More intensive home care or a nursing home?

MsMittens

Wondering what people's experiences have been around deciding to move a parent into a home versus doing care at home. My mum's dementia seems to be progressing rapidly. She has around 20 hours a week of care at home at the moment which we are going to be keep scaling up but we are going to start looking at homes too. It seems that the evidence says dementia sufferers who stay in their home environment do better but the speed of mum's progression is making me feel she won't be able to live alone for much longer.

SDianeL

very soon she will need 24/7 care. Since you’re already looking I think you know she will need more care. She should probably not be alone now. Would she know what to do in an emergency? Can she use a phone? Would she enjoy activities in a care facility?

M1

I would humbly challenge that statement that there is evidence that those who stay in their own environment do better....what evidence? By what measures? Sounds like propaganda to me.....? I think it's a common bias that is not supported.

H1235

My mom’s doctor actually recommended AL vs being alone all day while my brother was at work. She didn’t even get dressed in the morning, because it didn’t matter. She had no one to talk to, couldn’t go outside(risk of a fall), and often had a bowl of cereal as a meal. I would also disagree that people with dementia do better when they stay in their home.

harshedbuzz

Hi and welcome. I am sorry for your reason to be here but pleased you found this place.

I think the more urgent question is whether she's OK living alone the 148 hours she doesn't have a care giver at home. If you've not spent a couple of 24/7 periods in her home with her, you may be fooled by showtiming or missing times of day when she's sundowning and less lucid.

I noticed you referred to your mother as "mum", are you in the U.S.?

Assuming so, often the decision to bring in care or going into a MCF or SNF is driven by cost. Running a nursing-home-for-one out of one's residence is much more expensive than placement. Not only are there the costs of aides around the clock, but you may also have to modify the home to make it work and change your homeowners policy to cover people working in your home. If you hire independent caregivers, you'll be doing background checks, payroll, withholding taxes, scheduling and filling in for no-shows.

I'd be interested in any evidence that backs up the claim that folks do better "at home" and what's in it for the organization funding the research. Links? Currently in the UK there is messaging about the dignity of inclusion for PWD living in the community and being supported in their "independence" with help from shopkeepers and random folks of the street. It sounds lovely if it works, but I suspect funding plays into this.

I know folks who did well at home living with a spouse or adult child as their primary caregiver with HHAs to provide respite or allow them to work parttime. My friend had her mom at home until she passed. My mom was able to keep dad at home until about 2 months before he died.

And I know folks who did better in a MCF. My dad was more cooperative with the well trained and well rested staff and as a result his care was better— he was cleaner, took his medication, drank fluids and ate well. And since mom could just be his wife and love on him, they were more content together instead of a power struggle. My aunt had been living alone as a widow when she went into MC. She positively blossomed. Not only did her health improve from proper exercise, medication compliance and help with hygiene, she was happier and engaged with crafts, activities, trips and social interaction with the staff and other residents. She thrived and lived in the MCF/SNF (last 12 months) for 8 years.

HB

Quilting brings calm

It’s not just about the person with dementia… it’s about you too. 1/3 of caregivers end up dying before the person they are caring for. You deserve a life too. Any children or grandchildren you have deserve your attention too. It’s okay to add your own wants and needs into the equation to determine where mom should be

sandwichone123

A care facility has many advantages, one of which is that the staff work in shifts, so while there's always someone there, everyone gets a good night's sleep and regular days off. As the person needs more physical support, the caregivers are able to call on each other for assistance in a way that home care staff are not. Another is that the entire environment is set up for success, with no breakables and with easy-access facilities. The primary caregiver (you) can return to the role of daughter, rather than caregiver or manager of the care staff.