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My mom is ready for assisted living but my siblings and mom are reluctant to take this step. I understand this but I don’t think my mom should be living alone. It is only a matter of time for this to become a reality.



While I start to find an AL facility I was thinking perhaps visiting nurses would work for a time. I have my doubts.



Mom (90) has terrible, painful health issues. Among other issues she has a condition called Trygeminal Neuralgia and she’s having a very painful episode. Her meds make her confused. Her days and nights are mixed up and she is taking too little or too much. She can’t eat much. Really I think we should take her to hospital.



I’m my husband’s caregiver as he recovers from a bone marrow transplant so this is a bit harder to manage now. Siblings are pitching in but I don’t understand the way they are dealing with this.



My mom is suffering which I’m sure is contributing to this decline, but her ability to continue as she has is greatly diminished.



Would visiting nurses be able to manage this? We set up a pill box but she’s not understanding it. I know AL is the best option but how do I get my siblings to agree?



TM

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Honestly if you do not think mom is safe living at home a "visiting" nurse is not going to help much more than a "caregiver / companion" that would come a few hours a few days a week. (a caregiver or companion would be less expensive than a nurse and if there is no medical need for a nurse this would be an expensive out of pocket expense) A caregiver can give medications, they have to be physically taken by the client but the caregiver can put them in front of her and if mom would take them herself that would be acceptable to an agency. If you hire privately the caregiver can actually "give" medications.

If you think mom should go to the hospital though then she should go. At that point you can stress to the medical staff, the Social Worker that mom can not be discharged to home. That might make it a bit more "real" for mom and siblings.
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Reply to Grandma1954
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If there is a fire, can she get out independantly? Can she cook for herself or toilet by herself? Can she take her meds or dress independantly? What if she falls at night? I just mentioned a few ADLs that would qualify for AL. The most important question is about her safety when alone,
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Reply to MACinCT
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Visiting Nurses come In for 10 minutes - 20 Minutes - They do the Vitals and check on medication . Sometimes even after the script Is written it can take them up to 10 days to arrive and then depending On whom you get They can be Late . They are a quick fix when someone leaves the Hospital .
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Reply to KNance72
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Welcome!

Does Mom have dementia?

It doesn't sound like she should be living alone.

If she JUST needed someone to manage her medications for a couple of weeks until her confusion (say post surgical) cleared up, the Home Health Care (what visiting nurses provide MIGHT be appropriate), but if her confusion is from dementia, that's only going to get worse.
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Reply to BarbBrooklyn
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I think she needs to get an evaluation by her PCP. She hasn’t had one in a year.

Thanks for your responses.
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Reply to NJmrsTi
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Igloocar Feb 1, 2024
I agree; she absolutely needs an assessment! If you need help with home care temporarily, for some functions a nursing assistant from a homecare agency could be helpful. However, nursing assistants (whether certified nursing assistants or not) cannot GIVE meds to patients, only show them what to do. To administer meds, you would need a nurse (or a med tech). But getting a nurse in a few times a day just to give meds is not logistically or financially feasible. Homecare agencies usually require a minimum of a 4-hr visit, and I do understand that you're not looking for a nurse through a home care agency, but rather through a visiting nurse agency. Others have explained the difficulties of trying to do that.

If your mother right now needs as much assistance as you indicate, perhaps her doctor would send her temporarily to a skilled nursing facility while you look for assisted living for the longer term, after she recovers more. The amount of assistance she needs right now sounds like too much to try to have at home or even in an AL. BTW, I am familiar with trigeminal neuralgia, and I know how awful it can be. That that's also going on right now is another reason she needs more comprehensive care right now than she can receive at home with the amount of assistance that might reasonably be available. Please speak to her doctor, although as you probably know, he can't speak to you about her condition without her permission if you are not her health care POA.

Re your sisters, you are the one taking responsibility right now. Does any of you have health care POA? That will make a difference in who can make decisions. Your mother is fortunate to have you looking after her welfare! Hugs!
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I would echo what KNance said. Even after a hospitalization mom only had visiting nurse come about 3 times for 20 minutes or less, the first visit being a week after she was released. I believe the VN requires a doctor's order.

After mom's last hospitalization for double pneumonia and a collapsed lung, the visiting nurse came for "wound care". She kept asking mom to show her the wound and mom said she didn't have one. So the nurse wrote her up as "refusing care". I'm sure there are some wonderful visiting nurses out there, but our experience was not good.

Your mom needs a physician managing her care and potentially ordering home services (if you can get them to do that). But in the long run, she is going to need much more. I know how hard it is, and I wish you the best.
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Reply to LilyLavalle
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In our experience, visiting nurses aren’t necessarily RN’s and aren’t always allowed to do medication management. When my adult son (medically complex all his life and left with a brain injury) was young, we had visiting nurses. They made me batty. I’ve never had medical training but I was much more confident in caring for him than they were. I’m not slamming on nurses, my daughter is one, I’m just not convinced about the home health ones in many instances. They can seem rushed and less sure of what to do. I ended up letting them go. If you know what’s coming, start that process now and stop expecting anything from siblings. That’s my two cents and experience.
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Reply to Daughterof1930
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Trigeminal neuralgia is horrible, and the meds for it may have bad or even dangerous side effects, depending on the meds. However, unless her doctor orders it, it's not usually a condition that requires hospitalization. If your mother is confused and has evidence of dementia, putting her in a strange environment could be very psychologically damaging. I agree with the other statements made about visiting nurses. If your mother can take her meds herself, as it appears to be the case, you might for now hire a home care agency that uses nursing assistants (not necessarily CNAs). They should be able to follow a medication schedule in terms of advising your mother as to what she is allowed to take; if she tries to take more, they will let their agency know. They should also be able to manage some of the other situations you've mentioned. Whether or not she needs 24-hour care at this point is unclear.
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Reply to Igloocar
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I was a secretary for a VNA. We were non-profit subsidized by the Township. We only went into homes of people where insurance and Medicare didn't cover something a Doctor wanted done, we needed an order from him. We did wound care, catheter care, filled pill planners, checked vitals, and even bathed a client when they had no one to help them.

Unless your Mom has a lot of money, she probably could not afford an RN. My DD is one and has made an average of 90/95k a year in the last few years. If your Moms main Caregiver than the decision to place her is yours. If she is not taking her medications correctly, then an AL is a good choice. It will also give u more time with ur DH.
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Reply to JoAnn29
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Does your mom
live with you? Sounds like your mom should benefits hospice care. And on top of that, you should find a caregiving company to have continue come out and help her or you with the medications. That is SO IMPORTANT.
I didn’t realize it, until my friend said I needed a caregiver to help meet my husband. Doing this alone is so stressful. And now you are caring for 2 people.
You may want to get a man who can help you with your husband, and also help with your mom..
think about it. More people will respond. That added layer of caregiving helped me out a lot. I didn’t know I needdd it.
caregiving burnout. It is real. You may need just a break for a bit
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Reply to MAYDAY
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