<p>Side question: when they’re older and frail and first move into AL, do they need some extra attention from the family? Eg, staying for dinner, stopping in the first few days? We try not to do that for our kids when they start college. But how did you manage the first few days for your elders? </p>
<p>Lf- I visited during transition, but not at dinner time. That allowed my folks to meet people and develop some options for dinner companions, the highlight of the day st some places where food and atmosphere are good . Checked in by phone regularly. </p>
<p>A bit of playing by ear is in order, as every situation is different. A couple’s needs may be different from one shy elder . AL directors may be of help with initial connections to possible peers, though of course, things evolve organically. At parent 's place, there were a lot of welcoming intros to AL. All in the same boat, starting over with new friendships made it feel like college. I enjoyed seeing them regularly, but let them have enough time independently to check out activities and establish a routine. </p>
<p>LF, i practically lived there the first 4 or 5 days. Somehow it seemed like a different thing than moving D to college (to me). Part of it was that my dad was certain i was going to abandon him, so I wanted to show him i wasn’t going anywhere. I also wanted to start establishing relationships with staff (which has been invaluable at times) as well as making them familiar with some of Mom & Dad’s habits and idiosyncrasies. </p>
<p>Keep in mind that older adults with cognitive problems can get easily disoriented. Its best to try to make as many things the same as their home ( e.g., which things are in which drawers in their dresser and the kitchenette, etc) as their remote memory is going to be comparatively intact, but their ability to learn and retain new information is typically impaired. So they are often acutely confused and agitated, especially when so much is new and unfamiliar. So yes, plan to spend some time with them to help them with the transition. </p>
<p>Somebody they recognize and trust is essential as they make the transition. For my parents, when they moved to independent living, I was there practically every day. Remember, they don’t know anyone, and it is hard to move into a new community. </p>
<p>Well LF, neither me or my brother were there for the first month. Both of us lived far away and it happened suddenly after an ‘event’. We each had daily contact with my mother by phone. My mother seemed to do well with this as she did adjust to the setting after about a week or two. Her sister in law ( a saint) did visit every few days to bring her things and I sent packages to her weekly for a while. Not sure how it would have been had we been there daily. I do think maybe she would have clung more and not tried to learn new people an activities. But, I can never know for sure. I visited in one month and she did not complain about the transition.</p>
<p>Thanks. It seems that each experience can be a little different, which is what I thought. My MIL adapted immediately, even with her limitations. I think a neighbor took her under her wing in the first hours. </p>
<p>I didn’t know if being there would interrupt some adapting or new routines. But I know they’re not 18 and it won’t be easy for some. Again, thx.</p>
<p>My mom is being released on Monday with aides 3 x a week/a nurse 1x/wk/pt 2 x a week. Right now she is referred to as a furniture grabber because while she can walk with a walker, she cannot stand without holding on to something. She can’t bend over, she can’t pick anything up or hold anything while standing. She could walk to the kitchen, but once there couldn’t get a plate, heat up a meal and carry the plate to the table. She couldn’t even open a can of soup with an automatic can opener. However, she’s very excited to go home.</p>
<p>We’re calling around to nursing homes, without being able to walk in the door, you can’t do independent living. So now we are calling around to find a place for her. We can’t find a place before Monday and honestly she’ll need to see for herself that her days of living alone are over. The person I need to speak with about the financing at the facility where she is now is out on vacation. But there are calls into other places. </p>
<p>Eyemamom, so sorry you have to go through this . I have not exactly kept up, is there a between NH and independent living , like AL?</p>
<p>Best with this, eyeamom. You are wise to plan ahead for additional care. Is the rehab discharge person a resource on this front? They may be very good at advising on options and level of care. </p>
<p>Sometimes these things break so fast it is hard to keep up. Hang in there.</p>
<p>Eyeamom, you mention independent living and nursing homes. Have you considered the in-between stage, assisted living?</p>
<p>I think she’s past assisted living now. She is going home, but I’m guessing even with the aides it won’t be long. As it is I can’t imagine why on earth she’d want to be home alone, particularly with the possibility of falling. At the facility she’s at now there are people there she knows, deliver her food right to her, she can go outside to the patio that overlooks the water and they’re all really nice and nice to her. </p>
<p>However, she told the people today from the aide agency that she doesn’t have any mobility issues. Granted her apartment is getting all kinds of grab bars, she can’t take a step without a walker, nor can she shower or dress herself. When I said IL I meant, to qualify for anything below NH you have to be able to get through the front door on your own, she cannot do that. </p>
<p>Gotcha. I’m so sorry. It really does sound like she’s a very poor candidate to be sent home, and I’m surprised they’re doing it. Do they know there’s no one to help her dress, bathe, etc? </p>
<p>eyeamom I too am surprised they are planning on sending her home. It is so great you are exploring nursing homes in the area. </p>
<p>If there is no way around this discharge, adding in more help seems important for safety. Is that a possibility? </p>
<p>I have found it easier to risk building in a bit more coverage than needed and then reduce it if excessive, than to urgently find care in an immediate crisis. </p>
<p>Well she chose to not sign up the aides. Just the nurse and pt, but she agreed to at least let the agency come see her on Tuesday. I hope Monday is enough for her to see she can’t possibly be alone. I’m surprised there has been no conversation on just getting her transferred to a permanent facility. When she doesn’t have the UTI she is apparently a lot better, but since you just take those meds orally it’s deemed fine to be at home. My sister talked about staying over Monday night but I told her if she keeps filling in and closing the gaps mom will never make the decision. Plus what will happen Tuesday night, and every night after that? </p>
<p>Good that the agency can come on Monday. UTIs often reek havoc, though her baseline sounds quite compromised, including her ability to assess her situation. I get not having sister close so many gaps that denial of needs is perpetuated, though wonder if a case can be made for being there at discharge to assess her current functioning at home, as well as provide assistance. It may help ensure appropriate planning. </p>
<p>As family sounds tentative about her d/c timing, feel free to state this to rehab, ask what happens if she is not safe at home and that is determined quickly, etc. Can she go right back to Medicare covered rehab without another qualifying 3 night hospital stay? Unsafe plans are daunting to all, a little polite push back may help staff help you and create focus on her present frailty. Might she gain some stability while awaiting as rapid a good placement as possible? Sometimes family’s concerns alter plans. The immobility is a huge safety hazard, as she can’t get out in an emergency and of course falls are a big worry. </p>
<p>So disturbing and if she is as vulnerable as I am picturing and at home, being alone is worrisome. </p>
<p>Hang in there. </p>
<p>All good points. I also wonder about her ability to take her meds accurately. </p>
<p>Once she’s discharged, that probably ends the Medicare claim. If she’s back at SNF in two days, that might very well be self-pay. You probably want to clarify before she’s discharged.</p>
<p>eyeamom, this just occurred to me as well. Under Medicare, if you think discharge is inappropriate:</p>
<p>
</p>
<p><a href=“http://www.medicare.gov/what-medicare-covers/part-a/rights-in-nursing-home.html”>http://www.medicare.gov/what-medicare-covers/part-a/rights-in-nursing-home.html</a></p>
<p>Deep breaths everyone. I almost want to scream in a panic. My mom is home now. She can’t stay home and I know I have to have the conversation with her much like Dharma. You can go now and go to the place you like…but if you hold out you will not be able to afford this and you’ll end up in a state run nursing home. She is going through money like crazy and my brother who is her finance person is just so blase about it I could wring his neck. I didn’t want to get her excited about this place unless she could afford it and somehow since she closed in July she has spent a tremendous amount of money. I’m waiting to hear from him now.</p>