How do I deal with half my family saying bring her home for hospice and the other half wanting to keep her at the boarding care home?

Do you have enough support and help for around the clock in home care? I did this with my dad, had to hire extra help, but if it had continued much longer I would have needed another plan. It’s exhausting to provide total care 24 hours a day. I have no regrets about my dad being home for his final weeks. But I know it wasn’t sustainable for much longer either. I wish your family peace and rest in this, I know it’s so very difficult

dear kat, sending lots of love to your mother and you. you sound like a very loving person.

i would say...listen to your heart.

you wrote:
“I believe that Mom would want to be in her bedroom and I've told her I would be right by her side in her last days.”

you know your mother best and what she would want. most of us, prefer if possible, to die at home (rather than more time “alive” but in a hospital/nursing home/etc.) (i understand some nursing homes are “nice”, but most of us would choose home if we can).

if possible, i would prefer 10 last days at home, rather than 10 months in a nursing home. if i were dying, i would want to die at home. if possible, surrounded by my loving family.

dear kat, you know the full situation best. do what is good for you too.

the best decision, so there are zero regrets.

bundle

If the Boarding Care home says its best to have Mom in hospice at the boarding home, rely on their professional opinion. 24/7 care for a completely disabled adult involves feeding, changing diapers, cleaning up messes, bed bathing, special diets, medications, physical transfers between bed, chair, etc. If you have never seen the toll this takes on caregivers, spend some time reading the forums here. Its not easy, and expect no thanks from your siblings. You will completely give up your own life to caregive. The Boarding home has the experience, the equipment and the trained personnel to care for your mother in this difficult time. Let the Boarding home take care of your mother's physical needs; you can visit her often, and then spend your time with her loving and comforting her instead of falling into overwork, potential despair and resentment toward your siblings (the ones who don't help you because they didn't favor moving your mother home) due to the demands of RTC caregiving. And don't resent your siblings who don't favor the move; they, too, are coming from a place of love and concern for your mother's well being.

It’s possible she can recover & then need to care for her 24/7. Stranger things have happened. Then what will you do? Pneumonia needs hospital care...Will you give her intravenous antibiotics? If it was me, I’d insist they keep her in hospital till pneumonia gone...Does rehab facility also have long term or hospice? I’m confused as to what a boarding care home is....being in her own bedroom not important...she may not recognize anyway...if she’s sleeping all day.. You will regret taking her back home...that’s all I know!
Hugs 🤗

If you and your daughter are willing to handle this VERY DIFFICULT care 24/7 then you are free to bring her home. I believe, as others said, that your brother is saying he will not assist, so you are forewarned. Most Board and Cares will not keep hospice patients. Most hospice today provides an uptick in care, but not a lot of people right there. So this care will be on you.
Are you clear that this is end of life care, that there will now be no tests and treatments toward "cure?' That is to say do you fully understand what hospice means?
I would say only you know how much full time hands on care you can do together. If it is all on YOU I advise against this. If your daughter can share in care it "may" be doable if you wish to do it.
I wish you luck and hope you'll update us.

You and brother live with her. He said no, which means he is not accepting responsibility of 24/7 care. Your daughter said yes - so ask her if that means she is going to be available to help you with 24/7 care. You will probably not be able to handle care for someone in her condition totally alone, so base your decision on the help you can absolutely count on.

The plus to her being at a facility is that you actually get to sit with her, comfort her when needed, and be a source of calm for her instead of being a stressed out caregiver. Comfort and you being with her is worth far more than a very slight possibility she is even concerned about being in her own bedroom.

Do you or your brother each have your own home?
Has your brother explained why he feels your mother should be brought home?
Does your mother have dementia? Does she seem unduly distressed by her current surroundings?
Have your daughters explained their reasons for their feelings?
If your mother is already “confused” it would seem that she might feel even more confused if her surroundings dings were once again disrupted by attempting to move her an additional time.
Why does her present residence feel she’d be best to have Mom with her Hospice team at the home? Does that mean where she is now?
You can certainly be “right by her side” in either situation.

If your goals are safety, peace, and comfort, it would seem to me that an additional move might disrupt her circumstances more than moving again, even if moving would mean to a place where she’d lived when she was well.

Keep in mind that if your decision is made with love and concern for her actual care, “opinion” doesn’t count.

Hoping you can move forward with Peace.

Just know that if you decide to bring her home under hospice care that 99% of her care will still fall on you or your family, as initially the hospice nurse will only come once a week to check her vitals and such(more if needed)and an aide will come about twice a week to bathe her. That still leaves the brunt of things on the family. Yes they will supply all needed equipment, supplies and medications, but her care will all fall on you. If you are prepared for that, then by all means bring her home, as I'm sure she would much rather die in her own home. But if that is not feasible at this time, then you must be realistic, and do what's not only best for your mom, but for you and your family as well. And that might very well be placing her in a hospice facility, where she will receive great care. However if she doesn't die within a weeks time, if you choose to keep her there, you will have to pay out of pocket for her to stay there. And of course if you keep her at the boarding house, hospice will still have the nurse come once a week, and an aide a couple times to bathe, so it's really up to you and your family as to what is going to work best for all of you. I wish you the very best in making this tough decision.

This is such a heart wrenching time, isn’t it? I am so very sorry that you are struggling with your mom’s suffering.

It is tough when siblings have different opinions.

All I can say is that my mom is in need of 24/7 care and is receiving excellent care from hospice.

My mother can no longer turn over or walk to the bathroom by herself (advanced Parkinson’s disease) and is relieved to be cared for by hospice in an end of life hospice facility.

Hospice is absolutely wonderful! They can offer more care than we can at home. For instance, they have a round the clock professional staff, a social worker for the entire family and clergy for everyone.

They also placed a catheter in mom so no more diapers or struggling to get to the bathroom!

Please reconsider bringing her home. Are you allowed to visit her? I know some places have Covid restrictions. If you can visit, you can stay with your mom there. Meds can be given to ease any discomfort.

My brother died peacefully in an end of life hospice facility.
Take advantage of their expertise in providing care for the dying with enormous compassion.

We are here for you if you need a shoulder to lean on.

Take a step back and relax just to get some perspective.  And advise your brother and your children that you're in the process of assessment, and that the best way they can help is not to express their opinions, but get data that you need to make a decision. 

So, some issues:

1.   Has your mother executed a Living Will or other document to express her end of life wishes and allow you to make decisions for her?  If so, the family can offer their opinions, but they don't have the authority to make them.  

2.   Is the physician the only one advocating end of life care?   For something this serious I would get a second opinion, but it does seem as though your mother is at that stage.

3.   Either research online, ask friends, or get a list from the Alzheimers' Assn. of hospice companies that have facilities and those that provide in home care.  Know that in-home care isn't 24/7, so you'd either be stretched to your limits or need additional support; family could definitely help, so that's an issue to be raised with them, asking them to let you know when they could stay with Mom so you can get some rest.

4.   If you find local facilities providing hospice care, ask them questions (which you'll have identified before calling) and test their responses.   I found some that were recommended to me to be rather obnoxious and demanding, pushing to get my father signed up and committed before even providing decent answers to my questions.

5.    At home hospice was never a consideration for me b/c I knew I just couldn't do it.  And I also knew that when I wasn't there, people would be coming over to visit my father but not providing care, just disrupting his peace.

6.    After calling and visiting some facilities, I settled on one which turned out to be a very good selection.  I interviewed, toured, thought about it and went with that one.   One particularly impressive factor was that they did NOT push me to make a decision, and they also advised me that they could not ask certain questions during this interview process.  That was not the case with the aggressive companies, which I realized later had asked questions which were inappropriate.   I can't remember for sure w/o checking my notes what prying questions were asked.

7.   At the hospice facility, fFriends could come and visit while Dad was napping; he may have known they were there, and they could satisfy their need to be with him at the end.  And it left me time to relax before visiting again.   To me that was critical, b/c  the night I admitted him from the hospital, I was so tired and emotionally drained, I couldn't walk out of the facility.  I just slid down on the floor and sat there, completely exhausted.   One of the staff came by and helped me out to my car.

8.  Care during the hospice period was of high standard; the admins even intervened when I had a problem with 2 visitors and had to ban them from coming (one ignored this and came anyway).  

9.  Staff even brought me snacks, pitchers of water and a carafe of coffee during the last few days, so I could stay with Dad, but attempt to achieve peace.  

In retrospect, I'm glad I didn't even attempt at home hospice care; it would have been too much of a challenge for both of us.

I wish you calm, peace and comfort as you approach this challenging period in your family's lives.