When Is the Apropriate Time....

Updated on July 12, 2007
C.H. asks from Lincoln, NE
6 answers

I'm trying to figure out how I can tell when the time comes, to put my dad & step mom in a nursin home or something to that effect. My dad & step mom are getting up there in age. They have their own place. All though my step mom is getting really sick. I'm not sure what all my step mom has. All that I'm aware of is asthma.
How can I tell when it's time for them to enter a nursing home?

I've thought about moving for several reasons. All though I'd hate to have to leave my step bro. the only one taking care of them. My dad & step mom live in a townhouse. The people (most) that live in the assosiation are pretty nice & help keep an eye on them.

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answers from Des Moines on

I guess that question is totally situationally-based. if they are getting to the point that they can't take care of themselves or are endangering themselves, then that's when they need more.

Nursing homes can be a very depressing place. "death Parking Lots" for some. Anymore there are several assisted living places that aren't the full-care type like nursing homes. Be sure to visit the homes and if your parents are coherent enough be sure to include them in th discussions and maybe some tours once you narrow it down.

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answers from Missoula on

Hi C.,
I agree with L. H the PT that gave you advice. Look into what she has said, and if you feel that they are not safe being at home contact their doctor and talk to them about placement. They might be eligible for in home care which is better for them if they can stay in their own home. There are many assisted living places to choose from in every town, which is another option. I work in a group home and that is nicer then a nursing home. Less people and better care and attention. We actually got one of our residents from a nursing home and he has done wonderful there.

If you do put them in a nursing home my advice there would be to visit at random times. Don't go on scheduled visits because my mom has worked in alot of nursing homes and has seen that the caregivers will take the extra time when they know a family member is coming in at a certain time. But they always take the extra time if they don't know what time they are coming in. does that make sense?

It is a hard decision when it comes to your own parents on what to do but I would start with the Doctor and get some help there.

Good Luck
God Bless
L. Shipley
Missoula MT

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answers from Des Moines on

How well is your dad able to take care of your step mom and their home? If they need help around the house, perhaps they would benefit from a home health assistant or a maid. While I do not know how your father is doing health-wise, the decision to go into a nursing home should be based on your father's and step-mother's needs, not their age. This is also a decision that they need to make, (unless they have given you power of attorney). If you and your step-brother have concerns about their health and well-being, discuss these concerns with them as a family discussion. Find out what their wishes are, then respect them unless their lives are in danger. There are alot of places to go to for help in the home, such as a home nursing agency or social services agency, to help them maintain their independence while giving you peace of mind.

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answers from Omaha on

First & foremost, what does your Step-Mom's family think???!!! They are the ones that should have a say so what they think is best for her. Second, what are their wishes? Do they have a will, or power of attorney that states what they want? If you have family I would sit down with everyone & discuss all the options. If they are capable of cooking, driving, doing their laundry, then why move them? The only reason we had put my Grandparents into an assisted living, was at the time my Grandma was dependant on a wheel chair, had Parkinson, and could not take care of herself, she has since passed away. I know what ever choice everyone makes, someone won't be happy. Just remember when you are their age, would you want someone making the choices for you? It is also a good time to maybe make a legal document for yourself stating when you are their age, what you want planned for you.

Best of luck!

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answers from Des Moines on

C.; I am a physical therapist and work in a hospital setting. Here are some things to consider: 1) are they mentally intact enough to be left alone safely? For example; maybe they forget names or the date or what they had for breakfast, but what is important is that they remember important things like turning off the stove, taking a shower regularly, remembering to eat, take medications in appropriate dosages. 2) Do they have the ability to move around their home safely? i.e. are they falling or do they look so unsteady when they walk they have to hold onto furniture, are they having to use a lot of stairs around the home and appear unsafe? 3) Are they able to take care of their basic daily needs at home? i.e. are they bathing themselves, dressing themselves, eating nutritious meals, do they look well kempt, are they incontinent and unaware or aware of it, is their home relatively clean.
Keeping these things in mind, there are many adaptations or services available to keep them at home- of course you have to figures out what insurance will pay for, what's private pay etc. For example: if they just have difficulty going up and down the stairs, can their living space be rearranged to keep them on 1 floor? if they are having a difficult time keeping up with housework- can housekeeping services be brought in every other week? if they are having difficulty keeping up with meals- is meals on wheels available in your area? if they are having difficulty remembering to get their medications taken- can a home health nurse come in a couple times a week to help? If they have difficulty bathing- can a home health agency provide bathing services or do they just need some extra grab rails in the tub or a bath chair? are you just worried that they won't be able to get help in an emergency- can they get lifeline set up? There are many services available to keep people at home as long as possible. If they are having difficulty walking or dressing, maybe they just need some physical or occupational therapy to help come up with some adaptations or activities to get them back on the right track again.

Now- if you think they need more than that, they don't necessarily have to go right to a nursing home. Maybe they need adult day care during the day and family or friends to check on they in the morning or evening. If that's not enough, maybe an elderly community where they still live independently, but there is someone on the premises that keeps an eye out for everyone or they can contact in an emergency. If that's not enough, maybe assisted living where again, they live independently but they can also go to a common dining area if they don't feel like cooking and there is a nurse on the premises 24hrs/day. There are some assisted living centers that provide levels of care; for example, maybe your parents can be independent but just need help getting dressed in the morning and getting ready for bed at night- the assisted living center could send someone in to help with that everyday. Or maybe they just need occaisional help getting on or off the toilet. Some assisted living centers provide levels of care based on time; for example, they'd have 4 levels- 1) the resident is independent 2) the resident needs 1 hour of care a day 3) the resident needs 2 hours of care a day 4) the resident needs 3 hours of care a day. And what care is provided in those 1 to 3 hours can vary from needing help getting medications set up to bathing to walking down to the dining area for meals etc.

If that is not enough care, then you might need to look into a nursing facility. And yes, there are bad nursing facilities and good nursing facilities just like there are bad hotels and good hotels. In my experience, you get what you pay for- and this can be difficult because they are all expensive relative to living at home. You'd have to see what kind of insurance or plans your parents have for long term care and go from there.

I think it is great that you are trying to look out for them. I guess my point is that at some point a nursing home might be appropriate, but many people aren't aware of the various services available to help the elderly.

Hope this helps.

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answers from Omaha on

Have you thought about looking into an assisted living type place? At least there, they can have some independence still, but have round the clock care in case something should happen. I do not have any experience with this yet, but my friend has had to, and she said that when it comes to the point where you are worried about their safety and aren't 100% positive they can live on their own, that's when she started looking for places. I don't think there is a definite "time" for it...everyone's different.

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