Heart over Head or Head over Heart...?

Medina, OH

Need advice from the Head side as well as the Heart. My 94 year old mother broke her hip and fell on 4/1. Dr. said she was in excellent health other than the hip and recommended a total hip replacement. We said that was fine. She survived the operation in great shape and was sent to a rehab hospital not far from here where she stayed for 21 days (hating every minute of it and complaining that they were over working her). She graduated from rehab and we were told she would do best in assisted living. So, to assisted living she went. Nice apartment with all of her own furniture and, more importantly, her cat. We did not tell her that this was the end of the road. She is desperate to get "home" which is just down the lane, actually. She says therapy is not doing any good and she can run circles around all of the "old folks" there. My heart breaks. She is more sound of mind than I am these days, and all she wants is to get back to her own "other" apartment and tend to her plants and her cat and her Geraniums. We can not afford to keep the "other" apartment as well as the assisted living apartment. I hate to be the one to sentence her to assisted living when she is doing so well, allbeit with a walker. Anyone in the same boat? Ever been there? Head tells me to keep her in assisted living, but heart calls me a bad name for not letting her go home for what little time she might have. Any thoughts would be appreciated. Thanx. Susan

Hillsborough, NC(Zone 7b)

Susan - the exact same thing happened to me (us, I have many siblings.) Mom broke her shoulder - not her hip. But once out of rehab, we let her go home to her independent living senior apt. (There was no stopping her anyway -- she was very sound of mind and very determined.) She fell again within a few months and this time it was the hip that broke. Looking a little closer we found evidence of some slipping --the apt manager said she wrote several checks to pay the rent but he straightened it out with her. The electric bed people knocked on her door and sold her a bed that was supposed to take all her aches and pains away (it was junk) she paid on that for a long time.... she left raw meat in the microwave and she had rotted fruit and food in the fridge... all this went on with her appearing to be in very sound mind (I am in the medical field and I spoke to her daily and she was not showing any signs of dementia.) She too did not want to live around the old people. And my mother has never been very 'social.' She keeps to herself and only has had one or two good friends. That alone gave us pause because we know that in assisted living lots of activities involve mingling...and she has always hated that. At the old apt in the senior living village, all her neighbors were her age or a tad older or a tad younger and she would refer to them as old people "the old lady next door" (who by the way was younger than mom.) Long story short -- I hear what you are saying --your mom is very sound of mind and that you feel bad taking away her choice of where to live and also of feeling like you have deceived her... .but these injuries truly do take the toll on the body and mind of the elderly. In my opinion and experience sometimes when the mind is willing the body is not and these injuries speed that scenario along. We sat down with mom and told her that we had reservations about her living alone and why (and she protested very loudly that we were all crazy and had no right to make decisions for her---and in part we felt she was right about that....) But we told her that we thought that she would best be served by assisted living --to sort out all the things that she could not sort out...and that we had real concerns that the choice of where to live would be taken from us and from her by some sort of social service agency that may intervene for her own safety. We told her that reports were made at the hospital about her falls and SS has to evaluate the wisdom of sending her home with no supervision. Making the decision to move to the assisted living would allow her to participate in the decision as to where and when. We took her out for overnights and weekends and were very much in touch (of course there are lots of us so it was not hard to do) before we knew it...she was 'glad to visit us but wanted to get back to her 'own place.' She accomodated to the change better than we did --we were so steeped in guilt. What I think would have prolonged that transition is if we were not up front in telling her the situation. As long as she thought that she was in 'temporary housing' she wanted to go back home. Telling her the way it is --is truly the best and most respectful way to approach the situation.
Today my mom is in a fully assisted nursing home and very deep into dementia. In her rare and brief moments of being herself she still refers to her housemates as 'these poor old people.' Sometimes she thinks I am her mom and sometimes her sister..... and rarely she knows it is me.... but the upside is that no matter 'who' I am ---she is ALWAYS glad to see me and scolds me about being away so long. Good luck with your decision- making and take comfort in knowing that you are doing the very best for your mom and protecting her -- she would expect no less from you.

Lancaster, OH

you must be exhausted. i would say to let her go to her 'other apartment' if you think she can do it. i have had experience as a home health nurse, and had many patients live at home with walkers. assisted living facilities are easy to get in to, and are usually looking for residents, so it isn't as if you are going to take her from a situation that she cannot return to. assisted living is really tough for the clear minded. equip her with an emergency pendant (like lifeline), and that way she can get help quickly. sometimes your head can make you do the safe thing, but she could fall at the assisted living just as easily as she could at her own home. chances are she will need more care in the near future, but go with freedom as long as you can...all we can do is hope and pray for the best outcome. good luck finding your answer. thanks for listening to my opinion, just remember, that's all it is.

Medina, OH

Guess this will be a roller-coaster ride till the end. Yesterday all was great. She had two therapy sessions and was pleased to report that she was mastering new skills. Even dressed herself although she admitted it "took forever". Will have a chat with her case worker later today and start collecting information from the "pros". Time is running short on the independent living apartment and I don't want to renew if for another month. Sad (?) thing is that Mother will agree with anything I say.... I recall my Dad saying "if it ain't broke, don't fix it". More later. S.

Hillsborough, NC(Zone 7b)

Craze - You are very fortunate in Ohio.

Here it is very hard to find a spot in assisted living - at least at facilities you would consider an acceptable option. Some of the better ones are a bazillion dollars (down) and quite a lot of money/per month, until the money is exhausted and those with skilled care attached are especially hard to get into and the requirement often is --if you want this particular skilled care then you have to start with us in the independent apt. No checking into the skilled care right from the home.

Medina, OH

Mother continus to improve in leaps and bounds. She bounded into the car today for a ride out here to the house. She was delighted to see the gardens and yart, but was not ready to try the stairs into the house. Only two, but she knows her limits. She also said she was afraid to try our "potty" she has become accustomed to a raised seat-will get one here tomorrow. I do think that she is almost ready to give it a go at her place-and the rental folks have been more than generous and sympathetic to our situation. She sees the surgeon tomorrow and I am confident he will discharge her. Next hurdle will be the therapists-but knowing Mother, she will WOW them. Give me strength!

Thanks for your support and please keep your ideas coming.

Medina, OH

Update from Ohio. Mother is about to be discharged from her therapies. She is fully in charge on the walker and does pretty darn well without it. Although she is still in assisted living, she is totally free from any assistance. Long story short...she is returning to her apartment next month. I shall have someone look in on her around noon, just to make sure she is "up and at 'em", as my father would say. This has been a real learning experience and I shall never sell her short again. Wish us luck! S.

Hillsborough, NC(Zone 7b)

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So happy for your mom. I wish her many long and happy years in her apartment. Did you get a lifeline or some other electronic device - or do you feel not necessary now?

Anne Arundel,, MD(Zone 7b)

skeeler- congrats on the good news. She doesn't seem to need the assisted part yet so good for her and you.
I predict more roller coasters like this in the years to come. Please consider other things that need to be in order (power of atty, getting payable on death on some investments maybe, check out other threads here for help)

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