Taking care of Mom!

[chinaco]

My siblings and I have been rotating care giving of our mother. She had to go to the hospital again today. It was a minor problem in the scheme of things... However, she has some major health problems. We have decide to try to keep her out of a nursing home as long as practical. It is getting more difficult. We will stand by her as long as we can, but she is getting in the stages where more unanticipated health problems are occurring.

She is afraid. Unfortunately, the body is failing but the mind is still (mainly) intact. This is difficult. The writing is on the wall. It is a difficult time.

I have been struggling with an adult day care center. These places do make caregiving possible... but it is not without difficulties.

We are constrained on options of day care. The current place does help. And finallay after 4 managers in 3 years, a manager has taken an interest in my mother and is offering active involvment. Unfortuantely the employees are low paid, low education, generally try to do the least work they can get away with. Since my mother has mobility problems and needs hands on assistance she has been a victim of limited help.

I have tried a number of tactics. Bottom line, these places are dismal if you need much help.

I have sized it up as follows: The employees of these places are not pad much. They could almost match the pay as a convenience store. Many (not all) spend more time avoiding work than engaging. The other problem is poor managment (and a high turnover rate). A poor manager avoids people issues. Setting high standards of care takes work. Most managers of these places seem to be Register Nurses. While they are technically capable, they are inept managers.

It is a sad state of affairs!

 

[bbbamI]

I'm sorry you and your family are going through a difficult time.

Perhaps good changes will be made in the future. At least for now, you all have each other.

 

[youbet]

Since your and your mom's experience with the adult daycare facility is negative, would you share some of the financial details so we can get a feel for what kind of service to expect for what kind of dollar outlay?

What's something like this cost? Is she using a 100% private pay facility? Or is there some medicaid or other public assistance involved? If cost were no object, is there better care available that you're aware of?

Have you started checking out nursing homes? How much?

Just asking because I'm working on budgets that include being self-insured for DW and myself...........

Hope things work out OK.

youbet.

 

[honobob]

My father attended an adult day care for almost 8 years. I had very good experiences with the staff and the same manager was there the whole time, I only paid $40 a day for 730 to 6pm.

I also had a backup place but their operating hours were shorter. I would suggest contacting Family caregivers Alliance,

We did have an employee borrow money twice from my Dad but she was fired after the second time.

Good luck.

 

[chinaco]

Since your and your mom's experience with the adult daycare facility is negative, would you share some of the financial details so we can get a feel for what kind of service to expect for what kind of dollar outlay?

What's something like this cost? Is she using a 100% private pay facility? Or is there some medicaid or other public assistance involved? If cost were no object, is there better care available that you're aware of?

Have you started checking out nursing homes? How much?

Just asking because I'm working on budgets that include being self-insured for DW and myself...........

We went through the health decline of my father. It began about 9 years ago. My mother cared for him till about 5 years ago. Then he went to a nursing home. They have assets. Mother paid for it. The NH was one that specialized. It is in an area of the country that has lower costs. The basic NH cost was $70k/yr (5 years ago). My father was there about 1.5 years before he passed away. By the time he went to the NH, he was in fairly bad shape.

My mother began having mobility problems about 5 years ago. It started with falling. Bottom line. It is a nuerological problem. Degenerative (no diagnosis) disease that has symptoms like several. We have taken her to 3 different Nuerologist and a Nuerosurgeon. All come to the same conclusion. We finally accepted that the only thing we can do is help her through it.

We assisted her in her home in the beginning. Then she needed more direct help so we moved her in our house (I rotate this duty with another sibling). She has progressivley degraded and needs more and more help. We have been taking her to a day care facility. It costs about $55/day. Baths are $9 each. (My wife help mother bath early on, she cannot do it any more). We are thankful to have a facility like the day care to help. But here is the problem with those facilities and NHs. If you have a parent that needs hands on care... they take special attention. These places seem to be filled with people who avoid that type of work (It is a little more diffiult). They will provide care based on minimum rules and do nothing/little more. Believe it or not... If someone has dementia and/or they can get around by themselves, it is not too bad (seems to work). But then again, those people can help themselves. If one requires hands on help, the staff will only do the bare minimum.

My mother pays for this. She is not on any government program yet (i.e., medicaid). She will pay for the NH using assets and house. Once that is gone, whe will go on Medicaid. I suspect that she will have enough to pay for about 2.5 - 3 years. We are not taking any manuevers to shield her assets. We are hoping that her assets will give us the flexibilty to get her into a better NH. By the way, once those assets are exhausted some NH will make the patient leave. This is a challenge. This depends a little on state laws and regs... but NH have figured out how to maximize their profit. Many of them want a higher ratio of private pay and only use Medicaid/Medicare as a gap filler. In other words and empty bed is lost profit due to their fixed costs. That said, the private pay person gets stuck with a higher bill (just like uninsured people going to the hospital for treatment).

Fact of the matter is: No one will look after your loved one like a family member. Unless someone at the facility seems to take a shine to your parent... you had better keep fairly close tabs. This new manager at the day care seem to have taken interest and is ensuring the staff is cooperating.

I had an incident with the first manager and a staff member. Essentially, they were leaving my mother in a wheelchair all day. IT was uncomfortable and she would slump over. I picked her up one day and she burst into tears. Plus, after about 2 months there she got a pressure sore (bed sore on the rear end). This was a sign of not being moved around. I read the mgmt the riot act. It was very ugly. They made some changes. That manager only lasted about 1 year. Oh to make matters worse, one of the staff began treating my mother like a child making comments that were inappropriate. He is gone. Not sure what happened, but between one of my rotations with my brother... A number of the staff were gone. I suspect some where fired or pressured to leave.

Don't get me wrong... I do not think most of the staff are bad people... they are low paid people who (if not working there), would be at a convenience store. If the manager does not actively keep things in line... problems occur. One that I have noticed is the division of work. Several of the staff try to avoid the undesirable things. THis sets up an environment like (well if she's not going to do it, neither am I).

There is a gap today. While NH are regulated by the govt (and believe me they should be)... I do not believe the day care and assisted facilites are regulated/audited. This is an area that needs more attention.

Bottom line: Adult day care, Home health care, Nusing homes... all of it is expensive. Plus if you are helping, it will challenge you in a number of ways.

As our mother experiences new and emerging problems, we have narrowed down some NHs to check out. We are trying to better understand our limits. When our limits are reached, she is better off in a NH. Our role will shift from direct care provider to advocate and watchdog for mother. I know enough about the system now to handle some of the ropes. I have a contact that the old HCFA (they have changed the name). She is an old friend that works (or at least used to work) in the NH audit group. If my mother winds up not getting the care that seems appropriate, I will make a call. It is a last resort, but the threat of an aggressive audit will snap mgmt into line. Hope I do not have to resort to it.

At the end of the day: I know that my brother and I have done the right thing. One either steps up and helps (provided they are able) or they put the person in a home. If I did not have a wife... It would be very difficult. Having a sibling that will help makes it easier also(i.e., breaks).

 

[2B]

My "expertise" is entirely from dealing with my in-laws over the last 2 years. It's been quite a journey. I'll give you some observations and suggestions based on this limited background.

From your description your mother is borderline nursing home. I doubt she has any chance of going into an assisted living facility with her mobility problems but it would be worth checking. The "life style" in the assisted living facilities is better than nursing care but it requires enough mobility to "enjoy" it. The levels of care are well defined and your mother would need to be evaluated.

If she qualifies for assisted living, I suggest you find a facility that also has nursing care. That will make the transition easier for everyone.

I also suspect she has "out grown" the adult day care. Most of these facilities are not geared towards people in your mother's condition. In Texas the licensing requirements of "day care" is much lower than either assisted living or nursing care. Assisted living is regulated and your mother would get a much higher level of care.

Now for the tough part. At this point there is nothing you can do that will improve your mother's quality of life. "Keeping her out of a nursing home" sounds more noble than it actually is. Since she has the assets for a higher quality facility she will get better care than what you have described she is currently receiving. She will even get better care than if you or your siblings moved in with her fulltime. It will also take a giant burden off you and your siblings.

Yes, you need to keep up with what's going on in a nursing home but my in-laws experiences have been positive. They are being given good care.

Good luck in dealing with this. Don't let your or your sibling's emotions determine the path forward. Look at the clinical issues and what is the best way for your mother to get the care she needs.

 

[chinaco]

My "expertise" is entirely from dealing with my in-laws over the last 2 years. It's been quite a journey. I'll give you some observations and suggestions based on this limited background.

From your description your mother is borderline nursing home. I doubt she has any chance of going into an assisted living facility with her mobility problems but it would be worth checking. The "life style" in the assisted living facilities is better than nursing care but it requires enough mobility to "enjoy" it. The levels of care are well defined and your mother would need to be evaluated.

If she qualifies for assisted living, I suggest you find a facility that also has nursing care. That will make the transition easier for everyone.

I also suspect she has "out grown" the adult day care. Most of these facilities are not geared towards people in your mother's condition. In Texas the licensing requirements of "day care" is much lower than either assisted living or nursing care. Assisted living is regulated and your mother would get a much higher level of care.

Now for the tough part. At this point there is nothing you can do that will improve your mother's quality of life. "Keeping her out of a nursing home" sounds more noble than it actually is. Since she has the assets for a higher quality facility she will get better care than what you have described she is currently receiving. She will even get better care than if you or your siblings moved in with her fulltime. It will also take a giant burden off you and your siblings.

Yes, you need to keep up with what's going on in a nursing home but my in-laws experiences have been positive. They are being given good care.

Good luck in dealing with this. Don't let your or your sibling's emotions determine the path forward. Look at the clinical issues and what is the best way for your mother to get the care she needs.

She lives with us full-time now. The day care is only from 7:30 am - 4:30 pm. Assisted living is not an option. She moved past that stage a couple years ago. She got that from my sister and another brother. I would not say that we are doing heroic efforts... But I can tell by looking at the day care facility that we are in the minority. Most people would already have her in a NH. In my expereince, I see only a few people making the effort we make. It is a personal choice.

She obviously wants to be with family rather than strangers.

You are correct. We recognize that we have limits and eventually she will need more help than we can provide. And by eventually, I mean it will happen in less than 12 months. We are getting comfortable with the notion of NH. A consensus has to be worked with sibilings. Plus, we need to prepare mom. She knows it is probably inevitable. But she is afraid.

Her illness is dreadful. There is not diagnosis... except that it is attacking her motor skills in multiple ways. I think it is affecting her cognitive skills a little (very light dementia). But she is still fairly clear minded. Since she has problems talking, people think her mind is worse than it actually is.

From taking a look at the state of things today. I am not sure what is going to happen with us boomers. The system is going to be overwhelmed.

 

[Meadbh]

First of all, I agree with what 2B said. Your mother's needs are fairly high and are increasing. Ask your mother's physician and consider calling a gerontology service for recommendations. Start researching homes in your area and ask them for evidence of accreditation, including what recommendations they have received. Ask if they are collecting data on the incidence of bedsores and falls, and what they are doing to avoid them. Look for patient and family satisfaction data and worker turnover. If they look at you like a deer in the headlights, be wary. And most importantly, talk with the residents. Are they smiling?

I wish you patience and good luck during this very difficult phase. Unfortunately, decent personal care costs serious money. I think this needs more emphasis in our financial models of FIRE.

 

[2B]

She lives with us full-time now. The day care is only from 7:30 am - 4:30 pm.

That's pretty heroic from what I can tell. It will take a severe toll on your marriage and your quality of life.

If you were in your mother's condition would you want your children to dedicate years of their lives to your care when a good alternative is available?

But I can tell by looking at the day care facility that we are in the minority. Most people would already have her in a NH. In my expereince, I see only a few people making the effort we make. It is a personal choice.

She obviously wants to be with family rather than strangers.

The fact that you are in a minority should tell you something. Part of the issue is that you have siblings to share the load. I am assuming you are the primary caregiver so the largest burden falls there.

Of course, she would rather be with family. She is afraid and her mental capability is reducing her rational abilities. You (and your siblings) have to decide what is best.

I saw my in-laws both adapt quickly. They are doing fine. We are doing even better. Visits are positive and not physically and emotionally draining like the period where my wife tried to take care of her father (Alzheimer's). Of course, we had SIL out of state just saying "Dad just needs a little more help." I told her we could put him on a plane and she could pick him up at the airport quited her down a little bit.

Her illness is dreadful. There is not diagnosis... except that it is attacking her motor skills in multiple ways. I think it is affecting her cognitive skills a little (very light dementia). But she is still fairly clear minded. Since she has problems talking, people think her mind is worse than it actually is.

Getting old is not for sissies. You and your siblings are paying a great personal price and the actual benefits to your mother are limited. Let me repeat -- There is nothing you can do that will improve the quality of her life.

 

[chinaco]

... You and your siblings are paying a great personal price and the actual benefits to your mother are limited. Let me repeat -- There is nothing you can do that will improve the quality of her life.

I see your point and I do not disagree with your observation. We are working through it. I think she has an outside chance of staying out of an NH for another 12 months. Maybe only 6 months. The length of a rotational period is shortening to either 2 months or 1 month. At the same time, we realize that a new health problem could occur that would force a decision immediately. We have identified a couple of NHs. We are going to tour the facility to make a choice. That way if the need arises sooner than expected, we will have a plan.

 

[Dawg52]

My mother is 89 and fortunately is in great shape. But if/when the time comes to decide on nursing home care, that will be an extremely difficult decision. She has always told us she does not want to go to a nursing if at all possible. I'm sure many here have heard similar statements from their parents. So if I can give my mom good care from home with help from house sitters etc..., I will do so.

This is a very personal decision. One answer is not appropriate for all. Good luck with your mom!

 

[FinallyRetired]

Sorry about your situation, it's something many of us are facing. I have an aging mother and and aging mother in law. Even though they still live by themselves (with family help), it's just a matter of time before we need to make other alternatives. We may be switching my mother in law between ourselves and another sibling for a while, but she's close to needing nursing care. Medicare doesn't offer much help for long term care, and she falls into the medicaid gap, has an income about 1000 per year above medicaid and 20-30,000 a year below NH costs. There are some creative ways to move income around, but they are very difficult to execute.

This is the one thing that I failed to plan on for FIRE. We planned for our own long term health care, but neglected to think about our parents needs. It doesn't take too many years of 20-30000 unplanned expenses to shoot a hole right through retirement plans.

One thing I'm considering is becoming our own NH, equiping our home with stair lifts, handicap access baths, reclining beds, etc. This is expensive, but I can buy a lot of it for less than the money needed for just one year of NH. Of course, there are specialized medical things that we could not do, but maybe we can get periodic nursing care for that. And if there is a health event, medicare does provide some temporary coverage.

I'm trying to think creatively about this, so appreciate everyone's experiences and any other thoughts.

 

[chinaco]

Sorry about your situation, it's something many of us are facing. I have an aging mother and and aging mother in law. Even though they still live by themselves (with family help), it's just a matter of time before we need to make other alternatives. We may be switching my mother in law between ourselves and another sibling for a while, but she's close to needing nursing care. Medicare doesn't offer much help for long term care, and she falls into the medicaid gap, has an income about 1000 per year above medicaid and 20-30,000 a year below NH costs. There are some creative ways to move income around, but they are very difficult to execute.

This is the one thing that I failed to plan on for FIRE. We planned for our own long term health care, but neglected to think about our parents needs. It doesn't take too many years of 20-30000 unplanned expenses to shoot a hole right through retirement plans.

One thing I'm considering is becoming our own NH, equiping our home with stair lifts, handicap access baths, reclining beds, etc. This is expensive, but I can buy a lot of it for less than the money needed for just one year of NH. Of course, there are specialized medical things that we could not do, but maybe we can get periodic nursing care for that. And if there is a health event, medicare does provide some temporary coverage.

I'm trying to think creatively about this, so appreciate everyone's experiences and any other thoughts.

I a way, that is what we and my brother have done. My Brother has a two story. Bedrooms are upstairs. He purchased a stairlift. Cost about $2500.

Regarding NH expenses, Medicaid will pay for it. You have home health care available. It is kinda expensive, plus we felt it would be as much hassle as doing the care ourselves so we did it ourselves and use the day care facilities/services more and more as needed.

2B makes some good points. You have to know your limits. Eventually, you cannot make a difference by trying harder to fill the gap. For instance, my mother is losing wieght and she has begun choking some on food and beverage. The weight loss has us worried. That is likely to be the critical factor that requires us to place her in a skilled nursing facility. But even besides the weight, she is starting to have other problems. Not being a medical professional, I do not trust my judgement in sizing certain things up. We take her to the doctor regularly and nurses see her daily at day care. But I am increasingly becoming uneasy.

My Brother and I will go NH scouting this week. We are preparing.

 

[wabmester]

The only creative solution that comes to me is euthanasia. When my quality of life is zero, and caregivers are expending efforts to help me perform bodily functions and moving me around so that I don't atrophy, I want somebody to put me down. And I don't want my kid to have to do it herself or find some illegal path.

I want this to be an acceptable choice with simplicity, dignity, and quality. Low cost and no mess.

The number of elderly is increasing faster than the number of caregivers. This is guaranteed to decrease the quality of care in the future as even the most compasionate caregivers will be overwhelmed. If you think it's bad now....

Holland is already offering this option. Only 1% currently choose to take this route in Holland, but I'm sure they're relieved to have it available as an option.

In the meantime, the path we recently took with our grandfather was at-home care with three CNAs on rotating shifts. It was fairly expensive. It was hard to find and retain good CNAs. It was a relief to all when he passed.

 

[lazygood4nothinbum]

my mother had excellent care for i think about $60k/year for four years. here in florida many of the nursing home workers are haitian women who tend to be very caring people. my ol'man employed caribbean workers on the job and they also had a very good work ethic. these are people who came to the united states to better their lives and that shows in their work.

i did a ton of research into facilities before selecting one for mom. i picked the one that served the best chocolate cake. it was between my brother and my house (closer to his) and so we visited all the time. my mom and the facility were kept clean. they had lots of activities including outings for mental stimulation & physical exercise.

could be that the prices are lower and the services better here in south florida where there are lots of aging people and even more old aged homes so the competition factor is relatively high. there were a few times when service slacked off but we were always monitoring the situation so corrections were made pretty quickly. removing mom from her house was one of the most horrible days of my life, but in hindsight, it was the best thing we could have done for her and though it was tough to go through, the entirety of the experience was, in retrospect, not so bad.

edit:

The only creative solution that comes to me is euthanasia. When my quality of life is zero, and caregivers are expending efforts to help me perform bodily functions and moving me around so that I don't atrophy, I want somebody to put me down. And I don't want my kid to have to do it herself or find some illegal path.

I want this to be an acceptable choice with simplicity, dignity, and quality. Low cost and no mess.

first of all, i apologize to the op for discussing this topic when his concern is the best care for his mom, not the end of his mom.

i just want to comment here--since the subject has been broached-- that i do not have any problem with suicide or assisted suicide. i do have a lot of problems with euthanasia in that it is not up to society to hold open the door for anyone who has missed their window of opportunity.

again, apologies to the op.

 

[Moemg]

I'm dealing with these same problems right now .My Mom is 90 and mentally fine but her arthritis has limited her mobility.She currently lives in a small apartment next door to her sister who is 72.I pay for a caregiver to assist with shopping ,doctor's visits ,etc..My sister has decided Mom should move to Florida and spend half the year with her and half the year with me . So I'm torn between staying in Florida and going along with my sister's plan (.I'm not crazy about relocating older people)or selling my house and moving to Pa.to be near my Mom .Also where my sister is moving in Florida is the boonies definitely not the best health care . Help being in the sandwich generation is tough .

 

[2B]

I think the "sandwich generation" will describe every generation going forward. Medical science has successfully extended life but hasn't done much for extending the quality of life.

Checking out the nursing homes is fine but there may not be an opening when you have that crisis that forces the situation. It's better to make the move when the need is apparent but not try to wait until the "last possible moment."

All of the home care sounds nice but the quality of care, access to medical professionals and overall lifestyle for everyone is better at a high quality facility.

My kids are under orders to ignore there babbling old fart father and put me where I need to be and not anguish and ruin their lives trying to take care of me.

 

[wabmester]

All of the home care sounds nice but the quality of care, access to medical professionals and overall lifestyle for everyone is better at a high quality facility.

If you can find a high-quality facility. We went through 3 of them before we realized that the amount of monitoring and intervention required is a huge reality check. In the end, we decided that it was easier to monitor the quality of care at home.

 

[chinaco]

I agree with just about all of the points of view that have been shared. For us, we are at a point where my mother will need a SNF. When she goes, that will be it. She will be in a state where there is no turning back. That wil be soon. We will monitor and visit regularly.

We are intending to choose a better facility. Since we have money to pay... I suspect we will have some flexibility. We live in a large metro area. There are a number of options. The key (in my mind) is to have good management. If management is poor... you can forget it.

 

[youbet]

We are hoping that her assets will give us the flexibilty to get her into a better NH.

This is an interesting discussion........

We're trying to plan for MIL who is 83, diabetic and arthritic. Yet she's mentally sharp, lives on her own (with DW and her brother making regular visits) and seems to be enjoying life dispite some discomfort getting around. Her income is SS only but she owns her condo in a very nice building and has a few thousand in the bank.

Today, everything seems fine with DW and her brother each kicking in small amounts of money to be sure there is quality food in the fridge, a cleaning service, etc. But we know we're only a fall/broken bone or some other event away from everything changing. Then we'll be sliding down that same slope and trying to decide when the appropriate time for MIL to enter a NH is. Since she'll quickly be on Medicaid, it's not a savory thought.

Simultaneously, I've been trying to work both potential MIL expenses and plans for our own possible LTC into our RE budget. I'm finding this, by far, to be the toughest budgeting scenario I've ever tried to figure out. If I trusted LTC insurance, that would simplify things, but I don't.

chinaco and the other posters who are sharing their experiences, thanks.

 

[chinaco]

sorry made a mistake... posted one with nothing to add.

 

[wabmester]

Since she'll quickly be on Medicaid, it's not a savory thought.

Medicaid will also pay for various types of at-home care. I believe that if her doc will document that she needs help with daily living, medicaid will cover the cost of somebody coming by each day even for non-medical care. Or you/she can also pay somebody $10-15/hour for the same type of service. We have a relative in this situation, and the extra help is a welcome relief for all involved.

 

[Nords]

The only creative solution that comes to me is euthanasia. When my quality of life is zero, and caregivers are expending efforts to help me perform bodily functions and moving me around so that I don't atrophy, I want somebody to put me down. And I don't want my kid to have to do it herself or find some illegal path. I want this to be an acceptable choice with simplicity, dignity, and quality. Low cost and no mess.

That "solution" sounds oh-so-attractive when we're contemplating the end from the prime of our lives, but how will we feel when we're in our 90s? Who will we be then, and will we even have enough sentience to recognize the situation?

My grandfather spent the happiest 14 years of his life in senile dementia, years which a euthanasia decree would have cut out of his experience. Sure, he couldn't even remember why he was happy, but was that a reason to deny him the emotion that he rarely indulged in when he was sentient?

My mother dealt with breast cancer for her entire 40s. As a registered nurse, in the 1980s she had plenty of knowledge of & access to illicit euthanasia resources. (She was good at it, too-- after she died we realized that in a 3000 sq ft house she was never more than six feet away from a bottle of Demerol.) She could have gone at any time of her choosing. Yet she chose life for nearly a decade after the diagnosis, even as the cancer metastasized and her skeleton rotted and she couldn't walk more than a couple blocks without severe joint pain. She even resumed smoking to avoid dealing with nicotine withdrawal during chemotherapy-- hardly a short-timer's attitude.

One day, pretty much like any other by then, her bones had atrophied to the point that her leg broke. After the bone was set and the hospital had finished what she came for, she checked herself out and had herself driven home. She spoke with family (in person or by phone) and mentioned that she didn't want to go through any more of that pain. The next day she stopped eating & drinking but held on long enough for me to fly out. She died the morning after we arrived.

Did you ever read the story of Admiral Nimitz's suicide? Not the WWII Nimitz-- his son:
The New York Times, Jan. 12, 2002
http://www.lifesite.net/ldn/2006/aug/06083106.html

Admittedly these are hardly objective sources, but they shed a light on a subject that's all too easily glorified as the last expression of American independence.

I have a DNR filed away, but personally I think I'll always be curious what tomorrow's sunrise will look like.

 

[wabmester]

Who will we be then, and will we even have enough sentience to recognize the situation?

That's what a DNR is for, but that doesn't mean it's easy. My DNR has gone through several iterations already. Some of the cases are relatively "easy," but there's always enough ambiguity that somebody in the family will have to offer input. For whoever makes that decision on my behalf, I just want my wishes to be as clear as I can make them, and for all options to be on the table.

Edit: regarding the "mercy-killing" article, I would think that depression/desperation of our caregivers should be a primary concern of ours. Perhaps more so than whether or not we'd still be entertained by sunrises and sunsets.

 

[chinaco]

My mother had to go to the emergency room twice last week. I will not give the details. Both situations were disturbing, but she was in no danger.


We checked out some NH yesterday. About $70k/yr.... That is the basic cost. Obviously alll medical, therapy, etc. is additional.


I did my homework online. But nothing like a visit to uncover more info. We have a target in mind. Very nice, new facility (it is plan A). Another (plan B) facility is nice also. I had a good impression from plan A and B. The third one was a waste of time. Typical... Older facility. A slight foul odor when we entered, place was run down. Staff looked kinda like the facility.

We may look at a couple others.

Fortunately, she has some money. This will help her to get into a better place.

My advice to all... be sure to get your LTC insurance or have some sort of plan on how to handle the expenses should you need that type of help.