Nursing Homes

[Mithrandylan]

Its appropriate when the homecan offer something the relative needs that you can't
   

[Cetil]

i assume that you are too young to know what you are talking about. I have a relative in a nursing home. I suppose i could've kept him at home if i had 24 hour nursing backup and someone to keep watch while i sleep.

When does it become ok to put a relative in a nursing home? Is this a matter that should be discussed amongst family and spiritual advisor?

Yes, it has to be a decision involving everyone in the family and your priest I think. I took care of my Mom at home when she  had AD for 12 years, and it is not easy for sure. The first five years I could safely leave her alone during the day as she could handle things during the day on her own. I just called her from work several times a day to make sure, and often my brother was able to stop by at lunch and check on things. Then she became late stage and I had to hire a health aide during the day while I did night duty and dealt with the night time wanderings and the aggressiveness that is all part of it. I managed for two years while my brothers sometimes helped out so I got some breaks. You really find out who your friends are that's for sure as some "split" as they thought I was nuts to do this, and yeah they were "trads". I hadn't expected to become a "pariah" with some, but I just tried to take it in stride and be grateful for the friends I still had. And then fortunately, I got married and my wife joined me in the cause and we took care of Mom for five years after that until she passed away in 2009. Fortunately, my Mom had a survivor's pension from my Dad and savings to pay for all the equipment we eventually had to buy, like a lift, hospital bed, etc. All in all the equipment wasn't all that expensive. But I really would not trade that experience for anything, it really changed my outlook on life for the better. It is very sad to watch the slow deterioration, but you have to remember we will all be like that eventually. It's life and I don't think marginalizing the elderly is a solution. Whether you can take care of them at home or not, they need attention from their families. So many in USA don't even visit.
 Our best investment was a little book called "Learning to Speak Alzheimer's" by Joanne Koenig Coste. She is not even a health care practitioner but took care of her husband for seven years when he had AD. Her various little "tricks" for managing an AD patient are highly effective and are now being used in many nursing homes. I would encourage people to try home care of their loved ones, but I certainly don't judge anyone who has to put someone in an NH. It's not easy, you have to really dedicate yourself to it. But you have to be very careful in choosing nursing homes and you need to visit as often as possible. The more you visit, the higher the standard of care that your loved one will receive.

C. 

[verenaerin]

I dont really see why you need a priest to make this decision. You can either take care of the person in question or you can't. Obviously, if you can, you are bound to do so. But there are many circumstances where it is impossible.

[Fontevrault]

My mother-in-law has been in a wheelchair for 38 years.  If/when her husband (a good, goog man who has cared for her through it all)
passes on, we (Pilgrim and I) have been told in no uncertain terms that she does not want to move in with us.  She wants to be in a good nursing home nearby.  For her the nursing home gives her some independence and aility to take care of things without imposing on others.  It drives me crazy that she thinks of it as an imposition, but I have to see her perspective.  She knows she can't take care of herself and has seen this coming for a long while. 

I think one of the most important things I can do for her issimply respect her wishes n this.  I would willingly care for her and so would her son.  But if she wants this, it really isn't entirely our decision to make.   

[Liza_Do_A_Lot]

It all depends of the circumstances.  My aunt & cousin cared for my uncle (husband & father) for years at home until recently.  He has diabetes, many strokes, unable to control his bodily functions and finally became a vegetable.

My aunt (is in her late 60's) and cousin had to force feed him, lift him (he is a very large man) change him like a new born baby, pull him along for walks for exercise (when he could still walk) etc.  They did not want to put him into the home, however the risk to her own health was apparent.  He needs 24hr care, and the average person can not do this. 

Nursing homes have lifting equip, 24hr nurse care etc.  I don't think the case above requires a Priest permission

[OCLittleFlower]

Sometimes people need skilled nursing.  Both of my grandmothers were in that situation for a while at various times -- they were able to return home and be under my mother's care after they recovered.  I think they called this transitional care -- you're too healthy for the hospital, but not healthy enough to go back home.  Some people end up needing that on a longer term basis, unfortunately.

Now, my husband's grandmother is in a home because no one can be bothered.  Her daughters are mostly career women, and they see no shame in having her live in an assisted living place.  It's a decent place -- more of an apartment complex than anything.  On one hand I can understand it, though.  Apparently she used to live with each of her children in turn -- but that ended when she left her pills lying around and her young grandson swallowed them.  After he had to have his stomach pumped, the family wasn't comfortable with that anymore.

Sometimes even smaller issues can be deal breakers.  My Filipino in-laws don't really eat American food, while I have a soy-free kitchen due to allergies.  They are also very pro-Novus Ordo.  Even my parents, I don't know how well living with us would work.  My mom doesn't eat meat, so asking her to give up soy seems rough.  My husband and I have joked that we should all go in on three houses in a row, with our house in the middle and our respective parents on either side. 

[Phillipus Iacobus]

Sometimes even smaller issues can be deal breakers.  My Filipino in-laws don't really eat American food, while I have a soy-free kitchen due to allergies.  They are also very pro-Novus Ordo.  Even my parents, I don't know how well living with us would work.  My mom doesn't eat meat, so asking her to give up soy seems rough.  My husband and I have joked that we should all go in on three houses in a row, with our house in the middle and our respective parents on either side. 

If they get old I am sure some mealtime concessions could be made, no?

I realize that certain situations warrant the use of care facilities.

[OCLittleFlower]

Sometimes even smaller issues can be deal breakers.  My Filipino in-laws don't really eat American food, while I have a soy-free kitchen due to allergies.  They are also very pro-Novus Ordo.  Even my parents, I don't know how well living with us would work.  My mom doesn't eat meat, so asking her to give up soy seems rough.  My husband and I have joked that we should all go in on three houses in a row, with our house in the middle and our respective parents on either side. 

If they get old I am sure some mealtime concessions could be made, no?

I realize that certain situations warrant the use of care facilities.

On which end? 

[moneil]

I don’t think there is a singular “right” answer, but rather what is the “best” answer in a given situation.  Some children, siblings, or parents may be prone to “warehouse” a relative rather than be inconvenienced with their in home care.  Others “try” (often badly) to care for a disabled person or elderly relative at home because they are afraid that professional care might eat up “their” inheritance.

The post from Fontevrault was especially apropos:

My mother-in-law has been in a wheelchair for 38 years.  If/when her husband (a good, goog man who has cared for her through it all) passes on, we (Pilgrim and I) have been told in no uncertain terms that she does not want to move in with us.  She wants to be in a good nursing home nearby.  For her the nursing home gives her some independence and aility to take care of things without imposing on others.  It drives me crazy that she thinks of it as an imposition, but I have to see her perspective.  She knows she can't take care of herself and has seen this coming for a long while. 

I’ve had two aunts and four uncles die in the past six years, aged between 82 and 94.  My mother is 90 and still lives alone on a farm but doesn’t drive to town any more so someone has to give her a ride.  Otherwise she is independent except for having a cleaning lady come in.  I live 120 miles away but go down at least twice a month to help out; a brother lives close by and does most of the driving.

Each family handled the situation differently, with a mix of retirement homes, skilled nursing facilities, in home professional care providers, and being cared for by family members.  Two uncles and one aunt had dementia (fortunately Alzheimer’s has not been present in the family), otherwise all the relatives were mentally sound and in control of their situation.  In visiting with them in their latter years one common sentiment I heard from all was that they wanted to be as independent as possible (and ironically several felt they had more independence in a care facility than they would living with one of the kids) and they did not want their biological lives “artificially extended” beyond what God’s nature intended.  I hasten to add that nobody wanted things “speeded up” any, but they were ready for God’s call and saw no point in excessive drugs, pumps, machines, and surgeries other than what was appropriate for palliative care.  This was a particular issue with one uncle (who was of very sound mind) who I heard almost had to threaten to disinherit a couple of older daughters if they didn’t stop “meddling”.

There are several important issues to consider:
Are they mentally sound or are they experiencing dementia or Alzheimer’s?
Are they mobile (albeit with a walker or wheel chair) or are they pretty much bed ridden?
Do they require routine therapy (physical, respiratory, dialysis) that would require regular travel if they are in a private home?  This therapy might be available “in house” in a nursing facility.
Similarly with personal care issues such as haircuts, nail care, chiropractic adjustments, etc.
Can they be left alone for a short period of time without “getting into trouble”?  (I’ve known 2 or 3 people who made a valiant effort to care for a parent with Alzheimer’s, until about the 2nd of 3rd time they had to call the police to come help find them after they wandered off unnoticed).
Can the caregiver provide skilled assistance when needed?  (A friend of mine was trained to inject epinephrine directly into his wife’s heart if it should stop ~ an emergency life saving measure until an ambulance could arrive; not everyone would be up to this).
Is a private home a workable environment?  Can they go to the toilet or take a bath on their own (provided they would be able to do so if the facility were handicapped capable)?

Cetil makes one of the most important observations:

Whether you can take care of them at home or not, they need attention from their families.

.

Where the elderly spend their final years, and who cares for them, should be determined by what provides them the best care in an environment they are most comfortable in.  The family’s primary responsibility is to remain a part of their lives on a regular basis, and to see that their spiritual needs are cared for (taking them to Mass or helping them live in a facility that offers Mass on a regular basis; making sure their priest is aware of their condition and comes to visit as appropriate, etc.).

[Doce Me]

I don’t think there is a singular “right” answer, but rather what is the “best” answer in a given situation.  Some children, siblings, or parents may be prone to “warehouse” a relative rather than be inconvenienced with their in home care.  Others “try” (often badly) to care for a disabled person or elderly relative at home because they are afraid that professional care might eat up “their” inheritance.

The post from Fontevrault was especially apropos:

My mother-in-law has been in a wheelchair for 38 years.  If/when her husband (a good, goog man who has cared for her through it all) passes on, we (Pilgrim and I) have been told in no uncertain terms that she does not want to move in with us.  She wants to be in a good nursing home nearby.  For her the nursing home gives her some independence and aility to take care of things without imposing on others.  It drives me crazy that she thinks of it as an imposition, but I have to see her perspective.  She knows she can't take care of herself and has seen this coming for a long while. 

I’ve had two aunts and four uncles die in the past six years, aged between 82 and 94.  My mother is 90 and still lives alone on a farm but doesn’t drive to town any more so someone has to give her a ride.  Otherwise she is independent except for having a cleaning lady come in.  I live 120 miles away but go down at least twice a month to help out; a brother lives close by and does most of the driving.

Each family handled the situation differently, with a mix of retirement homes, skilled nursing facilities, in home professional care providers, and being cared for by family members.  Two uncles and one aunt had dementia (fortunately Alzheimer’s has not been present in the family), otherwise all the relatives were mentally sound and in control of their situation.  In visiting with them in their latter years one common sentiment I heard from all was that they wanted to be as independent as possible (and ironically several felt they had more independence in a care facility than they would living with one of the kids) and they did not want their biological lives “artificially extended” beyond what God’s nature intended.  I hasten to add that nobody wanted things “speeded up” any, but they were ready for God’s call and saw no point in excessive drugs, pumps, machines, and surgeries other than what was appropriate for palliative care.  This was a particular issue with one uncle (who was of very sound mind) who I heard almost had to threaten to disinherit a couple of older daughters if they didn’t stop “meddling”.

There are several important issues to consider:
Are they mentally sound or are they experiencing dementia or Alzheimer’s?
Are they mobile (albeit with a walker or wheel chair) or are they pretty much bed ridden?
Do they require routine therapy (physical, respiratory, dialysis) that would require regular travel if they are in a private home?  This therapy might be available “in house” in a nursing facility.
Similarly with personal care issues such as haircuts, nail care, chiropractic adjustments, etc.
Can they be left alone for a short period of time without “getting into trouble”?  (I’ve known 2 or 3 people who made a valiant effort to care for a parent with Alzheimer’s, until about the 2nd of 3rd time they had to call the police to come help find them after they wandered off unnoticed).
Can the caregiver provide skilled assistance when needed?  (A friend of mine was trained to inject epinephrine directly into his wife’s heart if it should stop ~ an emergency life saving measure until an ambulance could arrive; not everyone would be up to this).
Is a private home a workable environment?  Can they go to the toilet or take a bath on their own (provided they would be able to do so if the facility were handicapped capable)?

Cetil makes one of the most important observations:

Whether you can take care of them at home or not, they need attention from their families.

.

Where the elderly spend their final years, and who cares for them, should be determined by what provides them the best care in an environment they are most comfortable in.  The family’s primary responsibility is to remain a part of their lives on a regular basis, and to see that their spiritual needs are cared for (taking them to Mass or helping them live in a facility that offers Mass on a regular basis; making sure their priest is aware of their condition and comes to visit as appropriate, etc.).

Extremely helpful post, Moneil, thank you. 

I have a 92 year old mother who is in fairly good shape mentally and physically.  But I am aware of the fact that things could change, and I would most likely be the care provider (as I live near by and don't have my own family).  It is good to be aware of all the issues to be considered (by myself and other relatives) if care giving becomes necessary.

My mom actually played caregiver to me for a couple months just 5 years ago (when I broke my back).  We had professional caregivers at first, but Mom insisted that she wanted to take over because of the expense.  She showed me how to do it right.  I hope I don't need to return the favor, but if do I am ready to do what I can.