My mother is 86, recovering from partial hip replacement surgery, and about to leave her nursing/rehab facility across the country. Her income is extremely limited. I've gotten her on the list for a great assisted living here, as a permanent solution, but I'm having trouble finding interim beds that we can afford. I'm terrified by the thought, but should I care for her in my home for now, with perhaps daily visits from an in-home aide?
She's been with us for a month now, and she's doing much better than she was in the skilled nursing facility. As someone pointed out to me, the ratio for her care is now much lower....there were so many patients in the facility, and at my house she's one of three people who need help. She's stabilizing here. We have a routine down for when she needs cream of wheat and a scrambled egg, etc. She's starting to take over more of her needs now.....yesterday I showed her how to use the microwave. She's moving around in her walker a lot as well. The physical therapist is working on having her go down the steps so we can actually have her leave the house. I have a goal for an outing next week to a nearby arboretum for a drive-through.
We haven't heard much yet about how long the wait will be for the assisted living facility of our choice, but that's fine. If it becomes too long we'll consider other plans. We're adjusting as things go. My mother's possessions are en-route now. We're making longer term plans for caregivers in the house, hopefully one person who can adjust a schedule to ours and sometimes stay overnight....I want to go camping with my kids this summer! So far I've been able to get out a little when we've gone over the routine, she has her emergency button, or the home health aide or a volunteer elder sitter from my neighborhood came by.
My kids are doing all right with it. I got us all a bigger TV to compensate for the move of our "den" to the downstairs floor....although we all like it better down there anyway. At first my kids avoided being around my mother entirely, but that's stopping. She's pretty quiet, and they say that they're getting kind of used to having her around. She's actually rather pleasant at dinnertime each day...she comments on the birds she sees out the window.
I'm a little antsy with the constant presence and hyper-awareness of all the details of my life...my mother comments on how long I leave the milk out, etc. But I think it's going quite well, overall. We still have a lot of work to do on working out the new insurance, the new pharmacy, getting my mother new glasses, etc.....but I think the first phase of transition to this new era for my family is going really well.
Thank you for thinking of us, everyone. Happy Memorial Day.
While a wheelchair will get your mother to the airplane door,are airplane aisle wide enough for her to use a walker and will her seat be near the front so that she does not have to walk too far?
The last time that I flew across country, I don't remember the aisle being very wide.
She is okay with the wheelchair; she's been using one at the nursing facility. She herself had a conversation with the PT there about how she could probably use an on-board wheelchair to get from the plane door to her seat, rather than her walker....I was pretty pleased that she was gathering info like that. She tends to overanalyze things to the nth degree and sometimes get stuck on irrelevant factors, but having so many people involved in her life these days seems to be a healthy balance to that.
Thank you!
Again, my mother isn't staying in my house permanently; that's not an option. I so appreciate all the suggestions and details for ways to prep her for the trip, take her trip, etc. Her driver's license....I would never have thought to ask.
Update is that my mother was deemed to be making sufficient progress to stay at her nursing facility through the 28th, at least. So now I have a bit more time. I bought a toilet chair, an adjustable bed, disposable pads, set up home care, including an initial LPN housecall from a geriatric service, I'm changing her banks, I've talked to the special needs agents at the airline three times, I've told my caregiver support group all about the plans, talked to my sons....I think it's going all right.
Thank you all. I'm going to move further questions from the "Tough Issues" thread, I think. I will be following much of your advice in the meantime.
As far as the comments on flying go - there are other options for getting someone cross country. When we brought my grandfather to our house, my father rented and outfitted a large RV for him to make the trip. The family was with him, cared for him and he made the trip without incident. The local paramedics were happy to assist getting him in and out of the RV in a safe manner. My father was a doctor and understood that a safe room on wheels is better than a flight. Anything can be done if you want to - if you are on the fence, it can't.
As for motion sickness, I am the poster child for that, the best thing I found is Dramamine, but make sure her doctor approves of her taking it because of interactions with other meds, it will make her sleepy.
When is your flight time, if it is during a very busy time at the airport don't be surprised if the airline cannot supply a wheelchair as requested due to the fact they are all already in use. Be sure to reserve a chair far in advance to better your chances of getting a chair.
Oh, the airlines will not allow your Mom to have her walker in the cabin, mainly because it is too wide for the aisles and a trip hazard for other passengers. Don't be surprised if the flight attendant takes the walker to be placed in cargo, as it is probably too large even folded up to go into the baggage bins.
While sitting on the plane during the flight, make a little game around moving one's legs, stretching, wiggling the toes, making circle motions with your foot, this will help limit the risk of a blood clot which could happen to anymore, more so as we age. Hopefully you won't have a seat mate that need to run to the bathroom a dozen times, with the airplanes being so very cramped with less leg space, you and your Mom might need to stand up to let the seat mate come and go.
Please let us know how all this turns out on your flight. Here's hoping it will be a smooth one :)
1. Medicare does not "automatically" pay for 100 days. The patient needs to be making progress. If they are no longer making progress in their rehab, then the Medicare payment stops, as well as any other insurance.
2. The flight sounds like it would be unmanageable for your mother.
3. If you move her in "temporarily" from across the country, I can almost guarantee that it will become permanent. The relationship with the family will never be the same and it may be extremely stressful for your boys. In addition, your home may not be able to be altered enough to be elderly-friendly.
4. Miller trust or not......there is the still look-back period which is 5 years in most states. Any attempt to hide or transfer assets (even if legit as a trust) will be scrutinized and make you ineligible for Medicaid until the look-back period has ended.
5. She may be too infirm for assisted living. AL assumes that the person is independent and only needs a little help. If she needs things like a 2-person assist, help with getting on/off toilet, etc. - she needs to be in a Nursing Home.
My mother wants to come here, by the way. She really likes the idea of the facility I think is best. We'd been talking for a long time about moving her further east, to be closer to me. My care manager in Tucson has been talking about the plane flight with her, and she remains very much on board. She hasn't been in Tucson her whole life--in fact, she was born in Illinois---and has moved around a decent amount.
I have a call in to her MD to discuss this all in detail. I appreciate the thought.
This was not what she had been like, at all. But the change was just too much.
My father in law had to fly her back to IL., first class. She looked at her check book the whole time and announced that he had stolen money from her.
Once back in IL. she was put into a nursing home and regained her senses.
My own mother in law, is now in assisted living at Mountain View and all of the residents there are independent and need no help other than bathes, meds and meals.
Good luck and keep in touch.
Yours is in better shape than mine was, both mentally and physically.
I think this may work out OK. Travel as light as you can, have stuff shipped rather than try to carry a lot, keep the meds with you and check in with the special needs agents in advance. You won't know for sure how tough it will be at your house til you get there and deal with it a while. An OT pre-eval to help,you uncluttered and put in any equipment could be good. Line up a good new primary care doc, maybe even a geriatric center, and maybe some follow up outpatient therapy options too. It's going to be a really busy time! Hope she settles in well and you can put together a comfortable routine for everyone pretty quickly.
oh yeah...make sure she's got a valid DL or photo ID! Details, details.
There's a lot of info in there, but I do think at this point I should change my query....from "is it best" to "please help me do this." Every elder care professional I've consulted, numbering 6 now, thinks that this is the best solution for the current situation. A main factor is that my family simply cannot afford many of the options listed--people to fly with me, 24-hour home care in a state across the continent, etc. My mother lives on such a limited income, and I have already strained myself financially flying out to Arizona twice and hiring a care manager there, etc., that it's just really hard to read all the posts above about what I should be doing if I were willing to take money out of my chldren's college funds (which are certainly not burgeoning, by any means.)
So, that said, thanks for the helpful thoughts about stretching her legs and anxiety medication and chucks for her seat. Of course I have consulted with her MD about flying. I also do not agree with the idea that her skilled nursing facility is discharging her because she is not meeting the Medicare standards of "progress", but that is certainly the case, and I do not have the means nor the energy to fight that decision, especially when it is quite clear that she will do far better in a place where she has family (here), as opposed to there, where she has no one. I have also considered the flying question pretty carefully, but putting her on the train to cross the country will only nauseate her (she struggles with motion sickness), require a change of trains, and take far far longer than a flight.
I am arranging medical care to assess her as soon as she arrives, which is really somewhat difficult when changing states, but I think I'm finding assistance. I also absolutely do not plan to keep her with me longer than a few months, during which time I will have the time to apply for various subsidies that will bring her into consideration for assisted living group homes, which are more likely to fit her miniscule budget, while waiting for our preferred assisted living. But I simply do not have the time right now to visit them all, assess the social dynamics of them all, fill out the subsidies, all the while that my mother is stressing over the fact that she has no one at her facility that really understands who she is.
So, I'll read the above through for suggestions, and if anyone would like to give a few more "good luck" and "we know you can do it", that would be super. Those who have (again, along with the SIX professionals I have consulted, who either know me, my mother, or have talked to me at length, and all feel that this is the best solution), I thank you so much.