Should I feel guilty about placing Mom in a skilled nursing facility?

Dianne, Your mother is probably afraid that if she goes in the SNF that she won't come out again. That is a scary thought, I know, but sometimes it is a choice that has to be made. We can't be a medical team for our parents, no matter how we may want to. Some things are beyond our ability to handle. What we can let them know is that they can come home when they're better, but that they need more help than we're able to give them.

It's a sad situation to work through. I hope people who have been in the same situation will let you know how they worked through it.

DianneKK, any chance your Mom could afford a caregiver to come to the house for one shift during the day to help her? That would give you a much needed break, and help get Mom used to having a non-family member be helping her in case in the future does does need to go into some type of continuing care.

You may want to ask Mom's doctor about rehab. My husband was in rehab for 4 months this year for help with his lack of mobility. Did it help? Not really, but he is not the sort of person it would have helped. However, it gave me a much needed break. We have had a nurse come to the house once a week since he was released in May. Other than that, it's all up to me and I have my health issues too. Most of us caregivers are not trained to care for our loved ones. I learned what I do know by watching the aides at my husband's rehab.

Not knowing you or your Mom, it's not easy for us to say "Yes, definitely admit her to a SNF." But since she, like my husband, has health concerns as well as medical issues, caring for her will only become more difficult. IMHO, you need to care for yourself as well as her, and a SNF may be the best way to go.

I'd rather do anything then admit her to NH. I was hoping it would be temporary, like rehab, until mobility improves. However, I'm having 2nd thoughts, and just going to go with in home PT. Hopefully, they can help build her strength back up. I do believe that the way her health is declining it will have to happen at some point, but I prefer not to be the one who iniated that process. I plan to call before the appointment Monday and let them know we don't need that assessment right now. I couldn't deal with the guilt. Just have to build me a little health team, to help me, help her. I hope she never has to be there indefinitely, and will keep doing what it takes. Only, with in home help like some of you suggested. Thanks for thoughtful and caring comments. It's a difficult journey, but I would never change taking care of my mom. I buy her fresh flowers every week, and she gets excited and tells me where to set vase so she can see it. I agree, that you have to do what is best for your particular situation. For now, I can handle things as long as mobility doesn't worsen. Best wishes to you all😇😇😇&prayers sent for your journeys as well. God won't bring us to something, if he isn't going to bring us thru it!! Love and light.XOXO

I've helped with my aunts and now my mother. There have been times that they were in therapy, which strengthened them to come home again. When it became more difficult, we had in home help then skilled nursing care, which the doctor wrote a script for. This is truly a different decision per person, based on what the person's needs and the family's ability to provide care. It is a difficult journey, however, it is clear that you have your mother's best interest (as well as you and your child's) in mind. Think about the good advice here, and work with your mother and her doctor, but also explain your limitations so your health doesn't suffer. Wishing you the very best resolution. :)

Medicare will allow some time (60 days I think). Your doctor should know this. Medicare has what they call "lifetime reserve days" and the 60 days would count against the lifetime days. I have a friend who called Medicare and explained that she needed help and they allowed 60 days. You can read more at www.mymedicare.gov

You’re first question you asked of us was "should you feel guilty?" And unequivocally...NO. When you are doing ANYTHING in the best interest of your loved one, guilt doesn’t play a role. The definition of guilt is that you’ve done something wrong. As long as you are being responsible to your LO, there should be no guilt. All actions should come from what is in the best interests of all parties. Your health by the way, should also be considered. You should be allowed to be her daughter...not her nurse. One can only do so much. I personally despise the term guilt when it comes to caregiving....unless one is being abusive, it has no place. I hope your situation works out well for both of you. By the way...from experience...a LO can get all the rehab in The world, but their strength will deteriorate after rehab ends. So unless it’s kept up, don’t expect miracles. I know this from my dad's experience.

I have not read any of the other replies as I am running late today...

I'd suggest should she be admitted to a SNF that you tell her that the doctors want to keep an around the clock watch on her symptoms for a few weeks so that they can determine the best course of treatment...Then keep pushing the potential discharge
date back a week or so at a time...

As I see it, this is not deceitful. I say that because years ago, I had a similar experience..Wife had massive stroke and was paralyzed and could not speak. I kept her at home for two years by myself...I then had a heart attack and she had to be put in a SNF. We told her I'd be able to take her back home in three months and did so seriously....Doctor then told me I'd likely die if I took her home and care for her by myself, I told her that the doctor needed a few more weeks to review her situation and symptoms and then said I was forbidden to care for her at home...Ten years later, she was still in the SNF and when asked if she had a happy life, she nodded yes. She finally died earlier this year a happy woman until the very end..I sat by her bedside twice daily all those years..Of course, being retired, I was able to do this...

Moral of story: Take care of oneself as well as the afflicted one..

For what it is worth.

Grace + Peace,
Bob

In a similar situation - when I had to move mom into an assisted living community- someone told me this will be the hardest thing I have ever had to do. Hard stuff. It sounds like you love your mom very much, have you told her honestly what a toll this is having on you? I finally broke down, cried and told my mom how horrible I felt about moving her and all and how caring for her was pushing me to the breaking point. That seemed to get through to her. Good luck and do what is best for you and your daughter. 

You sure are a kind person. If you can not afford to bring in home care for her, that is most likely your best option. I threw out my back the final days with my mother in law, and it did not help matters. Finally got the back fixed, and then I was limited for the rest of her life in helping with diaper changes, and any kind of lifting. You can't take care of her if you are not well and although 16 year olds can be some help because physically they are near grown, they are still too young emotionally and intellectually to really grasp the issues you all are facing. If your mom will not forgive you for trying to find the best possible treatment plan for your group as a family, that is an issue. If she is the kind that is going to 'never forgive you'.. I guess you may as well get started learning to deal with it now because she will not change or improve with age and hopefully you will be around for her until her end.

Does your Mom has the ability to pay for an in-home companion (care giver)? Sometimes, just having 'that person' in your home, doing the "heavy lifting" can make all the difference. It can be very affordable. And if you work from home, or are an online student yourself, you can just oversee the care, and find peace that your Mom is in your home, where she wants to be, and you and she have the needed help.

A hard, hard decision. You have a big heart. And like so many of us, you want your parent to be happy. Or whatever passes for happy when they are so compromised.

You are at one heckuva crossroads. You have surely mulled over every what-if and 1-year/5-year/10-year scenario as they relate to Mom and her POV. As you work through your options, it is crucial to devote exactly as much "brain space" to analyze the scenarios as they relate YOU. And one more time -- as they relate to your son.

You and son have more life ahead of you than Mom. Sounds harsh, but it's just simple math.

If you continue to plow through as-is while your spine and neck issues worsen, how likely is it that you will enter limited mobility decades younger than Mom did?

Picture your life after Mom's funeral. Will you be working on (or completed) that degree, managing your own health issues and on your way to greater financial stability? With son in college or possibly graduated and building his career?

Or will you be so physically compromised that you are unable to work? (With or without your degree.) And son will feel that he has to limit his options in his 20s or 30s to take care of his relatively-young but disabled mother?? What a cycle, eh?

This gets lost in translation all the time, but the caregiver's health is just as important as the care-receiver's issues. Possibly more important, if you think about " the math."

I hope you can find a solution that works for your mother's issues, yet honors the futures that lay ahead for you and your son. 💛 ((((hugs)))))

All the comments really put things in perspective. Thanks for taking time to lend me time and advice. I'm getting her walker and then the in home therapy but have decided to put things on a time limit. Like 2 or 3 weeks. If things are still the same way I plan to move forward with SNF. It's too much on me and my health, and I don't foresee great improvement. I keep trying to give it more "time" but I have to be realistic, and make right decision for all involved. It will be sad, but I will visit 2-3 times weekly and take her goodies. Again, thanks for the excellent advice because I listen, and take it to heart. She actually fell over the weekend, and it's too dangerous. I have her not getting up at all now for restroom, but not sure if she Will forget about depends on or whatever. It's been one hell of a ride lately and don't feel guilty for looking forward to my own life, and not worrying constantly. If I could make it all work with her home, I would but it's just past that point. I use to take care of everything, and all she did was dress herself and go to bathroom alone as well as her personal hygiene, but now I do that all too. I'm only human. I will update, and you don't know how much it means to have you all for listening ears who give thoughtful yet meaningful advice. Love and Light, Kelly.

Please feel free to share your personal experiences as well! It's great knowing I'm not alone in this:')

When my MIL was still alive she needed a lot of PT. She did several stints in in-patient rehab and that was when she made big strides that would sustain her for several months afterward before her condition started declining again. Unlike her in-patient PT which was twice daily, her in-home PT was weekly and, IMHO, was more for her psyche than body. Check out Sit And Be Fit by Mary Ann Wilson so that your mother is doing something every day. You know the old adage "use it or lose it?" Do not expect miracles from PT. Your mother does have to want to help herself if she doesn't want to end up living in a SNF.

And no, you should not feel any guilt about doing what is best for your mother.

All children want their parents to be in their own home if the parent had not already made the transition to some kind of senior living home that has SNF when they need it. They are expensive and the average person doesn't have the money. So, if you are fortunate to be able to keep your parent at home I think most children would go that route. If you are unable to really care for the parent or live out of town then the SNF would be your only option. If I had to put my family in a SNF I would be sure to visit daily if I lived in the town or as often as possible if I did not. Be sure to help when you are there. Don't expect the facility to do everything even though you are paying them. It's a low paying job for them. They are not just responsible for your parent they are responsible for many parents.

Dear Dianne,
It's all hard but you seem to have more than enough on your plate without trying to be a 24/7 nurse. I managed the household for my Mom & Dad for 11 years. My Dad ended up his last 6 months in a NH and it wasn't bad. He had had some small strokes and was demented. Much more than both me & my mother could handle. (He was big and we are small!) Then me & mother were in the house alone for about 5 years. She got somewhat demented and VERY stubborn. I had to hire an ambulance to get her to the Dr. (2 big buff guys show up in the LR and she thought it was a party! Still a flirt at 93! But it cost $250- every time & no coverage because she didn't really need it!) And I got some help about 20 hours a week so I didn't get stir crazy. One day after hours of "no, no, no, no" I got to the boiling point. I knew it was time to bail out. Now I am the oldest of 8. And no on else could clear their calendar to take on Mummy. I am not comparing my situation to yours. Mine was much less serious in a way. So I emailed my sibs and said, in essance, that mother needs to go into AL (she's in good health, except for dementia) and that I was going back where I came from, before all this mom-dad stuff.

The bottom line of all this is, when the care givers are anonymous strangers mother is MUCH more accepting. She likes her cute room (we got some new furniture. She was using the furniture they bought when they got married. 70 years old, falling apart.) Her room looks over a parking area and she likes to watch the cars go by. The one sister left locally is better with her than I was, but she only has to see her a few hours a week. There's a little salon and mother gets a shampoo and hair cut. I couldn't get her into the car to go to a salon. Her toe nails were gross but I couldn't get her to go to a podiatrist. Manicures at the salon has solved that. Both me & that sister visited every AL place in town (big city, actually) and she talked me into a nicer place than I had favored but Mummy loves it.

Cavate, (I'm having spelling problems, sorry. Mummy is 93 and I'm 71.) see if you can get clear on the what parts of Medicare and Medicaid the different places take. I lucked out on the NH for Daddy, but at some time, if she lives many more years, Mother will run out of Medicare funding and we will have to move her to a place that takes Medicaid. A bridge too far, at this point. A social worker at your health plan can probably help with that.

I guess what I'm aiming at- guilt is out. I agree with that. You have a life to live. In your case, 3! In MANY cases oldsters get better care in places devoted to that care. They get hung up on a house they've been in for years, furniture that's falling apart, care from someone they know, when professionals can do it faster, KINDER, less intrusive. A week and they get used to it. They all cry and beg to "go home" but if you visit as often as IS PRACTICAL, they get used to where they are. Think of going to the NH for rehab and then right to AL.
Love, love, be easy on yourself.
Betsey

Self care is sometimes the hardest thing we ever do. It is not selfish. Your mother is frightened, I am sure, of a rehab or nursing care center but it is the best for everyone that you take care of yourself as well. You are on the right track. Be loving but firm. God Bless and keep you and your family safe.

If her lung disease is progressing then she might qualify for hospice care. I just placed my mom in a SNF and I've been up and down the emotional roller coaster about this but I had to do it because I was affecting everyone around me... (Because I was totally stressed out and i was a BIT out of control....) Also, had she stayed here at home, I wouldn't be able to go to the doctor's for my own health issues because I was having a difficult time scheduling caregivers to come in for a lengthy period of time. And, you need to remember that you have a 16 year old as well. I have 2 sons and they were helping me a lot with my mom but I realize that they also need to lead their own life. Please don't count out the nursing home because you need to take care of yourself first.

I am in a similar situation. I am my mother’s POA and primary and ONLY dedicated caregiver. I’ve been caring for her since July 2015 when she fell during the night and was never the same since. Even though she had no serious injuries from the fall, from that day on she was never able to walk on her own again due to severe imbalance and slow to respond gait. Her dementia, which was mild prior to falling escalated to more of a Level II.

What has transpired in the two years and two months since her fall has been all-consuming, intense, & nerve-shattering just to name a few. Like you, Dianne, I had promised my mother years ago I would do everything within my power to keep her at home in her elder years. Since her fall this is what has happened...three admissions into rehab facilities for PT following hospitalizations for dehydration, weakness, etc from UTIs. Discharged home all three times with Home PT. While Home PT was in progress, Mom seemed to be improving. However, as soon as it stopped, the same weakness returned, she was hesitant to do her exercises, and she actually regressed. She has had Granny Nannies home Care which I was able to afford through a county grant. She gets 40 hours a week. My sister, who has removed herself from any and All Care with Mom, reported me to DCF (Florida Adult Protection) on three different occasions for abuse of our mother (neglect & financial) all of which were falicies but none the less I had to endure interviews and inquiries. My sister is bipolar which only adds to the interference. She is finally more or less easing out of the picture (long story) but her presence in any capacity adds stress to an already stressful situation. At present, my mother’s ability to walk even with a walker is declining. Her dementia is worsening and her UTI’s have become more on than off causing worsening of hallucinations and delirium, weakness, etc. I still have the nannies and cams in the house to watch her in the afternoons when she is alone between nanny shifts...however, she now is having trouble understanding how to use the phone so when I call her she can’t hear me because she’s holding the phone upside down. You get the picture.

I feel at this point that a SNF is in our near future. It saddens me to no end to proceed this way but I truly feel I have done all I can do. Like Dianne, I have disc issues in my back, tendinitis in both arms from lifting Mom, and my anxiety is 24/7. My husband died five years ago. I had access to only enough income for about five months. I went thru my savings account and now am living off a reverse mortgage which is almost all used up. I pet sit to earn some supplemental dollars. But I am now very scared I will lose my home lose everything if I don’t start caring for myself. I have given my mother all of me for the past two plus years and it has enabled her to stay in her home, but I feel I am on the verge of a total burn out. I’m 59 years old but feel like I’m 69. I have health problems that need addressing. Somehow, I need to find work, something I never thought I’d have to do Again since getting married in 1995. Retired in 1998 from administrative medical work. I’m finding so many changes in the work force. It’s challenging & scary all at the same time. I wonder if I’ll even find a job that pays me enough to survive. A work-at-Home Job would be ideal for me, and I have had a few of those on a temp basis in the past, but these are difficult to come by now.

I will feel sad for my mom when the day comes to enter the SNF. However, I will not feel guilty because I know I have given her all I could to keep her home as long as I could.

I found a caregiver agency that would come in 4 hour minimum and it was on an as needed basis. Listen to me, if you care that much and are doing what you are, then why should you feel guilty? Do you think your mom would want to be a burden to you? Just talk to her and tell her you can't physically do it by yourself and that you need someone to help. If you do have to take her to a skilled nursing facility, just make sure to check out the place very well and make yourself visible to the staff so they never know when you may show up and speak up if you see anything you don't like

Hi,
I just placed my 93 year old mom into a SNF for a couple of weeks so I can get some respite. I am sooo glad I did, before I had yet another nervous breakdown!

NO GUILT, no matter what course you end up taking!!

We do what we have to AND what we can. Since you have a younger son, you are not as old as some of us. You have potentially a long life to live and you do not want to end up worse off than your mom, and maybe have to impact your son's future in caring for you!

When it came time to move our mother, she was given options, however she was adamant that she was fine, independent, can cook, etc etc, and wanted to stay in her condo, as is, with NO outside help coming in. But she was not fine, independent and could not cook anything that didn't come in a little box from the freezer (yick!).

Both brothers got sticker shock at the cost of Memory Care (I had been researching the whole dementia thing for over a year so I knew) and said for that money I'll take her in... I said my decision was already made.   I *cannot* take care of her physically (she outweighs me by at least 20-25lbs) because I already have back issues (3 discs removed/fused, lower back vertabral issues). I also said I would not fight them on this, but they needed to be FULLY aware of what they were taking on. Older brother is ~2 days away, so we would not be able to help him much. Younger brother is still working, and will be for some time - what will you do with her all day? The whole point of moving her is she cannot stay alone and refuses aides!

Anyway, although our back issues are different, I know that I must be *VERY* careful what I do and how I do it or I can be in great pain/unable to move well at all. Since you are still young and your scoliosis is expanding, you really do need to ensure you do nothing to make it worse! IF you can get in-home assistance, and mom accepts it (there are ways to help her "see the light" to transition help to the aides), either through Medicare/Medicaid or self-pay, DO IT! If she is not suffering from dementia, it should be easy enough to convince her that you are getting this help for both of you, and thereby ensuring that she can remain at home.

This allows mom to stay with you but takes all the heavy work off of your back. PT might help, but as others have said if she doesn't keep up the work they do with her, it will regress. It cannot hurt to try the in-home PT as well.

Again, NO guilt! Guilt is reserved for people who either DO NOT DO ANYTHING to help, do everything they can to hinder getting help or abuse the person/people. Whatever we do to help should have no guilt attached. In a rosy world we could all do everything and keep loved ones at home to the end, but we do not live in that rosy world! So, finding the best place for mom AND you, should you need to go that path, is doing the RIGHT thing and instead of guilt you should feel happy that mom is getting the best care (probably better than your back can provide!)

Just wondering how things have been this week, Dianne? Any updates?