When did you feel that it was best for parent to go to skilled nursing facility?

I am sorry that you are in this situation, but I think that you need to listen to the professional opinion of the doctor. Also, I think that you have answered your own question when you say that you can't lift her. You have done a good job taking care of her at home, but it does sound like she needs skilled care now. Take care of yourself.

Your mom has dementia. It only goes in one direction. You are a single parent of a 9 year old. What are you going to do when your mother starts trying to wander in the middle of the night? Do you leave your son alone in the house to drive around the neighborhood to look for mom? Do you lock the door to keep him safe or leave it open to allow her back in if she wanders back?

In a nursing home, there will be acitivities, events, walking protocols and the eagle eyes of nurses who will notice changes in your mom's condition. This would be (and was) a no brainer for me.

I was able to convince my two husband-wife friends that it was time to go to a place with more help when the wife became incontinent and began to wander. She needed 24 hour care at that point and after much discussion with the husband, who couldn't see her deterioration due to his own short-term memory problems, he agreed to do this for his wife's sake. I had found a memory care apartment that would accommodate them as a couple in an assisted living facility and just needed the husband's agreement and signature on the check to get the move process going. Since he couldn't remember he had agreed to this, we had the same discussion 3 more times. Once there in their apartment that was set up to look just like their den and bedroom in their condo, they were happy. The wife got the additional care she needed right up to her demise 6 months later and the husband was happy to just stay there after that. Babalou made excellent points for you to consider and I hope you have success in finding a good place for her and then in getting her into it.

I found myself in the same situation you were in. After my mother fell and broke two kneecaps and her wrist, I simply couldn't lift her. Her doctor suggested nursing home and that did it. While in rehab we found an assisted living with wonderful care and services. We somehow managed to move her directly from nursing home/rehab to the assisted living so we bypassed moving back home. It was shocking to her to move to a strange place, but I had to explain that I, at 64, simply could not lift her anymore. She is pretty happy, although complaining a lot as is her nature, has to admit the people, the food, the care is excellent. My point is, I can't even imagine having her pick out what was getting moved to AL. It was difficult enough for me to do alone. So consider this while she is in rehab. Start looking now.

Actually, it sounds like you are answering your own question.

It doesn't work any more. That is really the moment for AL or for a nursing home. When the situation just doesn't work anymore.

With my mom, she couldn't remember to take her meds, she could not be left alone (which meant we were trapped in the house and could never go anywhere together), she got nervous and confused about junk mail.

I agree with others here - it's time. When the care at home becomes more than you can reasonably handle, it's time for help. It's not an easy decision, but you have to be realistic and decide what's best for Mom.

When my mother suddenly declined due to congestive heart failure coupled with kidney failure, the two conditions combined into a perfect storm of symptoms that caused her heart to stop briefly - but long enough that she passed out and fell out of her chair, striking her head and slicing it open down to the bone. If I (or someone) had not been here to get her the help she needed, she would have died, because she didn't have the presence of mind to even turn herself over - and she was bleeding profusely from the head wound. If that wasn't a wake-up call, I don't know what could be. I kept her at home as long as possible, but this situation didn't get any better, and I had to place her in nursing home about a month later.

This is a purely "relative" question. (No pun intended). I was told by the hospital social worker that my mom needed skilled care as well. I had been through a lot with her over the past few months and had pretty much reached this decision on my own. Based on my own life experiences with her, let me ask you these questions: if your mom goes from rehab to rehab, will she make enough progress to live on her own eventually, even with home care? Is home care financially feasible? In my experience, health insurance doesn't cover all of home care for any length of time. Do you have reliable help if she returns home? What if she winds up living with you? What kind of strain will this put on you and /or your marriage? Would Mom be safe in a home environment 24/7? My mom wanders at night. You want what's best for your mom and so does her medical team, but it doesn't seem you agree. Your best bet is to attend the care conference with an open mind and accept all ideas for consideration as well as share their's. There may also be remodeling concerns for her living situation, whatever that may be, her home or your's, that could be very costly. If she falls in a skilled facility, she will have immediate medical help. At home, you face grouchy EMS personnel (no excuse for that and I'd call the fire captain), charges for using their services, possible legal issues and last but. It least the fact that she could suffer greater and greater injuries without immediate attention. I wish you luck. I've walked in your shoes and understand.

Oh, yes, and...

She left the burners on, she let strangers into the house and told them all about herself,

she didn't know where to go to get cash,

she wanted to close down the bank account into which all of her money was automatically deposited,

she drove the car into the side of the garage (TWICE!).

It was not working anymore. Boy, did I take along time to figure that out!!!!

Don't wait, as I did, until my husband's hospice social worker started the transition for me. It was a blessing that she chose the best nursing home with an opening. At 84, I was worn out from caring for my ill husband, six years younger and more than 50 pounds heavier. Two years later, I'm still recovering from the strain.

All of the above answers are a good reason to put your Mom in assisted living! My Mom had to be put in also, she and my Dad were living with my brother and Mom got to the point where she could not be left alone at all and my Dad was afraid that she would fall down in the bathtub trying to take a shower and he couldn't pick her up if she did and she dropped at the dining table one morning and actually stopped breathing and in the fiasco of trying to get her out of the chair that is built into the wall they all tripped and fell on the floor. In that omg moment it re-started Mom's heart and she was taken to the hospital. After that they all decided it was time for her to just stay there in the assisted living area of the hospital. My Mom has Alzheimer's and now she has round the clock nursing and Dad doesn't worry anymore. He goes to visit with her all the time and she has things to do there even though she forgets but the main thing is she is doing so much better. Your Mother will to when she goes into assisted living. After all you cannot rely on calling the fire department for this, you don't realize that when you take them away for a call like picking her up they may miss one for someone having a heart attack that actually needs them or a house on fire or a car accident. I know because my husband was a fire captain, he spent 36 years in the fire service. I know you will make the right decision and get your Mom the help she needs.

msgarrett --
You make a good point about the firefighters' role by pointing out, "when you take them away for a call like picking her up they may miss one for someone having a heart attack that actually needs them or a house on fire or a car accident."

I am a retired long term care administrator. The wording of your question indicates a strong desire to make taking care of your mother at home work. It appears that you have tried longer and harder than many would, but please don't let your devotion to your mother cloud your discernment of what is best for your mother (and you). Some further thoughts (sorry if they appear tough-minded): will therapy at the rehab center result in her having the balance and strength to prevent future falls? If not, will she know when she needs help and not try to navigate on her own? If "no" to both of these questions, then are you willing to allow her to continue to fall and perhaps fracture her ribs, back and/or hip? Have you explored why you are having trouble coming to your own conclusion on this matter?
I have two points here. First, this is a difficult decision that would be best handled with someone who is more familiar with your mother's condition and the available resources in your area, e.g. the social worker at the rehab center. Second, you are fortunate that you have the time your mother is in rehab to research facilities in your area, if that is what is determined to be best for all concerned. Check out facilities in the evening and/or weekends and talk to the staff, not just administration.
Here is a possible alternative resource for you. There is a growing movement to create networks of volunteers and service providers that help keep seniors in their homes longer called the Village to Village Network. They may not be operational yet, but could have some helpful ideas.
And one more point: that fireman is a jerk. You have my sympathy.
May God bless.

When they start falling down, it's the beginning of the end, the nursing home awaits. My mother had dementia, fell several times, incontinent, and the last time she fell cracked her head open and nearly bled to death. Physical therapists came when she got home to show her exercise, as if building up legs of steel was an option! Visiting nurses came, suggested a few safety precautions. Mom fell again a few days later, it took two of us 15 minuties to get her up, changed, and clean up the floor. Enough was enough, a couple of months after that she was on Medicaid and in a nursing home where she did very well for a year. Guess what? She got up in the middle of the night, there, and walked down the hall in her stocking feet, fell, and broke her hip! They took her to the hospital next door and it was repaired, she was back to the nursing home in three days. She is doing just fine today. So please read all these suggestions, it's a downward spiral, nothing much more you can do. (the ambulance came to do a lift about half a dozen times for my mom, they were very nice indeed. Medicaid covered the bill. I am sorry you had such a nasty experience. The young guys who came couldn't have been nicer or more helpful, they did a LOT of that kind of thing and had some helpful advice, too. So I would report your rude man, no excuse for that!)

I agree with the suggestions! We do not have to kill ourselves to take care of our elderly parents; many times their care requires a 2 person team! My family is struggling with the same issue; my demented, frequently violent, barely ambulatory father has already started getting pressure sores, and my sister keeps on insisting that he should be at home with my 80 y old mentally challenged mother...my sister also gives him assistance at night & is drained, but insists that family is family & we must not abandon our elders in a nursing home! I worry about her health too! All the best!

Everyone has to find out for themselves...nobody can tell you what to do. Sometimes we wait until we drain all the life and energy out of ourselves

Just had my 93 yr old mother moved to a nursing home. She has lived in my home for almost 10 yrs. She's been a hand ful for most of the time, but really started failing 6 months ago. Moving less and less, falling, not cooperating with PT, wanting almost constant attention, needing help toileting and bathing, etc. It was wearing me out. No one can be on call 24/7, that takes 3 shifts. Everyone, the doctor, social worker, friends and family agreed she needed a nursing home. But she didn't want to go. Then she had a bout of congestive heart failure and spent 4 days in the hospital. From there she went to the nursing home. She and I have run the gamut of emotions. She's cried and begged to come home, she cursed and yelled and she has given me the silent treatment. I have felt afraid, worried, angry and most of all guilty. But the reality is I can't take care of her alone, and even with the little help I can afford it's not enough. She can't walk, and she can't feed herself she's helpless, she needs a nursing home and I need a life. Think of all I've gone through as you make your decisions, the doctors and social workers see the whole picture and sometimes when we're in the middle of things we just can't see things clearly. I'll probably continue to feel guilty, but I know she is in a good place and I visit often.

Nursing homes do not prevent falling. They fall just as much (or more) unless they are strapped into a wheelchair (a policy of many). As for lifting get a hydraulic lift (Hoyer is a good brand). If the doctor orders it, then medicare will pay for it. The one I bought cost $800, but you can get them cheaper used. They can also be rented.

Snow quail - in many states strapping a person into their wheelchair is considered a restraint and is illegal - the same hold true for trays attached. If you are seeing this please check your state laws regarding restraints and/or report it to the nursing homes ombudsman.

I am sorry the fire fighter was rude. Very few are going to act like that. Understand there are calls to 911 for lifting assistance fairly frequently and most times they are happy to help out. It's the people who abuse the system that cause reactions like you experienced. If she falls again, don't try to lift her yourself for fear of getting an attitude if you call 911. You could end up being the second patient.

Hugemom and all, I have worked in EMS for years and retired as a Captain. I would have never tolerated behavior like Kellydb experienced if I knew about it. Calls for lifting assistance are everyday emergency services business and usually done and handled in short order. No one should be hesitant about calling for help if it is needed. Woe betide the provider who would be surly with me if I had to call for help.

Richard thank you for your comment. Many of us needed to hear from someone like you to reassure us these services are there for us. Truly appreciate your input

If you can recall the date this happened, you may want to start with alerting the Fire Chief. You may want to show up in person especially if you had any witnesses. Another route you could go is to alert your states safety department and make a complaint. No offense, but to a point I can see where they're coming from because they can't be taken away from other serious matters. However, they are there to help and they shouldn't be rude to people who need them. Being rude is very unprofessional, I agree there. Remember that they are human and not perfect. EMTs have bad days just like the rest of us, so try not to take it personally if at all possible. If this was a personal attack, then yes, it should be addressed to the proper channels. Another place you may also alert is your state's civil rights commission because this may turn out to be a civil matter. Anytime a patient situation is mishandled, you may be told that it's a civil matter if you go to even make a police report. However, the surprise may come later down the road when someone tells you the real truth that you were just told this just because they didn't want to touch the matter. People will come up with all kinds of excuses when they just don't want to be involved at a time you must make a report to people who are supposed to be there to help. It's very devastating to hear that authorities you're supposed to trust won't help at your greatest time of need. Had you not called 911, the patient may have laid there for quite some time just because you couldn't pick them up when no help was around. Had you left the patient laying on the floor til help arrived, you could've gotten trouble for neglect, so you really did the right thing. I recall a time my elderly friend fell off the edge of his bed and sustained a minor injury. I knew I couldn't pick him up and he had an emergency call box installed. The only choice I had was to use that call box that calls for help. As long as I knew him he only had one fall where EMTs had to come and pick him up because I just couldn't. However, I can't count how many other calls were made for other issues he could've clearly taken care of on his own. He neglected his physical needs and really screwed his body up pretty bad over time. Toward the end of his life, he was in terrible shape getting numerous illnesses and infections. I mean, it was terrible and he could've lived so much longer had he only taken far better care of himself. When he started frequently calling the squad about once or twice a week, I realize he probably should've been in a nursing home or he should've had a live in in-home healthcare aid. This may be the very reason he tried to get me to move in with him when I already had my own life and home. He tried to get me to give up everything for nothing and I wouldn't fall for it. He then tried another trick to get me to spend all of my free time with him and never have a life outside of him. I kind of felt a little smothered to be honest, and numerous times I felt better getting away from him. When he realized I was pulling away, he used pleasant things to dangle in front of me to draw me back

I just thought of a few more things after giving this a little more thought and digging a little deeper her. I must agree with the idea of physical therapy. Yes, physical therapy will help strengthen the patient's body by building muscle structure. However, they can also work on balance to prevent future falls as mentioned here. Another thing they should also teach in physical therapy is how to pick yourself up if you do fall. That way, you won't be laying on the floor for hours or even days in some cases where no help is available when people live alone. Having vital skills to get yourself up will really help a lot, especially when you most need those skills. Physical therapy can teach a patient how to use surrounding furniture to their advantage, and they can even teach patients how to get up when no furniture is around and they are caught out in the open should they fall. Proper PT can really help prevent falls if not at least minimize the chances, but sometimes people do trip, which is why I think PT should also teach patients how to pick themselves up so that skill is there when no one else is. Even with others around, not everyone is going to be able to pick you up when you're down, which is why PT should be teaching patients how to pick themselves up and not rely so much on others.

Here's another scenario because you often hear cases where a patient wanders off:

Let's say your loved one wanders off in the night while you're sleeping. Let's say they wander down a lonely road and maybe worse yet into the woods. Just like the story about a young boy who was found alone in the forest, switch roles, putting your loved one in the boy's shoes. Instead of someone sending your love one into the forest, imagine if your loved one wandered off from your home and into the forest. If your loved one got lost in the forest, remember no one is there to help if they fall. This is why PT should teach patients with fall issues how to pick themselves up if they ever tripped over something and fall. That can happen to anyone at any age, and knowing how to pick yourself up is a very important skill that comes in handy when you most need it. It sounds to me like as people age they forget this is very important skill, and they may need help remembering how to help themselves.

My mother was in AL and was very unsteady. She had fallen several times but fortunately had not injured herself badly. Finally she had a fall that required her to spend the night in the hospital. The AL management took us aside and told us it was time for Mom to go to a NH because they did not have the staff to accommodate Mom's growing need for 24/7 monitoring for her safety. We moved her directly to the NH from the hospital. There she was under constant surveylance with a large staff that made sure she was assisted every time she went to the bathroom, with dressing, etc. Toward the end, she was moved from bed to a special wheelchair with a hoist.
Assisted living has 24/7 staff, trained nurses, etc. The point I'm making is that, if assisted living cannot safely care for and monitor a person who is unsteady enough to fall on a regular basis then it is 10x harder and dangerous for a single person to deal with those issues in a home environment.

I knew my mother needed assisted living care when she kept forgetting I visited a few hours earlier.
It took about 6 months to find the right place and I had to hire a senior care consultant to find the right place that met our financial, location, and quality limits..
We tried moving her to independent living at the facility (it was so sweet! 4th floor overlooking a lake and sunset), but, over the course of the next few days, she wasn't remembering where she lived and wasn't making sense with who she met.. She was getting lost wasn't going to the dining rooms at the community. She too started burning pans.. So the director recommended Assisted Living...primarily cause they can't recommend her living alone if she can't find her way home, as well as her neighbor saying she repeats herself and forgets who they are.
God bless!

You may want to consider an adult family home, also called board and care homes depending on state.My mom needed more care but not nursing care so we found a wonderful home with 6 residents. The family lives there and run an amazing home like assisted living. We are so happy with this type of care. I would be very happy to share more info with anyone who wants to know about them. They have 2 caregivers there all the time so the staff to resident ratio is unheard of in larger facilities. The price is also less than half the cost of nursing homes. They are a wonderful option for many.

Wow, I can see myself in every one of these comments. I know that it's getting close to "that time" but I just can't bring myself to think of a nursing home. Mum has been with us for almost 5 years. I retired early from a job I loved to care for her, my marriage has suffered from the stress. My husband and I have no privacy and no time together. Yet I still can't bring myself to make that decision. I think it will have to be made for me by a Dr. or the fact that I physically can't do it any longer. I'm close to that point now. I've lost myself in all of this. I don't remember what it's like to be me. This website has been a Godsend though. It somehow helps just knowing I'm not crazy feeling the things that I do! Thanks everyone. xo

I would only say to be careful in the process that you don't loose your marriage and end up all alone after your mom dies. Your marriage vows need to come first.

When the MD, the FD and the SW tell you it's time, listen to them. They are a little more objective than a daughter racked with guilt.

While our parents certainly want to remain in their homes (and who can blame them, really?), sometimes it's just not possible due to a number of reasons: #1 they live in another state than us, #2 many of us are not trained medical professionals, #3 their needs outweigh the dangers of staying in their own home, et al.