I’m conservator for my Sister who had a stroke is bedridden, cannot communicate well and on a feeding tube. Finding a facility that cares for patients with a feeding tube is challenging and costly due to liability. I called many facilities until a Catholic facility manager gave me a recommendation.

A small, comfortable healing Nursing Care facility, has healed her wounds and stabilized her weight and medication. She was prescribed many meds and is down to 2 along with supplements. The Severe bed wounds happened while hospitalized over 60 days.

Plan A: Because her funds are dwindling, I’m considering moving her to my home and hire a 8 hour/day CNA.

She is currently paying mortgage, taxes etc and nursing care. The home needs to be sold.

Plan B: Sell the home, use all funds to continue the comfortable outside care until all assets are spent. Then apply for Medicaid.

Any advisement is appreciated.

Use Plan B. She needs a team of professionals to care for her, and it should be in a facility where they'll have everything they need to take care of her.

Hiring a CNA to be in your home for eight hours a day has its own problems. For one thing, that's not nearly enough care. For another, it's a Certified Nurse Assistant, and they're not qualified to do all the things your sister will probably need - tube feeding, for instance, may not be something the CNA can do. There will be crises, symptoms that crop up and you won't understand, emergencies one after the other, things that will be required of you to do. The peace of your home is shattered when you bring in a sick person who must be cared for. You'd be exhausted in no time.

She's in a good care facility now. Leave her there. You can be supportive in many ways, but they shouldn't include turning your house into a nursing home or your life into a caregiving nightmare.
Helpful Answer (11)
Reply to Fawnby

I have not had a relative, but as a retired RN I cared for many in this condition.
Definitely for me it is plan B.
She currently is in quite dire condition.
At any time the bedsore problem could/would become an issue. Tube feedings are notorious for out of control diarrhea and sores. Sepsis from decubiti is a leading cause of death for those who are bedridden.
If she is getting good care where she is I would do all I could be have her stay there. You have been witness to the amount of skill and perseverance it takes to care for her. Do you really feel you can take that on for 16 hours a day while a CNA cost takes the money quickly that she still has?

Just on the face of this, with the facts you have given, I would go with plan B. I am not certain how long your sister would even WISH to live in this condition; nor how long she CAN live in it, and I would make the time she has as pleasant as you are able.

I hope your sister had a good advance directive and you know her wishes well for end of life, so that, if she becomes terrible ill and debilitated you will be able to withdraw the forced feedings and allow hospice to ease her exit with minimal pain. The prognosis for her, I know you already understand, is very dire.
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Reply to AlvaDeer

My mother was completely paralyzed by a stroke and had a feeding tube (placed on the strong advice of a team of doctors who assured us that it would be temporary as she recovered, a recovery that sadly, never came) She lived four years in the best nursing home in her city and had compassionate and competent care throughout. There was never a bedsore or any skin issue. She was a two person assist for every movement. She began as private pay, used a long term care policy (completely burned through it in no time) and then went on Medicaid. She remained in the same room with the same caregivers no matter how she paid. Her care was overwhelming, no way we could ever see it able to be accomplished in a home setting or that’s where she would have been. I would encourage you to find the best place you can and become your sister’s advocate. Show up regularly and show the staff that she is someone who is cared about, it will make a positive difference in her care. I wish you both peace
Helpful Answer (8)
Reply to Daughterof1930

Plan B. I am in a similar situation except the patient is my wife. In my state only a relative or RN can administer nourishment and medications to a patient with a tube. With the help of an Elder Care Attorney my wife is on Medicaid and home waivered services, but only get 20 hours a week of assistance. Next step is a skilled nursing facility should I not be physically able to provide for her.
Helpful Answer (7)
Reply to Robert525

One bit of advice I learned here on the forum is that some "better" nursing homes will allow people who have lived there for a certain period of time to remain as residents once their money is spent and they need medicaid to pay for care, if your sister has enough funds to private pay for a couple of years finding a facility like this might be the wisest option.
Helpful Answer (6)
Reply to cwillie

Plan B all the way.
Helpful Answer (6)
Reply to olddude

Go with plan b. You don’t need someone for eight hours, it’s more like 24. And although the house is exempt from Medicaid, the mortgage and taxes all still need to be paid.
Helpful Answer (5)
Reply to PeggySue2020

Plan B. Without even thinking about it--plan B.

Her assets are for HER, so use them as such.
Helpful Answer (4)
Reply to Midkid58

Plan B, and get a elder care attorney to help with Medicaid application.
Helpful Answer (4)
Reply to BluSky1

Sorry, I think I misunderstood the Plan B scenario. When you say comfortable outside care, I was thinking "outside of the nursing home", meaning at your home.

I change my previous answer. Go with Plan B! :)

Find a good Skilled Nursing Facility where she is comfortable, and gets good care.
Helpful Answer (4)
Reply to CaringWifeAZ

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