The Dilemma: Nursing Home? Group Home? Home care?

Image by Gerd Altmann from Pixabay

Making the decision to admit a loved one to a nursing home or care facility can be challenging for a family. My mother-in-law, before she became ill, requested NOT to be admitted to a facility as her sister had been. My sister-in-law was able to find a way to have her mom next door where she could care for her. She had been diagnosed with Alzheimer’s. When it became impossible for that care to be done in the home, my sister-in-law opted for a group home; she felt that would be the best care for her mom and also honor her wishes. Group homes can be a good choice in the right circumstances.

In my own experience with care facilities, because of the level of care my husband required, it was difficult to even consider having him in a care facility. At the time John needed this kind of care, the homes in the area were short-staffed and ill-fitted to handle someone with his daily needs.

Here is an example: There were occasions when John was just being released from the hospital after an exacerbation of his multiple sclerosis. He required more care than I thought I could provide so we agreed to have him in a facility until he improved a little. Because hospitals only provide acute care, many times a patient is not ready to go home but can transition via a rehab facility in this manner.

Day One

The first day I came to visit was a nightmare. John was lying on his side. They had been giving him a breathing treatment (which had been completed quite a while before I arrived). The mask was hanging sideways and he was tipped against the railing (thank God for the railing). Due to his condition, there was no way he could call for a nurse either verbally or with a call button.

This was a highly rated Medicare facility. (I won’t even talk about how they rate). Did the staff care? Yes. They were apologetic and moved him closer to the nurse’s station. Did it solve the problem? Partially. I made daily visits and had a serious conversation with the administrator. I’m sure John was not the only patient that was having problems. Within a week or so, we managed to get him home and hired private care. But going home and getting private care is not always an option. It was not an option for us when this tragedy started. I was fortunate to have a supportive family that helped us, or I would not have been able to get through until we could financially and emotionally manage at home by ourselves.

What if?

I think a lot about the what ifs. What if I did not visit at that time? How long would he have remained that way? What if he had a serious problem? He could not call the nurse and it’s obvious, despite the history we presented and his inability to do much physically, they put him in a room way down the hall from the nurse’s station. What if you have to make this kind of decision for a loved one? What do YOU do?

Everyone’s situation is different. Ours was sudden and it took some time for us to adapt. We learned along the way. I’m guessing most people in this situation experience much the same as we did. The first thing I would suggest is to TAKE A DEEP BREATH and realize you won’t have all the answers and you will make some mistakes along the way. I could write another article about how to choose home care and how to manage it. It’s expensive and takes time to find the right person. Depending on your circumstances, this person could become almost part of the family depending on the level of care that is necessary. At the very least, they have to be compatible with your loved one and hopefully the other family members that are involved in caring for your loved one.

Prioritize

I would also suggest you make a list of priorities for you and your loved one. Do this BEFORE you talk to the social worker. This will help you focus on the important things. There will be a lot of information thrown at you and they won’t allow much time to digest it. Especially if the hospital needs a bed (acute care). Discharge from a hospital could be a complete article within itself.

Nursing Home/Assisted Living

Before John was admitted to the facility I mentioned, I went to all the top-rated homes in the area and walked through unannounced. (I don’t know if this would be possible today). It gave me a sense of how the facility treated their patients. Were the patients all in the hallways? If so, were they receiving appropriate care? Were the rooms clean? Was the lobby clean? Did anyone greet you when you came in? In one of the top-rated facilities, I walked right in past the nurse’s station at the front door. No one even looked up to see who I was. Another required a code before I could enter. Look at the dining areas. Do they seem appealing? Would you want to live there? Remember, you may only have a day to decide so this is no small task. Buy time if you can so you can make an informed decision if this is the option you have chosen (or maybe it has chosen you).

Image by Alexa from Pixabay

Hope and Laughter

Probably the best advice I can give you is to stay hopeful. What that means to each of us is very individual. We often hoped for a cure (John always did). We sometimes hoped for a treatment or a way he could walk again. But we really didn’t talk a lot about his disease. We lived our daily lives much as other couples though we had to learn to allow a lot of outsiders into our home (check equipment, check on him, probably check on me) and a schedule that we would not normally have experienced. Some of the aides became our friends and the agency we used knew as much about us as we did. John was a huge fan of comedy, so we had no problem finding reasons to laugh. In these tough situations, it may be difficult to find anything that makes you laugh but if you can, DO. It helps.

We always kept our hope alive. We had faith that the right thing was ahead, no matter what form that took. I still feel that way today.

P.S.

These are my experiences with facilities in our area in northern Nevada. It may or may not represent what is happening today. These were pre-Covid and much could have changed. My concern is that you MUST be able to reach your loved one and SEE them every day if you choose to do so. During Covid, that was impossible in many areas. This is bad for the patient, bad for the family, and bad for the facility that is caring for your loved one. We still have jurisdiction over our health… at least for now. Don’t give it away; do what’s best for you and your family.