Mother gets 16 hrs in-home skilled nursing care. Looking to placing her back in a nursing care facility. How difficult would it be to place her?

Get her doctor to order facility care.

Then you can place her because her doctor prescribed it.

If she has no money you will need to file for Medicaid and she could only go into a facility that accepts Medicaid and has a bed available.

I would contact a NELA CERTIFIED ELDER LAW ATTORNEY, you can find one near you at www.nefl.com.

It is long over due for your family to take their rightful place as your 1st priority.

I bet these absentee siblings were in on the guilt tripping to get you to take in mom.

Help your wife find herself again, I would bet she doesn't share anymore because it has all been said and you were never ready to place mom, if I am wrong, no offense intended. Even if I am right, no offense intended.

FYI, it is NEVER the golden child that takes in the ailing parent.

I applaud what you have sacrificed. I’m no where were you are , but it gets to the point where enough is enough. Then that’s where it is. You aren’t Superman. Your wife and kids have every right to feel cheated. Because they are. Nothing is normal for any of you. Not their fault. Let your siblings know you’ve done all you can. If they can do better, or more then do it.

Is the scene kinda she thrashes and pulls the tubes out so it becomes you all go into emergency mode to deal with her and reset? If so, next time do not but instead call EMS to take her to the ER; ER will order all sorts of consults and she’ll get hospitalized (not under observation but hospitalization); then you do NOT take her back to your house but instead social services at the hospital looks for LTC placement for her.

If I had to guess she’s gonna be evaluated to go into a skilled nursing facility aka a NH and within the NH onto hospice. Now this decision may pose a family crisis cause those siblings of yours have not and do not want a reality check on what your mom’s health truly is. I’m assuming your her DPOA and MPOA. If your not, then it’s the dpoa holding siblings monkey to deal with. You’ve done your decade.

your wife and children omg I cannot imagine how this has affected them. Big hugs to them.

I will say - as a mom of a kid in college - you need to get a handle on this before your kids hit junior year of HS. Why? Couple of reasons...
1. Cause the time & costs of determining which college can be pretty involved. Unless your kids are in a rare HS which has great college prep counselors (my kid went to a highly rate college prep HS & his college counselor was beyond lazy, so parents ended up DIYing the process and that takes energy. (PM me if you end up dealing with “the common application” or one of the academy’s, these are sticky to do). Plus nowadays colleges expect prospective incoming to do “look at us” days or weekends for prospective students. Some schools - if your kid is on the cusp of whether to be accepted or not - will add points to those who came to prospective student weekend, so it can make the difference needed for admission. And really you & wife may both want to go to those family weekend colleges do & most have a separate younger siblings program (like the middle school & HS fresh & sophs go watch a college sporting event &/or movie & snacks at one of the dorms). You can’t do this if mom’s still in your home on 24/7 oversight.

2. FAFSA - the required financial aid document does not give a rats butt about the costs you have incurred in taking care of your mom. Only if mom is a legal dependent can she be considered a deductible household member. FAFSA kinda has to be done, unless kids going into the rarefied world of some of the Ivies (like Brown) which tuition isn’t a factor for those of ahem more modest means. FAFSA is pretty hard core and looks at you & wife’s income to determine the estimated college support and unless you have a brood of kids, FaFSA is gonna show you are able to pay your kids college costs. You think it’s hard now.... you really REALLY don’t want to tell your oldest that although their first choice has accepted them and their friends are all going away to schools that they can’t cause our time & $ & focus has been & is on granny.

You need to refocus on your kids future and that means mom into LTC. By doing this it also gives you & your wife something new to work together on that’s bright, shiny & hopeful. It’s good you recognize that you think she’s depressed but you may be also. Once mom goes into the hospital, you & her have a date night and no-none-nada-zero talk on your mom.... talk about spring gardening, the Oscars, Trump, Super Bowl, whatever is NOT your mom. (Ok maybe not Trump.) But date nite twice a month minimum.

The short answer is yes, she can be put back into a skilled facility. The best way to accomplish that probably depends on several factors including where you live. Someone mentioned doing it via a hospital stay and that is certainly a good clean way if she is apt to have a hospital stay sometime soon. If not there are other ways and having a discussion with her primary or most in tune doctor is a good place to start too, let them know you simply can't care for her at home anymore and need some guidance in the options for the next best step. They may be able to order a move or order an evaluation (there has been a change, you can't provide proper care) during which you make it clear you can no longer do the care. It's kind of like starting over, a restart or start of the next stage in this journey, her journey home. You have gone above and beyond and have nothing to feel guilty or badly about here, I sincerely doubt you will just abandon her so you will go on caring for her just not in your home. How others choose to use their last days with her is their choice. Someone else doing the medical and personal care allows you and your family to just spend quality time visiting with her again, a nice way to remember your last days, weeks years whatever the case might be.

By all means place your mother in NH. 24/7 care - her screaming will not bother the caregivers - they are ready to work the night shift. Give your time and your home back to you and your wife; give your children the attention they need before they leave the house for college, etc.

Great advice for you here so far. Place her and move forward for the well being of your wife, your children, and yourself. You will never regret it.

She's trying to pull the tubes out because she wants to die. Nine years! This seems to be to be a good example of why such tubes, particularly the feeding tube, should never be inserted as they are are impossible to have removed once they are in. I assume she did not have health care directives to prevent this situation.

Please go ahead with finding a nursing home for your mother. You and your family have done all they can. Don’t pay attention for even a moment to other relatives, they haven’t lived this like you have and should have no say at all in this. Well done in caring for your mom for so long, now your care needs to shift into finding a good nursing home and watching over her care there. Enjoy the family time you gain.

This is an incredibly hard place to be, and I am not sure how you all have coped with this for such a long period of time.  It takes an enormous toll that those who have not experienced a similar situation can never understand.

Before I could offer anything other than empathy and admiration, I have a few questions.

How old is she?  What precisely is your mother's condition? How aware is she? Can your mother speak, read, watch TV?  Can she enjoy the company of others?

For how long has she been screaming at night?  Is it every night all night, or intermittent?

Does the minimal 16 hour/ week nursing care maintain the tracheostomy collar, urinary catheter and feeding tube, or does your family have to do part of that maintenance and care?  Do you feel that your wife carries most of the weight of caring for your mother?  How are you all able to continue to function with losing sleep d/t to the screaming through the night?

Does your mother have a Living Will, Financial Durable Power of Attorney and a Medical Power of Attorney?  If so, who holds these?  If not, do you feel that you are treating her according to her wishes? 

What are your biggest fears about placing your mother in a facility?  Are you afraid that she will feel unloved and forgotten or that the facility won't take good care of her, or both? 

This is very, very tough, and it's important not only to think your way through it, but to feel it.  And one thing to remember is that not every decision is permanent or irrevocable.  You might consider whether or not you all simply need a break. And you can re-examine that need at regular intervals. We tend to think our decisions are permanent, but life is much more fluid than that.  Things can change on a dime, and sometimes because it's up to us.

I was in your situation for 13 years, my kids knew that every vacation we go with grandma and therefore the vacation conditions are limited. Fortunately for us, she was very mobile up to her 90. But then she being stubborn and dementia wise, never listened to us about her esophagus problems, refusing to eat puree food, that brought her to hospital with aspiration pneumonia and feeding tube, that by the way she was pulling away twice, not understanding that she need it...Then fortunately she was able to eat puree food but she still refuse to acknowledge that she can not eat solid. So I realized that at home the situation return in one week. therefore she was left at NH, where she stays first for rehab. Is it easier for me? in some point yes, it easier for my husband, my kids, but for me - hard question, you still need to go almost every day to advocate for her otherwise everything going not right there, even at good ones...So I am still depressed and relies on my wine and pills, but she adjusted and thinks that there now her home....Guilt sometimes killing me but what can you do, we also were unable to receive more than 18 hours per week at home only....

Do some research and find the best facilities in your area. Call and make an appointment to visit. Nursing homes know how to get people admitted. It's their business after all. Talk to them about your situation and they will tell you what you need to do.

I do not see myself as a home-wrecker and this is a cynical thought, but I will lay a small private bet that if your wife were to walk out you would get your mother placed in a nursing home before the sun went down that day. You would find a way.

Your mother's condition sounds like a living nightmare. Please don't think I don't genuinely pity her, in the true sense of that word. But what good have the sacrifices that you, your wife and your children have made to the family's feelings done her?

Experienced posters have offered lots of practical advice on what steps to take. Please take them, immediately.

It is my thought that you can no longer provide at home the medical care that your mother needs. Her needs are many. Therefore, it is best to place her in the hands of medical professionals at an NH. Please know that I realize you've done a splendid job thus far, but can no longer do this.

Firstly, if anybody is being selfish here, for sure it is NOT you or your family. Think the sibs who wanted you to take her out of a nursing home and then do nothing to do their share. Shameful. Actually, she is realistically beyond home care. So talk to Medicaid rep, check facilities and she will be better off, and so will your family.  What kid needs to grow up in a hospital setting?