Skilled Nursing Facility Move for Mom

At Thanksgiving at my 87 year old mother in law's home we noticed she was not herself.  On the phone she had sounded fine as usual, but something was different I commented to my wife after our visit. She was not engaged and off to the side by herself much of the time.  Jane has three children but lives alone with the closest relative about 100 miles away.

Soon after Jane had a week's hospital stay for being anemic then came to stay with us for a month while recuperating.  That's when the family became more proactive in caring for her.

A few things have been observed during this.  One thing is that you can't go entirely by how they say they are doing on a phone call.  While Jane was recovering at our home she was really frail looking and could hardly stand up and get her balance but when her son called she said she was doing just fine.  I was thinking the reality and the picture she is giving over the phone are two different things.  

Family members wished the best and wanted everything to return to normal but we suspected it wasn't.  We came up with a schedule for family members to visit Jane to buy groceries, fill subscriptions, pay bills and many other things.  By actually spending the day or even an overnight visit, we got a much better feel for how she was doing.  

Increasingly we noticed she was struggling in doing day to day living, letting her prescriptions run out, not able to take inventory of food supplies to get a good grocery list and really getting confused about paying bills.

We responded. We started her on meals on wheels, made her grocery list, checked medications, took over bill paying.  We came down to take her on doctor visits so we could hear firsthand what the doctor said.  

However on our visits we noticed uneaten meals on wheels, medicines on had that should have been taken and that she did not remember or not understand what the doctor said.  

We were visiting Jane when a lady called her to ask for money for some charity.   Jane said she did not know the lady even though she said she lived in the neighborhood.  Jane told the lady she didn't have much money but she would do what she could.  This concerned us for obvious reasons.

We were thinking time may be running short on her living by herself.  But she was not ready to do that refusing to move to an independent living low rise we had got her approved for and not ready to stop driving.

About two weeks ago we got a call from Jane at 10:30 pm.  She had fallen in her bedroom and couldn't get up.  The EMTs couldn't get her to stand and took her to the hospital for a week's stay.  She didn't break anything but injured herself badly so she has not been able to walk on her own.  The doctor says she has syncope which means she is prone to dizzy spells and at 88 years old says she does not need to live alone.

 They transferred her to a skilled nursing center for rehab where she has been this last week.   We told Jane what the doctor said about her not living alone.  She seems to understand but is in denial telling staff she can't wait to get back home.  This is the hard part.  

Skilled Nursing Facility says they do have an opening for a permanent bed but we need to make application right away as it takes time to get approved for Medicaid and you don't want to be paying the $170 per day.

There are little options for her as she is living on social security.  Medicare nor Medicaid will not cover

Assisted Living but will cover a Nursing Center in some cases.  Medicaid is a State and Federal program that will pay most nursing home costs for people with limited income and assets. Eligibility varies by State. The Skilled Nursing Center can give Jane some things she would not get at home:

MEALS -     Three meals at day served in the dining room or they will bring to your room.  At home we were wondering if she was eating properly.

MEDICINE - They will purchase the medicines and administer whenever they need to be given.  At home she occasionally let prescriptions run low and some medicines seem not to be taken.

SOCIAL - The center has activities to get residents together almost every day and Jane knows a few people from church.  At home Jane was sitting alone in her living room much of the time.

EXERCISE - Besides the rehab there is a full exercise facility.  At home there is no level place to walk, so she gets little or no exercise.

MONITORING - Nurses station, 24 hour nurse on hand, emergency button on her bed, checks being made every day.  They monitor eating habits, exercise, drugs, and social activities every day.  This helps her do those things on schedule and gives the family some peace of mind. At home no monitoring at all day to day.

SECURITY - Jane would be less likely become the victim of crime or fraud at the center.

SAFETY - The center provides assistance with bathing.  At home Jane's bathroom have a tub with no handicap access.  The Center has a safe exercise room, no need to walk over uneven payments with acorns just to get some exercise.  The center provides a safe regulated environment.  Living at home an 88 year old woman could be a target of crime or fraudsters.  Also the center provides assistance with bathing and getting dressed.

TRANSPORTATION - The center will take you to doctor appointments, church,  to shopping and for other trips.  At 88 with sharp shoulder pains, hip replacement, knee replacement, and hard of hearing, is it still safe to drive?

FEELING OF INDEPENDENCE - Moving from your home  may give the feeling of losing your independence.  But has this last year really been  independent living?   The center actually has opportunities for new activities and socialization not available at home.

Now it is week two in the Nursing Center and Jane has been meeting people, taking part in activities and enjoying the regular meals.  We have brought over photos and some personal items and had her phone transferred to her.  She seems to be getting adjusted to the move better than we expected, it just takes a while to get use to new surroundings.  

We are still there for her and she talks everyday to family members.  We plan to visit just as often as before. The family has been advocating for her needs too.  Got her a TV, adjusted her dining preferences, adjusted her bed so she can get to her night stand in a wheelchair.  We talked with the social director to make sure she is invited to the social activities.  They even offered to move her to room with a person she likes to talk with in the dining hall, but she elected to stay put.   A private room is available for a fee.   There are options.  

Sometimes it takes a crises like a fall, hospital stay and a doctor saying she really does not need to be living by herself to instigate a move like this.  But it seems for the better and I think all parties now agree, Jane too.  


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31 Aug 2016

By By Robert Fowler