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Mom moved back with us in May after brief, unsuccessful, stay at AL



Shes been declining for over a year since she had a fall Sept 2021



in August her Kidney failure reached Level 5, which happened quicker than previous changes. Doc, who I adore, referred Hospice. They’ve been coming weekly since beginning of Sept.



She has now stopped taking care of the dog, rarely changes out of jammies, won’t eat unless I make & serve, sleeps almost 18 hours (off/on). She’s obviously at End of Life stage now, but has been fairly “with it” along this pathway



until this week. She couldn’t recall my Dad’s name (passed in 2015, married 52 years)



then at 6:30 am my husband woke me, dog was barking so he went down to ck. Not in her room, living room or bathroom, Found her outside. She went down porch stairs, 3 cement, rollator in driveway, she’s on her rear end in garage. No idea how she got there. Oh, she had to have used the remote opener on garage door, again no clue how



she doesn’t remember going out, the stairs, nothing. She can barely walk, It’s mind boggling that she even physically could do any of this



Im in her room, hoping she’ll go to sleep, I’m anxious, frightened and concerned. Im gonna call hospice in a few, I’m wondering if it’s time for anxiety meds to help calm her?



lm thiinking it’s time for a hospice facility, or I need an overnight aide/caregiver?



Thoughts? Advice?



Good thoughts appreciated

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Not sure why you took her out of AL, however IMO it is time to place her again, this time in a higher level care. Sending support your way.
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I also wondered if the “…brief, unsuccessful..” attempt at AL should not be considered a “first attempt…” rather than a nonviable possibility.

When my LO entered AL, and quickly moved to MC, there was no safe viable alternative but to keep her in placement, so we quickly moved to Plan B, which included an evaluation by a good geriatric psychiatrist, who prescribed small doses of geriatric safe medications that stabilized her mood, reduced her anxiety level, and allowed her to participate in activities that she enjoyed.

Safety, peace, and comfort, with safety as a priority. You are doing the best you can, but it’s OK to admit that it’s time to allow her care to be done by experts whom you’ve chosen to do the job.

Talk to her doctor and the hospice team, consider all options, be open to co soldering ALL of their suggestions, then act.

I’m betting that you’ll choose a solution that will be the best you can find.
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If she's still mobile, this would be a challeng for a higher level of hospice. Plus, I'm not sure giving her anxiety meds comports with increased hospice care? I think it is mostly palliative treatments at that point?

Can you please tell us why you took her out of AL? This info would be very helpful.
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My question, how did she get out of the house? What type of doorknobs do you have? I had baby covers on my round knobs. They just go around and around. Only u know the secret in being able to open the door. You can put those slider locks up out of her reach.

I also had a baby monitor. Since I am a light sleeper, I placed it right out of my bedroom door. Mom snoring kept me awake. But, I would be woken up if she was moving around. I live in a split level and Mom was in the old family room, bottom level. She had her own bath and entrance so easier to get her outside. Because of the stairs, I had a babygate at the foot of the stairs so she could not roam the house at night. I had 2 more flights of stairs. Could you place a baby gate at Moms bedroom door?

Be aware if you have Hospice done in a NH or Hospice house, Medicare does not pay for the cost of the facility. Only for the Hospice care. Does Mom seem anxious when she is awake? My Mom started humming which got worse as the days went on so she was medicated.
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update

for those wondering, Assisted Living from12/21-5//22 was a joke. They didn’t respond to emergency wrist button when her BP dropped due to glucose issues. TWICE. They didn’t do her showers for 3 months. She couldn’t work remotes, phones, wouldn’t use her walker, dog wasn’t being taken care of properly. All she did was watch tv and sleep. Once she started missing meals cuz they didn’t remind her, we were done. Mismanagement and safety concerns plus cost did not show any worth

anyway

hospice put her on a small dosage anxiety med to help her sleep at night. No one here really answered my question about Meds, folks here were more concerned why she wasn’t in a facility. ¯\_(ツ)_/¯.

cuz my ducks are in a row is my answer. My decision are well thought out with logical discussions, research and pro/con conversations with all involved.

so I guess I just trust Hospice recommendations and my own research rather than looking for additional real life experience advice.


We baby proofed house, knob covers, interior door alarms, baby gates, baby monitor. We’ve had no additional issues.

Her end of life progression continues, each day she declines a bit more.
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Sounds like you got some great advice last time you came to forum with your request FOR advice, just not what you were looking to hear. Glad your mother is on hospice care now, medicated to your satisfaction currently, and that you've made safety modifications in your home to hopefully prevent further issues.

What we find here is that different situations work for different elders. My mother had a great experience with Memory Care Assisted Living and hospice services coming in to see her there. I never could have handled her level of needs at home, but it's awesome that you feel equipped to do so for your mom. I pray that she has a smooth transition when the time comes, and that God helps both of you through the process with mercy and grace.

Wishing you the best of luck with a difficult situation.
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I should’ve been clearer, she’s past Assisted Living, it didn’t work at all. She’s either going to a Nursing Home, in patient hospice or stay here and medicate her, stay here and have nighttime care.

I’m not familiar with various meds and what they would accomplish, I’m looking for guidance on that option and/or overnight care. I’d rather that than NH or hospice inpatient
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Geaton777 Oct 2022
Why is Memory Care not an option? Is that what you mean by NH? NH = LTC? She would need to be medically recommended for LTC. Not trying to bug you, just getting clarity for better guidance.
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An overnight sitter will likely run you 20.00 an hour if you know her personally and hire her personally; care from an agency high as 42.00 an hour. I have a friend on hospice now with 24/7 care; enormously expensive at the best. If Mom's funds will bear this, I would recommend the sitter. I think you won't have luck getting in facility care, which to my mind would be much preferred. It all is so "for profit " now. I would caution you against using your own funds. If a rigged door to bedroom would work that might be tried, one that would warn you when opened. A bench in front of it with tin cans alone might work. It is such a dilemma when the mind goes so far. Be certain that doors to cellars with stairs and to outside can now be secured by you. This may be worth discussing with an alarm device company. Take care as they can be full of scams.
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I don’t know the solution. I just want to say, what a wonderful, caring, loving daughter you are.
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I'd say facility. You've done way more than your due diligence already unless she (not you!) has the money for an overnight aide.
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