How do you know when it's time for a nursing home?

The problem with the theory of 24 hour care in a facility is that there truly is no one with them 24 hours a day in any facility unless you are paying extra for an aide to sit in the room with the patient like from an agency or you are staying in the room with the patient 24 hours a day. The theory that there is staff 24 hours a day is not the same thing as saying someone is with them 24 hours a day. In a facility there is no 1 on 1 care involved. Now I am not saying that some patients or families would not be better off in a facility. I am just saying that the very logic of someone with them 24 hours a day is not possible, likely or anything. The best thing you can hope for in any nursing home is to see a staff member once every 2 hours & that probably does not happen with staffing/funding being what it is but seeing another human being once every 2 hours is nothing close to be with someone 24 hours a day. Plus from my visiting my parents in homes no one responds to the call lights from rooms like ever. Seriously you can just walk up & down the hall & no one is responding to any room's call lights to even turn them off so as not to disturb other patients. Just doesn't happen. And this current NH is rated 88 out of 100 in my state on the list. Above average & everyone you talk to speaks of how they never take medicaid just medicare & how ritzy & the best in town it is. No nursing home I have seen responds to call lights they just beep & beep & beep. Very disconcerting so back to the theory of needing to be with someone 24 hours a day, I really would think at home (1 on 1) would be more likely to be with someone 24 hours a day than 1 nurse to 25-30 patients & seeing them only once every 2-3 hours. Just from a technical standpoint. Now if you want to consider training & certification or the person that sees them once every 2-3 hours being professionally trained that may be necessary at certain advanced health levels. That I can agree with or when they are not ambulatory & still not 6 months or less then I can agree they need to be there. BUT they are most definitely not with ANYONE 24 hours a day in any communal setting. Not unless you come home to eat & sleep & then stay in the room with them while you can walk to the nurses stn to get help. I took care of my parents 1 on 2, me on both of them & I had a family member take the overnight shift so I could go home & sleep. He came & slept there with them in the 2nd room while I slept at home. Then I went back in the am & stayed til my respite family mem. could come take the overnight. That only lasted a year - then they went into a NH & it has been hell ever since. I feel the NH's consume much more of my time & cause much stress compared to when I cared for them in the home. The only exception was the first 100 days when facilities really cared about them. Ever since NH medicaid my life has been much much worse.

I don't like to sugar coat facilities as a long term solution to a great problem. If there has usually been one caregiver for the patient there is actually going to still be just one caregiver for the patient. You. And honestly at first it will be great but as they deteriorate & they do you will either feel like you have to be in the building alot just so that their needs are met or have to clean up for not being there later. Or the building will eventually tell you they can't get the patient to eat or swallow their pills. Mom had a roommate once whose daughter had no choice but to basically move in because otherwise she would have had to find another facility because her mother was so difficult to get to swallow her pills. So she was in there all day long to cover every med shift. So the idea that you get to relax & take care of yourself is simply temporary when you facilitate them. Enjoy it while it lasts. That was a NH I was speaking of - not an ALF. As a daughter I often witnessed her being bullied & yelled at by the A DON for something her mother (patient) did wrong. It was automatically the daughter's fault that the mother ripped something out & since the bully couldn't yell at the patient he yelled at & threatened the daughter. That was another very well rated facility. So like I say a facility does not have someone with the patient 24 hours a day & in fact someone is with the patient far far less than if they were at home with 1 person. 1 on 1. If you want to calculate in your sleep, I would think compared to once every 2-3 hours I would think they would still have a person near them more than in the NH. If I were to facilitate them I would go before breakfast & stay until past dinner & then come home. That way I could see they were eating instead of taking building's word for it. Also to keep them company. They would do it for you. Plus I like it. I like having my dad's company. At home I would be alone. Up there he would be alone. Just come home to sleep. Eat with the patient.

Also, I don't pay for tv at home anymore. I just go watch tv with dad at the facility. Nicer with company.

I am at the same place now with wondering if my parents should go to a nursing home. They live in an independent living place now. My mom is in a wheelchair but can get herself to the bathroom and dressed. My dad was in better shape. He helped her a lot. He had a quadruple bypass 3 weeks ago and is not able to help her at all and is weak. I am unable to help them due to my own health issues. I hate to have to tell them I think it might be time for them to go to a nursing home. It really is hard to make these decisions.

And that makes me wonder....how do you go about putting someone in a home? Can you go to the home and do it yourself or does a doctor have to be involved? Husband has alzheimers. He is completly dependant upon me...for food, drink, bathing, bathroom cleaning. I feel when he is unable to get up and walk, I will have to put him where he will get the care he needs. I am doing this alone. Lately he still walks but legs start to shake so bad I have to hold him, to keep from falling. And yes, he has fallen a couple times...out of bed. I am trying to keep him home as long as I can, we are not rich. But some days are a little stressful. And it has been just 5 years.

You can't just put someone in a home, but a doctor and hospital can. Even at that a person could leave, but most patients that we are talking about are dependent on care, so they wouldn't do that. Call a few NH and ask for information on admitting your spouse.

I agree with and have experienced all of Standing Alone's reasons for NH placement. Yes, we deserve a life. What is the point in trying to prolong the life of someone with Alzheimer's? The quality of their life is very poor, it ruins the lives of others who love them and whom they once loved; love in fact turns into resentment and more, their dignity becomes utterly lost, and money is thrown away in an effort to prolong this terrible way of living. I would gladly sign a legal document that I want my life taken before I got to such a point, as my husband is now, where he lies for hours and hours in bed, in soaking wet clothes, in a room that burns your nose to enter it, and kicks at me and will bite, hit and push, yelling incoherently when I just want to help him get up and get him undressed, washed and cleaned up. I wish euthanasia would be legalized. It is a terrible, terrible thing to see dementia staring you in the face and feeling nothing but trapped in a nightmare life.

I am a newcomer but have been reading the questions and comments and find them very helpful and thought I would join the discussion. My mom is 93 and still lives alone in a senior facility. She has some of the health issues that Olmaadme mom mentioned. I have been trying for 2 years to get my mom to move in with me. I have an aide that comes in Monday through Friday 4 hours a day. I am there everyday in the evening for dinner and every weekend. My mom is by herself at night. I get calls from her all through the night and early in the morning. I retired in 2011 to assist with taking care of my mom and my granddaughter. Since then I now take care of my 2 grandchildren and my mom. I care for my grandchildren at there house 3 days a week. It would be a lot easier if my mom would just move in with me but she just won't budge. I am concerned when the time will come when she will wake up and not be able to see. She has had 2 falls in the past 6 months that she has recovered from but the doctors seem to think it is time for her to make the move. My husband and I are willing to give it a try. The NH for us is the last resort. My father in law lived with us for 5 years before we had him admitted to VA because of dementia where they took very good care of him for 8 years. I also agree with Care4Mama. There is no easy decision in this process.

Candy it is time and you need to do what is best for her and for yourself. Try to do this by yourself and you'll end up dying before she does. Share the burden with the nursing home and you'll both have more time together. It's what is best for BOTH of you.

When you're scared to death that your 90-something year old parent is going to outlive you...it's time for a NH!

When the doc says your 90-something year old parent is healthier than YOU are, it's time for a NH!

When the doc says that YOU'RE at more risk of a stroke than your elderly parent...it's time for a NH!

When you hear your parent yelling for you and you run to help them with your heart pounding, thinking they fell, only to realize that they didn't call you this time and that you're hallucinating....it's time for a NH!

When you go into your elderly parents bedroom to get them up in the morning, and they took their depends off and used the bed as the toilet AGAIN...it's time for a NH!

When your elderly parent is zipping around like the Energizer Bunny and you feel like taking a shower is the equivelent of climbing Everest...it's time for a NH!

When your elderly parent sleeps like a baby, but you're up twitching from stress and sleep seems like a thing of the past....it's time for a NH!

When your elderly parent can never be pleased or satisfied and is hyper critical...it's time for a NH!

When you catch yourself daydreaming of homicide with an evil grin on your face...it's time for a NH!

When the furthest you've been away from the house is the bank or grocery store for years...it's time for a NH!

When you find yourself waking up at 2-3 a.m even though you're exhausted, just to get some peace and quiet...it's time for a NH!

When it's been so long since you've had sex because of caring for your elderly parent that you've forgotten what a man/woman looks like below the waist...it's time for a NH!

When you realize one day that you haven't had a good laugh in years because you're so miserable care giving...it's time for a NH!

When your personality does a 360 and you don't recognize yourself anymore after eons of care giving...it's time for a NH!

When your partner/husband/wife/lover threatens to walk because you're so bogged down care giving...it's time for a NH!

When your boss threatens to give you the boot because you call out so much to help your elderly parent...it's time for a NH!

When you're new to AC and care giving and reading all of the posts scares the shit out of you...it's time for a NH!

When your pets have better toilet habits than your elderly parent...it's time for a NH!

When you find yourself totally alone because all your friends have bailed because you have no time for anyone but your elderly parent...it's time for a NH!

When you're facing the streets and find yourself broke as hell due to lost incomes and jobs, with medicaid ready to snatch up the parents assets when they're gone, leaving YOU with nothing...it's time for a NH!

When your parent refuses to give you POA....it's time for a NH!

When you're taking care of a 150 lb baby around the clock for a decade or two...it's time for a NH!

When you can't remember your last vacation thanks to care giving...it's time for a NH!

When you literally can't remember the last time you actually had some fun and weren't stressed and twitching...it's time for a NH!

When you feel like care giving is literally going to kill you...it's time for a NH!

When you're one of the 30% of care givers that die long before their charges do...it's WAY past time to consider a NH!

Yes indeed.

I feel your pain. I am the lone caregiver of my Mother that has Alzheimers and refuses to take her medication. I have the same feeling, and hope I find her dead everyday.

When you can no longer safely give her the care at home that you know she both needs and deserves, it's time to start looking. If you are at your wits end (allalone, this is for you) and know she would be better off in a facility with 24/ care, it's time. When you find yourself resenting the demands that caregiving is placing on you, your life, and your relationship with your mother - when caregiving is robbing you of precious memories and replacing them with hateful thoughts and dread, it's time.

It's a tough situation and you will be full of doubt at first if you did the right thing. I can share my story with you and tell you my mother has frontal lobe dementia and my father died suddenly last Christmas. I truly believe it was a direct result of caregiving and keeping quiet. I saw my mother weekly. I never realized where she was mentally until living with her right after he died. I have four siblings and I was the chosen one. I couldn't keep her at home more than six months, her safety was an issue, her sundowning was a bitch. When you live a stressful life and have someone who is only self aware to care for its going to eat you alive. We placed her in a nursing home and that was another ride from hell, constant calls, I wanna go home, what did I do to you? Why did you put me here, ect ect. Very heartbreaking and talk about being unsure if you did the right thing. Everytime we went to visit she was alone in her room, waiting to get her needs met. We finally decided to put her in a memory center. I cannot tell you the difference that makes for someone with dementia. They watch them very close and they have tons of activities all day long. At first she didn't like them bugging her all the time, now she loves the place, if we have to take her to the doctor, she can't wait to get back. Bottom line , she feels safe, her needs are being met and I am a daughter again. It has only been a year since all this happened and I feel like its been ten. Looking forward to a better year. I no longer have the angry feeling towards her, I feel sad that my dad is gone and my mother is progressing in a memory center. Life changes so fast sometimes. Good luck with your situation.

I need to stress that I have no outside help and have applied for assistance. I have been on a list for over a year and have been told that there are no funds available yet. I cannot afford a nursing home and have no outside help (financially or otherwise).

Allalone- If you can't afford a nursing home and your mom needs that level of care, Medicaid should help. Please check into it before you go crazy.

Go to a nursing home, unannounced and tell the receptionist that It is your initial visit and that you would like to get some information. That would be a start, I think.

Two things, according to research, typically predict nursing home placement: 1. Caregiver burden level--when its too high and too stressful; and 2. The safety of the loved one is in jeopardy. Dr. J

I had not thought of the divorce angle. That would be an interesting alternative to spousal impoverishment which is how one spouse goes into NH & the other stays in the house. In the case of spousal impoverishment the house would be taken/liquidated by medicaid (the state) after the one living at home has died & the one living at home does still need to keep some kind of limited means or produce financial reports at some times or something but since the house would be taken by medicaid after death, divorce is an interesting option. The lawyer's fee would probably be more expensive & I don't know how the patient's mental state would play into being able to get a divorce but if it saved the house for the next generation & not to mention making the financial life & general lifestyle of the community spouse much easier i.e not having to produce financial records to the gov. regularly or keeping income & assets down would be much easier & leave the time to the comm. spouse to visit & advocate for the patient. I just don't know the rules regarding the patient's ability to participate in the divorce. Alot would not do it but for practical reasons it isn't a bad idea. Imagine spousal impoverishment where the comm. spouse is the only visitor/advocate & the part about being a comm. spouse gets to be too much & interferes with the ability to care for the patient at the facility & what about when the comm. spouse starts to need help even temporarily what a mess of red tape. The divorce idea is really not a bad one & makes me start wondering if that is what couples might not to set up prospects for just in case considering the offspring & the family home. Instead of elder financial planning start considering whether the divorce idea might be a better fit for some. You would have to be careful to become the POA or guardian before divorcing or during the divorce so you can still help your spouse.

The divorce retainer would also be a spend down.

OMG! You SO have my heart. My late hubby developed alz & park & when we learned of it we discussed it & I promised I would keep him home as long as I could keep him safe. Well 10 yrs later I was to the point of sleeping 20 to 45 min a day total! I had struggled with the NH issue for months, I was so wore out, the only friend I had left said I no longer looked like me. etc etc well the day I was walking thru walmart with him & he set himself on fire was the day the decision was made. I knew then I was no longer able to keep him safe. It still was'nt easy to do the deed & I cried the entire first month even tho I drove 58 mi round trip every day to see him. They did an excellent job with him & he became even more of a handful. He was in the NH for a year & a half until he lost his battle with a rare cancer (Thanx Agent Orange) I did visit him everyday & took him out most days to get a burger, go for a ride, look at old cars etc. And I am glad I did. Still in the end I felt I had not done enough for him. I cried for MONTHS after he passed. Til I went to a grief counselor, 2 sessions & unbelievably I was able to handle life again & stop beating myself. So yes Honey I know where u r at, but truly a NH IS IN THE BEST INTEREST OF YOUR MOM, stop & think if she were to suddenly snap into full reality would she WANT YOU to do what you are doing to yourself? No as a parent she would WANT you to be happy & healthy.

I think each caregiver knows when the time comes - it's usually when you are asking if it's time. I enjoyed the time I had here at home with my mom but when she started getting up at all hours and we weren't getting any sleep, I got sick and had to make the decision. We found a place where Mom feels at home and is content. Has it been all roses? No. You still have to oversee the care to ensure that your loved one is being treated properly and if you have POA, you have control of what medications are given. Mom's home knows that I don't want her to have anything without going through me first - even if the doctor prescribes it, they check with me before ordering. I have to keep an eye on things but they have been good about fixing problems and have been responsive to my concerns. They know that if Mom's happy, I'm happy.

So, if you're asking when is it time, the time is probably now. Just find a place that you are comfortable with. It doesn't have to be new and beautiful, it just has to be clean and have caring people.

I wish you the best!

I gave up my home and career to move and care for my mother (Parkinsons & dementia) for four years. After one particularly bad fall when she landed in hospital (again) it5 was obvious that she needed care 24 hours. Her doctor told me that, so long as you stand there with a smile on your face the hospitals will just keep throwing her back to you so I stood my ground and said no more. She`s been in a NH over a year. In that time she`s broken a hip and had another stroke. Now unable to sit up or stand by herself, her dementia is severe, she`s mostly in bed and eats not enough to keep a bird alive.

I bought a dilapidated cottage which I`m fixing up, on 2 acres not far from the NH for me and my critturs. I`ve spent the last year ``in recovery`` and only just recently starting to feel human again, looking forward to a little homesteading and rebuilding my life. My mother has been a mean and A1 narcissist life long and made my life hell. At almost 65 it`s my turn now. You can`t put a price on freedom.

My husband is incontinent but still mobile. When he becomes bedridden, I may have to look into nursing home as I've already tried to change him when he is in bed and my back just won't take it.

Two predictors of nursing home placement decisions for family caregivers: 1. Safety issues for the loved one being cared for; and 2. Caregiver burden or stress, mainly determined by the caregiver and with physician feedback sometimes.  Dr. Chris Johnson, Professor of Clinical Sociology, Texas State University online M.S. in Dementia and Aging Studies program (first MS in Dementia Studies in America). For more information email me at: cjj38@txstate.edu

Thanks to every ones input,I feel I did the right thing placing her in a nursing home. Lots of falls,calling the fire dept to pick her up and now pending shoulder surgery due to the fall.Many other issues like dialysis,diabetes,mental illness,short term memory loss and can't walk and relies on her powerchair. Her safety as well as mine is at stake.

My mom can't do very much it sucks she has one of the worst ms I've ever seen she's in a wheelchair was a very beautiful women and was only 42years old and it took everything from her I don't know what to tell her she is so sad me and bro ,sister ,don't know what to do it's bad she is 57we have been trying for a long time 16 17 years it's time we love her so much