Need Input about grandmother ( long)

ladybugfruitMay 29, 2009

I've been lurking here recently ( wish i'd realized this forum was here earlier), as I have been caring for my grandparents the last 3 years. We lost my gramps last week after a rapid decline over the last few months and now I am at a point where I really need to re-evaluate where my gramma needs to be. I am working on getting her on hospice due to failure to thrive ( as was my gramps) and keep her from going back to the hospital ( my main goal) because she is tired of hospitals and doesn't want all of that anymore. She has dementia, but can still be cognisant of the basics of what is going on. Both of her children are gone as is her husband of 70 years and quality of life physically is practically nil. I really want to try and keep her in familiar surroundings with the staff and caregivers she knows ( I have sitters come and stay with her at night), but I am afraid that may not be enough at this point since her dementia continues to get worse...add depression and add anxiety issues and being alone and it gets dicey. I cannot be there all of the time and I myself have grown very weary. the last few months have really taken it's toll on me. ( I know I am preaching to the choir here).

So....I am struggling to make the right decision for her. Do I keep her where she is, familiar and comfortable on hospice ( eval not passed yet) where she still won't have continual care, or move her ( very stressful and unfamiliar) to a facility that deals specifically with dementia? Money is an issue as I don't have a whole lot left to keep her going and her income is now cut in half. My thoughts at this point are try and stay put and see if she lasts long and if we can make it work, but I am second guessing myself. I want her to be safe, but I also want familiar. I know that can be very important with dementia.

Any input is greatly received. While I have a little help from other cousins, basically, i am it when it comes to making sure she has what she needs etc.



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This is such a difficult decision. It is so hard to decide whether keeping her in a familiar place or moving her to somewhere with more security and supervision is best. Most elders prefer to remain at home, but that is not always best for them, or even possible. Many people keep them there, thinking it will only be for a few weeks or months, but it can drag on into years or even decades.

You also have to weigh in your exhaustion level. You have needs, too, and you've already done so much for both of your parents.

And then, there is the cost factor. As the hours of care needed increase, eventually it is cheaper to move them to a facility rather than hire in-home aides. But if the money just isn't there, the care falls on the family members. Is your mom eligible for a medicaid nursing home?

Where does mom live now? With you? By herself? Nearby or far away?

    Bookmark   May 30, 2009 at 10:01AM
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The "big three" for most folks are 1) can she walk around on her own safely? 2) Can she handle her own hygiene? and 3) Can she manage herself safely without doing risky things?

If she can do those things, mere attendance of one other person makes living at home possible for many. If she's moved beyond any of those limits, living at home becomes an entirely different consideration -- usually a decision-point.

In my case, living with my 97-year-old mostly blind and deaf mother is pretty simple. Someone has to be here (me mostly) but she doesn't take close/careful management. Her head's fine and we enjoy each other. However, we both know her inability to handle any one of these things will represent a departure-point. Sadly, we also both know that time will probably come. It works for us right now but we're very close to the edge.

Everyone's situation is different. Stand back and evaluate yours rationally. Don't refrain from accomplishing what you can easily, but don't pretend you can do things you can't do either. Your life and well-being are important, too.

    Bookmark   May 30, 2009 at 10:59AM
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Thanks so much for the input! My gramma lives in assisted living and I think for the time being, I am going to try and keep her where she is. We FINALLY got her approved for hospice and have upped her level of care, so I am hoping that is enough. I honestly don't think she will last very long since my grampa has passed away. It means I will still be doing alot of driving for a time yet, as I am down there almost every day,( often making sure everything is taken care of). Her AL has some really good caring staff and while it means with sitters, money will become an issue faster, I think it may be the best thing. I have decided that I will take this on a month by month basis, if she lasts that long. We had to go the hospital on Thursday because of a BP drop that seems to be happening more and more, but oh how she hated to be there, and I hated it for her,but thankfully that is what got us in the door with hospice. Her doctors were very understanding about not wanting anything aggressive, and while my gramma's dementia is pretty bad, her wishes not to be in a hospital setting are very clear, and I can't blame her. Thanks again for input!

    Bookmark   May 31, 2009 at 10:00AM
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If you're clear about what's coming, DO keep her the hell out of the hospital! Hospitals are about doing everything they can, always. That's what they do. They get sued if they don't. If you've seen there's no sense in that, hospice is where you need to be. Good on ya.

Death comes to us all. Every effort on every occasion to push it away is irrational. Especially if she's been clear about her not wanting to go there, I strongly advise resisting the urge when it may come.....and it WILL come. If you're the decision-maker, you may have to be strong when the decision-point arrives.

    Bookmark   May 31, 2009 at 8:40PM
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Asolo, that is exactly why I was trying to get her qualified for hospice. My mother raised me that death was just a natural part of life, so I am comfortable as a person can be with dealing with it and it is very important to me to respect my gramma's wishes. I know I would want the same in her shoes. No quality of life, both her children and husband gone, a hazy's more humane to let nature take it's course with no heroics, and focus on keeping her comfortable.
I had to make the same decision with my grandfather just a few weeks ago and while his last 8 hours were difficult, I chose to stay by his side every step of the way and had the great honor of holding his hand and ushering him up to the gates of heaven as he took his last breath.
As tiring as being their caregiver has been, I would not trade it for the world. I have no regrets.

    Bookmark   June 1, 2009 at 9:33AM
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