ASSISTED LIVING vs NURSING HOME vs HOME CARE

We need to discuss these alternatives with the Social Worker. While I agree there is a big difference between Morris and Mom in terms of Assisted Living, there is also a wide-range of Assisted Living facilities and tolerance levels for ADL (Activities of Daily Living) support. Not everyone in AL is as capable as Morris by any means. Morris and the people at Westminster are truly independent. This is not what you see at other AL facilities necessarily - and this is why the Nurse and maybe even the SW will be non-committal in terms of where Mom should go. It is the word "probably" that is the key word for me. Why is there no certainty around th is? What are the gray areas?

Also, perhaps if we could simply improve her transfer capability we would be on better ground to qualify her for AL in general. We could get her into The Havens relatively quickly, but there is no attached SNF. So another conundrum.

For the moment, we have to continue with Home Care, so I'd like to question both the SW and PT on how best to continue. Here is what I would ask:

a. What are we NOT doing that we should be doing? Can anyone explain why the walking ability just left so catostrophically? It seemed like it was overnight. Is there any way to get that back?

b. How would one go about evaluating just how Memory Impaired Mom is? Do we have a diagnosis on this? Is she truly impaired or is she merely exhibiting normal behaviour for an 82 year old? What impact would this have on an AL facility evaluation?

c. What other resources are there for assistance with improving her physical ability?

d. Is she losing her ability to swallow and is that why she is having difficulty in taking the meds?

e. Why is everyone non-committal about her qualification for AL? If it is not black and white, then there must be an AL facility out there that she would qualify for, right? There appears to be varying tolerance levels at AL facilities for additional care.

f. How does one prepare her for a "move" if this does not play out like we want it to, i.e., that she would be totally unaware of her surroundings or have a medical condition that would require hospitalization, then a move, etc. Would the SW help guide the conversation?

g. How is the best way to complete the application for The Cottages at Brushy Creek so that she can move up the waiting list? What conditions would need to be present to convince a table of Social Workers that Mom would be a viable candiate for the help they provide? (See prior posts. This is the facility with a 60 person waiting list that is a Skilled Nursing Facility that has the look, feel and operation of an Assisted Living Facility. It is THE place for Mom when we are done with Home Care.)

OTHER GENERAL QUESTIONS:
1. Would additional outside support on Sunday nights (and potentially for a short period of time on Saturdays for bathing/toileting) provide the necessary support for Weekenders to continue the Home Care Scenario for the time being? If yes, then how does this impact fund availability?

2. Should we set a "date" at which time we will abandon Home Care and move the Nursing Home Care?

3. Where are we now, on personal levels, in terms of where we think the best place is for Mom to be?


Believe me, there are lot more discussion points, I know. But these are constantly swirling around in my head. My fear and agita is over the very real possibility that Mom is not near the end and that she could go on and on for more than a few months just like she is. I think we are at decision time and need to reassess where we stand relative to Home Care vs AL/SNF. I for one hear and feel the Home Care commitment falling away - for many valid reasons. We are at a cross-roads.