Transition from hospital to nursing home

[Regina_1709]

Before my mums fall in October which resulted in a fractured pelvis and general deterioration, my 93 mum was living with me and although slower was able to do things. She has now been in hospital for 3 months and is due to be discharged into a nursing home next week. This is going to be a difficult transition for her and me. I have to take some of her things to the home which is really hard because I have to acknowledge she will never come home. Logically I understand the ageing process but emotionally it is so hard. I feel I am grieving for her already. I feel exhausted from having had to deal with this all on my own, I work and have visited her everyday but am not sure this is sustainable. Any advice, support very welcome.

[susieq]

Hello Regina

Sad to hear Mum won't be coming home, but after 3 months in hospital I expect she will just be glad to get out of the place ! (I was going 'stir' crazy after 3 weeks, don't think I could have coped with 3 months.) Is there the prospect that she will be able to come home after a period of rehabilitation ? or is the nursing home going to be permanent from now on ?

Certainly, if you can, take in some of Mum's bits 'n pieces to put in her room to make it feel more 'homely' - photos, flowers, ornaments that she's especially fond of etc. - that would help. Would she be able to have her own bedding (duvet covers etc) ?

One piece of advice I would give you is that once you have settled Mum into her room don't visit for at least a couple of days to give her time to get used to her new surroundings. Some nursing homes advise not visiting for a couple of weeks or so (!) but personally I feel that is too long. Once she is settled then you can start a new visiting 'schedule' which will be contingent on how 'aware' she is (are there any dementia/confusion issues ?) - maybe every other day for the first few weeks ?

With my own Mum (Alzheimer's and mobility issues needing a wheelchair) I got into the routine of visiting 3 or 4 times a week on average - on at least one of those days I was able to take her out shopping and a visit to her favourite coffee shop; and about once a month would take her out for Sunday lunch at our local pub. This schedule worked well for us - we got to know each other again as Mother and Daughter and I was able to shed the stressed "Carer" mantle.

[bowlingbun]

It's a tough time. Make sure you don't take anything to the nursing home that you would be upset about losing. Even in a nursing home costing over £1,000 a week, a variety of my mum's things went missing, even a vase!
Make sure whatever clothing she has is labelled and will withstand washing at 60 degrees. She is unlikely to need wool cardigans as the home will be very warm! Mum's home labelled all her clothes for her - so ask the home. They should give you a leaflet explaining how they deal with various things.
Mum's home didn't want her to have any cash. Instead there was a good system where she was charged for things like papers, toiletries etc. but they kept an account of these items which I settled at the end of the month. I hope you have Power of Attorney now? If not sort this out asap if mum is mentally OK. Then you can deal with the accounts on her behalf, and buy any extra nighties she needs.
Visit mum just before mealtimes, so there is a natural point at which to leave. When my mum heard the food trolley coming down the corridor (she wouldn't use the dining room) she would say "You'd better go, my dinner's coming" as if she'd been digging the garden all morning. In fact, she'd only eat a few teaspoons worth.
Definitely don't visit every day, so mum gets used to the staff. You can always ring the home to check mum's OK and ask if she needs anything. It should be much nicer than hospital in her own room. One member of staff should be her "key nurse" or similar, who will have special responsibility for mum, find out who this is.
Then be kind to yourself. Once the pressure is off, you will feel very tired. Plan a weekend away, once you feel mum is in safe hands. You've put your own life on hold for a long time.

[Pet66]

Definitely label the clothes. I even write hubby's name on his shower gel etc. Try not to visit every day. It's so emotionally tiring for visitors. I can see the difference between all day every day visitor's and the ones who pace themselves. Personally I have been better for going every other day and feeling less guilty. Sad, not guilty!
Please don't expect perfection. You need to look after your own well being,to enable you to visit as and when you can and want to.

[jenny lucas]

As well as labelling clothes, don't be too surprised if you see her in completely 'strange' clothes. I find that with my MIL. That said, MIL has advanced dementia, and hasn't a clue any more what is hers and what isn't, so your mum, if she is compos mentes, will probably recognise if the contents of her wardrobe get muddled up with someone else's.

Depending on the nursing home, she may also get the opportunity to acquire new ones. Before MIL was too bad, mentally, she would enjoy buying from the 'visiting clothese shop' that turned up in the lounge once a month or whatever. Hopefully, too, the nursing home will have a 'hair salon' where they can get their hair done weekly.

Also, check out the acitivies. In the god care homes it's more like an OAP 'hotel' or 'cruise ship' than an 'old folks home' if you see what I mean. There should be daily afternoon activities laid on, which residents can choose, or not, to partake in.

Also, with the home, sadly, you may have to accept that even if your mum is fully compos mentes, other residents won't be. I do think, speaking only personally here, that it is 'not fair' to place someone with full mental abilities in the constant company of those with dementia.....so do ensure that the home has a good complement of other residents that she can communicate with on equal terms. Otherwise it's a bit like being the only adult in a room full of children!

Finally, depending on her physical abilities, and maybe whether you have a car, etc, do take her out for 'jaunts'. Even with dementia my MIL really enjoyed our 'afternoons out' and I would take her off for lunch, or cream teas, and nice drives through the countryside and along the coast. Sadly, now, she is immobile, and couldn't get into the car at all - plus her mind is so far gone now she wouldn't have a clue what was going on, sigh.

One more thought - again, depending on your mum's abilities and the transport situation. WHen my MIL first needed residential care at all, her dementia was still pretty 'mild', and so my compromise with her was to have her back to me for 'sleepovers' twice a week. I felt it gave her a taste of 'home life' without taking over my life completely. IF such a compromise is possible for your mum, maybe she could still manage to come 'home for weekends'? That sort of thing?

It is, without doubt, a distressing and emotional time - an acknowledgement that her life is 'heading into the final phase' and that you are, as you so rightly identify, entering a 'premature bereavement'......it's hard to lose those we love, even if they have lived a good long life. We still want them with us.

[MrsAverage]

Hello Regina
You say you are exhausted, and that's without the day after day physical tasks of caring. Sadly, Mum's needs have increased to the level where she NEEDS a team to look after her. There is no way you, or any other single individual, could do this 24/7/365. Try putting a little "spin" on the situation and be happy that there is a team to help and a place of safety for her. By having the staff doing the day to day care you will have the opportunity to rekindle a loving relationship with your mother and spend nice times together.

I agree with visiting to start as you mean to go on. If, realistically, you can only manage once a week then start with that as it will be difficult to back track if you start daily. Yes it will take time for both of you to get used to it, but you will get there.

Encourage Mum to socialise and make friends in the home. She may be reluctant at first and they do tend to take things very cautiously. My Mum (95 this month ) gaily announced a new friend just 3 rooms away. "Is she newly moved in?" I asked. "Oh no she's been here longer then me" (nearly 2 years) said Mum. "What took so long?" I asked. "Well we like to take things slowly" said Mum, grinning

Even though Mum chose to go into a home, it still took months for her to fully settle. 90 odd years of independence and being in charge doesn't get swept aside lightly. Her room is her sanctuary, she took her own furniture. Now 2 years on she is needing all the care offered. Our visits increase and her mobility decreases BUT we know she is warm, clean, fed and safe, and we have the time and energy to love her because we are not exhausted by the day and night physical care tasks.

Hope this helps a little. Residential care may not be what you, and she WANT, but it is what she , and you, NEED


kr
MrsA

[jenny lucas]

A sane and wise post from Mrs A (as always! )

[MrsAverage]

Thanks Jenny.
Am currently laid up in bed with lurgy second episode so slightly surprised I made sense at all (but still laughed out loud that spell checker had me 'in bed with lusty second episode'

[bowlingbun]

And that's when you are poorly ?!?!

[Pet66]

Lol. Mrs A! You go gal.
Seriously though, sorry you have the lurgy again.