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Our mother has been moving between home and nursing home despite fantastic home care situation. She really would be excellent candidate for assisted living as she has mobility issues but is very sharp and otherwise has any other health issues well managed. She cannot afford financially to pay for both her apartment and the nursing home but seems oblivious to that thinking they can "put it on payments. Please help us understand how to deal with this and why she would be acting this way.

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Could you explain a little more about what you mean by "decision to give up"? Also, how is she moving between her apartment and a nursing home? A month or two here and a month or two there, or is it more long term than that? How many times has she been in a nursing home? Was there some incident that triggered the need for NH? What is her objection to Assisted Living?

This is a puzzle. Give a few more pieces and maybe someone will have some suggestions.
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Initially she was placed in a nursing home when her mobility issues became severe from her arthritis. However, upon being placed in the home she developed even more issues such as being able to do even less than she had before therapy but now she did not have the severe pain. Also, she was not incontient but developed that shortly after her arrival at the home. Even the nursing home social worker asked her for "goals" and she couldn't come up with any. They finally diagnosed her with depression and treated her for same even increasing the medication dose. It seems as if as soon as one issue is resolved another developes. Just when we confronted her about are you coming home she told us she was coming home. She was home for about a month and then a fall in which nothing was broken nor out of place etc. landed her back in the home. The er doctor suggested 3 days so she wouldn't be alone for a bit but she has turned that into more rehab and not being sure when she will feel like leaving. She constantly tries to create problems between my sister and I and the staff about totally unfounded issues. We have cleared that up in the most recent care conference but on to something else. Finally we said if she felt better and more secure staying we would be in agreement. Of now that we are in agreement she is not sure what she wants to do. The manipulation, drama, etc. goes on and on and on
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Ah. Sounds like it is her decision to make. In a way it is good that she feels comfortable and secure in the NH. Maybe that is a good place for her. Remove the drama and manipulation from the decision. "Mom, you can go home to your apartment, or you can sign up to be a permanent resident here. It is totally up to you. Whichever you decide Sis and I will help you make the transition." Do not get drawn into an argument. Do not give your opinion. Do not urge, confront, or plead. This is her life and her decision to make.

I believe that a reputable rehab facility will not keep working on somebody who has no need and is not making progress. Maybe the ER doctor thought 3 days would be enough but other things came to light once she got there. Have you talked to the therapists or do you have only your mother's version? If she tends to be a drama queen it is easy to dismiss her claims when they sound attention-getting, but sometimes even drama queens have dramatic problems.

Once she makes a decision, and only then, you can help her face the financial realities. How many years will she be able to afford to self-pay for the NH (or an Assisted Living place)? Presumably if she outlives her funds then Medicaid is in her future. But don't go into any of that until she decides what is the best place for her on other grounds.

Good luck!
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Since she is on our state's assistance program she is already on a medicaid waiver which means they take her entire income for the month minus $40 and prorate that on a daily basis. Soooo she is already in a financial dilema. They had been working with her on payments since last stay thinking it was only a temporary situation but it is only a question of when they require her to sign over her check every month. I appreciate you comments and believe acceptance at this point is key, just handling the incidentals and financial is the difficult part.
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