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My mother is in a very good nursing home but the aids are flat out so they only handle the bare minimum. I’ve been attending to her personal care needs including scratching, massaging, shaving, cleaning out ears/nose, dealing with her hair, flossing and brushing teeth (they’ll brush but won’t floss). I also straighten out her room, clean up tray table, manage her closet and belongings and make sure things are organized as we all know the quarters are tight . I’m also her quasi interior designer. She is basically like a quad and can do absolutely nothing for herself.



I have been going in daily at night to do these things along with feeding her dinner since her placement in March 23. My father goes in during the day and feeds her lunch but refuses to handle any personal care needs and attests that she has what she needs from the facility.



She doesn’t have what she needs fully from the facility, she needs more but I’m the only one doing it. Yes, I could stop doing it but then it won’t be done at all. In what will be a surprise to all, my only sibling brother lives 2 hours away and places calls with occasional visits and handles zero of the heavy lifting.



Father refuses to hire an aid to supplement. Basically school of hard knocks, mother just needs to adapt and deal with it if for example, her teeth aren’t flossed. I think she deserves better care. I could pay for it but it doesn’t feel right, I’ve already paid my parents with my life and I have been spending a lot on things like her clothing anyways, my father is exceptionally cheap. He does have a mani pedi person come in once per month which is helpful.



I’m feeling really demoralized, burnt out, unsupported and exhausted at this point. Maybe I am doing too much, but if a daily massage or supporting her with her personal care is the only thing that gives a profoundly disabled person some relief or peace, why wouldn’t we do that??? Why wouldn’t we help someone when they can’t help themselves? Why be stingy in this scenario?



Curious what people think about hiring a private duty aid for a SNF?

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It sounds like you’re trying to micromanage every aspect down to the finest detail.
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AlvaDeer Dec 29, 2023
There are so many "feelings" around a loved one placed in care. We just get so uncomfortable when that care isn't spot on perfect. If we are of a mind set that's a bit into control issues or a bit OCD (I plead guilty) we can go overboard in our expectations. Grief counselors always tell us that we want to get "mad" at doctors, nurses, caregivers, hospitals, et al because mad feels so much better than grief.

I hope our OP speaks with admins about her expectations. She will likely get told some of the realities of care. It is no longer about saving the teeth for a decade more of wear. It is about the impending loss of our loved one. And it's such hard stuff.

Count me in as a micromanager. I will try to micromanage issues that haven't even come UP yet, just "in case". And that after 81 years of life that has surely taught me it is to no avail. Alas. No answers out there ultimately. We just have to struggle on.
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I think you should seek some help for yourself.
You are not seeing that your going in and doing daily the things that you are doing is enabling the neglect of your mother. They know you will be in to do it.

Have you spoken with the administration?
I think that you need to understand that flossing teeth of all clients in care isn't "the norm". Mouth care is, but flossing isn't normally done in hospital or nursing home without special requests and reasons.

My recommendations are:
1. Do not spend your money on your parents. Start your own savings accounts for your own aging. You will need it.
2. Go to administration. Discuss with them your expectations versus what they can in reality provide. Come to the best compromises you are able to.
3. Allow your father to care for your mother's needs and provide visits, not daily, yourself. You are too enmeshed in your parents lives and should be concentrating perhaps more on yourself and your own needs for your own life with family and friends.
4. Consider counseling with a Licensed Social Worker in private practice. They are great at working with life transitions work. You aren't there to talk about your childhood and toilet training habits, but about your current day to day life and the expectations you have versus what may be a sad reality.

I surely do wish you the very best. This is a hard hard time for a kind and loving heart. As someone who's a bit OCD MYSELF, I sympathize with your mind's determination to bring some ORDER to this world that seems so laxadaisical and out of whack.

My very best to you and do know my heart goes out to you. I would want MY teeth flossed, too!
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Kristen2037 Dec 29, 2023
All good suggestions, thank you for taking the time to share them and for the encouragement.
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Kristen 2037.
Sometimes Private Aids are hard to find. I did pay a Home Health Aid to visit my Mom when she was in rehab for cardiac care. At another time I was at her Nursing home three times a day and I needed some relief. I gave the private Aid a set of typed instructions about my mother's needs. I found it helpful, and I know my mother appreciated seeing another face and getting extra attention. I like your question "Why wouldn’t we help someone when they can’t help themselves?" The sick and dying will never be healthy again. We are the ones that get to leave after the visit. We go home. They don't. It is very sad.
I hope you get some support. I found my Moms Aids through the local Council on Aging.
Some day you will look back with no regrets. My very best to you.
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Kristen2037 Jan 10, 2024
I'm sure your mom did like the extra attention - my mom certainly did (when she was at home and we had an aid coming in a few times a week) and does, there's really not an amount of attention that would ever be enough, that's just her personality. LOL. Thanks for the input.
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You are doing sooooo much for your mom. I know she appreciates it but you can and I think should back off a bit. Maybe you do these things for her weekly, but absolutely no to every day. What about your life??? You need time for you and other family, friends, downtime, exercise, etc. This schedule is not good for you and it is not sustainable.

Tell dad your new schedule and that you plan to do X, Y, Z once a week, not daily. Maybe he will notice that she is not as well taken care of and will be more willing to pay the money for an aide. I would check if they allow it but I know the AL where my mom is does allow it.

I know I often feel a twinge (or two) of guilt about not doing more to help my mom with all kinds of things. Taking her out to eat since the food there is not more than OK. Take her to the movies since she really likes doing that. And more and more things that I could be doing for her. She isn't very happy but I am very busy with my life and my grandkids and there's only so much I am willing to give up, especially after she lived with me for 7 years.
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Kristen2037 Jan 10, 2024
7 years is a long time to live with someone, I think it is great that you have prioritized your life and I need to learn to do the same. Thank you.
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What is in the contract? What does the facility say they will provide? Review this list and then have adjusted perspective.

"In what will be a surprise to all, my only sibling brother lives 2 hours away and places calls with occasional visits and handles zero of the heavy lifting."

hahah (respectfully)... this is NO surprise to many many participants on this forum. Just like you, your brother is not at all obligated to do anything. You cannot "assume" him into doing what you are doing. You are choosing to do it. You can choose to limit what you do so that you don't burn out. It doesn't mean you don't love your Mom, but it will eventually have a detrimental impact on you (sounds like this has already begun).

Only hire an aid if your Mom has the funds to do it and you're her FPoA. Do not pay for this yourself. The FPoA for your Mom doesn't need your Father's permission to spend her money. I get the feeling that you'd probably micro-manage the hired aid as well. You need to adjust your expectations for your Mom's care and your participation in it. Expectation = premeditated disappointment.

Bless you for showing your love in this way to your Mom. It's all very hard, but you need to not burn yourself out -- then you'll be no help to anyone (not least of all to yourself).
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Kristen2037 Dec 29, 2023
Thank you very much.
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"scratching, massaging, shaving, cleaning out ears/nose, dealing with her hair, flossing teeth" As far as I know no aide is expected to do this. Nails, aides are not allowed to cut. Not sure why ur Moms are getting dirty. My Moms never did. You will need to cut them. For toenails, Medicare will pay for ever 10 weeks by a podiatrist. The facility should have one who comes in.

Mom should be bathed, IMO, 2x a week. Unless she is getting a sponge bath in between. Her hair, what do you expect? They don't style it. Just gets brushed and combed. I actually carried a brush and sample bottle of hair spray in my purse to do Moms hair. Just some hair spray on the brush and brush it thru. Helps with the static. Then I would brush it the way she wore it and spray again. Your lucky if the teeth get brushed. One bad thing about facilities, dental health. And the staff should be feeding her.

My DD is an RN in nursing homes. I worried about Moms outfits matching. So I hung tops and pants together. Later he bra too because sometimes she did not have it on. She needed it because she would get a yeast infection if allowed skin touching skin under her boobs. My DD said "you can't worry about those things" But Mom had dementia and I felt at least her clothes could match and her hair look decent.
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Not a SNF, but I have a private aide coming in twice a week for a couple hours to my Dad's assisted living. He wanted a little extra help on the days that he bathes, above and beyond what the AL staff can provide, and he is ok that its coming from his money. We have an aide who is employed by an agency. Its not low cost, comes to $40 an hour. I pay it from my dad's funds. You may find more affordable private care to help out in this way outside of an agency.

First, make sure the SNF allows this. My dad's AL does allow it, but not all AL's allow it. Also, I would suggest to make sure the Aide is not doing things that the SNF staff should be doing. If you have the aide taking over things they should be doing as part of their job, it could be a slippery slope where then the SNF staff do even less for your mother. For my dad, I have clearly delineated to the AL staff what the outside aide is supposed to do, and what the AL staff must continue to do.
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Kristen2037 Jan 10, 2024
Very good point!
"I would suggest to make sure the Aide is not doing things that the SNF staff should be doing. If you have the aide taking over things they should be doing as part of their job, it could be a slippery slope where then the SNF staff do even less for your mother. For my dad, I have clearly delineated to the AL staff what the outside aide is supposed to do, and what the AL staff must continue to do."
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My Great aunt Had private caregivers coming Into assisted Living the last year of her life .
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Kristen2037: Ask the SNF for a care meeting.
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Not too surprising. This may be a SNF that is short staffed and have a hard time keeping people.
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