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I would like more information and your thoughts and advice on this topic. I do not want my mother to go to one of these places but due to her declining health and mobility, I may not have a choice in the long run. She has lung disease, on 8 liters oxygen full time and has falls every so often, which worries me so bad. I think if it gets to that point I'll know it has to happen so any tips even on a smoother transition would be extremely beneficial. Thanks In advance!!

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Dianne, since you characterize skilled nursing facilities as "those places", that suggests to me that you haven't looked.

My brother and I visited 5 or 6 places, met with the administrators and scoped out the character of each place. We visited each facility twice, at different times of day.

The highest rated facility smelled both times.

The lowest rated facility was older, had a homier feel and a priest and sister on staff. It wasnt perfect by any stretch, but my mom was content there a recieved good care. They were terrible at communication, but the care was attentive.

Go and start to look. You are lucky that you have the luxury of time to do this in a non-rushed manner.
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Dear Dianne,

Sorry to hear about what your mom is going through. Its a tough choice. There are so many factors to consider. I, too, wanted to keep my dad home after his stroke and stint at rehab and since his passing I don't know if I made the right choice. I underestimated how much was required of me. I let anger and resentment take over. If there is any doubt about safety, I would send her to nursing home or assisted living facility. I know others will have more insight as well.
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No such thing as a perfect nursing home. Even The best ones are not particularly pleasant places to be but they can be a godsend for folks and families that need help.

You're quite young. You have to consider your life as well as your moms.

You asked when it's time. If you're thinking about it the time is getting close. As she declines and you wear out it's time to make a change.
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Dianne, I'll address the opposite plan, i.e., keeping your mother safe at home as long as you can.

Ask one of her doctors, perhaps her pulmonologist, if she qualifies for (a) pulmonary therapy (b) physical and/or occupational therapy, or (c) palliative care at home.

The first has very restrictive criteria, but on 8 L of oxygen, she might qualify. Has anyone mentioned oxygen weaning, if that's possible? Does she have advanced COPD?

The second could at least help keep her mobile and address fall prevention.

The third is a program I've recently learned about which provides home health care outside of rehab, and focuses on people with chronic conditions. It is not hospice.

You've very wise to think about short or long term changes. As Barb recommends, begin checking out potential places. Medicare used to provide online evaluations of different types of facilities, how they rated on specific criteria, and more.

As you begin, you'll find that you'll develop your own checklist of questions. One which is critical is the ratio of patients to staff.
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