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Mom has been living in an assisted living facility for three years. I am increasingly disappointed with the nursing provided to this building which I found out is not even covered by the Better Business Bureau. The building is becoming increasingly dingy. However if she is released from rehab, the place will look familiar. She loves the ground floor apartment and beautiful surroundings (and having her cat).


I have also found a location five minutes from my house which is independent living, but I would have to arrange all of the nursing services to be brought in. By the time that is done, both the assisted-living, and the possible new place will be equivalent in price. I am completely overwhelmed. I had a total hysterectomy, two weeks ago. I go back to school in three weeks. I am an only child with no family. Do I bring Mom back to what is familiar, just deal with the sub-par location that makes her happy or do I do the move to the new place? I am overwhelmed. Any honest, friendly opinions would be hugely appreciated. Thank you.


Note, mom had 2 falls, a stroke, and brain bleed/neuro surgery. Some noticeable cognitive issues - sporadic. Memory care is not the level of need, but physical ‘check-ins.’

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Bring her back to her familiar setting and hire extra help if necessary, either by paying for enhanced care through her AL or bringing in outside help. Then reevaluate when you are well and have less on your plate.
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Leave her where she is for all the reasons you stated. You have too much going on to add more stress to your life.

Concentrate on healing. You’re as important as she is!

Also, bringing in the nursing services is a huge job when you’re recovering and going to school. Healing from a hysterectomy takes months even though you can go about your regular routine. It’s normal to feel tired and that lasts for a while.

That’s my honest opinion.
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You go back to school in 3 weeks? Isn't there a way to have more time off? Having a hysterectomy is serious surgery! (Is short-term disability available through your school district?)

From past postsf:

"...my mom was an alcoholic, manipulative, verbally abusive woman,"

That was then.

". I am chauffeur, bill payer, recipient of all guilt-laden comments, chore-runner... you know the drill. I'm so burned out. My teaching career and daughter-duties leave me with nothing left."

And this is now (before the recent hospitalization/rehab).

How much assistance did she need (before the hospitalization/rehab)? How many days a week did you go to her AL facility? How many hours did you spend there? How far away is it? To move her to IL seems unwise. Wouldn't you spend even MORE time there than at the AL?

Find out from the Discharge Planner what kind of assistance your mother will need after leaving rehab. Do not make yourself part of the discharge plan! Make sure your mother hasn't already told the Discharge Planner that you ARE part of the plan.

The IL idea seems unwise. She will have NO assistance other than intermittent nursing services. YOU will be the caregiver. You DO NOT want that (right?)!!

I'm assuming you are her POA/HCPOA? What is her financial situation? I hope that you are not contributing anything to her living situation or upkeep!

I vote for her to continue living at the AL (provided the DP says that is sufficient; is it possible a higher level care is now needed?). I also vote for you to STEP back and stop being her stepandfetchit and chauffeur.

YOUR health matters, and things sounded dicey before your recent surgery. You cannot jeopardize your health by continuing to be so enmeshed in your mother's life. Please look out for your OWN physical, mental, and emotional health before all else!

Keep us updated!
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What does the discharge planner at the rehab think?

If your mom has lots of falls, has dementia (according to your profile), it doesn't sound like Independent Living is going to cut it, with only sporadic nursing services coming in.

Going back to a familiar AL with Medicare-covered home therapy and nursing sounds like a better possibility IF they are willing to readmit her.

Have you spoken to the AL about her return? You may find that they will deem her ineligible to return.

I am terribly sorry for all the physical and mental strain you are under. Please make sure that the discharge planners at rehab understand this.
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I would leave her where she is, she likes it, if this is a step-up home that is even better as when it's time, she can go into the MC wing.

Old people do not do well with change either, she has friends where she is, let her be.

There is so much more involved with nursing services than you can imagine.

Get well, put this idea on the back burner for now.
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The familiar known vs the unknown.. Lots of pros & cons to weigh up.

What does Mom want to do?
What is Mom's NEW care level?
How much is reasonable for you to do?

Regarding the new IL option;
- Who will be the 'Care Manager/Co-ordinator' of the services Mom needs if IL is chosen? You right?
- Is this going to increase your care-load? A little? A whole lot?
- What about staff cancelations, no-shows? Will you be the backup?

How about baby steps.

Move back to the familiar - to start. Add more home care in as Mom needs. Wait a month. Re-assess.

What's really important? The building? Or the care?
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You need to focus on getting well. Don’t make any changes while you are recuperating from your surgery.

Your mother is happy where she was so she should go back for now.
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It does not get better from here… hard no to independent living…
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If your mother is happy where she is and likes her place, let her stay there. She's been living in AL for three years so she's past the point of independent senior living. If she's happy there and it's familar to her, why make her go?

You can always privately hire some homemaker/companion service to put in some time at her apartment in addition to what the AL already provides.
It won't cost all that much either even if you use an agency. Homemaker/companion is not CNA care. They do not do any hands-on care. The clean, prepare food, take a person out, and provide companionship hours so a person isn't alone. This might be a workable solution for your mom and I hope it is.
There are even organizations where volunteers come and put in some hours for free with the elderly. Go online and look a little. You might even find some free hours. It's worth a try.
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The BBB is a big nothing. It was founded in 1912 and a CNN Money investigation years ago found that its rating system was seriously flawed. Companies pay money to be members of the BBB.

You said you're disappointed by the nursing service and yet nurses are not the appropriate people to be doing "physical check-ins". If you want someone to lay eyes on your mother, you can hire someone for much cheaper than the cost of a nurse.

Talk to the director where she has her apartment and ask who can do a daily physical check-in with your mother. Is the building dirty or just dingy?
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