She barely interacts with us, and cannot really even articulate anymore, even when it is very obvious she is trying. Every time I leave after visiting, I am just devastated for the rest of the day after seeing her like this. I can't even imagine what seeing her every day for long periods would do to me.

And I have major health issues myself, so there's no way I can take on more physically than I am doing now. My A1C alone went up some five points the last few months my mom was at home, because I was eating at strange hours and no longer was as diligent about being careful with what I ate. Sounds awful, but I became so depressed for a while that while I still tried, I didn't care much about maintaining my own health.
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You are very smart to realize that hospice at home is not a good idea for your emotional and physical well being. Home hospice is basically the family providing 80 to 90% of the care. I never recommend it.
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yankeetooter Aug 2021
Exactly, and I know the rest of my siblings won't be willing to help hardly at all. They all have families, my brother lives an hour away, my one sister is very mercenary and wants to be paid for everything, and my other sister works some 80 hours a week.

And it's NOT going to fall all on me.
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It’s not horrible.

Hospice stays for brief intervals. Two friends with dying spouses & hospice relied on finding things to do because caring for and watching helplessly was too much.

One burnt out caregiver spouse hired 24/7 help.

The other situation was sudden and my friend wanted a nursing home but with no visitation (Covid), leaving the family member to die alone and confused was untenable. (Unimaginable so many had no chance to say goodbye last year). Home worked b/c family members took shifts and it was a few months.. My friend was terrified it would be longer and family help couldn’t be sustained.
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I assume a sibling has POA.
For what it’s worth, here are my rules for negotiations.

#1 Seek to understand.

What’s really going on to cause a change in status quo? Is the problem financial or emotional? If it’s financial, is the choice mom comes home or selling her house to pay for care. Which sibling agrees with what decisions and why? Do they think you’re living for free at mom’s house so you should give free care?

#2 Communicate with compassion and logic rather than frustration and careless words.

#3 Take ownership if you don’t follow #2 but don’t expect it of them.

#4 Document, document, document.

Journal. Add dates and details even if it’s a bullet list. It documents events and state of mind.

Send emails instead of calls. It lets you think instead of react. Email the POA/siblings to say you all love mom but mom needs to stay where she is because you do not agree to be her caregiver, you’re burned out and cannot guarantee her care or safety. (Which is true, isn’t it?)

Save the email replies. If the reply is a call, send an email summarizing the call (just to make sure we’re on the same page … and that documents the call).

If the POA still wants mom home, email the director of mom’s nursing home and advise them of the situation. My friend said nursing homes can’t release a patient unless the home environment offers appropriate care.

Take screenshots of this post and the replies to prove you are concerned about this before mom is released.

If the POA brings mom home without a hired caregiver, send an email reiterating you are not the caregiver so POA needs to hire care or let mom go back to a care facility. Email the facility director as well.

Tell hospice you are not mom’s caregiver and cannot guarantee her care or safety or even be home to answer the door. If that’s not enough, leave when hospice arrives. Stay away for hours. Let the hospice worker explain how an hour visit became four. If they talk to you, reiterate you are not the caregiver and tell them to contact the POA.

#5 Acknowledge different points of view and concerns but don’t engage is useless conversation.

People need to know they’re being heard even when they refuse to hear but there’s a point where the conversation becomes an energy sucking time sink. If the conversation goes in circles, email is your best friend.

#6 Plan a strategy and gather allies.

The goal is a consistent message and digital or paper trail so you have evidence. Then, if necessary, you can call your county health department or 2-1-1 or a lawyer to get help advocating for you and mom.

#6 Expect contentiousness. Look for potential opportunities and land mines.

What would the POA do if you say you’ll move? Call your bluff? What about if you say you’ll be out of town and leave for a week at a time? Will the POA get nasty and try to evict you or charge rent? Would the siblings let that happen? Can you get eviction protection? Will you have a relationship with siblings? Is that okay?

#7 Don’t feel guilty for having limits. Life isn’t fiction; you’re not a superhero. (Seems your no caregiver siblings set boundaries. So can you.)

#8 Breathe.

♥️ 🙏
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yankeetooter Aug 2021
Thanks for for all the advice. Sister was going to hire extra in-home care for 12 hours a day, but I presume that would be during the day and not overnight. I'm not going to be sleeping on the same floor as my mom was and I'm not going to interrupt my sleep to check on her. It sounds harsh, but I have a heart condition and other health issues and I need a complete night sleep. If she says it will be overnight, then I work. Back when Mom was needing more care, I was able to work from home, but covid was part of the reason for that and I don't think I would be allowed to do that now. Nor would I really want to.
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Most nursing homes have a contract with several different hospices. If your hospice agency wants to bring her back to her house in order to have her as a client, you can choose a different hospice that does have a contract at her long term care facility.
You already know how hard the 24 hour care is. Hospice may promise 12 hour care, but may not deliver it. Marketing team and clinical team are different.
Good luck, this is hard place to be in.
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