Mom (with about stage 6 Alzheimer's) is deteriorating instead of improving. Nursing home or home care?
She broke her hip the week before Thanksgiving. Was doing great until a UTI and has regressed physically and mentally since. Rehab gave notice of discharge. She will not always stand. Moving to and from bathroom gets scared and may stop say she can't do it and push walker away. She is scared when walking. She can do it physically, but her brain is not cooperating. So I am trying to decide between taking her home or putting her in a facility. She is a fall risk so at home I will have to have someone there from about 10 am to 8:00 pm. The hours she would be up. I would want sensors to let me know if she tries to get up from her chair or bed. Perhaps need a hospital bed. A facility would give me my life back. But she requires continued coaching to eat her food, can not turn on a tv or music, cannot push a button to tell someone she needs to go to the bathroom (she IS continent at this time). I am considering CNA's in my home. Three times a week I would have two during the day so I have some freedom. At night she sleeps well so I would be caregiver. She has lost 15 pounds in two months in rehab with me spending often up to an hour encouraging her to eat. I fear she will not eat adequately without the encouragement. Also I do not want bathroom breaks overlooked and incontinance to be expedited as part of her life. To a degree I fear a facility simply cannot see to her particular needs and out of necessity there is some degree of "warehousing of the elderly" that occurs. Thoughts?
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I would start by discussing an assessment to determine what level of care that she needs. (Does she qualify for Hospice?) For patients who are immobile and incontinent, she likely needs around the clock, constant care. Plus, your house will need to fitted with handicapped access, safety bars, etc. She may ambulate better with a wheelchair?
As far as weight loss goes. Sometimes, the patient loses weight, regardless of what they eat. The body may lose its ability to process the nutrients. I'd discuss it with her doctor. Perhaps have her swallowing assessed. But, if you feel that you alone can provide her the best care, I encourage you to be very candid about your ability to do that long term. She could continue in this stage for years or decline and be bedridden, which requires even more hands on care around the clock.
My cousin, who has severe dementia, has received excellent care in her Memory Care unit, so perhaps, I am biased in their favor. They change the resident's undergarments when needed and also on a schedule, hand feed those who do not feed themselves, bathe them, dress them, comb their hair, administer their medication, take their blood pressure, temperature, etc. every day with much care and compassion. They are also younger than me and trained to work with dementia patients. They have her medical care done on site. Which is another consideration. You'll have to provide transportation for her to and from doctor appointments from your home, which is challenging if you are alone and she is immobile. It's doable, but, time consuming and expensive and may be stressful for her.
The MC unit also takes the residents into the activity room where they have a daily schedule for activities, according to their ability to participate. They do have a tv for those who are interested, but, at a certain stage, television is not something that most people with advanced dementia are attracted to. That was difficult for me to accept with my cousin, because she always loved tv, but, at Stage 6, she lost all interest. I think they lose the ability to follow what is going on and it just frustrates them or else they just don't understand it.
Are you able to leave the work force financially? That's another thing to consider.
I hope you can find some answers that help you with your decisions. I'd also read a lot of the posts on this board and see how people who care for loved ones alone in their home go through. It's usually heartbreaking. It's very rewarding to help care for a loved one, but, it can also take an incredible toll on your life. I wish you all the best.
I am wondering about something. You said that three times a week you would need two aides. Why two? Why not have one aide three times a week?
Plus, I would examine your comments about how you are already have impatience and how you are thinking that it will make you unkind. (See your post upthread.) I'd heed those emotions and be honest with the appropriateness of what you have stressed is not working for you. It seems you already have stated your concern.