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Good question, not easy to answer.

I am in the school of thought that home are is the best. I am speaking from the viewpoint of a caregiver of a spouse who has advanced dementia. You will need to hire outside help because - let’s face it - you aren’t spring chicken anymore. That will be expensive, but less than AL or NH.

Good luck.
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I am in fairly good health, younger than you, and know that I could never do what the nurses can. They know how to safely move people, properly dispense medication, check vitals daily, monitor them at night and there is a Dr who visits. You won’t be able to leave your home without someone else there and you’ll need to change your home to eliminate any hazards. If you sell your mothers home, you can use that to help pay, along with social security.
When my mother first entered the AL, she participated in bingo and various board games, when she had no one her own age to interact with before.
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Living with you would give you a better idea if your mom really needs assisted living. However, it would be wise to consider spending a long weekend or week in mom's place before committing to either option. This way you can decide for yourself if you can handle having her with you. Here are a couple of questions to help you with your decision?

Is mom up and down or calling out throughout the night?
If she stays with you and has this problem, your rest will be greatly impacted.
You would need a sitter for her at night.

Does mom have mobility problems that are difficult for you to manage?
If you can't move her from bed to chair to toilet to tub/shower and can not afford assistive devices, it is only a matter of time before you get seriously injured.

Do you have serious health issues - heart, breathing, mobility...?
If you have a serious health concern, who will care for mom when you need medical care or in an emergency?

Do you have committed support from family members, friends, members of your faith community and/or paid help?
Most caregivers do not gather enough support people so that they can have a little "time off" daily and more "time off" weekly to meet their own health needs as well as to do fun things with other people they enjoy, Burnout is real, but can be prevented with enough "non-caregiver time."

Is there a history of early dementia in your family?
We do not know all the reasons why dementia develops, but if early mental capacity problems appears to be the norm - you may be at risk of having this problem too. In this case, it would be wiser not to have responsibility for another's care. Get annual testing for your own cognitive abilities if this is your situation.
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I am in the middle of caring for my 95 year old Mother in our home. Please, if you can afford it and can find a suitable community for her do it. Friends told me not to do this and I thought I could, it is 24/7 and I am exhausted. Not to take the spotlight off of your issue but our situation is that we cannot find a "decent" community the will revert to Medicaid when her money runs out. There is a community near us that we would prefer but they are private and do not take Medicaid. Be sure that you find a community that suits her needs and that will take Medicare when necessary. I know that my Mother will be upset about moving again as she is happy here, we do everything for her but it is taking it's toll on us. Listen to what so many here have told you, you do lose you life when you take this on.
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I spent 10 yrs of my retirement time caring for my mother. Starting at age 59 and now I’m 70 yrs old. Mom passed in August of this year. My down time was totally limited and I was never able to get away - not once. As the years passed, I had to add more and more responsibility to the agenda because mom was declining. The final year she was in hospice, but they were not there 24/7. They depended on me as much as I depended on them. I would never advise one to take their parent in no matter how great the relationship. I was my mother’s indentured servant in ALL aspects and this was hard to take. Now that I am free, I’m not really free. I still live in a prison of sorts as the 10 yrs of caregiving was so intense for me. I gave up so much. It gets better everyday, but the adjustment is slow. Mom’s in a better place now as she suffered in the end and she is with everyone she missed so much. She was 95 yrs old when she passed. If I had to do it over, I would have insisted she go into a place where she could age within - according to her care needs.
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ArtistDaughter Oct 2021
I understand what you say, "I am free, I'm not really free". My mom is still alive and I am only her advocate now, not her caregiver for the last 4 years. But my life for 10 years has been mostly about her, living with her, then taking her to assisted living, memory care, nursing care, and now to a Hospice home. I've known for a long time that I will be lost when she is gone, and not know any longer who I am. I'll have to make myself all over. I wish you the best in your adjustment.
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My mother moved in with me at age 83. We had a good relationship and I thoroughly enjoyed her living with me for the first 3-4 years. Mom had MCI and some limited mobility but was capable of a basically independent life during those years. When she fell due to her spinal stenosis and damage her knee to a point she could no longer walk without a walker and then became confined to a wheelchair, the caregiving became more intense. I promised my mother she could live with me as long as we could manage. We always knew her spinal stenosis might result in a situation where I would be unable to meet all her needs. We came close to that just prior to her death but we managed until Mom's death.

None of the "tasks" of helping my mother were a problem for me emotionally. When she could not stand or assist in transfers I was not physically able to handle the transfers alone or count on Mom's assistance/compliance as her MCI had more impact. The most challenging aspect for me was the 24/7 on-call. Mom attended Adult Day Care (ADC) 3 days a week most of the time (besides covid impacts), and we hired some help to attend her a few hours a week so I could attend the kids' games. Still, I did not _want_ to leave Mom much. I did not want to risk more exposure to covid risks. I choose to stay at home with her instead of attending certain events. I became more isolated due to my choices.

Mom has been gone for nearly 4 months now. The plan was to allow her a better quality of life for as long as we could, then have the money left to support her in a good facility when she needed it. We made it. I have no regrets over the way things worked out; however, I maintained some support from my family and I had grandchildren and great-grandchildren visiting for a few minutes most days. Mom was mobility and cognitively challenged to the point I could not leave her alone for a little over a year. That year was very long.
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First, you are an amazing daughter (making an assumption here:) for considering this. Second, what does your mother wish to do? My 92 y/o Mom chose to move to A/L, understanding better than her children that she would need increasing care and wanting above all else not to be a burden to her daughters. After 3 years there, Covid hit last year, and we were beside ourselves with worry about Mom being so isolated and not being able to be with her. My 70 y/o sister offered to bring Mom into her home and we talked Mom into agreeing with this. There was definitely an adjustment period and a hard realization that Mom did require more care than my sister anticipated, with meals, bathing, transport, middle of the night bathroom assist, etc. Also very important to note that, if it is not safe for her to be alone at home, you cannot run errands or just get out without finding coverage. All of these things can be alleviated with a variety of in-home care. Covid prevented us from bringing anyone in, but that should not be such a concern now. After 3 months, my beautiful Mom had a stroke and spun out in a terrible run of dementia, which thankfully for her, lasted only 2 weeks before she passed. Because she was in my sister's home, all of us moved in for the duration to be with her and care for her as she deserved. In hindsight, my sister would do it all over again, and I will forever be grateful to her for that. BUT, you are right to question the pros and cons. If you do this, let it be with eyes wide open. It would be a life changer for you and your Mom. I hope her finances are such that you can choose the best care, whether in A/L or with plenty of in-home care assistance. Wishing you the very best in navigating this challenging time.
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Oh bless you. Here is my answer:

Consider this, you are now on call 24/7. All your own needs and physical care cease being the priority.
Are you physically fit?
Are you healthy and strong?
Can she be left alone while you grocery shop, do laundry, prepare meals, house keep, or take care of your own self care activities ( dentist, healthcare hair appointments....)
Are you able to get her to and from appointments as well as your own without Injuring your back, legs, feet etc..
Do you love spending time with her, get along well.? Have little to no conflict?
Can you take care of all her finances, her bills. Her other needs and food etc.. Evaluate this carefully. If she has other children, will they be resentful of you if you do household improvements with mom's money?
The emotional toll and the physical needs of an elder parent as we age are tremendous.. I am praying God gives you wisdom, compassion and guidance.
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We tried Assisted Living (for all of a week) for my mom when she had Alzheimer's, but it just didn't work, so she lived with Hubby and me. It was frustrating but rewarding. She'd often storm out the door to wander, as many Alzheimer's patients do, so I got my exercise chasing after her. When she'd insult me, over nothing, (which she never did before), I knew it was the disease talking and not her. I tried to find humor where I could. I even wrote a book about our travails called, "My Mother Has Alzheimer's and My Dog Has Tapeworms: A Caregiver's Tale." I worked part time, and Hubby was able to adjust his work schedule to watch my mom when I was at work, which helped a lot. I learned to join my mom's view of reality, since her damaged brain often couldn't join the real world. If she thought that someone "stole" her (decaf) coffee, (since she didn't remember she just finished it), I went along with that viewpoint. Each situation is different. Your decisions can be fluid and not set in stone; you could try having her live at home, and if that doesn't work, try Assisted Living. If she lives with you, maybe she could go to an adult senior center's Alzheimer's day programs. Check your Area on Aging. Sometimes there are volunteers, either through the area on Aging, church or temple groups etc. who could sit with your mom an hour or 2 here or there, so you can have some respite. Maybe some colleges might have students who could volunteer. Good luck.
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My Mom is 95 and I am 70 years old. We took Mom after she had an episode and become very disoriented, she is well now due to our care.

All the advice given to you in this conversation is true.

We no longer have any privacy or freedom we are on call 24/7.
The worst is the daily mood changes from nice and needy to abusive and demanding .
I understand that is very hard for Mom to give up her independency, so she argues often on everything little thing. I try to be understanding, compassionate and loving with her but her behavior is very difficult on us. I never know what kind of mood she will be in the morning she could be pleasant or nasty, this is very frustrating and a is taking an emotional toll on everybody in the house.

We are looking for AL facilities near us and I think that will be the end result in a few months, but one day she wants to move to an AL and another she says she wants to stay with us.
The emotional rollercoaster is very taxing on me, since I am her main caregiver. You wont have anytime for yourself and forget about going out for more than 2 hours (we try to go shopping when she is sleeping during the day) vacations or little short driving trips or visiting our children are things we are not longer able to do since she doesn't want to come along and we can not leave her alone.
If putting her in a facility now is an option for you, do it. Try to get a place that is close to you so you can visit very often and keep an eye on her, you will be saving yourself and she will be under professional care. She will complain about it but she will also make friends there and both of you will have a better quality of life I least that is want I think it will happens to me and my Mom .

Good Luck and blessing on your decision.
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-There will be no dinners out, no vacations, very few (of any) breaks. Little to no social interaction. Can you handle that? 

- When will you be able to do basic errands like grocery shopping? You can't leave her alone and it's not feasible to take her with you. 

- What will you do if she gets combative at home?

- What happens if you, God forbid, get sick or injured? Who can step in at a moment's notice for what could be weeks or months?

- If Mom becomes incontinent, how will you handle it? Will you be okay with having to wake up several times a night and/or changing bed linens, handling soiled clothes?

- Mom could live another 10 years. Are you willing and able to care for her that long?

- If she starts wandering, what's your plan?

-Are you able to lift her?

-Will you be able to get her out safely in case of fire or some other emergency?

-If you take her in and she needs a nursing home later, keep in mind that will be another hard transition for her.
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I am also 68, retired and live by myself. My husband passed away 6 years ago. A year ago, my mom who is 93, moved into a retirement home. It was the best thing for her and she is very happy there. She likes all of the staff, the other residents and the food. There are a lot of activities there to take part in when she feels up to it. Prior to moving there she was very lonely and completely dependent on me for company. She has dementia and was forgetting to take her meds and pay bills. She was not eating well. Even when I brought her food it would sit in the fridge untouched. She was not receptive to any outside help so it all fell on me. That is a lot of pressure to deal with. I knew something had to change if I wanted to stay sane. If you move your mom in with you be prepared to give up a lot of your freedom. You are still young with many years ahead of you. Do you want to enjoy your remaining years or do you want to be a full time nurse/caregiver with no time for friends and the things you enjoy? I feel that a good facility with caring staff is the best option. Your mom will be cared for and have the company of the other residents. You will have peace of mind and will be able to see your mom as often as you like while still having your own time to do the things you enjoy. Best of luck to you and your mom! I hope you find an arrangement that works for both of you.
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my brother and I took care of my mom for 7 years. the last years took the two of us to physically and mentally take care of all her needs. we knew that her quality of life was much superior at home than at a facility. for example, at home she go a daily shower while at health facilities , they only offer twice a week. but the important thing was that we knew that mom would be miserable in a nursing home, away from family and her possessions/treasures and home of 50 yrs. mom was totally cooperative with us as I think she knew that we were doingcour best and that the alternative was a facility (though we never spoke about it). so depends if you have the physical and mental strength to do this and what does mom want. you have to also decide how you are going to pay for all of her expenses, poa if needed, and if you are going to get paid for your services...all this has be done with a lawyer as courts will not compensate you for anything if not legally agreed and signed by mom ..especially if there are other beneficiaries....so check with a elderly law lawyer.
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bundleofjoy Oct 2021
amazing all you did for your mother! and fantastic your sibling also did it.

many of us have awful siblings, who take advantage of us.
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I wanted to answer your question with asking yourself, "Am I insane?" but I hated to be flip. Ask yourself if you are being realistic about what 24/7 care of your mother would require of you. Her care needs will increase just as your own energy and physical abilities may decrease. Your life will become totally about taking care of your mother. You will probably need to hire additional help at home as time goes on.

You might look into home care where she lives now, but it would still be expensive. As much as you love her and are concerned about her care, moving her into your home would totally take over your life and time, demand great physical and mental energy, and fray your last nerve. It is not something to be taken on lightly.
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Lot’s of good advice on this subject. Especially that of the assessment. So important to know what would be her needs.
Have you talked to your mom about the possibility of AL? I’m curious what she thinks.
You and I are similar ages as are our mothers. But there is no way I could move my mother in with me. Don’t get me wrong, I love her and want the best for her, but she is OVER-THE-TOP demanding. If you don’t meet her needs the way she wants it and when she needs it, her abusive behavior kicks in. I’m not saying you mother is like this, but it is something to consider. Caregiving has many demands, as others have shared, but the biggest is that of your emotional exhaustion. I know, I’m caring for my wife of 31 years. She was diagnosed with early & sudden onset of ALZ. But even if we were not walking this journey with my bride, I still could not have my mom living with me because of her abusiveness.
Does your mom have any LTC insurance? Or enough assets to live either at home or a care facility? It is expensive. I pay $21/hr when a caregiver is here to help with my bride. But fortunately we have LTC insurance. A quality AL facility would be about $7500/mo where I live.
Hope this helps. You’re torn between your mom’s needs, your heart for her best, and your own emotional and physical health.
My prayers are with you!
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Tough one indeed..My brother let mom in his home and regretted it..No privacy and yes they can be demanding, critical and we saw bad behavior increase. It was very childlike behavior. Then moving her out out caused anger by her..”my kids are dead”. My mom is a loving Christian mother who became difficult to deal with. The money spent on Assisted has been a relief to us..Mom adjusted but it took quite awhile.. We visit 3x weekly..take her out and she has friends her own age. Think twice before you do this! I vote…..RUN SAVE YOURSELF!”
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Jlaroche, here is one thing that hasn't been mentioned. Be prepared for the adult/child dynamic if Mom moves in. Where once again Mom because the adult, and once again you become the child.

We will always be the "kid" even when we are 80 and they are 100, and we don't know squat.
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lkdrymom Oct 2021
Good point. On a rare occasion when my father wasn’t getting his own way he would remind me that he is my father. Luckily I was strong enough to throw it back at him and ask him what that has to do with anything
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She may need higher level of care than ALF provides. Do not bring her into your home. Read all burnt caregiving stories here. Also seek advice from elder law Atty if she has $$$ …There are no pros; only cons Hugs 🤗
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I would advise you to put her into a care facility. You state here that she's at the point where she wouldn't even be able to participate in the amenities of an assisted living facility. Think about that. The AL facility will likely not keep her long and you'll be having to look for a nursing home or memory care facility.
At 68 years of age, I would strongly recommend you not take this on. Do not move your 92 year old mother into your home unless you are willing to also have full-time home caregivers that can transition into 24-hour round the clock care staff because you will need them to.
Are you willing to have your house turned into a nursing home? Ikdrymom mentions in the comments a home that stinks like urine (and also sh*t), changing diapers, and being available 24 hours a day. One person cannot do it. Also, what happens if you get sick or need care yourself? What then?
Moving a 92 year old into your home is a bad idea. Please don't do it.
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Are you willing to give up your entire life to focus completely on her? It may not be like that at first but that is where it will end. You will not be able to work or visit friends. No more vacations. No simple pleasures like getting or nails done, going shopping, out to lunch, hobbies. You won't be able to leave home long enough for any of that. Are you strong enough to lift her out of the tub or when she falls? What happens if you get sick or need surgery, who will step in? Can you financially afford to take this on? Are you prepared to change diapers? Are you prepared to have your home smell like urine all the time? Are you prepared to get up two or three times every night because she fell out of bed or needed to use the bathroom, only to be too late so another hour of cleaning her and the floor? This isn't a job for only one person.
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She needs help with bathing - do you want to bathe your mother? I'm not up for that one, personally.

She needs help dressing - do you want to dress her every day? For the day, change if an issue, then into sleepwear.

She needs help walking - does this mean she can not walk without a person helping her? Or just that she needs a walker?

At 92, I'm not surprised that she is forgetting things!

AL is very expensive and you're right that she probably can not participate in a lot of the things available there. Can they even provide the level of care that she needs? They are pretty limited in the personal services they are willing to offer. Guess it could vary between facilities.

IF you bring her into your home, will you do it with the intention of this being for the long term or for a fixed time period? Can you do it for say 6 months and then re-evaluate? Can your mom understand something like that?

Can your mom afford to pay for helpers? If you take her in, I would hire someone to start right away to do the bathing and dressing and whatever else. And to give you a break, preferably every day. You don't want to be chained to your house 24/7. You need to live your life too. See friends. Go for walks, etc. etc. Your mom could live many more years.
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At 68 are you physically able to dress her, help her get up from bed to chair, bathe her and clean up numerous accidents if necessary if she can't toilet herself and the lack of sleep? Caring for an elder is physically and mentally challenging. Be honest with yourself if you are up to this. Once a loved on moves in it is 100 times harder to move them into a facility due to guilt about it, etc.
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I found myself doing things I never could have imagined having to do for another person and if you had asked me in advance I would have said there was no way I ever would. My main advice is to do your research and to have a Plan B ready - you may not need it or it may not be of any practical use as circumstances change but having an out can act as a pressure relief valve.
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The pro of having her live with you is you'd be in charge of all of her care, so you'd know how every single thing was being done. Her showers, her Depend changes (now or in the future), her laundry (clothing & bed linens), the preparation of all of her meals & snacks, all the entertainment, activities, movies, games, scenic drives she'd be taken on, all the meds she's taking and how they're doled out and if they're on time, the coordination of ordering them, picking them up, reordering them, getting them called into the pharmacy (including the med changes), coordinating her doctor's appointments & driving her back & forth to them, physical therapy (if applicable). You'd be in charge of all of those details and seeing to it that they were carried out to your satisfaction. You may also enjoy having your mom around for company, I don't know.

The cons are that you would be in charge of all of those details mentioned above and have little time for your own life. And that your privacy would vanish the day she moved in.

The pros of placing a loved one in Assisted Living is that they have autonomy; the right to do as they see fit, eat when and what they want; come & go as they please w/o having to answer to a son or daughter, the ability to socialize and mingle with peers their own age & have entertainment geared toward their their musical interests, etc. Card games with others, book clubs, happy hours on Fridays, outings on the mini bus every week, social events, etc. The ability to mingle and socialize isn't available in a home environment and I truly believe that is what's kept my mother alive at almost 95 years old with more health issues than I can mention in one sitting.

The cons of Assisted Living is the costs, the fact that her care would not be perfect and she'd have to wait more than 1 minute for her call light to be answered, she'd undoubtedly complain about The Food (it's the law in AL; they all complain about it as they gain weight!), and that some of her neighbors are too noisy or nosey or whatever.

That about wraps it up. Good luck deciding what works best for you & your mom!
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Jlaroche Oct 2021
Thanks for enlightening me on the pros and cons. I like being in control and mom likes her independence and a social life. I've got a hard decision to make.
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I’d suggest that you start with getting a needs assessment done on mom. This way you can have a realistic determination as to what mom can really do or more importantly cannot do, These tend to be done by a RN & SW duo. AL & NH should have names of whomever they use if there needs to be an outside assessment done.

Here’s the thing at 92 she has outlived all standards & charts for lifespan and ADLs. It may be that she actually would be just fine living with you and you could still still have an independent life. But maybe really she needs 24/7 oversight which means she needs a facility unless she had the $ to pay for caregivers to come in several hours per week. You cannot in any way shape or form be 24/7.

id be concerned abt her going into AL. She might be better fit at a NH. Perhaps a lively NH but nevertheless a NH. You do NOT want to move her into AL and then like 3 mos later get a “we just love your mom but she needs a higher level of care” letter AND have to move her again. Plus using her $ to private pay a few or even a couple of mos at a NH puts her at an advantage to staying in that bed but becoming a LTC Medicaid resident.

I’d get the assessment done and then you shop around to find 1 or 2 NH that are both private pay and Medicaid. Perhaps go at lunch and also when an activity is being done to see if it’s a good match for moms capabilities. Try not to think about the costs…. I say this because if they already are nonagenarian the likelihood is they are going to outlive their $ and end up applying for LTC Medicaid.

what 2 ask yourself….. if there was a fire at your home can you physically go from 1 end of your home to the other, pick up your mom (or have mom walk out)and have her & you outside on the street or middle of the yard within 5 minutes?
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Jlaroche Oct 2021
Thank you ! Your advice makes a lot of sense…a reality check for sure. I never considered a NH but the more I learn from this forum the more I need to consider this option. The less I need to move her the better it will be for her and me. I’ll get the assessment and do more research. I never thought of it as a 24/7 job…I didn’t see the whole picture.
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For starters, what is your relationship with your mom like?
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BurntCaregiver Oct 2021
Perfect question, rovana.
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