How do you know when it’s time to place a loved one in assisted living or nursing home?

I thought this would be a difficult decision to make, but when the time came I knew it without a doubt. I cried for weeks....because I missed him and felt for him his great loss. His care had gotten to the point that every second he needed me to do everything for him and even the nights. The unpredictable became the norm. I knew I couldn't keep going like that...the constant stress and lack of sleep. Drained in every way. Dementia does not stop or improve no matter how much you try. Earlier on, my Dad came out of it for maybe 20 minutes one day and his revelation was amazing to me. He was talking urgently...told me he has a problem in his brain and wanted to know if I knew he had this problem, asked if his doctors know about it, was anyone helping him, is there a cure for this, and has he been naughty. I was in shock and could hardly swallow. I answered truthfully all his questions. Promised I will always look after him, continue to handle all his financial affairs and won't leave, etc. He told me it is like a fog in his brain and he can't get through it. He can't find his way back. Slowly he slipped back into that fog, but I will never forget that short time he came back. Oh, I did lie to him about him being naughty....if he knew the things he was doing it would kill him. Like dropping his pants in the doctors crowded waiting room and reaching inside his Depends to check out his jewels! This man was always a complete gentleman before. Dementia is like being in a coma, except the person is still physically functioning to a degree. He never came out again. His short escape back to me is one of the most precious moments in my life. I thank God for that moment, because he was able to tell me his side and I was able to reassure him and confirm my love forever to him.
Putting your loved one in a good facility, when done with love, is not a cop out. They need the professional 24/7 assistance and so do you. They work shifts and you are trying to do it all with no breaks. Now I see him every other day and am able to have quality time with him. We take rides stopping for treats like ice cream, park at serene places and hold hands watching the ocean, talk about his past memories, etc. I am holding on to him with all my might and he knows it/feels my love. He is safer with professional care, because I don't know all the answers and can't identify all his needs. Oh I miss him soooo much!

I was told by others that I would know when it "was time." My family knew it was time about a year before I did. It is a very hard decision for some adult children to put their parent in an ASL or NH...it was for me. I'm so thankful now that I did.

We moved in with my mother and step-dad 4 years ago in order to care for them and keep them out of the NH. Well, it didn't happen. My step-dad went down very fast after we moved here with his alzheimer's disease and ended up in the nursing home and passed away a year after we moved here.

Mother, aged 84 now, was difficult to live with because she is so negative and talked terribly to me all the time. She didn't like me caring for her at all. She has dementia, insulin dependent diabetes, seizures, poor eyesight, loss of hearing, dizziness, and not very stable walking. As the years passed, she got worse in her abusive language to me and then toward my husband. She told people things that were totally untrue and I was always having to defend myself and my husband.

My only sibling, a brother, didn't come and help voluntarily. I asked him several times and he came every time. He still has to work long hours a day. I didn't call on him often because of that. Both of my daughters were mad at him for not helping me more and now there are problems with all of them. It's been terrible to see my family come apart because of us living with my mother.

Mother started about a year ago or so with bathroom problems. She started not wanting to take her insulin or check her blood sugar. I had to call my brother out a couple of times to give her her shot. She started eating less and didn't like what I cooked. Her hygiene became awful and didn't want to shower or put on clean clothes, except for underwear. We had the home health nurse come out for showering, but many times refused. She couldn't walk without her walker and ended up falling often pulling her walker on top of her. She would slide out of bed onto the floor in the mornings. Seizure days were awful. She started waking up during the night. She became more paranoid etc.

Finally, she started leaving the house. She thought many times that she wasn't at her house and wanted us to take her home. She'd try to run off.

Finally, the week before she went to the hospital and on to the NH, she became violent with me...throwing things at me, cussing me and my husband and daughter who was visiting. She tried to push her walker into me several times and I had just had a hysterectomy. Caregivers get sick from the constant stress of caregiving. And, we put locks up high on the inside of doors so she wouldn't flee. She told people when they called her to call the police or sheriff on us.

Well, the day "I knew" was after that week of "hell." Mother wouldn't get out of bed to come eat breakfast and take her insulin. My daughter helped me get her blood sugar and it was 42. I told mother I would call the ambulance if she didn't get up and she wouldn't. So, that did it. The first call was to 911 and the second call was to my brother telling him she was going to the hospital, stay the 3 days for going into a NH and then on to the NH. My brother built this particular NH and went to school with the owners, so he called them and they "had" a room for mother. So, she stayed 5 days in the hospital, gave the nurses fits fighting with them. And, she is now in the NH...been there two months now.

I have not changed my mind about she needs to be there getting good care. But, I still have sadness she has to be there. I feel guilty at times thinking I should be caring for her myself, etc. It isn't easy at all. I've gone from going to the NH two times a day at first, then one time a day, and now I just started going every other day at lunch and visit for about an hour...there about an hour and a half. It's hard to leave her with her saying she wants to go with me or she wants me to stay with her...and she says that every time I'm there.

Mother is always clean, looks pretty, hair fixed, creamed face and lotioned arms and legs. She fights with the nurses when they help her dress or her showers. She refuses to take her medicine, but they give it to her one way or another. They are good to help her practice walking, but keep her in a "jerry chair" otherwise to keep her from falling. My brother goes after work for awhile. The NH isn't perfect, but I see good things happening there. They do help mother to the bedside commode, but she does wear nice looking Depends.

Just ask around about what NH have they heard is "the best" one in town. Ask the doctors and nurses at the hospital. Our doctor was pleased she was going to the NH she is in. Mother's NH that my brother built has a good reputation as being "the best in town." One nurse in ER said they have less calls from this NH than any in town. So ask around.

We are still working on getting Medicaid started with an elder lawyer in town. Mother was blessed to have cash on hand for severa; month's for the NH, but we'll need her on Medicaid one day. Her NH is $100.00 a day.

God bless you with your decision. You can't do this alone. Caregivers end up having the health problems. My health went south and I ended up having surgery. The stress in unbearable. I went to bed wondering how I was going to make it the next day when mother lived here. And, it finally got to where I couldn't do it anymore. Let us hear what you do. God be with you in your decision.

From what you have written, it is obvious that she needs an intervention. If she has been diangosed with dementia, she cannot make these decisions on her own. She is definitely a candidate for an ALF or NH - the challenge may be in finding one that really understands dementia and all the behaviors that come with it. Too many of our forum members have been discouraged when the answer to behavioral issues results in over medication. So that would be my number one question of any facility. I would also ask to speak with the director and ask what they do when a resident acts out. Then ask to see the memory care wing. Better yet, try to find a facility that specializes primarily in memory care.
Do you have her medical POA? I hope so - that will make things easier.
I would start by doing the footwork now. Go visit facilities and gather information. When your Mom is feeling more receptive, introduce the topic. If she becomes agitated let it drop and give her time to think about it. Tell her how worried you are because you are unable to be there in an emergency. If you make it about you, she may be more receptive. These things go so much more smoothly when you can get "buy-in" from your parent - it is also the respectful thing to do.
I am sure others have told you this, but try not to let her words and actions hurt your feelings. It is just the illness talking. I try to disengage by becoming the "care manager" and think of my Mom as a "client." Then I can make non-emotional, rational decisions for her.
The bottom line is that she cannot go on living alone.
good luck

I have a Great Aunt that I have taken care of for the past two years. We are very close, I was actually named after her. Her dementia came not long after her husband of 52 years passed away four years ago. Last year, her sister, my Grandmother, died of cancer. I was taking care of my Grandmother at the time, and my Grandmother was very smart, even in the state she was in. She told me my Aunt would need to go into assisted living or at least have to move. We live in NC and my Aunt lives in VA. She resisted moving down here where all her family lives. She has no children.

Last Fall, in 2010, I went to visit her. She was missing money from her accounts. She was taking out hundreds a week in cash and basically losing it, and of course she still had a driver's license. I hired a caretaker to come in 6 hours a day. She was very resistant at first, but I told her it had to be done. At this time I had POA only. I was added to her checking account and savings.

Throughout the year, her condition worsened. The caretaker would tell me things my Aunt would do. She was more forgetful. Could not keep up with her bills, and I had to take over paying them. One day she went to the bank and took $30,000 to keep it away from me, seperate. She even put it payable on death to someone else. At this time, I had to step in. I was not taking money from her, but she was paranoid that I was. She was also paranoid that I wanted to put her in a home. See, people with dementia know something is wrong with them, they try to hide it, and at the same time, they don't understand their own actions. My Aunt would not sign a health care POA Form. I called an attorney and went through the process of getting Guardianship (meaning I had all the power over her health care needs) and Conservertorship (all the power over her banking needs.) Both meant I would have to keep inventory of her assets and her condition, and fill out papers to the court every 6 months. It's not easy, but very necessary. I was the only person available, and so it had to be done. A neurologist diagnosed her with Alzheimer's, so in the court's eyes, everything was legit.

In 3 weeks I am going to my Aunt's to bring her back to NC to be put in Assisted Living, in the dementia ward. She has good days and bad days, but her heigene has gotten to the point she soils herself, and does not know it. She has forgotten how to efficiently use toilet paper. She has become a recluse when the caretaker is not there. If I call her on the phone, she tells me she is fine, but does not talk more than 2 minutes. She is a shadow of the person she once was, and it is very sad to watch. This is the hardest choice I have ever had to make. She will not go willingly. Her doctor has prescribed a sedative to give her in case I need it for the trip down. I feel guilty knowing she is happy at the moment, and has no idea what I am going to do in 3 weeks. I will feel better though knowing she is safe with 24 hour care and I can visit her as much as I like, she will only be 15 minutes away.

The point of this long story is to say, there is no easy answer, and no easy way out. The only thing you can rely on is that you have to take action. People wil take advantage of your mother. She is not safe by herself. She could wonder off. She could burn the house down cooking. I think to myself my Aunt is okay because she knows not to cook and not to drive. What happens when she forgets that? I know your pain with being an only child. My Aunt has no children. My father, her nephew, is in prison. Her deceased husband's family checks on her, but they do not take care of her. My brother occasionally helps me, but I am the only one calling her on a daily basis, paying her bills, monitering her every move by keeping in constant contact with her caretaker. It's an exhausting, and mostly thankless task. I'm sure my Aunt will hate me for a while, maybe forever, as long as she is in assisted living. I'm 28 years old, newly married, with a baby on the way. I did not imagine something like this would ever happen to my Aunt, but I am thankful that she does have someone who can look out for her, and try to do what's right. As long as I am breathing I will always take care of her, it just wont be the way she wants it to be.

I was always told by some family and friends that I would know when I was ready to put my mother in the nursing home. My husband and children said I should have done it over a year ago, but I just couldn't.

My husband and I lived with mother, in her 80's, with dementia getting worse, diabetes, seizures, bad balance, and very rude and irritable to me and started not long ago toward my husband and daughter

For me, the day came and I knew it was the day. Mother had been on a terrible week of trying to run away, telling our friends to call the police on us, not wanting to take her insulin or medicines, throwing things at us, etc. We put latches high up on our doors so we wouldn't worry about her leaving at night. It was just a nightmare.

Well, when she wouldn't get out of the bed to eat breakfast that morning. My daughter was here visiting and I had her help me wrestle mother to take her insulin, which was 40. I brought her juice to drink and she wouldn't. So, I realized that was it. She won't let me help her and she won't help herself. The nursing home would help her.

I told mother if she didn't get up I was calling the ambulance and she said for me to call them. I called them and the next call was to my brother to tell him she was going to the hospital, be admitted to stay however long it is in order to go to the nursing home. My brother built the nursing home and he said he would call the owner and tell him and they did have an empty room.

So, she stayed in the hospital 5 days and went straight to the nursing home. It wasn't easy on me either. She cried for me when I left her that night and the following nights. But, I did realize she could not come back home anymore. Her dementia was so bad she wouldn't let me help her anymore.

She was in the nursing home 3 months and went down fast, but she was well taken care of. She was clean, hair washed, looked pretty, had her medicines, shots, good food to eat (I was helping feed her more). She was getting good care.

She died a little over a week ago with pneumonia.

I wish I could have cared for her at home, but the time got here where I could not. So, when you feel like you cannot help her, it's time. And, for your own health, too, and your relationship with your family. My health got bad and my family has bad problems over it. I hate all that. But, I just couldn't let go of my mother. But, I ended up having to do so for her own good anyway.

God bless you on your decision. It isn't easy, but you have to do what's best for you and your marriage and your family and what is best for you loved one.

Update on my Aunt. She has been in assiting living in a memory unit since November. I have to say it was the best decision I ever made, and it was the best decision for her own sake. Now I can take care of her financial needs, while professionals take care of her medical needs. I cannot emphasize enough how much weight has been lifted off my shoulders. I also cannot emphasize how she is in better health and mind since she's been there.

I thought her adjustment period would be extremely overwhelming, and she would have a hard time getting use to where she was staying. In fact, the opposite happened. A person who can think rationally and has a healthy mind would be nervous or sad about leaving their home. We set up my Aunt's room just like her bedroom at home. She adjusted to her stay in a matter of 48 hours. She still thinks she is in Virginia, just down the street from her own home, when in fact she is in North Carolina, 3 hours away.

Now, when I say her health and mind is better, I am not trying to give the notion that she is recoverying from Alzheimers. We all know that's not possible. However, she is now getting 3 full, nutritious meals daily. She is not alone during any period of time. She interacts with the staff there, and they are all her "friends" as she calls them. I will say she does not interact with the patients, but in her condition, she is still at a lower stage of Alzheimers than they are. Her medicaid pays for physical therapy, speech therapy, and occupational therapy. She participates when volunteers come to sing, dance, and put on plays for the patients. She is still reclusive like she was at home, but now she is forced to be a part of life. Before, she stayed in her bedroom, only getting up when her home health person came to stay with her for 6 hours. Now, she has full time care. She is 15 minutes away from me, and I can go see her anytime I want. I can take her out to dinner, or I can bring her dinner, and we can eat in a private room. She still has memory problems, and she has better days than others. The most important thing is that now, she is not a danger to herself or to others.

For the lady above who has to have the mother in law in her home, I know your stress. I couldn't be around my Aunt for more than 24 hours. I know it sounds cruel, but dealing with someone who has dementia and alzheimers is about the same as dealing with a mentally handicapped child. You do realize how stressful it is to take care of an elderly person until you are actually the one doing it. You also have to think, in an assisted livign facilyt, you have many many people taking care of the elderly. Not just one person. So how can you expect to live your life, have a healthy marriage, take care of your own children, go to work, and take care of an aging and senile family member? It's not possible. You will crack. It will destroy your life. It's the hard truth of the matter.

For the husband that wants to take care of his mother, the best thing he could do is put her in the care of a home. He needs to understand easing his own mind to take care of her himself is not really taking care of her. He can find her a good place to stay, where professionals will really take care of her, and he can still go see her.

I am speaking from the point of view of a person who had to take care of everything for my Aunt. I can tell you, my stress levels are much lower, and my Aunt is happier where she is now. It may hurt to take her out of her home, but you also have to think, "home" in her mind is no longer the home she once had.

Debrasue, you will not be killing your mom by putting her in a 5 star care center. But you might be killing your own health if you continue the way things are. I am very sorry that you have so much family tension to deal with, on top of all you do for mom.

Debrasue you've already gone above and beyond, it's not wrong for your mother to be cared for by those best suited to meet her needs. It is not a sin not to be the person to do that. I'm very sorry about the loss of your dog, please set the burden of your mother down and give yourself time to be.

Your mother cannot be handled at home. Physical limitations and fraility are one thing but dementia is another.
Nursing home.

Be firm. Tell them what they need to hear not what they want to hear. Don't be there 24/7. Don't be their lapdogs. Sounds callous, it's more callous to allow them to call the shots and demand all your time and effort. Loving your love one does not mean you have to become a servitude for them.